Non judgemental discussion about pain relief

[Heirhelp]

I am due my first baby in May and I am concerned about the birth but also worried about the proven side effects of some pain medications. In an ideal world I would love a water birth, if a pool is available, but I know that some pain relief methods prevent the use of a pool.

[goodnightdarthvader1]

At the risk of being dismissive, there's loads of info online. What specifically did you want to discuss?

No you can't have TENS, Pethidine or Epidural in the pool, but you can have gas and air.

[Junosmum]

I gave birth 6 weeks ago. Started off in the pool, ended up with forceps delivery. I had paracetamol in the first stage and a couple of goes on gas and air in the pool but i did nothing but make my face tingle so I ended up not using anything I had some local anesthetic when they did the episiotomy for the forceps but that was it. There won't be a next time, but if there was I'll be asking for an epidural as soon as. No one hands out medals at the end and I just feel stupid for not having more pain relief - I did 4 hours of pushing with absolutely nothing. I ended up with a retained placenta and they gave me a spinal to deal with that, it was wonderful!

[MilkTwoSugarsThanks]

Like Juno I ended up with no pain relief except the local for the episiotomy.

HAVE THE DRUGS!!!!

Seriously - there's no medals awarded for doing it without.

[whifflesqueak]

I had an epidural at the first opportunity.

loved it. read a book until I started to feel some pain again. called the midwife thinking I needed a top-up and she said nope, it's pushing time! I could still feel my contractions enough to know when to push, but I wasn't in pain and since I did tear so was glad of the epidural while being stitched.

I was mobile again pretty quickly afterwards, though obviously a bit wobbly.

I'm 36 weeks now and will have it again.

[InFrance2014]

If you have an open mind about it, why not start without and see how you get on? It's not about anyone awarding themselves medals, but you might find it's not total agony, and going through something physically challenging if you feel safe & in control can have positive sides too.
Many recommendations on this site for Juju Sundin's Birth Skills book, very practical advice for using body-based pain coping methods (similar idea to what athletes use to keep them going in races). Some of these will work fine with water birth.

[fakenamefornow]

I don't judge people for having pain relief in childbirth, why would that even enter your head op, do you judge women for having pain relief?

[AJ279]

I found any plans I had went out the window when in labour. I categorically said no way to an epidural and ended up asking for one. Just research so you are informed and go with the flow once in labour.

[Ughnotagain]

I gave birth last May.

Honestly - my advice would be to keep your options open, research all the different pain relief options, and go with what works best for you.

I hadn't even considered a water birth until I was in labour and had crippling back pain. The water helped a lot with that. I also had gas and air. The MW offered me diamorphine but I would have had to get out of the pool, and she said it might not help with my back pain.

I figured I might as well try the pool/G&A and if that didn't work for me then I could step it up a notch and take the drugs. At the very end I had to get out of the pool and my G&A was taken away but I did have a local anaesthetic for my episiotomy.

I'd recommend reading up on potential interventions too and how this can possibly link to the pain relief you have.

Basically - you need to do what's best for you.

[ShesGotLionsInHerHeart]

Who's judging?

I had one birth that really fucking hurt, the epidural brought back my ability to breathe/think/not panic.

I had another birth that didn't hurt much, so just used gas and air at the end.

Surely you just go with what you feel is required at the time? There's no pony having a philosophy on it, because it's likely to be blown apart by some aspect of your labour.

[ShesGotLionsInHerHeart]

Pony? Point!

[GothicRainbow]

I agree with AJ279 do your research on the types of pain relief available at your hospital so you know what you can have if you need it and then try and go into labour with an open mind.

I have told my DH that when we go in his job is to get me whatever pain relief I'm asking for (highly likely I'll be asking for an epidural!! I'm a wuss when it comes to pain) and to not attempt to talk me out of anything I'm asking for.

[Ilovenannyplum]

I had a completely drug free labour (apart from a couple of paracetamol) this was not my choice the midwife was an idiot, didn't examine me properly, just told me I was nowhere near ready for baby to be born as I 'didn't look like I was in enough pain' and when she finally examined me, DS was ready to be born. 45 mins later and there he was.

My advice? Take all the drugs. Take them ALL.

Good luck OP.

[Picklesauage]

I would say this, I had a pretty wide remit on what I would do in labour. My birthplace basically said 'I'd rather avoid pethidine'. In the end a massively quick labour left me in lots of pain and unable to gain control due to speed of contractions. My DH took the decision to give pethidine and it was the best for us all, it gave me enough time to relax and recover before the birth.

Second time round, I was on gas and air and begging for an epidural, but the 55minute labour didn't allow for it!

I had friends who were adamant they were going to have or avoid certain things, but they couldn't or didn't and ended up feeling a failure. Although they certainly didn't, they felt it. I would simply say, research, pick your preferences, but don't set them in stone! Be prepared to do whatever is best for the situation.

[Peppaismyhomegirl]

My advice would be don't put rules in what and what your not going to do (general advice for parenting to be fair!) because if it doesn't happen the way you imagines you only beat yourself up. I did it on gas and air. I'm pg with the second and will take whatever I need. I'm up for anything if needs be. Pethadine is my last choice tho

[Junosmum]

For those saying why would anyone judge, unfortunayely people do, I know more than one person who was told by their hypnobirthing leader (mine was lovely and totally non-judgmental) that they'd failed or not done it right when needing pain relief or interventions. I've had friens say things like 'was it too much' when I say I wanted an epidural next time, and people say, oh isn't it fantstic when you do it without pain relief. Well actually its fucking not and I now have significant birth trauma and anxiety (I'm sure for some it is, we are all different).

Sorry for the rant. But I get why the OP may have been concerned that people would judge.

[goodnightdarthvader1]

Well, even people on this thread are judging - they're implying that not having pain relief makes you a bit of a martyr.

I have no problem with whichever choice a woman makes, some pain relief, no pain relief, all the pain relief. I've educated myself fully on the pros and cons of all pain relief and could bore the OP to tears. And I'll happily do so, OP, if you can clarify any specific questions you might have.

[lilac3033]

Definitely do your research. I had my first last May and kept my birth plan open, but wanted to avoid an epidural. I used a TENS at home and paracetamol. At the hospital I had some dihyrocodeine. Went to the MLU, got in the pool and used G&A. After an hour or so of that I just asked for pethadine, as I figured I needed a break if I was going to last. Turned out it was transition and before my midwife came back I realised it was time to push. Delivered DD with nothing.
I have nothing against people getting an epidural but I really wanted to avoid it because I wanted to do everything in my power to avoid an assisted delivery/C-section. I was really afraid of forceps and I felt if I could avoid the epidural, I was in control. Is that true? Not really. I was on a trace for an hour around 3-4cm, if I had to be monitored the whole time I would have had an epidural. If it got too much, I would have had one. I think I would have been disappointed as it wasn't what I wanted, but I certainly wouldn't have beat myself up about it. You won't know until you are there, so I think there is a lot of danger in VERY rigid birth plans/expectations.
In the end it was good I didn't have one and that I could cope. My DD was back to back and because I was mobile I was able to change position until she turned. If I hadn't my midwife said I would have needed rotational forceps.
These are the sort of things you need to research and think about. I like feeling in control and for me that was more important than feeling little/no pain, at least at the level/length of time I had to manage.

[AnotherCider]

Posting this question is a VERY good idea, because you really need to think it through beforehand.

Sadly, a large number of midwives will steer you away from epidurals. I have a number of friends whose midwives said 'it's too soon you need to wait a bit longer' to suddenly saying 'oh it's too late now!'

Also, after 5 pm lots of staff go home, INCLUDING MOST OF THE ANAESTHETISTS!!!

With DS1 the ONLY anaethetist left was juggling 3 caesarians and so couldn't come to give me a epidural for 5 hours (a very long, drawn out labour).

With DS2 the midwife was a militant one who refused to have consultant 'interference' in her deliveries and it was only when DH manhandled her out of the room, and gave her a bollocking for talking to me the way she had been and demanding that my request for a consultant be met. (Formal complaint lodged about her - DS was stuck and was never going to come out without assistance). I could have kissed the anaesthetist who gave me the spinal the consultant ordered after 1 look at me.

[pinguina16]

Hi OP,

This tool might be useful www.which.co.uk/birth-choice/

Unfortunately birth is unpredictable and people who try to make you believe otherwise are being unkind/judgmental/dishonest/deluded?

You do make choices to begin with but then you have to go with the flow. A 12 hour labour is not the same as a 36 hour one but you can't know how long your labour will be before you're there. So you make choices but on the day you do the best you can with what you're given (so to speak).
None of my friends wrote their birthplace with an induction in mind for example and yet many have had to go through the process.
Personally I would read the standard literature on birth and interventions in birth but then have a good read through a number of threads here (about induction, forceps, c-section - ELCS and EMCS, episiotomy, depression) to get an idea as to why and how these happen and what women who've been through them say about them.

My top advice would be to get the best birth partner you can get your hands on. If no one in your family or friends can do it, consider hiring a private midwife or a doula. The likelihood of a male partner being the best is small in my view simply because men have never given birth (although I'm sure Bear Grylls would have been ideal for my birth!).

[goodnightdarthvader1]

This tool might be useful //www.which.co.uk/birth-choice/

A word of warning - for my hospital some info here is out of date, so check anything you're concerned about on your hospital tour.

[birdandbee]

What are the drug options for pain relief?
Is there anything other than pethadine or dihyracodine?
Are these only hospital meds or can you have them at a home birth?

[lilac3033]

It depends on where you are. As far as I know you can have pethadine and dihyrocodeine at a home birth.

[goodnightdarthvader1]

Right (if I miss anything, anyone else please jump in)

In the UK, drug options are:

• gas and air (opiate that doesn't dull the pain, but makes you "high" so you forget about it. Can make you feel sick and dizzy but that passes, and will stop within a few breaths of normal air). Usually available during a HB.
  
• Pethidine, injection (opiate, makes you feel "high", can vomit and feel dizzy. Usually given with an anti-emetic to counteract this.) Sometimes available during HB.
  
• Epidural, spinal injection (the only actual pain relief, which blocks the signals to the brain). A cannula is left in situ in your spine so can be topped up during long labours. Is left to wear off a bit near pushing time so you can push better. Rare side effect is a severe headache after birth. Can result in the use of forceps or ventouse if pushing is hard / ineffective. Not available in a HB.

[insan1tyscartching]

I've had an epidural four times (one ELCS) and the last one with just gas and air. I prefer the epidural tbh given at the first opportunity preferably before any pain if I'm honest. The gas and air birth was fine too but don't see the merits of being in pain when the outcome of not being in pain was exactly the same (all unassisted vaginal deliveries)