How to Manage Pain During Labor

Dealing with labor pain is something that most women fear a great deal, because of stories they read or hear, but the experience of labor is highly individual and can even be different for a second or third child. There are various options for easing labor pain and making the experience as comfortable as possible. Having a birthing plan created ahead of time is an excellent idea, but you should also learn about alternatives in case your plan has to be altered during labor. Ideally, you should learn about multiple options to be as prepared as possible when labor starts.

Method 1

Method 1 of 3:

Taking Birthing Classes

1
Study the Bradley Method of labor pain management. This method teaches techniques to the mother to manage labor pain without drugs and teaches the father to be an effective birth coach. The focus is on relaxation techniques, good nutrition, and regular exercise during pregnancy. ^{[1]XResearch source}
- Classes take 12 weeks to complete and are taught by certified instructors.^{[2]XResearch source}
2
Take Lamaze classes. Lamaze is the most used natural birthing method in the US. It focuses on breathing patterns, massage, relaxation and distraction techniques, and teaches how to care for your new baby.^{[3]XResearch source}
- The class requires at least 12 hours of instruction over a period of weeks.
- Instructors also prepare mothers for changing birthing plans at the last minute and discuss options for pain management. Lamaze neither supports nor discourages the use of pain medications, leaving it up to the discretion of mother and doctor.^{[4]XResearch source}
3
Study the Alexander Technique. This method promotes simple lessons for improving movement, balance and coordination that teach women how to accommodate for the changing size, shape and flexibility of their bodies throughout pregnancy. The philosophy for managing labor pain rests on knowing your own body well and how to move it efficiently, safely and comfortable under varying circumstances.^{[5]XResearch source}
- Classes should be taken once a week, ideally.
- This technique can be used with or without pain medications.
- The technique is taught to anyone who wants to take classes, not just expectant mothers.
4
Try HypnoBirthing. For this method, women work with a qualified educator to learn self-hypnosis techniques and study how good nutrition and appropriate exercise can make labor easier. They teach a combination of breathing exercises and relaxation techniques, including meditation and visualization.^{[6]XResearch source}
- Women typically attend five 2 ½ hour classes.
- If you are late in your pregnancy, practitioners may be able to make special arrangements.
5
Take a prenatal exercise class. Sticking to a careful, consistent exercise regime will help you prepare for labor. There are a few exercises that can help you practice movements you will use during delivery to make it as easy as possible. Tailor sitting teaches you how to sit during labor to best support your back and pelvis. Kegel exercises strengthen your pelvic organs. Squatting during labor helps open your pelvis to give the baby more room, but can tire moms quickly. Pelvic tilts can relieve backaches and ease delivery.^{[7]XResearch source}
- To practice tailor sitting, sit on the floor with your back straight and your legs out straight. Press your knees gently into the floor with your elbows. Hold the stretch for 10 seconds and repeat 5 to 10 times.
- Kegels imitate the effort you would make in stopping and starting urination. Do slow Kegels by contracting your pelvic muscles for 3 to 10 seconds. Relax, and repeat up to 10 times. For fast Kegels, contract and relax your pelvic muscles quickly 25 to 50 times. Relax for 4 seconds and repeat. Do up to four sets.
- To practice squatting, do a wall slide. Stand with your back against the wall and your feet 6 inches in front of you, shoulder width apart. Slowing slide down the wall into a squat, with your thighs parallel to the floor. Hold for 5 to 10 seconds and then slide back up slowly. Repeat 5 to 10 times.
- Pelvic tilts are easiest done on your hands and knees on the floor. First, pull in your abdominal muscles while arching your back like a cat. Hold for several seconds. Release the stretch, returning to a flat position. Repeat 3 to 4 times, up to 10 repetitions total.
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Method 2

Method 2 of 3:

Managing Labor Pain Naturally

1
Try focused breathing during contractions. Pay attention to your breathing while repeating the word “relax” in your head. Think “re-“ as you breathe in through your nose and “-lax” as you exhale through your lips. Let go of the tension in your body when your exhale also.^{[8]XResearch source}
- Don't worry about the speed or depth of your breaths, as long as you establish a rhythm and you inhale shorter than you exhale.
- Focused breathing helps relieve pain and allows you to conserve energy for later stages of labor.
2
Try visualization techniques. Focus your attention on something that makes you happy and imagine it in your head during intense pain. It could be your favorite object or your partner's face, or anything that gives you pleasure when you see it. Imagining you are in a relaxing place can also help you forget about the pain for a few minutes.^{[9]XResearch source} Think of your favorite vacation spot or imagine sitting in your most comfortable chair at home.
- If you could be anywhere, would you be sitting on a beach in the sun, listening to the waves crash and seagulls? Maybe you would prefer a cabin in the woods with a rocking chair out front and listening to songbirds and insects.
- The more fully you can imagine the scene, the better doing so will distract you from any pain. Use all of your senses to make your image seem more real. Try to feel the sun on your skin or the breeze blowing by.
3
Create a relaxing environment. Include soft music, candles, comfortable pillows for your bed or chair, or whatever you typically use as tools for relaxation time. Spend the minutes in-between contractions enjoying your surroundings in the moment, instead of anticipating the next contraction or thinking about the last one. This will help you get through contractions one at a time, instead of them having a cumulative effect.^{[10]XResearch source}
- Use the candle flame as a focal point to bring your attention to the present if you are having trouble keeping your mind calm. Sit comfortably and look at the flame, watching how it flickers.
- Include an object from home that you love and has personal value for you. Concentrate on it and think about what it represents or how it makes you feel to see it.
- Try using your favorite small thing you bought for the baby to remind you of why all the pain is worth it.
- Ask your partner to massage your feet, hands, or back to help you relax more. For some women, the counter-pressure of massaging sore areas can relieve some of the pain.^{[11]XResearch source}
4
Move around. If you can, get up and take a short walk. If not, change positions where you are as frequently as you feel the need. Sit on the bed on your hands and knees, squat down, lean over the bed or counter, roll on a birthing ball, move from the bed to a chair, etc. Moving your body helps labor along by taking advantage of gravity, and it also gives your mind something to concentrate on instead of the pain.^{[12]XResearch source}
- If in the hospital and hooked up to monitors and IVs, change your position in bed any time the pain starts worsening. Try sitting on the side of the bed with your feet on the floor, or getting up on your knees, if it is comfortable to do so. Ask your partner to support your torso with their weight.^{[13]XResearch source}
- Make sure someone is with you while walking around in case you get a contraction and need support or someone to lean on for a moment.
- Keep your walk short and go more than once if you like, rather than walking for too long and tiring your body out before the late stages of labor.^{[14]XResearch source}
- A birthing ball is similar to an exercise ball, often used in yoga and pilates. Bouncing and using it to rock your hips back and forth can help ease pain.^{[15]XResearch source}
5
Try water therapy. If you are at home or at a birthing center, you likely have a bathtub nearby. Fill it up with warm water (100 degrees F) and soak. Have your partner use a cup to pour water over your shoulders too. Or, take a hot shower instead. The streams of water can feel like a massage and relax you even more.^{[16]XResearch source}
- You should be dilated at least 5 cm before using water therapy.^{[17]XResearch source} If used earlier in labor, this technique might slow labor down.
6
Ask about a TENS unit. TENS, or transcutaneous electrical nerve stimulation, units can help to manage pain naturally during labor. These units emit a small electrical impulse that is delivered through electrodes placed on your lower back. They can help to reduce the need for other types of pain relief during labor and give you a sense of control, since you can control the frequency of the electrical impulses.^{[18]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}^{[19]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Ask your doctor about getting a TENS unit to use during labor.
7
Use aromatherapy. Although there are few studies on the effects of aromatherapy during labor, aromatherapy has not yet been found to be effective at reducing pain during labor.^{[20]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} However, it may be a nice addition to your labor experience to help promote relaxation. In one study, aromatherapy seemed to help reduce anxiety in women during labor and it also seemed to correlate with a reduced need for opioid pain relievers.^{[21]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Try using lavender, chamomile, or clary sage essential oils in a diffuser during labor and breathe in the scent as you inhale through your nose.
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Method 3

Method 3 of 3:

Using Medications to Manage Labor Pain

1
Consider an epidural. An epidural is a regional anesthetic administered through a needle into your spine. A low dose of medicine is delivered continuously through a pump, with a button to self-administer more when you need it. It might add about an hour to your labor time, but make all of the hours much more manageable.^{[22]XResearch source}.
- The old epidural could cause total numbness in the lower torso, causing many women to avoid it so they could experience the actual birth, but this is no longer usually an issue. Spinal headaches are also much less commonly a side effect now.
- Doctors can administer an epidural even in later stages of labor, but it takes 10-20 minutes to start working. Women close to delivery may get a combined spinal-epidural, which adds a second shot lower in the spine that offers almost immediate relief. A spinal is only effective for about 2 ½ hours.
- Spinal anesthesia may be recommended by your doctor instead of an epidural dependent upon progressing health and labor.
- If you prefer not to use drugs for pain, you may want to ask your doctor to keep an epidural on your backup plan in case you cannot manage the pain on your own.
- If you decide during your labor to take pain medication, your doctor may suggest a combined spinal-epidural to give you quick relief.
2
Ask about analgesic pain medications. Some women cannot get an epidural for medical reasons and may need a narcotic pain reliever, such as Stadol, nubain, morphine, or fentanyl. Opioids also relieve pain during labor and are usually administered as a single shot.^{[23]XResearch source} These can also be given using a patient-controlled pump. However, these medicines are not typically given if you will be delivering soon because they can affect the baby.
- They may cause drowsiness in both mother and baby since they affect the entire body.
- All pain medications offered to ease labor discomfort are safe for the mother and her baby. Going over pros and cons of each one can help you make the best personal choice.
3
Ask about nitrous oxide. Nitrous oxide functions as a safe analgesic (pain reliever) and anxiolytic (anxiety reducer) when used at a low dose during labor. In some countries, 50% nitrous oxide blended with 50% oxygen is frequently given to women in labor. It will not negatively affect the baby, and it will allow you to remain alert during labor.^{[24]XResearch source}
- Another benefit of nitrous oxide is that it is a short-acting drug that you can control. If you do not like the effects, then you can discontinue use and the effects will wear off after about five minutes.
- Be sure to consider the risks of this drug as well. While nitrous oxide is relatively safe, it does have some potential side effects, such as nausea, vomiting, dizziness, and putting you to sleep. Discuss the risks with your doctor before you decide if this might be a good option for you.
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Tips

Think about your baby and how the pain will all be over soon. Remind yourself that every contraction is one closer to you seeing your child.
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Consider finding a midwife to assist you with the birthing process, especially if you want to try a natural birth. Ask your hospital or clinic about midwives there and any special skills they have, like giving aromatherapy or shiatsu massage.
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Making a birth plan can help alleviate any fears you have before going into labor. A good plan has your preferred methods of delivery, as well as a backup plan in case circumstances change. Always trust your doctor's suggestions about what pain management or delivery method is best for you during your labor since the process tends to be unpredictable from woman to woman and even baby to baby.
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