1. Gas and Air (Entonox) – Entonox is a mixture of oxygen and nitrous oxide (laughing gas) and is good for pain relief during labour as it doesn't cause sleepiness. The gas takes about 30 seconds to take effect. For the entonox to work properly, it should be breathed in at the start of a contraction, which means that it will be at it's maximum efficiency when the contraction is at it's most painful. When the entonox has stopped being breathed in then the effects wear off within a minute. Gas and air can be used from early labour right through to the delivery of the baby and although it does relieve the pain, it doesn't completely remove it.
2. TENS – Transcutaneous Electrical Nerve Stimulation is best used during early labour. The tens machine has small pads that attach to the back and a low voltage electric current is passed across the pads and this in turn stimulates the body to produce it's own natural pain relief. It can take up to 30 minutes before the effects are felt from the TENS machine, and the pain relief is moderate . Most women who opt for a TENS machine will hire it from the hospital or groups like the National Childbirth Trust.
3. Injections – Pethadine and Meptazinol (Meptid) are the most common drugs given by injection, into the thigh or bottom, during labour, they are very similar to morphine and take around 20 minutes to start working. These drugs give good relief of pain and can last up to three hours. It the drugs are given too close to delivery though, they can make the patient and baby feel sleepy.
4. Epidural – This is one of the most effective forms of pain relief and can provide complete freedom from pain throughout labour. An epidural can be given from early on in labour right up until the end of the second stage when the cervix has fully dilated. Epidurals are administered by anaesthetists, but  once they are in place, a midwife will take over. The patient will be asked to lie on their side or sit up and bend over a pillow, this opens the spaces in the spine, the  skin will then be made numb with a little local anaesthetic and then a small hollow needle is inserted into the back. A very fine plastic tube called a catheter is then threaded through the needle and secured into place with tape once the needle has been removed. The anaesthetic  is then administered through the catheter. It takes about 10-20 minutes for the epidural to become effective. A top up is sometimes needed for the second stage of labour, this means that the birth will be pain free, but it will still be possible to feel some kind of pressure when the baby is born.
5. Complimentary Therapies – These include aromatherapy, acupuncture, reflexology or hypnosis. Aromatherapy oils can be used in massage to help relaxation. However, the essential oils used by aromatherapists are very powerful and should only be used in labour after consulting an aromatherapist . In acupuncture, fine needles are used to stimulate the energy channels of the body and the release of natural painkillers or endorphins.  Reflexology involves massaging various areas of the feet to help  stimulate channels of energy which connect with other parts of the body. Reflexology can be very helpful during labour  but needs to be carried out by a trained therapist. Self-hypnosis can be taught for use during labour by a hypnotherapists.  The aim is to make the pain more manageable, or minimise it.  Practice during pregnancy is advised so that it is more effective in labour.
6. Water - Many women have found that soaking in deep warm water during labour allows them to relax, and gives some relief from the discomfort of contractions. Birthing pools are very popular now and can be used in either hospital or at home for pain relief and to help relax. The pool can be used until it's time to give birth or can be used for giving birth, also gas and air can be used at the same time, giving extra relief.

Each type of pain relief has pros and cons, so it's a good idea to discuss these with the midwife and birth partner, before labour begins.

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