by Dr. Arlene Dubier, ND, Birth Doula and Lactation Expert

When we think “pain relief” and birth, our minds typically go straight to an epidural. After all, it’s one of the most commonly used pharmaceutical pain techniques. However, it isn’t the only option for pain-relieving techniques or comfort measures. We will review three techniques that you can use either yourself or with the help of an expert

Hands-On Techniques

This is referring to massage, acupressure or counter pressure that is done by a birth partner or doula. In the early stages of labour when surges are not as intense, light-touch massage can be a wonderful tool to stimulate superficial nerve endings on the skin. This touch releases tons of endorphins, otherwise known as “feel-good” hormones.

As labour intensifies, either acupressure, counterpressure or both can be used to apply a firm hold to certain body parts in order to take the pressure off the discomfort of the surge. These are tools which can be taught to you by your doula or knowledgeable healthcare provider. The key is to hold this firm pressure for the duration of the contraction so that the pregnant person feels relief and can focus on breathing through each surge.


Water can be such a wonderful tool during early and active labour. Water is used in a multitude of ways. For example, using the warm and running water from a removable shower head can relieve back pain from back labour. For our clients who have had a slow early labour, taking baths was one of the only tools that really helped to take the edge off the more uncomfortable surges. This should ideally be done with lukewarm water, and should not exceed an hour of being submerged. The reason for this is that being in the bath confers benefits up to a certain point of time. In practice, we have seen that feeling relaxed in the bath and having the water support the belly can help pregnant people progress a little more in active labour. However, after a certain point it may almost be too relaxing where labour does not progress. In this situation if water is helpful, we suggested staying in the bath for 50-60 minutes, getting out
for some time to try different positions and then getting back into the water.

Another stage of labour in which water can be helpful is during the second stage of labour; the pushing stage. During this stage, there is a lot of natural stretching that happens to the tissues of the perineum (the area between the vagina and anus) as the baby rocks down and around the pubic bone. Having the warmth and movement from the water can again take the edge off this pressure from these stretching sensations. Yet another way water comes to the rescue!

Nitrous Oxide (Laughing Gas)

Here is a type of pain relief you may have never heard of. Nitrous oxide, or laughing gas is only used in certain environments such as certain hospitals or at the Toronto Birth Center. Nitrous oxide is a colourless, odourless gas, mixed with oxygen and is inhaled via a hand-held face mask. The benefits of this is that it can be useful to relieve anxiety as well as dull the pain sensation. Most people use nitrous during the transition phase of labour which can
be to most intense (but shortest) part as the cervix is doing its last couple centimetres of dilation. Realistically you can use nitrous during any part of labour, including postpartum if you have a perineal injury which needs to be repaired.
The benefits of this is that using nitrous allows for people to be mobile because it does not affect muscular strength. It can also be started and stopped at any time, as it works very quickly and leaves the body just as quickly. Some potential side effects of using nitrous is that people can notice dizziness, nausea or claustrophobia from having to breathe deeply and using the mask. Click here to learn more about the use of nitrous oxide in labour.

There are so many pain management alternatives, I couldn’t mention them all in this post. Speak with your OB or midwife about the alternatives that are available to you. If you are looking for even more support, specifically with hands-on techniques, you may consider including a doula in your birth experience. If this is the case, please reach out to our team and inquire about our offerings.

Wishing you all the best on your pregnancy and postpartum journey!

Dr. Arlene Dubier, ND