Pain Relief In Labour

Labour can be a painful process and every woman responds  to it differently, Some  prefer the medical route whilst others choose the natural approach. Nevertheless, explore  the alternatives so that  when the time comes you can make an informed decision. This article is drafted in order to advise pregnant women on pain relief options in labour.

Gas And Air (Entonox) For Labour

Entonox is basically a mixture of gas and air that is colourless as well as odourless. It comprises of oxygen and nitrogen dioxide in equal ratios. Also, known as laughing gas; Entonox does not completely block off the labour pain but relieves it to a bearable extent. Gas and air  is the most popular method used in hospitals and by  midwives. Once the labour has established, it is the right time to put gas and air to use.

How to use Entonox?

You breathe in air via an antibacterial mask or mouthpiece which you hold yourself. It takes around 15 to 20 seconds for the gas to work and in approximately 3 minutes to reach the full effect so you breathe it in as soon as the contractions start. For best results take slow, deep breaths during inhalation. Continue breathing until you start to feel light headed. Once, you have reached that point remove the mask, you will start to feel better in a  few minutes.

What are the advantages of using Entonox?

1. This method is quite flexible and fast acting.

2. It is easy to use. No technical knowledge required.

3. It is under your control that is when and for how long to use it.

4. It does not interfere with labour.

5. Once you stop inhaling, the effects wear off right away.

6. It does not have any harmful effect on baby, rather extra oxygen is beneficial for both mother and baby.

What are the side effects/ disadvantages of using Entonox?

1. The gas and air may make you feel very lightheaded, nauseous and overally sick.

2. You may end up feeling dizzy and tingly if you had  inhaled it for long periods.

3. It dries your mouth.

4. There may be increase in drowsiness if you are taking pethidine along with it.

5. It is a mild analgesic and may take time to to reach the required levels.

6. Holding onto the mask may make the patient irritable as it will be difficult for her to get into the labour position comfortably.

Water Birth

Water birth means that labour/birth  will take place in a pool of warm water. It can be performed in hospital, birth centers or home by midwifes. Utilizing this method during the  first stage of labour helps in easing  pain, cuts down the need of getting anesthesia and speeds up the entire labour process. In stage two of labour, when  the cervix is fully dilated and you are about to push the baby out, it is safe to come out of the pool  just incase of an emergency it would be easy to take you to the hospital. 

Who is a good candidate for water birth?

You should not try it if you fall under any of these:

1. You are younger than 17 or older than 35.

2. You have complications such as preeclampsia or diabetes.

3. You are giving birth to twins or multiples.

4. The baby is premature and in breach position.

5. You are suffering from an infection.

What are water birth risks?

1. You or the baby could get an infection.

2. The umbilical cord might snap even before the baby is out of water.

3. Baby’s temperature can go too high or too low.

4. Baby might suffer from seizures.

What precautionary measures can you take?

1. You are under supervision of experienced, licensed health care professional.

2. Proper infection control measures.

3. Tub is clean and well maintained.

4. There is proper plan to get you out of tub as soon as its time.

5. Water temperature is closely regulated between 97 to 100 F.

6. Keep yourself hydrated.


Goal of hypnobirthing is to teach a pregnant woman on how to stay calm and under control during birth and labour. it embraces a completely different way of how you think and respond to your situation. The technique of hypnosis is learned through classes (in person or online), from books, CDs etc.

How does it work?

Our mindset is very important with this type of approach. This is because the language we use  plays an important role in how we feel, at optimistic outlook is necessary

1. Painful contractions are substituted by tightening or surges.

2. False labour is replaced by practice labour.

3. Birth breathing is used instead of pushing and contractions.

Learning outcomes of hypnobirthing classes

1. The most suitable positions for labour and birth.

2. Deep relaxation technique along with self-hypnosis.

3. Breathing techniques.

What are the benefits of hypnobirthing?

1. The duration of first stage labour is shortened.

2. Intensity of pain reduces to bearable levels.

3. Hospital stays are shorter.

4. After the birth of baby, you feel less anxious and fearful.


It is  a system of massage used to relieve  pain and treat illnesses.  This alternative technique and can be used alongside  other pain relief methods. This involves application of pressure using thumbs, fingers, hands to the  feet aiming to stimulate distinct parts of the body (since different points on the foot represent different regions of the body such as heart, kidneys and lungs). Performed by a trained practitioner, the reflexology session lasts for about 30mins to one hour at different intervals. The most targeted area is the base of both big toes this stimulates the pituitary gland which  releases hormones that speed the labour process

Who can have it?

Women wo have had a history of any of these should avoid reflexology:

1. Miscarriage

2. Risk of preeclampsia

3. Deep vein thrombosis or other blood clotting issues.

Transcutaneous Electrical Nerve Stimulation (TENS) Machine

TENS machine is a device used to relieve pain via  mild electric current. This small battery functioned device has leads attached to sticky pads called electrodes. The pads are attached to the skin and give off a tingling feeling when electric current is passed through it.

They work in the following two ways:

1. Reduces the pain signals going to the spinal cord and brain which ultimately relaxes muscles and relieve pain.

2. Stimulate the production of endorphins, natural pain killers.

It is most effective during the early stage of labour when a pregnant woman is experiencing lower back pain. However, it has not shown beneficial results when contractions are prolonged, strong and more regular.

Use of TENS machine has no side effects on you or your baby. 


It stimulates the body to release natural pain killers- endorphins along with mood lifting enzymes. Massage plays an important role in strengthening your bond with your birthing partner or midwife.  Touch makes you feel relaxed and better whilst you are dealing with contractions. It has a therapeutic effect.

Positions for massage

Specific positions will bring about  greater results  in  the massage, These include:

1. Leaning forward on a birth ball

2. Sitting on a chair, turned back to front.

3. Sideways stairway to heaven

4. Lying sideways

5. Standing lunge position

6. Standing forward lean

7. The slow dance

8. All fours

Can massage oils be used during labour?

Although using a massage oil makes the experience more pleasant but it is important to know which oils are suitable during the time of pregnancy.

The precautionary measures you can take:

1. Use one drop of essential oil at a time

2. Do not use one oil for long periods of time

3. Dilute the essential oil with a teaspoon of base oil before use. The base oil you can use are grapeseed oil or sweet almond oil.

Which oils can be used?

1. citrus oils, such as tangerine and neroli

2. German camomile

3. common lavender

4. frankincense

5. black pepper

6. peppermint

7. ylang ylang

8. eucalyptus

Oils should be avoided if you have a history of/or currently have any of the following:

1. miscarriage

2. vaginal bleeding

3. epilepsy

4. heart problem

5. diabetes

6. blood disorder

7. thyroid, liver or kidney disease.

Best areas to massage?

1. Shoulder- keeps them relaxed and  this helps in rhythmic breathing.

2. Lower back- to cope  with the pain of contractions.

3. Foot

4. Hand- in case you’ve had epidural, foot massage can be very soothing.