Pharmacological and nonpharmacological pain management in labor: Literature Analysis


Urtė Jucevičiutė1, Ugnė Grimutienė1, Giedrė Vanagaitė1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Each woman’s sense of pain is individual, it can be influenced by the woman’s psychological condition, preparation, method of childbirth (spontaneous or induced) support of loved ones during delivery, environmental factors, even the environment of the maternity ward (1). 50 percent of women say they feel severe and unbearable pain and only 10-15 percent of parturients refer to mild pain during childbirth (2,3). Severe pain increases stress and catecholamine secretions and can lead to hyperventilation, which can lead to fetal and maternal hypoxia due to hypocarbia (4). However, the use of analgesia can also be detrimental to the mother, so it is important to choose the right method of analgesia. This article reviews pharmacological and non-pharmacological methods of obstetric pain management, their complications and benefits.

Aim: To select and analyze expert recommendation for pharmacological and non-pharmacological pain management methods of labor and to compare their complications for mother and fetus.

Methods: Literature sources were selected from PubMed and Cochrane Library scientific databases, selecting only publications of meta-analyses and systematic reviews from 2014 to 2020 in English, using the keywords in the original language: “pharmacological” or “non-pharmacological” and “labor pain relief” and “natural childbirth”.

Conclusions: Childbirth pain is an individual matter, so the methods of pain relief should be chosen personally to the mother. Non-pharmacological measures are less effective in reducing pain, but have fewer side effects that are mild. Pharmacological methods are more effective in reducing pain but have more severe adverse reactions, so analgesia should be controlled as much as possible by the woman herself to reduce the risk of adverse complications. It should be appointed on a personal basis, taking into account the harm-benefit balance.  

Keywords: pain management, childbirth, obstetric analgesia, acupuncture, hypnosis, epidural anesthesia, opioids, inhalation anesthesia.