Pain relief

You might be keen on having your baby at a birth centre (midwife-led unit) but you’re unsure about the pain relief options. Here’s what you can expect

For lots of women, midwife-led units or birth centres are the ideal places to give birth. They’re less ‘medical’ than a hospital but with more support and back-up than you might think you’d get at a home birth.

You’ll probably want to know exactly what pain relief is available at midwife-led units. And whether you can get more if needed. Or is it too late by then because you’ve not opted for a hospital? We break it down for you.

Epidurals

They aren’t available outside of hospitals because there needs to be an anaesthetist around to give you an epidural. Midwife-led units and birth centres are staffed 100% by midwives.

It might be a good idea to chat through epidurals with your midwife before you give birth. This might help you to decide whether the lack of epidural option makes a difference to you or stresses you out (NHS, 2015).  

Another option is to have your baby in an alongside birth centre, if you have one available near you. Alongside birth centres are on the same sites as hospital labour wards. That means you can be transferred easily if you do need or want an epidural (Which?, 2018).

If you’re not in an alongside unit, you can be transferred from any midwife-led unit or birth centre to hospital for an epidural too. Your midwife might even phone ahead so you get it as soon as possible.

Gas and air (entonox)

You inhale gas and air through a mouthpiece and it’s available readily at midwife-led units or birth centres. While it might not take the pain away completely, for a lot of women it dials it down a rung or… eight.

Gas and air also has the benefit of having no risks for you or the baby. On the other hand, it can make you a bit lightheaded or sick (OAA, 2018).

Pethidine and other injected opiates

These drugs are also available at midwife-led units or birth centres. They relax your muscles and can make you feel sleepy, confused or like you’ve had one too many glasses of wine.

Some women love it and feel less anxious. Others find it doesn’t do that much for their pain and can make them feel nauseous, helpless or out of control.

Pethidine and other opiates might also make your baby sleepier and slower to start breastfeeding after they’re born. Talk to your midwife about whether these drugs are the right pain relief for you (OAA, 2018).

Water in a birth pool

Hopping into a birth pool during labour can be a brilliant pain reliever (Cluett et al, 2018).

It can help you chill out and it’s just as safe as giving birth out of water (Cluett et al, 2018; OAA, 2018). Just check out whether your midwife-led unit or birth centre has birthing pools before you go in. They should be well equipped for water births.

TENS (transcutaneous electronic nerve stimulation) machine

Passes a gentle electric current through pads on your back that can help to reduce pain (NHS, 2018).

You can happily use TENS at midwife-led units or birth centres but not all of them have them. Find out in advance whether they have TENS machines although you can always buy or hire one.

Complementary therapies

Bonus: some birth centres offer complementary therapies like acupuncture. This can help you chill out, make contractions feel less painful and reduce the likelihood of you screaming out for drugs (Smith, 2006; OAA, 2018).

Birth centres are also likely to support hypnobirthing, aromatherapy and reflexology. You might need to arrange for some training in advance and/or a therapist to be with you in labour (OAA, 2018).

Self-help techniques

At a midwife-led unit or birth centre, you’ll also be encouraged to use self-help techniques to manage your pain when you’re in labour.

These can include:

  • using different positions to get comfy
  • movements like swaying, walking, dancing, circling your hips, and other upright positions that can help your baby’s head to come down
  • focusing on breathing out very slowly, panting or blowing
  • singing, moaning or humming
  • distractions like TV or listening to music
  • massages (step forward birth partners)
  • relaxation techniques.

Some of these are most useful in the early stages. Other self-help techniques like warm water, movement and focusing on your breathing can work all the way through (Lawrence, 2009; Cluett, 2018; Smith, 2018).

This page was last reviewed in May 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

If you’re unsure about your pain relief choices, you can use the Which? Birth Choice tool to compare services near you and to find out their contact details. You can also find out how to book a tour of your birth centre if they are offered, where you can ask questions about what kinds of pain relief are available.

Cluett E, Burns E, Cuthbert A. (2018) Immersion in water in labour and birth. Available from: http://www.cochrane.org/CD000111/PREG_immersion-water-labour-and-birth [Accessed 21st May 2018].

Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. (2009) Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev. (2):CD003934. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003934.pub3… Cochrane Database of Systematic Reviews [Accessed 21st May 2018].

NHS. (2015) Where to give birth? Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/where-can-i-give-birth/ [Accessed 21st May 2018].

NHS. (2018) TENS (transcutaneous electrical nerve stimulation). Available from: https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/ [Accessed 21st May 2018].

OAA. (2018) FAQs pain relief. Available from: http://www.labourpains.com/UI/Content/Content.aspx?ID=29 ] [Accessed 21st May 2018].

Smith A, Collins C, Cyna A, Crowther C. (2006) Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. (4):CD003521 Available from:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003521.pub2… [Accessed 21st May 2018].

Smith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M. (2018) Relaxation techniques for pain management in labour. Cochrane Database Syst Rev. (3):CD009514. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD009514.pub2/full]  [Accessed 21st May 2018].

Which? (2018) Pain relief during labour: what’s available? Available from: https://www.which.co.uk/birth-choice/coping-with-pain-in-labour/pain-relief-during-labour-whats-available [Accessed 6th November 2018].

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