Several options can help with anxiety during labor, ranging from inhaled gases and IV medications to hands-on comfort techniques and continuous emotional support. What you’re offered depends on your hospital, how far along you are in labor, and whether your anxiety is tied mainly to pain or to the experience itself. Here’s what’s available and how each option works.
Nitrous Oxide
Nitrous oxide, commonly called laughing gas, is one of the most direct tools for labor anxiety. It’s a tasteless, odorless gas you breathe through a mask that you hold yourself, giving you full control over when and how much you use. It won’t eliminate pain, but it dulls it while reducing anxiety and creating a sense of well-being that makes contractions more manageable.
One of its biggest advantages is speed. Nitrous oxide takes effect within about a minute of inhaling it, and the effects wear off just as quickly once you remove the mask. That fast on-off quality means you can use it during contractions and skip it between them if you prefer. It also doesn’t restrict your movement, so you can still change positions, use a birth ball, or walk around. If you tend toward anxiety in medical settings or want to stay mobile, nitrous oxide is worth asking about, though not every hospital offers it.
Opioid Pain Medications
Opioids given through an IV or as an injection act on the entire nervous system rather than numbing a specific area. They reduce your awareness of pain and produce a calming, sedative effect that can take the edge off anxiety. These are typically offered during active labor, especially if you’re not ready for or don’t want an epidural.
The main limitation is timing. Opioids given too close to delivery can affect the baby’s breathing and alertness after birth, so your care team will factor in how far along labor has progressed before offering them. They can also cause drowsiness, nausea, or dizziness in you. For many people, opioids serve as a bridge, helping manage pain and anxiety during the most intense stretch of labor before delivery.
Antihistamines Used as Sedatives
Some hospitals use older antihistamines like hydroxyzine or promethazine specifically for their sedative properties during labor. These first-generation antihistamines cross into the brain easily, producing a calming and drowsy effect. Hydroxyzine in particular is formally indicated for relief of anxiety and tension, not just allergies. Promethazine is similarly used for sedation.
These medications are sometimes given during the early, slower phase of labor (called the latent phase) to help an anxious or exhausted person rest before active labor begins. They’re often paired with opioids to enhance the calming effect and reduce nausea. Your team may offer one of these if anxiety is preventing you from resting when rest is still possible.
Epidural and Spinal-Epidural Anesthesia
An epidural is primarily a pain relief tool, but removing severe pain has a powerful secondary effect on anxiety. Intense labor pain triggers a stress cycle: pain increases fear and tension, which increases the sensation of pain, which drives more anxiety. Breaking that cycle with effective pain relief can dramatically lower anxiety levels.
Research comparing epidural anesthesia to combined spinal-epidural anesthesia (which adds a spinal component for faster onset) found that the combined approach produced lower anxiety scores and reduced stress hormones like cortisol and adrenaline. Both approaches work, but the combined technique tends to provide stronger, faster pain relief during the first stage of labor. If your anxiety is primarily driven by pain or fear of pain, an epidural may address both problems at once.
Non-Drug Approaches That Reduce Anxiety
A large review of non-drug coping strategies found they produce a meaningful reduction in pain scores compared to standard care alone. Several specific techniques stood out as effective: birth ball exercises, acupressure at a point on the hand (between the thumb and index finger), music played through a smartphone, ice pressure, and structured distraction techniques. The Bonapace Method, which combines massage, breathing, and focused attention, ranked highest for pain reduction among all the non-drug methods studied.
Music therapy in particular has been studied for its effect on both pain and anxiety before and during labor, not just pain alone. These techniques work best when you’ve practiced them before labor starts, so if you’re interested, look into childbirth education classes that teach specific coping methods rather than just general information.
Hydrotherapy, which means laboring in a tub or shower, is another widely available option. Warm water reduces muscle tension and can create a sense of privacy and calm that’s hard to replicate in a hospital bed. Many birthing centers and hospitals with labor tubs offer this as a first-line comfort measure.
Continuous Labor Support
Having a doula, a trained support person who stays with you throughout labor, has some of the strongest evidence for reducing anxiety-related outcomes. A study evaluating doula programs across three states found that women who received doula support during labor and birth had 64.7% lower odds of developing postpartum anxiety or depression compared to similar women without doula care. They also had about 53% lower odds of cesarean delivery.
These benefits held even for women with pregnancy complications: those with high-risk conditions who had doula care showed a 54% reduction in odds of postpartum anxiety or depression. The key factor was having the doula present during labor and birth itself, not just during prenatal visits. Continuous emotional support, breathing cues, position suggestions, and someone calmly narrating what’s happening can keep anxiety from spiraling during the most intense moments.
What Affects Your Options
The stage of labor matters. Nitrous oxide can be used at almost any point and stopped at any time. Opioids and sedating antihistamines are generally given earlier in labor to avoid affecting the baby’s breathing at birth. Epidurals are typically placed once active labor is established and can continue through delivery.
Your hospital’s resources also play a role. Not all facilities stock nitrous oxide, and not all have anesthesiologists available around the clock for epidurals. If managing anxiety is a priority for you, it’s worth asking your provider during a prenatal visit what’s available at your planned delivery location. Knowing your options ahead of time can itself reduce anxiety, since uncertainty about what to expect is one of the biggest drivers of fear during labor.