Labour begins when the uterine muscles start contracting, working to dilate the cervix and guide the baby through the birth canal.
These contractions—initially mild and subtle—gradually intensify. While they can be painful, each woman experiences them differently depending on many factors.
Every labour experience is unique and deeply personal, and understanding the challenges and options for managing pain can help you navigate your own.
What kind of pain can you experience?
During labour, most women experience pain in the lower abdomen or lower back (or both).
It is often described as a combination of cramping, sharp, aching sensations, and pressure. These can radiate in different directions, including from back to front, front to back, or through the hips, pelvis, thighs, and buttocks.
Several factors might affect your experience with labour pain, including:
- Your position
- The position of the fetus
- How long you’ve been in labour
- Your prior experience with similar pain (such as past labours or painful menstrual cycles)
- Your environment and support system
Managing contractions
Labour pain is unique in that it has some features that can help you manage and cope with it as labour progresses.
Contractions vary from person to person. As labour progresses, they typically start to follow a pattern of regular waves. This makes them easier to predict, allowing you to anticipate and prepare.
For example, as a contraction builds, you may adapt your breathing or reposition yourself to better cope with the peak of the contraction (which is the most intense but shortest part). As the contraction eases, you can refocus and prepare for the next.
It’s important to remember that labour contractions progress in intensity over time. Typically, the mildest occur early on, with the strongest happening during delivery.
Labour pain relaxation techniques
Approaching labour with a foundation of relaxation techniques can be incredibly helpful.
Here are several comfort measures to consider:
- Water therapy (such as a tub or shower)
- Heat pads (commonly used to soothe back pain)
- Massages or acupressure
- Position changes
Movement not only helps manage pain, but it also supports labour progression. Many women find comfort in walking, sitting on a birthing ball, bending forward, or rocking in a chair.
Some women also choose to use music, meditation, or hypnosis to help manage labour pain.
Coping with pain using deep breathing
The most commonly used labour pain coping skill is deep breathing. By focusing on specific breathing techniques, women can stay calm and relaxed, even during contractions.
Many women choose Lamaze breathing (focusing on slow, deep breaths) or patterned breathing (rhythmic breathing with a fixed rate and depth). These techniques enhance relaxation, improve pain responses, provide a sense of control, and increase oxygen flow to both the mother and the baby.
What are the benefits of relaxation techniques?
As we’ve mentioned, the length of labour can influence your pain tolerance and ability to cope. This is especially true for women undergoing labour induction or cervical ripening, where the extended time can be a major factor.
Being able to continue with activities like walking or resting can reduce the need for early medical pain relief.
The advantage of non-medical interventions like the ones we’ve discussed is their flexibility—they can be used throughout all stages of labour, from cervical ripening to active labour and delivery.
Note: Choosing a mechanical cervical ripening method, such as DILAPAN-S, has been shown to stimulate fewer contractions during the ripening process compared to pharmacological methods. Additionally, they often require significantly less pain medication.
What about medical pain relief?
As labour progresses, many women opt for analgesia or other medical interventions to manage pain. Availability might depend on where you’re delivering and the medical staff present.
When discussing pain medication, it’s essential to understand the importance of timing, as there may be restrictions on when these options can be used. Timing matters, and some interventions may be unavailable if it’s too early or too late in labour.
It’s important to stay open-minded about pain management, whether or not you plan to use analgesia. Be prepared to adapt or shift your plan as circumstances change.
Laughing gas
Gas or Entonox (nitrous oxide gas mixed with oxygen) can help with pain relief during labour. Nitrous oxide, or laughing gas, is one option to consider. You administer it yourself by inhaling through a hand-held mask when a contraction begins. You’ll feel the effects immediately and can control how often and how much you use.
Opioids
Narcotics or opioids are another option. Your healthcare provider may administer them by injection into a vein or muscle, or via a nasal spray.
These can impact cognitive abilities, often making the mother sleepy. Timing is critical—if administered at the wrong time, they may cause complications for both the mother and the baby.
Epidural
The most common pain relief method is epidural analgesia. This type of analgesia is performed by an anesthesiologist.
Epidural analgesia delivers a continuous flow of medication that can last for hours or even days, and the dosage can be adjusted or stopped as needed. Most women experience little to no pain from contractions with an epidural, though they may need to stay in bed for a few hours after the medication is stopped.
Exploring your options
There are many different approaches to managing pain during labour. Non-medical methods, such as water therapy or breathing exercises, are flexible and universal. Medical pain relief options, like opioids or epidurals, offer specific benefits, but it’s essential to discuss these in detail with your healthcare provider.
No matter your labour plan, we recommend learning and practicing some of the relaxation methods mentioned in this article.
