How do I know if I need pain medication in labor?

One of the most common questions I hear from my Confident Birthing students is:

I’m planning on a natural birth. But, what I want to know is, how do I know if I’ve reached my limit? How do I know if I need pain medication, an epidural, or if I can push through without?

My answer is twofold.

First you use the “Three Contraction Guideline”.  That’s for when you have doubt. “I think I *might* need pain meds, but I’m not sure.”

  1. Go to the bathroom. Sometimes, we aren’t paying attention to the rest of our body because we are so focused on labor. That small bit of extra discomfort can put us over the edge. So, go use the toilet, that’ll make you feel better.
  2. Eat and drink. Remember, FOOD = ENERGY. When we don’t eat enough, our bodies tire faster and we get cranky. A small bit of food will boost your mood and your pain tolerance.
  3. Change position and try a different comfort technique. Were you sitting? Try standing. Standing? Try lying down. On the ball? Try the shower. Nothing on your back? Try an ice pack. You have many options. Choose something different from what you were doing before and give it three contractions with the new position/technique.
  4. Did it work? Yes – then you are good for now and don’t need pain meds at this time.  No – Then you can say you’ve tried everything and choose pain meds without regrets, knowing you made an appropriate choice and know your limits.

Alternatively, there is something called a “Safeword”. (Uh, but, Deena, I’ve heard that term before in another context…) Yes, dear reader, you have heard it elsewhere. The intention and use of the term is the same. It means, “make the pain stop and make it stop right now”. 

The safeword should be something totally unrelated to pregnancy, birth and babies, and be easy to remember. The only people that should know that word are the laboring mother, her support partner and their doula if they have one.

Why? Because I’ve had a provider say to a mother, “You look like you are suffering. Do you want to say, ‘blueberry’?” That killed the mother’s confidence and she choose pain meds before she needed to do so.

Choosing pain medication is a very personal decision. There is no right or wrong about it. Be confident in your choices and you can have a good birth.

Please use and share the infographic below to help you remember these guidelines for choosing pain meds during labor.

How do I know I need meds in labor

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