Northern Norwegian Women Use Epidurals to A Much Lower Degree Than in The Rest of The Country

"It was naturally intense and painful, but I would do it again, ten out of ten times," says Marthe Mølstre about the choice to give birth without an epidural.

She lives in Bodø, Northern Norway with her family.

In 2025, she became a mother for the second time, 13 years after her first birth. This time, she was certain about one thing:

"I wanted my body to manage on its own, and for the birth to be more natural," she explains.

Poor experience

Her experience with the first birth was a heavy influence on her choice.

The first birth was long and demanding, which eventually led her to have an epidural. She describes the experience as anything but good.

"It meant that I no longer felt the urge to push myself, so it was just an insanely uncomfortable experience."

The second birth was both quicker and more intense, but also much better, she explains.

Instead of an epidural, she got nitrous oxide, a pain relief she hadn't tried before.

"It was absolutely fantastic. I didn't get that with my eldest, as they didn't have it when he was born in Bergen. But they have it at Nordland Hospital," she says, describing the experience as magical.

Culture and expectations

Figures from the Medical Birth Registry of Norway show that epidurals were used in 45 percent of births nationally in 2024. But the average hides significant regional differences.

At Oslo University Hospital, 56 percent of women in labour received an epidural in 2024. At Haukeland in Bergen, the proportion was around 60 percent.

Meanwhile, in Harstad, Northern Norway, an epidural was used in only one in four births.

Senior Physician at the maternity ward at the University Hospital of North Norway (UNN), Eirin Haugli Falch, believes there is no decisive single factor that can explain the differences.

She points out that both culture and social expectations can influence the choice of pain relief.

"If you have friends and acquaintances who do not use an epidural, then you might not expect to use it yourself either," she says.

At the same time, the opposite can also apply:

"If everyone else uses an epidural, the threshold may be lower for wanting it yourself."

Increasing interest

The birthing population in the North also differs from the rest of the country.

"We probably have a slightly higher proportion of women who have given birth before than in Eastern Norway. They statistically have faster births, and the need for an epidural may therefore be smaller," says the senior physician.

She also sees a clear trend on social media, where more and more people express a desire to give birth without medicinal pain relief.

"Which means we have to compensate with other methods and coping strategies, and we have tried to respond to that demand in Tromsø."

At the maternity ward at UNN, several non-medical alternatives are actively used, including nitrous oxide, bathtubs, and close follow-up from midwives.

"This is not unique to the North, but it is something we focus on in the hope of providing other tools to cope with the experience of pain before possibly moving on to an epidural."

At the same time, the senior physician emphasises that the goal is not to influence the use of epidurals in any particular direction.

"The most important thing is that the women in labour have their needs met and receive equal treatment," says Eirin Haugli Falch.

Tougher in the north

In Marthe's circle of friends, the experiences are mixed, she explains. But many have given birth without an epidural, especially those who have more than one child.

"Many of my friends who have several children did not use an epidural. It often goes faster on the second and third births, and some don't even have time," she says.

She didn't miss it for a moment herself. 

"It was naturally intense and painful, but it passes, and it is worth it."

She has no clear explanation for why women in the North use epidurals less frequently than the rest of the country.

"Maybe we're just tougher up here?" she says, laughing.

"No, I have no idea. I think it has a lot to do with what the staff offers and recommends. I had written in my birth plan that I didn't want an epidural, so it wasn't offered, it wasn't even a topic."

For Marthe, it was exactly as she wanted: a birth that allowed the body to work on its own, and where she experienced control, mastery, and support.