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Knowing your pain relief options can help you feel calmer and more confident about labour
Pain Relief at a Home Birth: Entonox, TENS, Water & Comfort Measures
One of the questions I’m often asked when families are considering a home birth is, “What pain relief can I have at home?”
Choosing to give birth at home doesn’t mean giving birth without pain relief or comfort measures. There are a number of options that can be used throughout labour, and we can discuss these during pregnancy so that you understand what is available and can decide what feels right for you.
As part of my home birth care across London, Essex and Hertfordshire, I support you to use a combination of pain-relief and comfort measures, including Entonox (gas and air), TENS, water, movement, positioning, massage, hip squeezes, breathing techniques, heat and other practical ways of helping you feel comfortable and supported during labour.
Can I Have Entonox at a Home Birth?
Yes. Entonox, commonly known as gas and air, can be available for your planned home birth with Guided By You Midwifery.
Entonox is a mixture of nitrous oxide and oxygen that you breathe through a mouthpiece or mask during contractions.
You remain in control of when you use it. Many women find that it helps them manage the intensity of contractions while still allowing them to move around and remain actively involved in their labour.
Having Entonox available at home can also provide reassurance if you are concerned that choosing a home birth means having very limited options for pain relief.
We can discuss how Entonox works, when you may want to start using it and what to expect from it during your antenatal appointments.
Using a TENS Machine in Labour
A TENS machine can be particularly useful during labour.
Small pads are placed on your back and deliver gentle electrical impulses. You control the intensity yourself and can increase or decrease it depending on what feels comfortable.
Many women like using TENS because it allows them to remain mobile and can be started early in labour while you are still moving around your home, resting, eating or preparing for labour to become more established.
TENS can be used alongside many of the other comfort measures available at home.
Water and a Birth Pool
Warm water can be a wonderful source of comfort during labour.
Some women choose to use a bath or shower, while others choose a birth pool during labour and may also decide to give birth in the water.
Being in warm water can help you relax, change position easily and feel more private and comfortable within your own environment.
You don’t have to decide in advance that you will give birth in the pool. Some women spend part of their labour in water and then choose to get out, while others find they naturally want to remain in the pool for the birth.
Your preferences can change throughout labour.
Movement and Positioning
One of the benefits of labouring at home is having the freedom to move around your own space.
You may want to walk, lean over furniture, kneel, squat, use a birth ball, rest on your side or move between lots of different positions.
There is no single “correct” position for labour.
Your midwife can help suggest different positions depending on how you are feeling, where you are experiencing pressure and how your labour is progressing.
Massage and Hip Squeezes
Firm touch, massage and hip squeezes can be incredibly helpful for some women, particularly where contractions are felt strongly through the back or pelvis.
Your birth partner can be shown how to provide counter-pressure and massage in a way that feels comfortable for you.
This can also give your partner a practical role during labour rather than leaving them wondering what they should be doing to help.
And if you suddenly decide you absolutely do not want anyone touching you anymore, that is fine too.
Labour is individual and what feels wonderful during one part of labour may feel completely different an hour later.
Using a Birth Comb During Labour
A birth comb is a simple comfort technique that some women find surprisingly helpful.
The comb is held in the hand and squeezed during contractions. The sensation in the hand can provide another physical focus while a contraction is building.
It is small, inexpensive and easy to use alongside other comfort measures.
Like everything else on this page, it is an option rather than something you have to use.
Breathing and Relaxation
Breathing techniques can help you remain focused and work with each contraction.
This doesn’t mean that you need to have completed a particular hypnobirthing course or mastered complicated breathing exercises before labour.
Sometimes simple reminders to slow your breathing, relax your jaw and shoulders and focus on one contraction at a time can be incredibly useful.
Your birth environment can also make a difference.
Low lighting, music, familiar smells, privacy, warmth and having people around you who make you feel safe can all contribute to creating a calmer environment for labour.
Heat and Warmth
Warmth can be another simple but effective comfort measure.
A warm shower, bath, birth pool or appropriate heat pack can help with muscular discomfort and provide comfort during different stages of labour.
We can discuss practical ways to prepare your home and the things you may want to have available before labour begins.
Your Birth Partner Can Be Part of Your Pain-Relief Toolkit
Birth partners often worry that they won’t know what to do when labour starts.
During pregnancy we can talk about practical ways your partner can support you, including massage, hip squeezes, helping you change position, preparing the birth pool, encouraging you to eat and drink, creating a calm environment and simply recognising when you need quiet reassurance rather than lots of conversation.
Your partner doesn’t need to become a midwife.
Their role is to know you, support you and help protect the environment you want around you.
What Is the Midwife’s Role in Supporting Pain Relief?
Your midwife is there to support you throughout labour, observe how you and your baby are coping and help you explore different comfort and pain-relief options as your labour progresses.
What you want in labour may change.
You might spend early labour using TENS and moving around your home, later decide that you want to use the birth pool and then choose Entonox as labour becomes more intense.
There is no requirement to choose one method and stick with it.
As birth approaches, a second midwife also attends your planned home birth, providing additional midwifery support around the time of birth and immediately afterwards.
What If I Decide I Want Stronger Pain Relief?
Planning a home birth does not mean that you lose the right to change your mind.
Some forms of pain relief, including an epidural, require care in hospital.
If during labour you decide that you would prefer pain relief that cannot be provided safely at home, we can discuss this with you and support a transfer to hospital where appropriate.
Your preferences remain important throughout your care, even if your original birth plan changes.
Do I Have to Decide My Pain Relief Before Labour?
No.
It can be helpful to understand your options before labour begins, but you do not need to predict exactly what you will want.
You may have preferences, but labour is an experience you haven’t had yet, or it may feel completely different from a previous labour.
My role is to make sure you understand the options available to you so that you can make decisions as your labour unfolds.
Frequently Asked Questions
Can I have gas and air at a home birth?
Yes. Entonox, commonly known as gas and air, can be available as a pain-relief option for a planned home birth with Guided By You Midwifery.
What pain relief can I use during early labour at home?
Early labour can be supported with options such as TENS, warm water, movement, different positions, massage, hip squeezes, breathing and relaxation techniques, heat and a birth comb. What feels helpful will vary from person to person.
Can I use a TENS machine and then have Entonox later?
Yes. You don’t have to choose just one comfort or pain-relief method. Your preferences can change as labour progresses.
Can I use a birth pool just for pain relief?
Yes. Using a birth pool during labour does not mean you have to give birth in the water. You can use warm water for comfort and get in or out of the pool whenever you wish.
Will my partner be shown how to help me?
Yes. We can discuss practical ways your birth partner can support you during labour, including massage, counter-pressure, hip squeezes, positioning and helping create the environment you want.
Will there be two midwives at my home birth?
A second midwife attends around the time of birth as part of your planned home birth care. Having two midwives provides additional support for you and your baby around birth and immediately afterwards.
What if I decide I want an epidural?
An epidural requires hospital care. If you decide during labour that you want pain relief that cannot be provided at home, we can discuss your options and support transfer to hospital where appropriate.
Can I book a one-off appointment to discuss my birth planning and pain relief options?
Absolutely. If you would like more time to talk through your birth preferences, pain relief options or any questions you have about labour and birth, you can book a one-off private antenatal appointment with me. This gives us dedicated time to explore your options, discuss what matters to you and help you feel informed and prepared for your birth, without needing to book ongoing private midwifery care.
Planning Pain Relief for Your Home Birth
You don’t need to know exactly how you will manage labour before it begins.
Understanding your options simply means that when the time comes, you have different tools available and people around you who understand your preferences.
If you are considering a home birth with Guided By You Midwifery, get in touch, we can discuss pain relief, your birth environment and the support available to you during your antenatal appointments so that you can approach labour feeling informed and prepared.