Pain is a common and treatable symptom in all stages of pregnancy. All agents must be prescribed considering the perceived benefits whilst acknowledging the potential fetal adverse effects. Oral agents can be used safely and effectively during the antenatal period, and management must be tailored for each individual. Intrapartum analgesia should be multi-modal with consideration for complimentary therapies including continuous labour support and water immersion. Epidural anaesthesia is the gold standard for pain management in labour, with inhalation anaesthetic offering excellent adjunct analgesia. A combined spinal/epidural anaesthesia acts rapidly compared to traditional epidural. Pudendal nerve blocks are effective methods of analgesia with decreasing popularity. Transversus abdominis plane blocks and wound infiltration of local anaesthetic reduces post-operative requirement for opioids. The obstetric anaesthetist plays a significant role in the multidisciplinary team in identifying and planning care for high-risk individuals. Furthermore, anaesthetic intervention at the time of delivery is not infrequent and can be optimized.
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Published online: December 16, 2022
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