By Ali Weatherford

Pain is one of the leading causes of fear around birth, and that’s unfortunate because fear is one of the leading causes of pain!

You may have heard horror stories about how birth was the most painful experience of a person’s life. If you mention the idea of having an unmedicated birth, people around you might tell you you’re crazy. Or tell you not to bother–just get the epidural. It’s too painful to manage without it.

These are not comforting things to hear.

But are labor and birth really that painful? Should we be afraid? Are there things we can do to make it better?

I gave birth twice, both times without pain medication. It WAS painful, and it was manageable. Not only was it tolerable, but it was actually a great experience in so many ways. I didn’t expect that. I expected it to just be painful and awful and something I had to get through to have my baby. And many others have shared this same experience.

I also teach birth classes, so I’ve learned a lot about pain for my career. In classes, we talk about pain. I even teach a whole class about managing pain in labor without medication. From my experience and my education, I can tell you that:

  1. It is painful.
  2. We don’t need to be afraid.
  3. There is a lot we can do to manage it.

There are some great reasons to have an unmedicated birth, and there are also some great reasons to use medication. Either way, most people will experience some pain while giving birth.

You’ll learn in birth classes that before you can push your baby out, you have to labor for a while to get your cervix open from 0-10cm. That’s the part that takes the longest and requires most of the contractions…..small ones AND big ones. You’ll also learn that you’re not supposed to go to the hospital or birth center until you’re approximately 5-6cm dilated. That means that we’re supposed to be doing a significant amount of our laboring and dilating at home BEFORE we can even ask for pain medication. So, it’s clear that almost everyone should learn about ALL of the options for pain management in labor and birth.

Some strategies to cope with pain WITHOUT medication.

When I teach about pain coping I use my own method for helping people remember the types of things that can help. I call them THE 6 Rs.

  1. Respiration (breathing)
  2. Refreshment (fuel and hydration)
  3. Relaxation
  4. Rhythm (movement)
  5. Resting Position (positions for being more comfortable)
  6. Resources (tools)

We learn about several different techniques that fall into each of these categories. A lot of these things work very well for most people. Some of them work just a little, while others make pain dramatically better. It depends on the person, and where you are in your labor. My advice is to try LOTS of things and keep trying! It’s very likely that something will work for you. And even if something doesn’t work well now, it may be really beneficial later.

Of course, there is also medical intervention to help with pain in the hospital.

Epidural Anesthesia

Most people opt for the epidural because it works. An epidural is when anesthetics or a combination of anesthetics AND analgesics (narcotics/opiates) are put straight into a spot near your spine using a needle threaded with a little hose that gets left in your back after the needle is removed. It offers to block the pain completely, and it almost always does.

There are some downsides to an epidural. You have to stay in bed so have limited mobility, and it takes a significant amount of time before pain relief is achieved. Bladder catheters are usually inserted, and the second stage of labor (pushing) often takes longer. Some of the medicine is also shared with the baby, and fever accompanied by antibiotics is much more common with an epidural. After birth, there may be a little more recovery time in bed while you get all of your mobility back and the bladder catheter can be removed.


There is also the option of using analgesics for labor pain management. These are painkillers in the narcotic and opiate categories. These are given as an injection or through an IV. They work quickly, but definitely don’t completely block the pain. They take the edge off, and there are some other downsides.
You might have some side effects from the medicine like sedation, altered mental state, nausea, vomiting, and dizziness. The baby also gets some medicine and might be born a little sedated. This can make getting started with breastfeeding a little more complicated.

Nitrous oxide gas

This is another option that people might choose, although it’s not available in all locations. It’s a gas that is inhaled through a mask that covers your nose and mouth. Some people call it laughing gas, and it’s commonly used in dentists’ offices.

This doesn’t block pain, it just sort of makes people feel happy and even euphoric so they don’t care that they’re in pain! It works quickly, takes the edge off the pain by making you feel good, and your ability to get up and move is not affected. It doesn’t seem to affect the baby at all. The downsides are that it can be annoying to hold a mask on your face the whole time you want the benefit, and it can make people feel dizzy. It may also cause nausea and vomiting.

Some other things to know about pain….

Pain is a really important part of life. We learn that pain is telling us that something is wrong and that we should do something about it so we can stay healthy and whole. It protects us. It would benefit everyone to have a healthy level of respect and gratitude for pain! That can be hard to imagine, but it can happen. We don’t have to be afraid of pain, and we can learn a lot to help us cope very well with pain.

Also, the pain of labor is different! It is NOT telling you that there is something wrong. Labor pain is showing you that your body is working on getting your baby out. Each painful contraction is doing something to BENEFIT you and your baby. That’s a big mind shift to make, but if you can do that, you might find that labor pain is more manageable.

Positive Mind Shifts During Labor

The pain of labor is also temporary–it can really help to remember that. Each painful contraction will last only about one minute. Ask yourself if you can handle the pain for just one minute. After you manage that minute, then you get a break. The vast majority of people have more break time than painful time during labor. Some of the most important work that you can do to prepare for birth is to do this kind of thinking. Making positive mind shifts about pain is so valuable, as is changing your mind about other things that are stressful or causing fear. Take a little time to think about and learn about those things as preparation for labor and birth.

For further help or planning for a medication-free delivery, consider our live-taught online Coping With Labor Pain Without Medication class.

Our articles are not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment.

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