Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Pain Management in Labour

Pain management in labour combines communication, continuous support, positioning, breathing, massage, water or other non-pharmacological methods, and prescribed analgesia or regional techniques. Care is individualized and regularly reassessed.

Purpose

  • Relieve pain and anxiety
  • Support coping and physiologic labour
  • Promote informed choice and maternal-fetal safety

Indications

  • Pain or distress during labour
  • Maternal request for analgesia or comfort support
  • Pain associated with examination, procedure, or complication

Equipment

  • Privacy and support person
  • Pillows, mats, birth ball, massage aids, or water facilities where available
  • Prescribed analgesics and administration equipment
  • Maternal and fetal monitoring equipment
  • Records and emergency equipment

Preparation

  • Check allergies, medicines, contraindications, staffing, and monitoring equipment.
  • Explain the plan in plain language and involve the support person with consent.

Procedure steps

  • Ask the woman to describe pain, goals, preferences, previous experiences, allergies, medicines, and risk factors.
  • Assess labour progress, maternal and fetal status, and whether pain is disproportionate or signals a complication.
  • Explain non-pharmacological and pharmacological choices, benefits, risks, limits, and effects on mobility or newborn.
  • Support breathing, relaxation, movement, upright or side-lying positions, massage, counter-pressure, heat, water, and companionship when appropriate.
  • Administer prescribed analgesia safely, checking identity, allergies, dose, route, timing, and contraindications.
  • Monitor maternal observations, sedation, respiratory status, pain relief, labour progress, and fetal response.
  • Reassess with the woman and adjust the plan; do not dismiss uncontrolled or atypical pain.
  • Escalate inadequate relief, respiratory depression, altered consciousness, fetal compromise, or suspected complication.
  • Provide post-analgesia safety and newborn-feeding support.
  • Document assessment, choice, consent, intervention, monitoring, response, education, and escalation.

Precautions

  • Unusual severe pain may indicate rupture, abruption, obstruction, or another emergency.
  • Use medicines only as prescribed and monitor respiratory depression or sedation.
  • Respect refusal and avoid coercing a particular method.
  • Use safe positioning and assistance after analgesia affects mobility.

Aftercare

  • Reassess pain, mobility, bladder, feeding, and adverse effects.
  • Continue support and update the birth plan.

Nursing considerations

  • Believe the woman’s report and combine subjective and objective assessment.
  • Use multimodal support and shared decision-making.

Patient education

  • Pain relief can be changed as labour changes; report inadequate relief, breathlessness, severe unusual pain, or dizziness.
  • Use safe positions and ask for help after medicines.

Documentation

  • Record pain assessment, options discussed, consent, medicine or method, observations, response, and plan.
  • Document adverse effects and escalation.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

Open Component Task app