Editing Childbirth (section)

===Pain control===
{{Main|Pain management during childbirth}}

====Non-pharmaceutical====
Some women prefer to avoid [[analgesic]] medication during childbirth. Psychological preparation may be beneficial. Relaxation techniques, immersion in water, massage, and [[acupuncture]] may provide pain relief.  Acupuncture and relaxation were found to decrease the number of caesarean sections required.<ref name="Cochrane Database of Systematic Reviews">{{cite journal | vauthors = Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP | title = Pain management for women in labour: an overview of systematic reviews | journal = The Cochrane Database of Systematic Reviews | volume = 3 | issue = 3 | pages = CD009234 | date = March 2012 | pmid = 22419342 | doi = 10.1002/14651858.CD009234.pub2 | pmc = 7132546 }}</ref> Immersion in water has been found to relieve pain during the first stage of labour, reduce the need for anaesthesia, and shorten the duration of labour.<ref>{{cite journal | title = Immersion in water during labor and delivery | journal = Pediatrics | volume = 133 | issue = 4 | pages = 758–61 | date = April 2014 | pmid = 24652300 | doi = 10.1542/peds.2013-3794 | author1 = American Academy of Pediatrics Committee on Fetus Newborn | author2 = American College of Obstetricians Gynecologists Committee on Obstetric Practice | doi-access = free | hdl = 11573/1473752 | hdl-access = free }}</ref> Additionally, [[water birth]] is associated with a decreased risk of postpartum hemorrhaging, low Apgar scores, neonatal infections, requirement for neonatal resuscitation, and neonatal admission to intensive care. However, there is a higher chance of cord avulsion.<ref>{{cite journal |last1=McKinney |first1=Jordan |last2=Vilchez |first2=Gustavo |last3=Jowers |first3=Alicia |last4=Atchoo |first4=Amanda |last5=Lin |first5=Lifeng |last6=Kaunitz |first6=Andrew |last7=Lewis |first7=Kendall |last8=Sanchez-Ramos |first8=Luis |title=Water birth: a systematic review and meta-analysis of maternal and neonatal outcomes |journal=American Journal of Obstetrics and Gynecology |date=March 2024 |volume=230 |issue=3 |pages=S961–S979.e33 |doi=10.1016/j.ajog.2023.08.034 |pmid=38462266 |url=https://www.sciencedirect.com/science/article/pii/S000293782300604X |access-date=14 March 2024}}</ref>

Most women like to have someone to support them during labour and birth; such as a midwife, nurse, or [[doula]]; or a lay person such as the father of the baby, a family member, or a close friend.  Studies have found that continuous support during labour and delivery reduce the need for medication and a caesarean or operative vaginal delivery, and result in an improved [[Apgar score]] for the infant.<ref>{{cite journal | vauthors = Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A | title = Continuous support for women during childbirth | journal = The Cochrane Database of Systematic Reviews | volume = 7 | pages = CD003766 | date = July 2017 | issue = 8 | pmid = 28681500 |pmc=6483123 | doi = 10.1002/14651858.CD003766.pub6 }}</ref><ref name=ACOG2014>{{cite journal | vauthors = Caughey AB, Cahill AG, Guise JM, Rouse DJ | title = Safe prevention of the primary cesarean delivery | journal = American Journal of Obstetrics and Gynecology | volume = 210 | issue = 3 | pages = 179–93 | date = March 2014 | pmid = 24565430 | doi = 10.1016/j.ajog.2014.01.026 }}</ref>

====Pharmaceutical====
Different measures for pain control have varying degrees of success and side effects to the woman and her baby. In some countries of Europe, doctors commonly prescribe inhaled [[nitrous oxide]] gas for pain control, especially as 53% nitrous oxide, 47% oxygen, known as [[Entonox]]; in the UK, midwives may use this gas without a doctor's prescription.<ref>{{Cite web|url=http://www.nnuh.nhs.uk/publication/download/medicine-administration-for-midwives-mid21v6-1/|title=Medicine Administration for Midwives|last=Lancashire|first=Liz|date=9 July 2018|website=Norfolk and Norwich University Hospitals|access-date=16 June 2019|archive-date=16 June 2019|archive-url=https://web.archive.org/web/20190616201305/http://www.nnuh.nhs.uk/publication/download/medicine-administration-for-midwives-mid21v6-1/|url-status=dead}}</ref> [[Opioid]]s such as [[fentanyl]] may be used, but if given too close to birth there is a risk of respiratory depression in the infant.{{update after|2021|3|16}}<ref>{{Cite journal|last1=Kumar|first1=Manoj|last2=Paes|first2=Bosco|date=July 2003|title=Epidural Opioid Analgesia and Neonatal Respiratory Depression|journal=Journal of Perinatology|language=en|volume=23|issue=5|pages=425–27|doi=10.1038/sj.jp.7210905|pmid=12847541|issn=1476-5543|url=https://rdcu.be/dFdEd}}</ref>

Popular medical pain control in hospitals include the regional anaesthetics [[epidural]]s (EDA), and [[spinal anaesthesia]]. Epidural analgesia is a generally safe and effective method of relieving pain in labour, but has been associated with longer labour, more operative intervention (particularly instrument delivery), and increases in cost.<ref>{{cite journal | vauthors = Thorp JA, Breedlove G | title = Epidural analgesia in labor: an evaluation of risks and benefits | journal = Birth | volume = 23 | issue = 2 | pages = 63–83 | date = June 1996 | pmid = 8826170 | doi = 10.1111/j.1523-536X.1996.tb00833.x }}</ref> However, a more recent (2017) Cochrane review suggests that the new epidural techniques have no effect on labour time and the use of instruments or the need for C-section deliveries.<ref name="epi 18" /> Generally, pain and stress hormones rise throughout labour for women without epidurals, while pain, fear, and stress hormones decrease upon administration of epidural analgesia, but rise again later.<ref>{{cite journal | vauthors = Alehagen S, Wijma B, Lundberg U, Wijma K | title = Fear, pain and stress hormones during childbirth | journal = Journal of Psychosomatic Obstetrics and Gynaecology | volume = 26 | issue = 3 | pages = 153–65 | date = September 2005 | pmid = 16295513 | doi = 10.1080/01443610400023072 | s2cid = 44646591 }}</ref>
Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus.<ref>{{cite journal | vauthors = Loftus JR, Hill H, Cohen SE | title = Placental transfer and neonatal effects of epidural sufentanil and fentanyl administered with bupivacaine during labor | journal = Anesthesiology | volume = 83 | issue = 2 | pages = 300–08 | date = August 1995 | pmid = 7631952 | doi = 10.1097/00000542-199508000-00010 | doi-access = free }}</ref> Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an immediate effect on neonatal status as determined by Apgar scores.<ref name="epi 18">{{cite journal | vauthors = Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A | title = Epidural versus non-epidural or no analgesia for pain management in labour | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | pages = CD000331 | date = May 2018 | issue = 5 | pmid = 29781504 | pmc = 6494646 | doi = 10.1002/14651858.CD000331.pub4 }}</ref>