For my wife's deliveries, the common options available were a narcotic (morphine usually, but I understand others use demerol) or epidural.

My wife's family has a history of epidurals flat out stopping labor, which requires pitocin or another labor stimulant, and the labors can take longer, so she's refused to do that each time. The other reason she has avoided epidurals is that she likes to move around during labor, and labor in different positions, which she's been told is difficult to do with an epidural. Perhaps things have changed on that front, though.

Two of the deliveries used morphine, in both cases where the water already broke, and we tried other stimulation, but labor wasn't progressing as quickly as desired. So she took the morphine along with the pitocin.

In one of those cases, the baby was delivered within 4 hours of administering the morphine, which caused some concern as the baby's body isn't developed enough to filter it out of their system, and it can cause breathing problems. They had me rubbing and squeezing his feet to make him cry for some time and they were satisfied that he wouldn't require time in the NICU (Neonatal intensive care unit). He was very, very sleepy, though.

Lesson one - if you use a pain killer other than an epidural, it has to be administered early enough in labor that the mother's body can filter it out and the baby doesn't have issues.

For last child we went to the hospital earlier than the middle three, with enough time to have the morphine again. We brought our wii fit (exercise video game) and passed the time playing with that. Turns out hula hooping really speeds up the labor! It's also very uncomfortable for the mother, but, I suppose, so is labor^*. We even got the midwife to hula hoop for a bit. This baby was delivered well after the four hour limit, but still had problems breathing and spent nearly a full day in the NICU. They did xrays and double checked things, but nothing seemed amiss - just needed a bit more time to get used to air. He just turned one and is fine.

For middle three we waited at home until she could stand it no more, then went to the hospital, because laboring in a hospital is harder than at home for us. In all these cases, however, we waited too long for painkillers, and each child was delivered in 1-2 hours after arriving at the hospital.

Lesson two - For us, laboring at home is easier, and results in a natural birth because we already knew we weren't going to do an epidural, and it was too late for other painkillers.

In all deliveries she started out having contractions 5 minutes apart - we didn't get the early warning 15 minute contractions others might experience. In one case she labored at home until transition - that was an interesting ride to the hospital. We usually have to monitor the strength of the contractions to know when to go in - when she couldn't walk or talk through them, or leaned on something it was definitely time to go, and by that time contractions are coming 2-3 minutes apart.

However, the three without any pain medication were wide awake and had great APGAR scores both initially and at the five minute mark. Much better than the two delivered with pain medication. Each delivery is different, though, so we can't draw any significant conclusion from my anecdotal experiences. In any case, all five children are as healthy and intelligent (insofar as we can tell) as the others, so I can't discern any long term effects.

Lesson three - Pain medications, for us, have an initial negative consequence on the baby. There's a stark difference in terms of alertness, activity, and both APGAR scores between those born with pain medication and those without.

We didn't look into other forms of pain medication, and so have no experience or knowledge of others.

We did use a lot of non-medicinal pain relief techniques, but that's another question altogether...

^*I did not tell her this at the time. During labor my communications are generally, "Yes dear," "Right away dear," "You're doing great!" and counting. Pretty sure that is my instinctual self preservation kicking in.

Like Adams wife, I tend to just stay at home for most of my labour.
I hate IV's and being confined, so an epidural was never something I wanted to be tempted to get. (That being said, every time I've been in transisiton I've said, "It's too late, isn't it?" and my nurse has replied with something along the lines of "Yup, that's why you got her 15 minutes ago, right?" That usually happens right before I announce I've changed my mind, I don't want another baby, and would somebody please call me a cab so I can go back home.)

My first son was a very long labour and a forceps delivery, and they gave me nitrous oxide for the pain. My ex-husband (a former high-school stoner) asked what it was like, I rolled my eyes and told him, "I'm high, it still hurts, I just don't care as much". So, it doesn't so much take away the pain, as much as just remove you from it a little bit. (Like being pleasantly tipsy.) It also gave me enough space to concentrate on my breathing and just riding the waves of pain instead of being swamped by them. You control it yourself, and it also wears off really fast. I have no idea how it affected my son, but apparently not much, if at all, his apgars were good, and he seemed just fine, but because he'd been in distress and stuck in the birth canal, they ran off with him pretty quickly. (They brought him back to nurse within 15 minutes, not long after they had finished stiching me up.)

I've used a couple of different medications while in labour:

• Nitrous oxide (aka laughing gas): Oh yuck. This just made me nauseous and did little else. I believe Neen sums up what is supposed to happen nicely though.

• Fentanyl: I used this to get me through transition. It didn't kill the pain, but it did take the edge off so that I could concentrate on breathing through it. The nurse told me it had a short half-life and that it wasn't a major concern for the baby (as compared to other opiates).

Here's an article that you may find useful: Using Narcotics for Pain Relief During Childbirth

I believe that the common pain medication options you have may be dependent on your country. The Mayo Clinic has a couple of articles about pain relief in labor which, given their location, I assume are relevant for the US. Labor pain: Weigh your options for relief is a high level overview of pain options while Labor and delivery: Pain medications specifically discusses pain medication options. In the latter article, they discuss the pros and cons of epidural blocks, spinal blocks, narcotics, local anesthetic injections, pudendal block, and tranquilizers.

I got to the pushing stage without medication but then ended up getting a cesarean so I had a spinal block. For me, it worked great and I had no side effects but I usually handle medication well. Since it was a cesarean, my baby was out pretty quickly after I received the medication and he was very healthy with apgars of 8 and 9 (which the doctors said is very good for Colorado).

My wife had an epidural for all 3 of our kids. With our first it was a mobile epidural, but she ended up not being able to feel her leg properly and with other drips in so it wasn't that mobile. It took most of the pain away, but not completely. By the time we had our second she was diabetic so being able to move wasn't really much of an option. She had an epidural again which worked okay. The hospital by this time no longer offered mobile epidurals.

For our last, she tried to do without an epidural. However, things were going pretty slowly and the midwife wanted to put a drip up to speed things along. The same drip had been used on both of the previous two so she knew it made it hurt more and asked if she could have an epidural in first. The epidural got put in but never really worked properly. Things got moving quite quickly with out the aid of a drip, she tried gas and air but it just made her gag.

She never tried pethidine, (which is the other pain relief common here) because she expected it to make her sick.

The NCT has a very good page about pain in labour, with all the usual options for medical pain relief that are available in the UK (the NCT is the biggest parenting charity in the UK). It also contains some useful info about avoiding the need for medications.