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Thinking back to pain relief options, if the gas and air doesn’t cut it and you are begging for more drugs, you might want to turn to the big hitters: pethidine, diamorphine and Meptid.
Pethidine is a usually given by an injection into the muscle of your leg or bottom (yes, there are still muscles there). It takes about 20 minutes to work and is effective for about three hours. The idea is that it relaxes you so that you don’t feel the pain of the contractions with quite so much, ahem, clarity.
If you don’t like feeling spaced out then it probably isn’t for you, plus there can be side-effects. These include feeling shaky and light-headed and vomiting (you should be given an anti-emetic to relieve the latter). The main disadvantage is that it also crosses the placenta, so can make your baby drowsy, and given too close to the baby’s arrival, it may lead to breathing problems. Although these can be counteracted by using other drugs, some women feel that the risks to the baby outweigh the pain relief that the drug may bring. If you are worried about side effects or how you might feel, but feel that you need something to keep the monsters at bay, a half dose might be a good compromise.
Diamorphine is similar to pethidine but – and this is where it gets a bit Trainspotting – it is actually the medical name for heroin. This is handy because if your unit runs out, they can go to the chap behind the bus station and buy a load more on the cheap. (Disclaimer: this may not be exactly how the NHS procurement system works.) Some women find diamorphine slightly more intense than pethidine, offering a deeper pain-relieving sensation of relaxation: As with pethidine, diamorphine can result in breathing difficulties and floppiness in a newborn baby. An antidote called Narcan can be given in extreme cases.
Meptid, or meptazinol, is similar to pethidine but usually causes fewer side effects in both mum and baby. Like pethidine, it is usually administered via injection. The main side effects for you are nausea and vomiting. Meptid doesn’t cross the placenta in quite the same way that pethidine does, so is less likely to affect the baby or cause breathing difficulties. It doesn’t make you feel quite as sleepy as pethidine does. Not all hospitals offer Meptid, largely because it is a more expensive drug than pethidine. It takes a while to kick in (about 15 to 20 minutes).
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