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Labour and birth—sterile water injections for relief of back pain in labour

Sterile water injections for relief of back pain in labour

Many women will experience back pain in labour. Often referred to as ‘back labour’, the pain can continue through the normal resting phase of a contraction and be severe enough to influence plans and decisions about pain relief.

Sterile water injections (SWI) are an effective method for the relief of back pain in labour. The procedure involves a small amount of sterile water (0.1ml to 0.2 ml) injected under the skin at four locations on the lower back (sacrum).

The injections cause a brief but intense stinging sensation, like a wasp sting, that lasts for about 30 seconds and then wears off completely. As the stinging sensation eases, relief from the back pain is felt. To distract from the stinging sensation the injections are done during a contraction by two midwives. Women benefit from support and encouragement as the injections are being given.

SWI provides effective pain relief for up to 85 per cent of women with back pain in labour and can last for up to two hours.

Advantages of SWI include

  • often immediate effect
  • no effect on mother's state of consciousness
  • no effect on baby
  • does not limit mobility
  • does not adversely effect labour progress
  • is a simple procedure that can be administered by your
  • can be repeated as needed.

SWI are an excellent alternative for relief of back pain in labour. Though SWI will not provide pain relief from contraction pain, once the back pain is alleviated, you may cope better with labour pain. As the back and pelvic muscles relax following the relief of pain, this may assist with the progress of your labour.

As sterile water is not a drug and there are no known side effects for mother or baby, SWI may become the preferred choice for the relief of back pain in labour for many women.


  1. Melzack R & Schaffeberg D (1987) Low-back pain during labour Am J Obstet Gynecol
    156. 901-5
  2. Mårtensson L & Wallin G. (2008) Sterile water injections as treatment for low-back
    pain during labour: A review. Australian and New Zealand Journal of Obstetrics and
    Gynaecology; 48: 369–374
  3. Fogarty, V. Intradermal sterile water injections for the relief of low back pain in labour:
    A systematic review of the literature. (2008) Women and Birth; 21: 157-163
  4. Hutton EK, Kasperink M, Rutten M, Eitsma A, Wainman B (2009) Sterile water injection
    for labour pain: a systematic review and meta-analysis of randomised controlled trials.
    British Journal of Obstetrics and Gynecology (Published Online: 14 May, 2009).

© 2012 Mater Misericordiae Ltd. ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 03/11/2015.
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