Labour pain ranks among the most intense pain a person can experience. Yet for most women in India, it is still accepted as something to be endured. Pain relief during labour, most commonly given as an epidural, is safe, well established and widely used in many countries. In India, it remains the exception.
A small share of births
There is no single national figure, but the studies available point the same way. Reports from Indian cities suggest that only about one in four labouring women has access to any form of labour analgesia, and some estimates put routine practice closer to one in ten.
The barrier is not the doctors’ willingness. In a 2024 national survey of anaesthesiologists, 72.9% said they provided labour analgesia in some form, most often an epidural. But more than 60% of that work happened in private hospitals, private medical colleges and nursing homes, leaving many women in public hospitals without the option.
Why the gap persists
Awareness. In a study of 300 women in rural northern India, 84% had never heard of labour analgesia, even though 86% described labour pain as severe or unbearable.
Availability. Women go into labour at any hour. A labour epidural needs an anaesthesiologist available round the clock in the labour room, along with monitoring and trained nursing staff. Many hospitals, especially in smaller towns, do not have this.
Cost. For families paying out of pocket, the added cost of the epidural, the drugs and the anaesthesiologist’s time can be significant.
Fear. Many women and families worry that pain relief will harm the baby, slow labour or lead to a caesarean. Some providers share these concerns. Obstetric care providers in eastern Uttar Pradesh named fear of harm to the baby and the non-availability of anaesthesiologists among the main reasons epidurals were rarely used.
What changes when women know
The encouraging news is that once women learn about the option, most want it. In one survey of 200 expectant mothers, 98% had no idea that labour analgesia existed, but 95% wanted to learn more about it. A low-dose labour epidural relieves pain while allowing the mother to stay awake and take part in the birth, and it is placed and monitored by an anaesthesiologist throughout.
What can help
Expectant mothers can ask about labour analgesia during antenatal visits, well before labour begins, and choose a hospital that offers it at all hours. Hospitals can build dedicated obstetric anaesthesia services, and antenatal classes can give women accurate information in their own language.
A painless delivery should not depend on where a woman lives or how much she knows. India’s anaesthesiologists already have the skills to provide it. The task now is to make those skills available in every labour room.
