Pain relief during labour: your options explained

Labour is an intense experience, and for many people it comes with pain. How you experience that pain differs from person to person and from one birth to another. Some women find that breathing techniques or a warm shower are enough, while others benefit from medical pain relief.
There’s no right or wrong choice — it’s about what works for you. In this article, you’ll learn about the available options, their pros and cons, so you can decide what feels right for you during labour.

What can you do for pain relief without hospital transfer?

We’ve already discussed natural ways to cope with contractions in the previous article. Here, we’ll focus on gas & air and TENS.

Birth TENS

TENS (Transcutaneous Electrical Nerve Stimulation):

• How does it work? TENS uses mild electrical impulses delivered through electrodes on your skin to block pain signals from reaching your brain. You control the device yourself — which can give a strong sense of control.
• Benefits: A natural, drug-free method; you control the intensity; can be used at home or in hospital. Birth TENS doesn’t eliminate pain completely but can make it easier to manage for some women.
• Disadvantages: Not effective for everyone; may cause a tingling sensation; less suitable in later stages of labour. You’ll need to purchase or rent a Birth TENS unit yourself. Available online at www.geboortetens.nl or second-hand. Some insurance providers reimburse (part of) the cost.
• Possible side effects and effects on the baby: None — since no medication is used, it doesn’t affect the baby.
• Costs: Many insurers reimburse part of the cost of renting or buying a Birth TENS device. Check your coverage here. If you enter practice number 3022902 when ordering, we receive 10% (at no extra cost to you), which we use to support vulnerable pregnant women.

Gas and Air (N₂O)

• How does it work? You inhale gas and air through a mouthpiece, usually only during contractions.
• Benefits: You control how much you use. It works quickly and wears off just as fast. It reduces pain, helps you stay calm and relaxed, and decreases anxiety.
• Disadvantages: It can cause dizziness or nausea. It’s less strong than an epidural and works for about 4–5 hours.
• Possible side effects and effects on the baby: None — it leaves your body quickly and does not affect the baby.
• Important: Available only at Birth Center Zuid, Birth Center East en Amstelland ziekenhuis.and Amstelland Hospital.

What are your options with hospital-based pain relief?

For the following types of pain relief, you’ll need to go to the hospital and be under the care of the obstetric team (secondary care). This is because when medication is used, your heart rate, blood pressure, and breathing must be continuously monitored, as well as your baby’s condition through a CTG. The equipment and expertise for this are available only in hospital settings.

Below we explain each option in more detail.

Remifentanil

• How does it work? This is a strong painkiller given through an IV drip. You control the pump yourself to administer small doses as needed.
• Benefits: Works quickly and for a short duration; allows you to remain in control.
• Disadvantages: Can cause drowsiness and slower breathing, which is why continuous monitoring is required. It works for about 4–5 hours.
• Possible side effects and effects on the baby: May lower the baby’s heart rate if the mother’s breathing slows too much, so close monitoring is essential.

Epidural: how it works, benefits, and risks

• How does it work? An epidural (also known as a spinal block) is one of the most effective forms of pain relief during labour. An anaesthetist inserts a thin tube into your lower back, through which a numbing medication is given. This blocks pain signals from your lower body to your brain.
• Benefits: Extremely effective pain relief while you remain fully awake. It can help prevent exhaustion during a long labour and provides sustained relief for many hours.
• Disadvantages:
  • Reduced sensation in your legs, making it difficult to walk.
  • Possible drop in blood pressure, which can cause dizziness.
  • Sometimes reduced urge to push, requiring assistance (e.g., vacuum extraction).
  • Small risk of side effects such as itching, fever, or headache afterwards.
  • Chance of developing a fever, which may require antibiotics for you and your baby.
• Possible side effects and effects on the baby: May influence the baby’s heart rate, which is why continuous monitoring is done.

Summary: How to make your choice

You have several options when it comes to pain relief during labour. Here are the key points to remember:

• Medication can be effective, but may have side effects.
• You don’t have to decide now. During labour, you’ll know best what you need — we’ll help you make the right choice at that moment.
• You stay in control. It’s your birth and your body. What matters most is what feels right for you.

Do you have questions or want to know more? Feel free to discuss it with us at your next appointment.

The above videos are in Dutch, so below is an informational video from the North Bristol NHS Trust in English.