Question for any MWs out there about pethidine.

[MrsTittleMouse]

When DD was born she had respiratory distress, but was OK after 10 minutes (ie Apgar of 10 at 10 minutes). 20 minutes later we were able to do skin-to-skin and she started feeding, but then she stopped breathing again, and we thought she'd died but she was rescusitated sucessfully.
Cue a couple of weeks later and I was seen by a stand-in HV, who asked about DD and the birth, and when I told her about the breathing difficulties, she told me that it was because I'd taken pethidine in early labour. I told her that I had taken only a half dose (50mg) and that it was 8 hours before DD was born, but she said that that didn't matter. I've been feeling v guilty about it since, even though DD was OP and the labour was very long and painful, and I really don't think that I could have coped without it.
But now I've seen on the "cord around the neck" thread that quick clamping of the cord can cause breathing problems. I know that DD's cord was clamped as soon as she was out, because she has passed meuconium, and so was whisked off by the paed team. Could that have been why she stopped breathing, or was it my fault?

[SofiaAmes]

HV doesn't know what the hell she is talking about. Give a little knowledge to an uneducated person and it can be a dangerous thing. Pethidine can cause breathing difficulties if it's given just before birth which is why they don't give it to you if they think you are about to give birth. I don't think that there is any evidence that pethidine given 8 hours before the birth is likely to cause breathing problems. And really I think it's completely irresponsible for the hv to be making you feel guilty about pain relief that was presumably given to you during labor by a medical professional. (I am now making the bold presumption that you didn't sneak into the medical cupboard and steal the pethidine during your labor). And since you are clearly (and undertstandably) traumatised by your child almost dying it's reallly not productive for the hv to try and assign blame to anyone and particularly not you. There are lots of things that can cause breathing difficulties after birth and it is unlikely that any of them would be your fault. Just ignore most of what most hv's say and enjoy your baby and be happy that she is now happy and healthy.

[lulumama]

Your HV is talking bolleaux


giving pethidine in early labour , IMHO, will not affect the baby at birth, takes around 4 hours for the effects to wear off, so 8 hours later, and half a dose should not depress the baby's respiratory response

it is not your fault

I would contact the head of midwifery or PALS team at the hospital and see about going through your notes and seeing what really happened. I can assure you , that had your baby not been breathing due to the effects of pethidine, there is an antidote that can be given ( narcan, IIRC ).

ALso, have you had any counselling since the birth, it sounds very traumatic and must play on your mind.

[RedFraggle]

I'm not a midwife but can only say that my midwife told me that pethidine wears off after 4 hours so surel that couldn't be affecting your baby all that time later?!

I definitely second Lulumama (waves to Lulumama) about going back to the hospital to see your notes. Your GP should be able to arrange for you to have a debrief with either your consultant or a senior midwife. I found this really helpful. Also many hospitals now have specialist counsellors trained in caring for women after traumatic births. My consultant referred me for this and it was enormously helpful. Go and ask for help as soon as possible so you can start to put this behind you.

[lulumama]

you know, red was always my favourite fraggle

[MrsTittleMouse]

Oh thank goodness!
I have my hospital notes, which is why I can be so certain about the dose and timing, and there isn't anything about DD having narcan. So it looks as though she is talking out of her .... I'm also in the process of getting DD's notes, so that might enlighten me more.
I'm also trying to get counselling at the mo, it's all been a bit difficult, partly because we've moved twice since then, partly because my GP thinks that I should be grateful that she hasn't had any lasting effects and should just pull myself together. Luckily, yesterday I spoke to the HV at the practice, who was the first person to take me seriously and has found out where I can get counselling, but I have to be referred by the GP! Rats! So back to the GP I go.

[lulumama]

keep on pushing for that referral, in the mean time you could look at the thread entitled' birth trauma' in this section and look at the links for the birth trauma assoc. and birth crisis

keep going

[lulumama]

keep on pushing for that referral, in the mean time you could look at the thread entitled' birth trauma' in this section and look at the links for the birth trauma assoc. and birth crisis

keep going

[MrsTittleMouse]

I have to admit that I'm finding it all a bit exhausting getting everything sorted: getting forms counter-signed for the medical notes when I don't know anyone here, trying to get a second opinion for my episiotomy problems, and trying to work out how/where I can get counselling. I just keep thinking that if I keep on pushing then things have to get better. It's very tiring though, and I don't get much done in the day except looking after DD. It would help if DH understood, but even though he's a lovely bloke he doesn't understand why I want counselling. He thinks that it will just encourage me to dwell on it, and he thinks that that's what my problem is. In fact, I've been reading the birth trauma sites, and have become a bit addicted, which I think is a symptom of things not being at all right.
What would I do without MN eh?

[MrsTittleMouse]

PS have to say that if anyone reading this is considering using pethidine during labour, then I found it brilliant. It completely knocked me out, I had the only good sleep that I'd had in 3 nights/days, and when I woke up I had the courage and energy to keep going again.

[lulumama]

you are right about that


being desperate to talk about it, read about it , read about others experiences and keeping it in your mind at all times are signs that you are not yet comfortable with what happened, nor have you fully processed the experience

at the end of the day, your baby did not breathe well at birth, and that was terrifying, and i don;t think that needing closure on that is unreasonable

[RedFraggle]

Mrs Tittlemouse,

It might be worth calling the hospital direct and asking to speak to your consultants secretary. They may be able to get the consultant to see you without your having to go through the GP. Just a thought - I spoke to my consultant's secretary after DD's birth and she told me about a support group held at the hospital as well...
The fact of the matter is that if you were at all fearful of your DD's life (ie the breathing problems at birth) this will probably keep playing on your mind until you can talk about it.
I felt awful after my DD's birth as I thought she nearly died (it wasn't that severe in reality, but it's what I had in my head as she was very distressed and I had a crash section) the whole thing just kept going around my head like a stuck record. It really affected how I bonded with her and I am just so glad I got help. It still upsets me, but I am much better at coping with it now. I think my DH must have been sick of me talking about it, but I think he came to realise that I had to get it all clear in my mind so I could recover.
Keep asking for help - the fact that your DD is healthy is sometimes not enough to get over a traumatic experience.

[RedFraggle]

(thread hijack)
Hi Lulumama,

I'm fine thanks -almost due with baby two now! I decided to go for a section in the end as I was getting totally freaked out at the thought of any complications this time around. It seemed to be the best option for my mental state! I'm booked in for this Tuesday, so fingers crossed this will be a straightforwards delivery.

Hope the Doulaing is going well!

(hijack over!)

[bizziebee]

This is interesting for me - I was given pethidine at 5pm (was great!) and dd was born at 8pm. She did have some breathing difficulties at first but was fine - could this be why do you think. No one mentioned any risks of pethidine.

[lulumama]

that is great redfraggle ! i will look forward to the birth announcement doualing going very well i;m glad to say xx

[MrsTittleMouse]

Hi Red Fraggle,
That's the main problem that I have: I've moved to a different part of the country, so I'm no longer near the hospital where I gave birth. If I'd stayed put, then I know that that hospital did postnatal counselling, as there was a poster up in the postnatal ward. I'm now "out of the system" if you see what I meain. I'm quite shocked that the new GP is so clueless though.

[RedFraggle]

Oh no! Is there more than one GP at your practice? Or could your consultant from the other hospital put you in touch with someone at the new one I wonder?
DOn't give up, though - you definitely need to talk to someone.
I'll keep my fingers crossed for you..

[nonscareymidwife]

Hi I have been a midwife for ten years so have given pethidine numerous times. I can honestly say that I can't remember a baby that has had any severe problems due to pethidine. Some have been a bit slow to get going but nothing a good rub with a towel didn't solve. I would not be at all concerned delivering a baby whose mother had had 50mg of pethidine, if she had had 200mg or more (this is rare) I would be slightly concerned until baby safely out but even then would not normally anticipate problems apart from the possiblity of breastfeeding problems. I have never had to give narcan myself, (that is the drug that is an antidote to pethidine). As for quick clamping of the cord, it would not normally cause breathing problems it just makes to transition to outside life a little more abrupt. There are thought to be some benefits to the baby of delayed cord clamping but no major risks with quick clamping. Was it quite a long time ago that your dd was born? Where I work if there is meconium and the baby is ok the paediatrician is normally there but does not check the baby over unless it needs some resuscitation. That is something that has changed in the last few years though.

[MrsTittleMouse]

DD is 7 months. She wasn't breathing when she was born, and was floppy and "dusky". She also didn't cry for 10 minutes but even when resuscitated was grunting (from my notes).
It's getting so nuts that I''ve considered going back to the hospital where I delivered for the counselling. It would be worth the travelling and being away from DH to get things sorted.