Pain Management Education for Expecting Parents
Alternative Pain Management
Pain relief without medicine.
There are other options for pain relief. More research is needed to prove their effectiveness. Here are a few methods to consider.
Nitrous Oxide
What is it?
Nitrous oxide, or “laughing gas,” is a pain relief option used during labor. It is popular in Europe, Australia, New Zealand, Canada. Nitrous oxide can reduce cramping and aching with contractions. Not all hospitals have this pain relief option.
How It Is Given?
Nitrous oxide is a gas with no color or smell. You will be given a mask or mouthpiece to breathe the gas in. During labor, you may inhales the gas whenever you need pain relief from a contraction. It is combined with oxygen to ensure that you and your baby receive enough oxygen.
How it is Used?
1. The best time to start using the gas is during a contraction. It will take a few breaths to feel the effects.
2. Take slow deep breathes to get as much pain relief as possible.
3. Communicate with your nurse if the laughing gas is not helping with your pain.
What are Side Effects?
While nitrous oxide is generally considered safe for labor pain relief, it can have some side effects, including:
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Nausea
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Vomiting
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Drowsiness
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Dizziness
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Lightheadedness
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it’s important to remain seated or lie down during use.
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What Are Risks?
When used as instructed, nitrous oxide is safe. Here are some points to keep in mind when using nitrous oxide during labor:
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Decreased Oxygen
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You will receive oxygen along with laughing gas to make sure your body receives enough oxygen.
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Inadequate Pain Relief
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Nitrous oxide may not provide enough pain relief. .
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Nausea and Vomiting
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Using nitrous oxide can lead to nausea and vomiting.
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Dizziness
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Sometimes, nitrous oxide can cause dizziness and can cause you to fall.
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Adverse Reactions
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Although rare, some may have an allergy to nitrous oxide
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Sterile Water Back Injections
What is it?
Labor can cause back pain during contractions. One low risk way of reducing back pain is through sterile water injections. These injections work by changing how your brain senses the pain in your back. It can provide some pain relief for one to two hours.
How It Is Given?
Small amounts of sterile water are injected into four locations in your lower back with a tiny needle.
The water is placed underneath your skin.
What are Side Effects?
A burning sensation may be felt while the sterile water is injected in your back but will go away after a few minutes
What Are Risks?
The only risk for this procedure is that it may not provide enough pain relief.
TENS Unit
What is it?
A TENS unit (transcutaneous nerve stimulation) is a small device that gives small electrical shocks.
This can help reduce labor pain by changing how your brain senses pain.
How It Is Given?
Small pads are placed on your lower back that are attached to a TENS unit with wires
What are Side Effects?
The stickiness of the pads may cause skin irritation.
Over use of the TENs unit may cause soreness at the pad sites.
What Are Risks?
The only risk for this procedure is that it may not provide enough pain relief.
Where Did We Get This Information?
Almassinokiani, F., Ahani, N., Akbar, P., Rahimzadeh, P., Akbar, H., and Sharifzadeh, F. (2020). Comparative analgesic effects of intradermal and subdermal of sterile water on active labor pain. Anesthesia and Pain Medicine, 10(2):e99867. https://doi.org/10.5812/aapm.99867.
Barash, P. G. (2017). Clinical Anesthesia with Multimedia (8th ed.). Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781496383129
Buhre, W., Disma, N., Hendrickx, J., DeHert, S., Hollmann, M. W., Huhn, R., ... & Vutskits, L. (2019). European society of anaesthesiology task force on nitrous oxide: a narrative review of its role in clinical practice. British journal of anesthesia, 122(5), 587-604.
Dowswell T, Bedwell C, Lavender T, Neilson JP. Transcutaneous electrical nerve stimulation (TENS) for pain management in labour. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD007214. DOI: 10.1002/14651858.CD007214.pub2
Grant, G. (2022). Pharmacologic management of pain during labor and delivery. UpToDate.
Retrieved September 15, 2023, from https://www.uptodate.com/contents/pharmacologic-management-of-pain-during-labor-and-delivery?search=use%20of%20nitrous%20oxide%20in%20labor%20analgesia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H16
Nanji, J. A., & Carvalho, B. (2020). Pain management during labor and vaginal birth. Best Practice & Research Clinical Obstetrics & Gynaecology, 67, 100-112.
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