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Childbirth is an extraordinary and transformative experience, but there’s no sugar-coating it—labor can be intense. Every parent-to-be approaches this milestone with their own vision of how to manage labor pain, whether that includes medication, alternative methods, or a mix of both. Understanding your options ahead of time can help you feel confident and prepared as you approach your due date. In this guide, we’ll explore pain-relief options for labor, including medications, potential risks, and alternative methods, so you can pick one you feel good about!

What types of medications are used for pain relief during labor?

Medications are a common choice for managing pain during labor, and there are several types available, each with its own benefits. While labor medications are generally safe, they do come with potential side effects. Discussing these risks with your care team ahead of time can help you make an informed choice!

Epidural for Childbirth

The epidural is considered the most effective labor pain relief method—it’s also the most common method in the U.S. An epidural involves administering anesthetic medication—sometimes mixed with an opioid analgesic—through a catheter that an anesthesiologist places in the lower back. The anesthesiologist will remove the needle, but leave the catheter so you can get pain relief as needed through labor. It numbs the lower half of the body, significantly reducing pain while allowing you to remain awake and engaged during labor. 

Possible epidural side effects: Overall, the epidural is considered safe and effective, but occasionally will have side effects, including:

  • Itchiness
  • Drop in blood pressure
  • Sore back
  • Headache
  • Difficulty pushing
  • Difficulty emptying your bladder
  • Postpartum shaking

Rarely, serious complications can occur, such as breathing problems, numbness, or injury to the spinal cord and nerve—but these side effects are extremely rare.

Intravenous (IV) or Intramuscular (IM) Medications During Labor

Opioid medications, like fentanyl or morphine, can be delivered through an IV or injected into a muscle to dull pain without completely numbing the body. Though they can “take the edge off” they often don’t provide complete pain relief. These medications are often used early in labor or when an epidural isn’t in the cards.

Possible opioid side effects: These medications may cause drowsiness or nausea for the birthing person and temporary breathing issues in the baby if administered close to delivery.

Nitrous Oxide During Labor

Nitrous oxide, commonly known as "laughing gas," is inhaled through a mask to dull the pain of contractions. While it may not lead to an ouch-free experience, it can help reduce anxiety and make discomfort more manageable. Though not super popular stateside, nitrous oxide is widely used in places like Europe, Australia, and Canada (for example an estimated 50-75% of women in the UK use laughing gas during labor!). 

Possible nitrous oxide side effects: The main side effects are dizziness and nausea, and its efficacy varies. Nitrous oxide doesn’t provide complete pain relief, so it may not be enough for some people.

Local or Regional Blocks for Labor Pain

In cases like an episiotomy or assisted delivery, local anesthetics may be to numb specific regions (like the perineum or vulva) temporarily. Spinal blocks, similar to epidurals, are similarly used for short-term, complete numbness.

Alternative and Complementary Pain Management for Labor

For those seeking a non-medicated or minimally medicated approach, you can try one of the following techniques instead of—or in addition to—medication:

  • Hydrotherapy: Immersing yourself in warm water may help reduce tension and soothe contraction pains…that’s why many hospitals and birth centers offer labor tubs! (Read more about water births.)
  • Breathing and labor relaxation techniques: Lamaze or hypnobirthing methods encourage focused breathing and visualization to cultivate calm  and reduce pain perception.
  • Movement and positioning: Changing positions, walking, or using a birthing ball can ease discomfort and facilitate your baby’s trip down the birth canal.
  • Acupuncture or acupressure: The evidence around these ancient practices is inconclusive, but some folks believe they can be used to manage pain by stimulating specific pressure points.
  • TENS Machines: Transcutaneous electrical nerve stimulation (TENS) devices deliver small electrical pulses to reduce pain signals and release endorphins.

When do I need to decide about labor pain management?

You don’t have to decide everything before labor begins, but it’s helpful to understand your preferences. Many people include their pain management choices in their birth plan, which serves as a guide for your care team. Some experts recommend having at least a rough plan by about 28 weeks—even if it’s a flexible one! After all, labor is unpredictable, and your needs may change as it progresses. For example, you may start with breathing techniques but later decide an epidural feels right.

How to Choose the Best Labor Pain Relief Option

When planning for labor pain management, consider the following:

  • Your preferences: What’s your vision? Are you hoping for an unmedicated birth, open to medication, or unsure? Do you want to move around, or are you okay laying down(Epidurals typically require you to be bed-bound.) Knowing your priorities can guide your decisions.
  • The setting: Options can vary depending on where you give birth. Hospitals typically offer epidurals and IV medications, while birth centers may focus on non-medicated methods. A home birth also won’t allow for as many medical interventions.
  • Your medical history: Certain health conditions may limit your choices— be sure to discuss your history with your provider.
  • The baby’s wellbeing: Some medications can affect the baby, especially if administered close to delivery. Your care team will weigh these risks carefully.

Labor Pain Management Options: Final Thoughts

Labor pain management isn’t one-size-fits-all—it’s about finding the approach that feels right for you and your baby. Whether you opt for an epidural, rely on alternative methods, or use a combination of both, the most important thing is that you feel supported and informed. Talk to your healthcare provider about your choices, and remember, there’s no wrong way to bring your baby into the world!

More on Labor & Delivery:

 

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REFERENCES

  • American College of Obstetricians and Gynecologists (ACOG): Medications for pain relief during labor and delivery
  • National Center for Biotechnology Information (NCBI): Birth: Learn More – Managing pain during childbirth
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development: Pain management during labor and delivery
  • American Society of Anesthesiologists: Pain management: Epidural.
  • American Society of Anesthesiologists: Types of pain relief during labor
  • University of New Mexico Health: Unpacking 8 common myths about epidurals
  • Brigham and Women's Hospital: Intravenous and intramuscular pain relief for labor
  • American College of Nurse-Midwives (ACNM): Nitrous oxide for pain relief in pregnancy
  • Anesthesia Patient Safety Foundation (APSF): Safety and utility of nitrous oxide for labor analgesia
  • American College of Obstetricians and Gynecologists (ACOG): Making sense of childbirth pain relief options

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.