-By Bushra Hatahet, UK-Trained Clinical Midwife
There’s no right or wrong way to manage labour pain. This guide walks through non-pharmacological options like movement, massage and TENS, alongside pharmacological choices like gas & air, morphine and epidurals — plus how many women combine methods as labour progresses.
Labour is an intense and unique experience, and there is no “right” or “wrong” way to manage the pain. Every labour is different, and what helps one woman may not help another.
The aim of pain relief is not necessarily to remove all pain, but to help you feel calm, supported, and able to cope with each stage of labour.
Many women use a combination of different pain relief methods as labour progresses. Your choices may also change depending on how your labour unfolds—and that’s completely okay.
These methods do not involve medication. Instead, they work by encouraging your body to release its own natural pain-relieving hormones (endorphins), reducing fear and tension, and helping labour progress more effectively.
What is it?
Walking, swaying, rocking, leaning forward, kneeling, lunging, squatting or changing positions regularly throughout labour.
Why does it help?
Movement can:
Your body will often naturally guide you towards the positions that feel most comfortable.
What is it?
Slow, controlled breathing during contractions.
Why does it help?
Focused breathing:
Try to focus on:
Slow breath in… slow breath out…
rather than holding your breath during contractions.
What is it?
Using a warm shower, bath or birthing pool (where available).
Benefits
Warm water can:
Many women describe contractions as feeling much more manageable while immersed in warm water.
Massage provided by your birth partner or midwife may include:
Firm massage over the lower back is particularly helpful for women experiencing back labour.
If your baby is positioned towards your back (back-to-back labour), firm pressure over the sacrum during contractions can significantly reduce discomfort.
Sitting, rocking or gently bouncing on a birth ball can:
A peanut ball is commonly used once you have an epidural or if you’re resting in bed.
It helps:
• • Support continued labour progress while lying down.
Applying warm packs to your:
can help relieve muscle tension and provide comforting pain relief.
What is it?
A small battery-operated machine that delivers gentle electrical impulses through pads placed on your lower back.
Benefits
TENS may:
It works best when started early, before contractions become very intense.
Some women find pregnancy-safe essential oils helpful for relaxation.
Common choices include:
Always use essential oils under appropriate guidance.
Listening to familiar music or calming playlists can:
• • Help maintain rhythm during contractions.
Keeping lights low and creating a calm environment helps promote oxytocin production.
Oxytocin is the hormone responsible for effective contractions, and many women find they labour more comfortably in a quiet, private space.
Relaxing your jaw, shoulders and hands often helps your pelvic floor relax too.
Many women benefit from:
These methods involve medication provided by your healthcare team.
What is it?
A mixture of 50% oxygen and 50% nitrous oxide breathed through a mouthpiece during contractions.
Benefits
Possible side effects
Gas and Air does not completely remove the pain but often makes contractions feel much more manageable.
Morphine is usually given as an injection into the muscle.
Benefits
Things to know
Morphine may:
Many women undergoing induction find morphine extremely helpful in conserving energy before active labour begins.
Pethidine is another opioid injection used in some maternity units.
Its effects are very similar to morphine.
Some hospitals now use morphine more commonly, but both medications work in a similar way to help reduce pain and promote rest.
Fentanyl may be given intravenously or as part of an epidural, depending on your hospital’s protocols.
It provides rapid pain relief but requires close monitoring by your healthcare team.
sed in some maternity units.
Its effects are very similar to morphine.
Some hospitals now use morphine more commonly, but both medications work in a similar way to help reduce pain and promote rest.
What is it?
An epidural is a local anaesthetic placed into the epidural space in your lower back by an anaesthetist.
A small catheter remains in place, allowing continuous pain relief throughout labour.
Benefits
An epidural provides the most effective pain relief available during labour.
It can be particularly beneficial if:
Possible side effects
Although an epidural provides excellent pain relief, most women continue to feel pressure during contractions, particularly during the pushing stage.
Many hospitals use a patient-controlled epidural system.
This allows you to safely administer small additional doses of pain relief by pressing a button whenever required. The pump is programmed with safety limits, so you cannot give yourself too much medication.
Labour changes, and so do your pain relief needs.
Many women combine several methods throughout labour.
For example:
There is no prize for using less pain relief.
Choosing pain relief is not a sign of weakness—it is simply about finding what helps you feel safe, supported and able to cope with your labour.
“Labour is unpredictable, and it’s perfectly normal to change your mind about pain relief. Your birth preferences are exactly that—preferences, not promises.
The most important outcome is that you feel informed, supported and confident in every decision you make.
Whether you choose breathing techniques alone or an epidural from the very beginning, every birth is different, and every choice is valid.”
If you are looking for calm expertise and genuine continuity of care, let’s talk.
