Women can feel pain differently during labour. Some women cope with labour and birth without pain medication and other women want or need pain medication.

During labour, the muscles in your uterus will alternately contract and relax. You will feel your abdomen become hard to the touch and then relax with each contraction. Contractions occur during labour to help your cervix open up and to help push your baby out. This is painful for most women.

Some women plan to go through labour without pain medication and others plan to use pain medication. Sometimes women change their minds about pain medication use during labour. It is helpful to keep an open mind about how you will manage your pain in labour. Inform yourself about the risks and benefits of medical pain relief before labour begins. It is also helpful for you to know, ahead of time, the pain control options available at your place of birth.

You may find it more difficult to cope with labour if:

  • You lack confidence and are not prepared for labour and birth
  • You feel overly fearful or anxious about the process of labour and birth
  • You are not well-rested
  • You do not have a support person to be with you during labour and birth
  • You are not able to change your position or move around during labour
  • Your baby is in a position that gives you more back pain
  • Your labour has been induced or is longer than expected or you have had other medical interventions
  • You have a low tolerance for pain
  • You have experienced a traumatic experience in your past

Different Pain Medications

There are different pain medications to help women cope with labour pain. Options available to you depend on where you give birth and your stage of labour.

Pain medications come in a variety of forms. Some relieve pain more than others and some relieve pain for a longer period of time. You may not know which type of pain control will work best for you until you are in labour. Talk to your health care provider about the pain control options you may want to try during labour. When in labour, choose the method that works best for you and your baby.

Pain medications used in labour can be divided into several categories:

  • Non-opioid analgesics, which can provide mild-to-moderate pain relief. They are usually taken orally.
  • Opioid analgesics, which can provide moderate-to-strong pain relief. They can be given by injection or intravenously.
  • Anesthetics, which can provide a range of pain relief including almost complete pain relief. Nitrous oxide such as laughing gas, epidurals, and pudendal nerve blocks are examples of anesthetics.

For information about transcutaneous nerve stimulation, acupuncture, and other ways of coping with the pain of labour.

Risks and Benefits

Pain medications have risks as well as benefits for you and your baby. Some pain medication may have side effects. Learn about the side effects of any medication you are considering. Some side effects might include:

  • Nausea or vomiting
  • Dizziness or weakness
  • Decreased ability to walk or change positions
  • Itchiness
  • Headaches
  • Concerns for the baby during labour or at birth
  • Increased risk of assisted vaginal birth

Note that these side effects do not apply to all medications.

If you are close to giving birth, the type of pain medication you can safely have may change

If certain pain medications such as narcotics are given too close to birth, they can cause your baby to have breathing difficulties at birth. They will not be used if your baby’s birth is expected within two to four hours. Your health care provider will do a vaginal exam before you receive pain medication to make sure that you are not too close to giving birth. If you are very close to giving birth, you can still receive pain medication but the type or amount of the pain medication may change.

You and your baby will be monitored more closely if you use pain medication in labour

How often your blood pressure, heart rate and breathing rate is checked will depend on the medication used. In some cases, your baby’s heart rate will need to be monitored continuously for a period of time.

If you or your baby experience side effects from the medication, your health care provider can try to reduce these side effects by:

  • Reducing or removing the medication
  • Changing your position
  • Giving you intravenous or oral fluids
  • Giving you, or your baby, other medication to counteract the effects of the pain medication
  • Giving you oxygen in some instances

Learn more about pain medications in labour

You can find out more about pain medications in labour from the following resources.

  • Perth District Health Unit, Huron-Perth Healthcare Alliance – Stratford General Hospital Perth County Prenatal Classes
  • Your health care provider

Adapted and reprinted with permission by the Best Start Resource Centre

April 12, 2016