From an expert's point of view and also that of many women, the gold standard for pain relief in labour is a neuraxial analgesic technique that offers efficacy and flexibility, has the least central nervous system depression, and allows for an alert participating woman and an alert neonate.1 Nevertheless, more than a quarter of a million women per year in the UK, and many more worldwide, receive intramuscular pethidine for labour analgesia despite its limited analgesic properties and adverse effects on both the mother and the neonate.