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If you want labor pain relief (无痛分娩), say so directly; it does not raise the risk of cesarean section

  • Moderate value
  • Evidence A
  • Saves time
  • For: Pregnant or trying
  • Costs a little
  • Takes minutes
  • Some willpower

In plain words

Painless labor (无痛分娩) means an anesthetic injection in the lower back that damps down the pain of giving birth. It works better than other pain relief methods and does not make a cesarean any more likely. The claim that “after the epidural your back hurts for life” has no basis either. It now has its own billing item, and hospitals are more willing to offer it.

Cost

A few hundred to a little over 1000 CNY, and the price varies by place. Ask ahead of time whether the hospital and its anesthesiology department can do it. The hard part is that you have to bring it up yourself.

What you get

The Cochrane systematic review concluded that epidural analgesia is more effective than methods without an epidural at relieving labor pain and raising the mother's satisfaction with pain relief. Painless labor uses epidural analgesia. The same review also says that “epidural analgesia has no effect on the risk of cesarean section or on long-term back pain.” The increase in instrument-assisted delivery (using instruments to help the baby out) is no longer seen in studies after 2005. Starting in 2024, the National Healthcare Security Administration's (国家医保局) guide to pricing items for obstetric medical services listed “labor analgesia,” “doula-assisted birth (导乐分娩)” and “family-accompanied birth (亲情陪产)” as separate items. The reason is exactly that there had been no separate price item, which held down hospitals' incentive to provide labor analgesia.

Notes

The two most widely repeated claims, “the epidural gives you back pain for life” and “the epidural makes labor difficult and means surgery,” have no basis. Cochrane pooled epidural analgesia with other pain relief methods and concluded it has no effect on the risk of cesarean section or on long-term back pain. The real side effects are these: low blood pressure, fever, weak legs, trouble passing urine, a longer first and second stage of labor, and a greater chance of needing oxytocin. Whether to have it is your decision, but don't give it up because of rumors. Whether it can be done also depends on whether the hospital has an anesthesiologist on site 24 hours a day, so ask at your prenatal visits.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A (2018). Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database of Systematic Reviews, (5), CD000331. https://doi.org/10.1002/14651858.CD000331.pub4
  2. 国家医疗保障局 (2024). 重构产科服务价格项目 助力构建生育友好型社会. https://www.gov.cn/zhengce/202406/content_6957553.htm

Translated from the Chinese original. Original book, section 27, tip 9. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer