Entonox (Gas and Air)

A mixture of oxygen and nitrous oxide inhaled during contractions.

Benefits:

• Quick acting
• Easy to use
• Woman remains mobile
• Can be used at any stage of labour

Possible side effects:

• Dizziness
• Nausea
• Tingling sensations

Opioid injections

Examples include diamorphine, morphine, and pethidine.

Benefits:

• Can promote relaxation
• May help women cope with contractions
• Does not require specialist anaesthetic staff

Possible side effects:

• Drowsiness
• Nausea and vomiting
• May temporarily affect the baby’s alertness after birth

Remifentanil PCA

Remifentanil is administered through a patient-controlled pump, allowing women to self-administer small doses as required.

Benefits:

• Rapid onset and short duration
• More effective than intramuscular opioids
• Women remain in control

Considerations:

• Requires continuous monitoring
• May cause drowsiness and slower breathing

Epidural

An epidural is administered by an anaesthetist through a catheter inserted into the lower back.

Benefits:

• Most effective form of labour pain relief
• Can be topped up throughout labour
• Can be extended if operative birth is required

Possible side effects and risks:

• Reduced mobility
• Additional monitoring required
• May increase the likelihood of an assisted vaginal birth
• Difficulty passing urine, often requiring a urinary catheter
• Headache is an uncommon complication
• Serious complications are very rare

Limitations:

• Requires anaesthetic staff and can take time to establish
• Does not work immediately; full effect may take 20-30 minutes

Find out more

Information on pain relief choices during labour
Pain relief options in labour and birth (Tommy’s)