Labor pain relief: a narrative review of the current state of the issue

Labor is inherently associated with pain. Pain during childbirth arises from both psychological and physiological processes, including myometrial ischemia and tissue stretching. It is considered one of the most painful physiological events experienced by women and has a direct impact on postpartum quality of life. Although pharmacologic pain relief is widely used in current clinical practice, it is often associated with adverse effects and financial costs. These factors, together with patients’ individual and cultural preferences, may encourage the choice of non-pharmacologic methods. This review summarizes fundamental information and presents recent research findings regarding the advantages and disadvantages of pharmacologic and non-pharmacologic methods of labor pain relief. Non-pharmacologic methods activate the body’s endogenous analgesic mechanisms, promote relaxation, reduce anxiety, and enhance birth satisfaction. Their low cost, minimal invasiveness, and absence of significant adverse effects make them an attractive option for many women. These methods can reduce pain intensity and should be integrated into practice when patients prefer to avoid neuraxial analgesia or pharmacologic interventions to ensure a more comfortable labor process. However, limited analgesic efficacy, low prevalence of use, and insufficient knowledge and skills remain barriers to their implementation. Pharmacologic methods of pain relief may be used in patients for whom neuraxial analgesia is contraindicated; however, they are often associated with decreased satisfaction with childbirth, as well as a number of adverse effects (including labor dysfunction, hypotension, elevated body temperature, nausea and vomiting, and prolonged duration of labor) affecting both the mother and the newborn. The choice of analgesic method should be individualized, taking into account maternal preferences, obstetric context, the presence of comorbidities, and their potential impact on labor progression.