At UW Medicine, we understand that pain control is an important part of your care. Your childbirth experience is unique—including your experience with labor pain—and we can help you find the most effective method to get the relief you desire.
Our caring staff encourages and supports you every step of the way to help you feel as nurtured and relaxed as possible.

Managing Pain during Labor and Delivery

During all stages of labor, keeping your mind focused and your body relaxed may reduce pain and help you to maintain a sense of calm. We offer a wide variety of
non-medicated comfort measures. Techniques include using visualization, music, voice and touch to focus attention; massage; physical activities such as walking or sitting on a birth ball; and mental activities such as patterned breathing and guided imagery.

If non-medicated comfort measures are not enough to help you manage your pain, we offer both analgesic and anesthetic pain medications.

Analgesics lessen pain without a total loss of feeling or muscle function, and can raise your threshold for pain tolerance. Analgesics are usually delivered as a shot or through an IV (a small tube placed into a vein) and can be given more than once until the later stages of labor (when you are pushing or delivery is near).

Anesthetics are medicines that produce a loss of sensation and muscle strength, and block pain. Regional anesthetics are used to numb a particular area (or “region”) of the body.

All medicines have benefits and risks to you and your baby, so talk with your provider about the best option for you. Some of the most common options for relieving pain during labor are shared below.

An epidural is the most common form of pain relief used during labor and delivery.

  • Can be used throughout active labor and delivery
  • Injected by an anesthesiologist (a doctor with special training in providing pain medicine) into the lower back or through a very small plastic tube (catheter) placed in your back
  • Begins to work within 10 – 20 minutes after medicine is injected; the effect wears off one to three hours after the medicine is stopped
  • Numbs the area between your waist and toes, but you remain awake and alert
  • Patient-controlled option available—allows you to control when pain medicine is given by pressing a button
  • Does not affect your labor progress or your baby’s health

Like an epidural, a spinal block provides regional pain relief

  • Used primarily for cesarean delivery
  • Small amount of medicine injected by an anesthesiologist into the lower back
  • Begins to work within three to five minutes and lasts one to two hours
  • Numbs the area between your waist and your feet

A CSE is another kind of epidural and provides faster pain relief than an epidural alone. It works by injecting the first dose of medicine directly into the cerebral spinal fluid (CSF) before an epidural catheter is placed.

  • Works quickly to relieve pain and provides continuous pain relief
  • Numbs the area between your waist and toes
  • Lower doses of medicine can be used than in an epidural alone for the same level of pain relief

A type of local anesthesia that is injected into the top of the vagina during delivery

  • Used for discomfort during an “assisted” delivery (when forceps or vacuum are needed)
  • Begins working within two to five minutes, and lasts about an hour
  • Affects only the vagina, vulva and perineum by causing numbness; does not block contraction pain.

Anesthetics that only affect a small area of the body to provide relief from pain

  • Numbs the perineum
  • Begins working within two to three minutes and lasts about 20 minutes
  • Used for episiotomy or vaginal tear repairs after delivery

Another option for pain relief during labor is nitrous oxide, also known as “laughing gas.” Nitrous oxide has been used in labor for many years in Canada, Europe and Australia to help decrease pain sensation, and has few side effects. You inhale the nitrous oxide – a mixture of 50% nitrous gas and 50% oxygen – by breathing in through a mask about 30 seconds before your contraction begins. Because you control the mask, you can use as much or as little as you need. It will not affect your labor progress.

Nitrous oxide does not work for everyone. For some women, it can “take the edge off” of the contraction and make it easier to cope with labor. It can also reduce anxiety, which can help you to better cope with labor pain. If you don’t like the way it makes you feel, you can stop using it and the effect wears off after a few breaths. Other pain relief options are still available after using nitrous oxide, but not at the same time.

There are times when nitrous oxide cannot be used, and it may not be available at every hospital. If you are interested in nitrous oxide, talk to your nurse or provider to see if it is an option for you.


Your comfort and experience are important to us. We look forward to partnering with you throughout your labor and delivery to help you find the best pain management option.