Tips & Tools: Labor Pain


How should I make a plan to meet my need for pain relief in labor?

What steps can I take before labor to help ensure that my needs for pain relief in labor are met?

How can I determine ahead of time what my preferences might be?


How should I make a plan to meet my need for pain relief in labor?

The decision to use or forego pain medication should not be made casually, although you may be encouraged to do just that. In this case, one size does not fit all. Each possibility presents a different profile of advantages and disadvantages and potential benefits and harms. The option or options that appeal to you as having the best balance between pluses and minuses will depend on your temperament, past experiences, and personal values and goals.

As you develop your plan, you will want to consider that many options can be used in combination, and some can be used in sequence. Combining and sequencing techniques and strategies may increase their effectiveness or reduce the chances of experiencing an adverse effect. Keep in mind as well that whatever your initial preferences, it is difficult to predict what your labor will be like. You would be prudent to have a "Plan B."

What steps can I take before labor to help ensure that my needs for pain relief in labor are met?

You will want to:
  • learn about labor so that you have a realistic understanding of what it is likely to be like
  • determine whether you prefer to avoid or use pain medication: (see the next question for help with this) discuss your preferences with your partner, and try to reach agreement before labor; if you cannot agree, your wishes must prevail, as you are the one going through labor
  • choose a place of birth that supports your initial preference (for details, follow the links for avoiding and using pain medications, below) you may find that you want to change your current plans to a setting that is a better match
  • choose a caregiver whose basic attitudes about pain relief agree with yours: this isn't essential, but things may go more smoothly if you aren't feeling the need to defend your choice; as with birth location, you may wish to switch to a more compatible caregiver
  • educate yourself about the various methods for relieving labor pain: this will help you decide which ones suit you best
  • consider hiring a doula (a woman trained and experienced in providing labor support): an important part of a doula's job is to help you achieve your goals for labor and birth (this website has a complete section devoted to labor support)
  • take childbirth preparation classes, which can help and your partner understand what to expect in labor and ways of coping with labor pain.

How can I determine ahead of time what my preferences might be?

Before making a decision, it is important to learn about your options (see sections on labor pain options and best evidence about labor pain options) and clarify your values and preferences as they relate to these options. If you have a partner, it is also important to understand that person's views.

To help clarify your feelings about pain and pain relief in childbirth (and those of your partner), you can download the Pain Medications Preference Scale. This tool was developed by Penny Simkin, a national leader in childbirth education who has worked extensively on labor pain issues.


Separate pages provide guidance for those who prefer to avoid pain medication and for those who prefer to use pain medication. If you are still undecided, your decision may become clearer by reviewing both of these pages.
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 11/16/2012