pain relief in labor

Pain Relief in Labour: What Are My Options?

While you are thinking about and planning for your birth, options for pain management is a hot topic! While some women will plan for non-medical pain management in labour, whether you intend to use other methods of pain relief, it’s still important to know your options, weighing the benefits and risks of the decisions you might be faced with. 

Depending on your hospital or birth centre, the options for pain management will vary. At our local hospital, the options you’ll typically be offered are: Nitrous Oxide, Fentanyl, or an Epidural.

Each of these are very different, and all of them have their pros and cons. Each labouring person will react and respond differently to each of these methods of pain management, and it’s important to realize that what you might have hoped would work, may or may not work for you. 


Let’s take a closer look…


Nitrous Oxide

Nitrous oxide is delivered as a blend of nitrous oxide and oxygen, through a mask that the labouring woman holds and self-administers through contractions. 

The Pros:

Nitrous Oxide is fast acting and wears off quickly. It can be used at any point in labor right up until the pushing phase, and doesn’t have an effect on the well being of baby. While you will still feel the pain, a lot of women find it helps them relax and reduce their perception of pain. 

The Cons:

Some women find that it makes them dizzy or nauseous. It doesn’t provide complete pain relief, and it isn’t always as effective as some hope for it to be. 



Fentanyl is a narcotic medication that is administered through an IV and delivers pain relief that should be more effective than nitrous oxide. 


Fentanyl can be easily accessed in labor, and tends to be a stronger pain relief option. You are still able to be mobile and will hopefully find some rest and reliefduring and between contractions.


Narcotics dull the pain, but they don’t fully eliminate it. Fentanyl causes some women to be dizzy and nauseated. Narcotics also cross the placenta and can contribute to fetal distress or impact baby’s breathing after birth, especially if they are administered too close to delivery. 



The epidural: administered by an anesthesiologist, who for many a labouring women, greatly resembles a knight in shining armour bringing sweet, sweet relief. An epidural is administered through a catheter placed in the epidural space in your lower bak, and can be delivered during the active labor and pushing phase. It is typically recommended to hold off on epidural use until you’ve reached 4cm dilation to ensure that labor is progressing well. 

The Pros: 

The epidural usually provides complete pain relief. This can be incredibly useful if the fear or struggle with the pain of contractions is causing tension or an inability to ‘let go’ in labor. If a labour is long and her body is growing tired, the epidural can allow for rest and prevent the need for a cesarean in some cases. 

The Cons: 

It isn’t always accessible. Depending on how busy the maternity floor is, or the availability of the anesthetist, it can take anywhere from 30 minutes to a few hours to access an epidural; be prepared to wait. 

Epidurals have a few unwanted, potential side effects, like a drop in blood pressure or the risk of developing an epidural fever. Epidurals can sometimes slow labor which can lead to the need for synthetic oxytocin (pitocin). Fetal distress due to the effects of the epidural are greater, and so is the incidence of vacuum delivery.


Curious to learn more information? Book a birth planning session with one of our doulas to discuss your options in more detail and feel prepared for your birth. We’d love to chat with you and help you understand your choices and make a plan that works for you!


Positions for Birth, Part 3

"Hands & Knees" 


Hands and knees is a great position for labor that allows for open hips and pelvis, and can also be a highly effective position for pushing. If you experience significant back pain in labor it’s likely you will find a lot of relief on your hands and knees. It’s thought that significant back pain in labor can be the result of a mal-positioned or posterior baby. Hands and knees may be suggested if labor is stalling. You might not find it comfortable at first (or at all); try to give it a few contractions for your body to adjust – it might be what your labor needs to take the next turn.  


The most important thing is that you get comfortable. You might be on your knees for a while if you find your groove in this position, so make sure to set yourself up with cushioning under your knees and a comfortable place to rest between contractions. If you have an exercise ball you can try draping yourself with your arms over top and room for your belly. Lay a blanket over top if you find the ball uncomfortable and keep a glass of water with a straw nearby to stay hydrated. The ball allows you to rock through contractions comfortably and makes a nice resting place in between. A couch or hospital bed moved to a comfortable level also make a good place to anchor yourself and rest in between.


Keep your hips wide for hands and knees. The rocking motion of the birthing ball can be beneficial to encourage baby to descend into your pelvis. Through contractions try to drop your arms and shoulders into the ball or bed and relax your bottom to bring baby down and open your cervix (as much as you can – this can be easier said than done! Your doula will encourage and remind you of this.) Having your partner or doula use counter-pressure or the double hip squeeze can help relieve the pressure you may feel in your back through contractions.

Listen to your body. If you are feeling uncomfortable, find a new position. You are the most in tune with what your body needs to go through labor and birth your baby – don’t ignore it!