There is no one size fits all when it comes to pain relief in labour. You may like to use a mix of medication and natural management techniques or no medication at all. There are lots of natural options available, and this article covers a wide range while acknowledging that we’ve not been comprehensive. Natural pain relief methods can vary in terms of their evidence basis, but what’s most important is the health and safety of you and your baby, so always make sure any option you choose is discussed thoroughly with your healthcare team. Let’s consider our ladder of pain again.

Can Netflix be a pain reliever?

Like a warm bath or going for a walk, simple distractions can be enough to relieve pain in early labour. Watching a Netflix series or, better yet, chatting with your partner in a loving way is perfect for this stage. It is very hard to distract yourself from genuine contractions, and you should not try to take your mind off warning signs like bleeding, fever, reduced or absent foetal movements, severe headaches or cramps, or any of the other red flags we mention in Episode 2 of Unii’s Antenatal Journey. However, distraction is a useful coping mechanism while you're waiting for labour to establish itself.

What is a TENS (Transcutaneous Electrical Nerve Stimulation) machine?

A TENS machine can actually be another form of distraction in early labour, as it gives you a tingling sensation and relief that you control. You can buy one to use at home. These machines work by stimulating the nerves in your lower back with electrical currents through sticky pads attached to your skin. You control the strength yourself, which can also reduce any anxiety you may be feeling, and they’re so small and light that you can walk around or bounce on a birthing ball while using one. On the other hand, they’re not the most reliable source of pain relief. Given that people experience pain differently, you likely won’t know how well they work until you give one a go. You can’t use a TENS machine if you have epilepsy, a heart problem, or any metal implants.

Does bouncing on a birthing ball achieve anything during labour?

Lots of people laugh about this, but staying active and upright during the early and established stages of labour comes with many benefits, including a wider birth canal, easier contractions, and less pain. You may feel silly, and you will look a bit daft, but nobody around you will care. In addition, just walking around or even slow dancing with your partner are active solutions that will also keep you upright.

How can massage help?

Some pregnant women don’t want to be touched when in pain. Or when not in pain. We get it; some people have no boundaries, and your bump is not community property. However, having your birthing partner massage your lower back with oil and the heels of their hands can relieve cramps, and some women are comforted by shoulder and upper back rubs as well. Research has shown that 30 minutes of massage during early labour can reduce the pain felt afterwards. It’s worth working out how you like to be massaged in general by experimenting with your partner at home in these final weeks. You won’t know whether the same things appeal in labour until it happens, but fortune often favours the prepared.

Can aromatherapy provide relief?

Aromatherapy can alleviate stress and anxiety in labour and has been found to decrease the need for (or topping up of) opioid injections to relieve pain. If you’re interested in using aromatherapy during pregnancy, please do not put any directly on your skin. Pure essential oils are very strong and can cause irritation and rashes when used directly or improperly. In addition, some oils are contraindicated for use by pregnant women. That said, some hospitals do allow aromatherapy to be used at all stages of labour through compresses, vaporisation, inhalation, and massage, as well as in the birthing pool. Common oil options include lavender and clary sage for relaxation, peppermint to soothe nausea, and mandarin for revival.

What are some helpful breathing techniques I can learn?

Fear and anxiety are natural in labour, and if you are nervous, your midwives won’t want you to deprive your baby of oxygen. Don’t hold your breath when you are in pain. Hyperventilating is also bad for the baby. If your midwives notice you doing it, they may recommend something called “box breathing.” This is simply breathing in for a count of four when you feel a contraction begin, and then breathing out for the same number while keeping your shoulders relaxed. If you’re struggling with controlling your breathing, this is where entonox (gas and air) may be useful. The midwife will guide you in how to use it, but it will help you regulate your breathing whilst allowing you to relax at the same time through the contraction, but this is absolutely your choice. Speak to your birthing partner prior to labour about breathing techniques so that they can coach you through each breath, counting you into each breath and down again. This is extremely useful don’t worry if you forget, the midwife will do it in front of you both and your birth partner can take over whenever they feel confident.

Should I learn hypnobirthing?

Hypnobirthing is not for every mum-to-be but it is an increasingly popular option for mum’s seeking to manage labour and birth pain without pharmacology. It is based on the theory that mothers tend to go into ‘fight or flight’ mode when labour begins, and by using self-hypnosis, you can overcome this and replace your adrenaline with increased amounts of relaxing oxytocin, prostaglandin, and endorphins.

Be aware that it requires a significant amount of time and practice to develop this as a skill, as well as to hone your technique. You need to attend all the classes and practice as instructed for this to be effective. There is no medically specified time frame for when you should begin to learn, but according to Katharine Graves, leading hypnobirthing teacher and founder of The Hypnobirthing Association, the sooner you start, the better.

Can I give birth in water?

The warm water of a birthing pool can have an epidural—or “aquadural"—like effect, and many women find the experience pleasant and cosy. You may need to ask in advance, as hospitals and birthing centres have limited numbers of these, but usually your healthcare team would try to accommodate this if your pregnancy is uncomplicated and you have the support of your midwife or doctor. There are a number of reasons they’d advise against a water birth. These can be based on your medical history, whether you are bleeding, your waters have broken, you’ve been induced, or your baby is breech.

You're also unlikely to be allowed to get in a pool if you’ve been given an opioid injection, as your doctor or midwife would worry about getting you out of the pool quickly and safely if necessary. You can’t have an epidural or TENS machine in water, either, and will be advised on the right pain medication to use during one of your antenatal appointments. Once in the pool, you won’t routinely be asked to get out unless you’re losing a lot of blood or struggling to deliver the baby or the placenta. Often the movement from the pool to the bed (because of gravity and the need to lift the leg over the pool edge) is what helps the placenta be delivered. But more often than not, the client is able to deliver the placenta in the pool (however at this stage the water from the pool would have been drained so that your midwife can see clearly how much blood she is losing and monitor it closely.

How can I cope with labour pain using natural relief?

Massage, aromatherapy, and your favourite binge watch can all help.