Pain relief options

We offer a selection of pain relief options for your labour and birth at Hillingdon, depending on which birth setting you choose to have your baby. 

Pain relief options available


Labour Ward

Midwifery-Led Unit (MLU)


Tablets and capsules yes yes yes
Massage and relaxation techniques yes yes yes
Water or birthing pool no no yes
TENS machine yes yes yes
Gas and air (Entonox) yes yes yes
Opiod injections (pethidine and others) yes yes yes
Epidural and spinal yes no no


Tablets and capsules

  • We can provide paracetamol and/or dihydrocodeine (sometimes called co-dydramol)
  • They can take up to 30-60 minutes to start providing some pain relief and last for around 4-6 hours
  • They can be effective to reduce pain during the early stage of labour, you will most likely need to consider some other method(s) to go alongside these
  • Side effects include feeling sick (nausea) and feeling dizzy.

Massage and relaxation techniques

  • Massage and other relaxation techniques such as hypnobirthing, playing peaceful music, breathing techniques and dimming lights are methods that can help you relax and control your breathing. This helps you focus on something else other than your contractions
  • Pain relief from these methods begins as you start using them and they can be used throughout labour and birth if you choose to use them
  • If you wish to use aromatherapy, reflexology or homeopathy you will need to discuss this with your midwife or obstetrician first, as these methods will need to be provided by an experienced and trained person due to potential side effects that can occur.

Water and birthing pool

  • Water and using the birthing pool can work in a similar way to massage and other relaxation techniques by helping you relax and feel more in control
  • Pain relief begins from when entering the pool and lasts as long as you stay in the pool. The pool will be maintained at around 37 degrees for the duration.
  • You cannot use a TENS machine or have an epidural whilst in the pool
  • You can use water and opioids (see below for information about opioids) during labour but not at the same time. Your midwife will advise when you are able to get into the pool after opioid medication.

TENS machine

  • TENS stands for Transcutaneous Electrical Nerve Stimulation and passes a small electrical current through four pads that are stuck onto your lower back. It disturbs the nerve signals that cause you to feel pain and lowers your overall pain levels
  • Pain relief begins as soon as you start using it and stops when you remove it
  • You will feel a tingling and tapping feeling and you can control the strength of the current yourself, providing extra pain relief during a contraction
  • You are able to use a TENS machine alongside all pain relief options except with an epidural or water
  • You will have to provide your own TENS machine, but these are easily hired or brought online.

Gas and air (Entonox)

  • Gas and air (sometimes called Entonox) is a mixture of oxygen and nitrous oxide gas
  • You breathe in the gas through a mouthpiece during a contraction. The gas takes around 20 seconds to start working and the effects wear off within a few minutes of stopping use.
  • It works better when breathed in slowly and you can use gas alongside all other methods of pain relief
  • It may make you feel lightheaded, sick or sleepy.

Opioid injections (pethidine and others)

  • Opioid injections offered at Hillingdon are pethidine, meptid and diamorphine
  • They make you feel relaxed, which can help you rest and sleep
  • It is given by a single injection into your buttock or thigh muscle along with an anti-sickness medication
  • They take around 15-20 minutes to start working and last for around 2-4 hours
  • Opioid medication can travel through the placenta to the baby, this can cause them breathing problems if born soon after the injection is given. Your midwife will assess which injection is most appropriate depending on how advanced in labour you are.
  • As a side effect opioids can make you feel sick, dizzy and tired.

Epidural and spinal

  • Epidurals involve a small tube being inserted into your back by an anaesthetist. By putting the tube into a specific space in your back, pain relief is targeted at your lower body which numbs the area to provide pain relief.
  • Pain relief medicine is given through the tube hourly and you are able to have extra by pressing a button if needed
  • It can take 15-20 minutes to begin working effectively and lasts the whole time that medicine is given
  • Sometimes the tube can come out of place or only give pain relief on one side, this sometimes means that you would have to have the tube re-sited
  • Epidurals can stop you being able to feel when you need to go to the toilet, so a urinary catheter may be needed for the duration of labour and after birth
  • You may be able to mobilise and you will still be able to feel touch on your skin
  • As a side effect having an epidural can make you feel itchy and shivery. You may get a headache and have low blood pressure.
  • Spinal anaesthetic works similarly to an epidural except it is given by a single injection, mainly used for caesarean section.