Your comfort and wellbeing during labour and birth

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Labour and birth positions

Positions during labour and birth are about what feels most comfortable and supportive for you. It may not look or feel the way you expected, and that’s okay.

You can move, rest, change positions or stay still at any time. Trust what feels right for your body in the moment.

Learn more

Recommendations for pregnancy | Australian Government Department of Health, Disability and Ageing

Positions for labour and birth | Pregnancy Birth and Baby

Managing pain and discomfort in labour

Talking about pain relief is part of an ongoing conversation between you and your maternity care provider. These discussions include what matters to you.

Each birth experience is different. You may not be sure what you might need or want, or methods that worked in past pregnancies may not be right for you in this pregnancy. Being open and flexible can allow you to try different options and adjust as your labour changes. You can ask questions, say yes or no and change your mind at any time.

Sharing your goals and preferences can help your care team support you in a way that feels right for you. This might include whether you want pain relief to be offered or whether you prefer to ask for it yourself.

There is no right or wrong way to manage labour and every experience is different. What matters most is that you feel informed, supported, safe, and respected, and that you use the options that work best for you. Many people use a mix of approaches during labour.

How pain relief decisions may change

Your choices about pain relief may change over time depending on:

how your labour is progressing and what the lead up to labour has been like
how you are feeling physically and emotionally
what options are available in your place of birth
a pain relief strategy you have used earlier in labour begins to feel less effective.

Non-medication pain relief

These options do not involve medication. You can use them on their own or combined with other methods. They can help you feel more comfortable, relaxed and in control. You may use them at home and once you’ve arrived at your intended place of birth.

Non-medication pain relief options

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Some options include:

Moving and changing positions (walking, swaying, leaning, using a birth ball, hands and knees).
Breathing, relaxation, or meditation techniques.
Using water, such as a shower or bath (depending on what is available).
Massage, touch, or firm pressure on your back.
A TENS machine – a small device that can block pain signals, most successful if started early in labour (IMPORTANT – can't be used in water or while on some CTGs). These need to be arranged prior to labour.
Heat or cold packs – check with your intended place of birth and bring them with you from home.
Having the right people supporting you.
Support tools like pillows, balls, peanut balls, or stools.
Music, low lighting, or a quiet environment.
Aromatherapy – you may need to check with your maternity care provider about the essential oils you’re planning to use.
Visualisation, self-hypnosis and relaxation techniques (calm birth, hypnobirth etc).
Sterile water injections – these can be effective in helping relieve back pain in labour.

Starting some of these early in labour can help you get used to them. Many people find that using a combination of approaches works best.

Medication pain relief

Medication can help manage pain during labour. These options work in different ways and may be more helpful at certain stages or feel less effective over time. You can decide to use them on their own or together with non-medication options or other medication options.

Your maternity care provider will explain the benefits and risks of each option so you can decide what feels right for you, it is a good idea to have this discussion with your maternity care provider before labour starts.

Gas (nitrous oxide, gas and air, blended air)

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Gas is breathed in through a mouthpiece during contractions. It can help you feel calmer and reduce the intensity of pain.

It works quickly (within a few breaths) and wears off quickly.

You can:

control when you use it, but works most effectively with consistent use
increase or decrease the strength depending on your needs.

Some people feel light-headed or nauseous while using gas but it is considered safe for you and your baby.

Strong pain relief injections (opioids)

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These medications are given as an injection, usually in your arm or thigh.

They can:

help reduce pain and help you rest
work fairly quickly (15-20 minutes for full effect)
be used at the same time as the gas and air.

You may also be given medication to help with nausea.

Some people feel sleepy, dizzy, or sick after these medications. They can also affect the baby, especially if given close to birth, so timing is important. Your maternity care team will guide you on the best time to use opioid medication.

Epidural

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An epidural is a strong form of pain relief given through a small tube in your lower back that is put in by an anaesthetist. It can provide very effective pain relief by numbing the lower part of your body.

With an epidural, you will:

stay in bed but your position can still change with assistance
have ongoing monitoring of the fetal heartbeat
need an IV in your hand or arm
need a urinary catheter, this is a tube inserted into your bladder, so you can pass urine.

Your care team will help you move and change positions in bed to stay comfortable and to help the baby move further into the birth canal.

Epidurals are mostly used in active labour especially if pain feels overwhelming or you’re exhausted. In some cases, epidurals may slow labour or increase the chance of other procedures being needed to help your baby to be born. Your maternity care provider will explain this based on your situation.

Once inserted, an epidural starts to provide relief quickly but the procedure to safely insert the epidural can take some time and will require you to be still, sometimes during contractions. As an anaesthetist is needed to insert an epidural, there can sometimes be a delay to them being available but they will come as soon as they’re able. Your maternity care team will support you during this time.