•Labour is an emotional experience and involves both physiological and psychological mechanisms.•The pain of labour is severe but despite this its memory diminishes with time.•Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage.•The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments.•Pain relief in labour is complex and often challenging without regional analgesia.•Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth.Go to:IntroductionThe experience of labour is complex and subjective. Several factors affect a woman's perception of labour making each experience unique. However as a consistent finding, labour pain is ranked high on the pain rating scale when compared to other painful life experiences1. The memory of this pain however is short lived and of parturients who experienced severe pain in labour, 90% found the experience satisfactory three months later2. This short term memory may be related to the positive outcome that often occurs at the end of labour.The pattern of labour pain differs between nulliparous and multiparous women and it is well documented that pain scores are higher in the nulliparous compared to the multiparous woman especially if there has been no antenatal education. Consistent findings also indicate that nulliparous women on average experience greater sensory pain during early labour compared to multiparous women3 who seem to experience more intense pain during the pelvic phase of labour as a result of sudden stimulation of nociceptors surrounding the vaginal vault, vulva and perineum4 and rapid descent of the foetus5,6.Labour pain as well as being unpleasant for the mother, can have deleterious effects on the foetus (figure 1).