# Labor Pain Relief: Epidural, Nitrous Oxide and Other Options

> Every labor pain option compared: coping techniques, nitrous oxide, IV medicines, epidural and spinal.

Stage: pregnancy - Topic: Getting ready - Page: https://www.askcladle.com/guides/pregnancy/pain-relief-options-in-labor

Grounded in: ACOG Practice Bulletin "Obstetric Analgesia and Anesthesia" and patient guidance "Medications for Pain Relief During Labor and Delivery", ACOG "Approaches to Limit Intervention During Labor and Birth", and the American Society of Anesthesiologists. Summarized in Cradle's own words; none of these sources endorse Cradle. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- Wanting an epidural is reasonable, and so is avoiding one. You can change your mind at any time.
- Options range from support, movement and warm water, to nitrous oxide, IV opioids and the epidural (the most effective).
- Ask what your hospital or birth center offers. Birth centers and home births don't offer epidurals.

## Your choice, in your own time

- Wanting strong medical pain relief is a reasonable choice, and so is wanting to avoid it. You can
  change your mind at any time.
- You don't have to reach a certain dilation before you get an epidural.

## Coping without medicine

- Continuous support from a partner, doula or nurse.
- Moving and changing positions: walking, swaying, a birth ball, hands-and-knees, leaning forward.
- Warm water: a shower or tub. Laboring in water can lower pain; giving birth in water is more
  debated, so ask your setting.
- Massage, counter-pressure on the low back, warm or cold packs.
- Breathing patterns, hypnosis or meditation practice, music, dim lights.
- A TENS unit (mild electrical pulses on the back) helps some people in early labor.
- Sterile water injections in the low back can ease back labor for a while, where offered.

## Nitrous oxide (laughing gas)

- You hold a mask and breathe it in just before and during contractions.
- Takes the edge off and eases anxiety rather than removing pain; wears off within minutes.
- You stay in control and can move around. Some people feel dizzy or sick.

## IV or injected opioids

- Short-acting pain medicine through a vein or shot. Dulls pain for an hour or two.
- Can cause sleepiness and nausea, and if given close to birth can make the baby sleepy, so timing
  matters.

## Epidural

- A thin tube is placed in the low back, delivering numbing medicine continuously. It's the most
  effective option.
- You stay awake. Legs feel heavy, so you'll usually stay in bed, with a urinary catheter and
  continuous monitoring. Some hospitals offer lighter "walking" doses.
- Possible effects: a drop in blood pressure, itching, fever, a longer pushing stage. A severe
  headache afterward is uncommon, roughly 1 in 100 or fewer.
- It does not raise the chance of cesarean, and it doesn't cause long-term back pain.
- A combined spinal-epidural works faster. A spinal alone is used for most planned cesareans.
- Some conditions, such as low platelets or blood thinners, can limit epidurals. Ask for a visit
  with anesthesia before labor if you have these, past spine surgery, or worries.

## Other numbing

- Local anesthetic for stitches, and a pudendal block (numbing near the vagina) for a forceps or
  vacuum birth or a tear repair.
- General anesthesia is only for urgent cesareans when there isn't time for a spinal or epidural.

## Planning ahead

- Ask your hospital or birth center which options they offer and whether an anesthesiologist is
  always available. Birth centers and home births don't offer epidurals.
- Practice coping skills in a class even if you plan an epidural; you may need them before it works.
- Note your wishes in your birth plan (see the birth plans and where to give birth guide).

## When to check in

- Book an anesthesia consult before labor if you have a bleeding disorder, take blood thinners, or
  have had back surgery.
- After an epidural, tell your provider about a headache that's worse when sitting or standing; it
  is treatable.