What types of pain relief are available during labour and birth?

There are many natural and medical ways to help manage pain when you are in labour. Some people feel that it is important to them that their birth is as free of intervention as possible, and some will consider medical pain relief.

Non-medical pain relief

Non-medical pain relief may include:

• relaxation
• active birth (moving around and changing positions during labour)
• massage
• heat packs
• warm baths or showers

Other non-medical pain relief options include devices or techniques such as:

• TENS (transcutaneous electrical nerve stimulation)
• water injections
• acupuncture or acupressure
• aromatherapy

Non-medical pain relief can be used during labour by itself or together with medical methods.

Medical pain relief

Medical pain relief uses medicines to help you manage pain during labour and delivery.

Medical pain relief options include:

• nitrous oxide gas (also known as 'laughing gas'), which you breathe in using a mouthpiece or mask
• injections of pethidine or morphine
• epidural pain relief

For epidural pain relief, a small amount of an anaesthetic is injected into the space around your spinal cord (known as the epidural space), reducing your feeling of pain from your waist and down. A small plastic catheter (tube) is then left in this space, so more anaesthetic can be added over time.

What should I consider when choosing pain relief?

Pain relief preferences during labour and delivery are very individual. They may be influenced by your background, culture, tradition and religion. However, there are some practical factors to consider about when forming your birth plan.

It is important to make sure that your pain relief choices are available where you plan to give birth. For example, a water birth requires a birthing pool, which is not available at every birthing unit. If you are planning a home birth, you will not be able to have an epidural, which requires highly specialised doctors. You may also want to think about the cost of different types of pain relief.

Some medical conditions can affect which pain relief methods you use. For example, if you have HIV, hepatitis B or hepatitis C, you may not be able to use a pool for labour or birth. If you are not sure if you have a medical condition that may affect your pain relief options, ask your doctor or midwife. If your baby is born well before your due date, or if you go into labour past your due date, this may also affect the types of pain relief that you can use.

What pain relief preferences should I have in my birth plan?

Your birth plan should include your pain relief preferences during labour. Make sure your plan has enough detail, so that your care team and support people can understand your wishes and know how to support you.

If you are not sure about what pain relief options are right for you, you can learn more in an in-person or virtual antenatal class.

What if I change my mind during labour?

It is not unusual for people to change their birth plan during labour. This might be because their labour experience is different from what they were expecting, or because of the your or your baby's medical needs. If you change your mind during labour, you should tell your support people your wishes so that they can help you.

It is not always possible to change from one type of pain relief to another during labour. For example, you cannot use certain pain relief medicines before entering a bath or pool for pain relief, as these medicines can cause drowsiness.

If you aren't sure which pain relief methods are right for you, it may be helpful to plan as broadly as possible. It's a good idea to learn about available all the pain relief options and techniques, at your chosen birthing centre, even if they're not part of your ideal birth plan.

Planning broadly can also save you the disappointment of not being able to stick to your birth plan if the birth doesn't go as expected.

Who can I talk to for advice and support?

You may find it helpful to speak to friends and family about their experience with pain relief during labour. Your doctor or midwife will be able to give you advice and support and will be happy to discuss your birth plan with you.

Resources and support

• Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
• RANZCOG has many pamphlets and resources about pain relief during labour.