Experiences of Pethidine

Ps, I know all the arguments about intervention, but I'd much prefer intervention to pain, myself.

Mears, I was definitely not having a go at you. Your posts always seem a model of sanity. I'd much rather have you attend a birth of any child of mine than to have another version of me there! However, I don't think all midwives share your view. There do seem to be some very militant, anti-pain relief enthusiasts out there (I read quite a bit of the AIMS site and it made me shake with anger - there is a bit describing midwives who offer pain relief as not having 'dealt with their own issues around pain' - when it's clearly not their issues we are talking about!). I personally know of three women (I may be unusual but this is true) who opted for private elective caesarians because they did not want to face the possibility of hours and hours of unrelieved pain. And I do feel the same. If I felt genuinely confident that I would not face this scenario - so sue me, I don't enjoy pain! - I might think of an alternative to a cs. I understand that if the head is visible it is quite probably too late for an epidural (!) but that's not always the case. Indeed on the AIMS website one midwife describes trying to persuade women not to have one by telling them that they are further on than they are and that 'they are doing well'. I can't imagine how a woman in pain and in labour could have the strength fight this kind of thing - which I consider to be bullying. I think it is wrong and patronising to assume a woman doesn't know what she wants. There seems to be a quite frequent infantalising of women who are pregnant or giving birth - think of all those maternity dresses with virginal prints Peter Pan collars that women had to wear not so long ago. I think refusing/discouraging pain relief falls into the same category. If I asked my dentist for pain relief, I don't think I'd be too impressed if he refused, saying I was 'doing very well'. I'm not sure why birth is different. I certainly think if more women could go into birth thinking their wishes would be respected - whether those wishes are for full and total pain control (me, please) or for active birth, or water birth or whatever, then this could only be good thing.

CAM, literature I read suggested that pethidine works in only 20-30% of cases and I didn't fancy the side effects for dd either. By saying I "only" had an epidural I meant that I had no other form of pain relief during my long labour. my sciatic pain and vomiting were the two worst aspects of my labour and I was glad to have had an epidural because it meant I could be conscious during my emergency c-section. I was the one who asked for an epidural and still feel the same about pethidine. each to their own.

When you have the waters broken,which I did in both my labours when the baby's head was right at the cervix and ready to be delivered, it simply allows the second stage to progress. I think Jaytree you were in transition when you couldn't speak as that happened to me. The second stage contractions take your body over and are all about expulsion not dilation so feel very strong (and painful!)

I had morphine for both my labours - just one dose and it helped. I found gas and air didn't work - made me nauseous and I couldn't stand faffing around with the mask. First labour I hung on for as long as possible till there was no options left and then had the dose - baby was born about 3 hours later. It did make me a bit dreamy but I was very tired anyway. Don't think it slowed labour down and I managed to deliver fine. However I found I didn't sleep well for about a week afterwards.

2nd time I think because I knew what to expect and my body had the drug before the experience was much better. I had the morphine again late on in labour but it had hardly time to take effect before baby was born. I had no bad side effects this time.

Someone I know pointed out that it's pretty much impossible to say anything speeds up labour because you can't compare the same woman giving birth with that intervention or without it, IYSWIM.

I think it was having my waters broken that hastened my labours rather than the pethidine in itself. The ctx got so painful after ARM that I was desperate for pain relief. But if I'd known that ARM could speed up labour so much and that I was so close to delivery I'd not have bothered with pethidine.

I don't know if pethedine speeds up labour but it does have a relaxing effect more than other opiate analgesics - thus its use in gallstones/kidney stones etc - relaxes the tubes and allows the stone to pass.

I had 2 lots of pethadine for my first labour-I think-I was out of it for quite a while after that.I had to ask dh about the labour afterwards because I was a little out of it to remember much then.They gave me such a strong dose I was also talking a bit of gibberish although I realised I had and shut up after that.it made me sleep in between contractions and I woke up to the sound of the midwives telling me to push each time.So for my next labour I still wanted pain releif as they refused me an epidural on the grounds of my AS and previous GBS infection of first baby.So I asked if I could not have such a strong dose of pethadine and coped with the labour concentrating on my breathing and it was much more pleasant.And nice to recall exactly the whole labour.

Just scanning this but those who had pethedine seem to mention that the baby was born quite quickly afterwards - muscles relaxing????. I know my daughter was born 2 hours after first pethedine (which I loved, btw). So, is there any evidence that it does speed up the birth at all?

aloha, were you to have another you might well find that labour progresses naturally or faster than you thought, you're too late for drugs as mears says (assuming no problems which mean c section etc) and it's not as bad as you thought. I'm not saying that anyone should have to suffer pain if they don't want to, not at all, I don't think pain = good and drugs = bad, not at all, I just wonder whether circumstance may change your mind at some point. A c section just for this reason alone seems extreme to me. Imo, imo etc etc.

I haven't looked it up but I doubt that the rise in sections is due to women opting to have elective sections due to extreme fear of pain or the fear that there won't be any drugs available, surely? I'd have thought it is much more likely that the rise is due to medical management of labour or insurance or something rather than this being a women led thing. Anyone know, I really would be interested?

Aloha - any woman in my care who requests an epidural will get one if it is possible/advisable. Sometimes it is not possible because the anaesthetist is in theatre with someone else having an emergency C/S or other operative procedure. During the day there are 2 anaesthetists, but at night there is only one who stays in the building 'on call'.
Sometimes women come in in advanced labour with the head visible. There is absolutely no point putting in an epidural at that stage because the baby will be out before the epidural is effective. If the head is not visible and an epidural is put in during second stage, it is highly likely that this will result in a forceps delivery because the pushing sensation is lost.
Sometimes women who come in asking for an epidural change their minds when they find that they are more advanced in labour than they thought they would be, and that the experience in not as bad as they imagined.
Often women asking for an epidural do not have a clue what the procedure involves and think that it just means they will have their baby with no pain involved. When they realise they will be stuck on a BP machine, drip, monitor and that labour can be slowed down by an epidural, increasing theis chance of a forceps/ventouse delivery, they are not so keen. Many chose to see how they will get on without it first.
For women who are truly terrified of labour, an epidural is given very early on at the outset if they present in time. It is not actually that often that women come in too late. I have also had women who have had epidurals first time round and did not want to have one again because of the lack of being able to walk around during and immediately post delivery.
I am not a fan of epidurals for uncomplicated labour, as you are aware from my previous posts, because it is an intervention that is not without side effects. However, they are invaluable for women running into problems and I have been there advising women to have one. There are far more women out there delighted that labour went well enough for them that they did not 'need' an epidural. In my experience they outweigh the women who feel they were denied adquate pain relief for labour. It is the same argument about adequate pain relief after C/S. Many women are very sore afterwards and feel they had inadequate pain relief. The thought of a C/S terrifies them. However, your experience was that it was not that bad. You probably have a high pain threshhold and wouldn't find labour pain that bad either. It is all relative and I would hope that in the main, midwives try to meet the needs of all individual women as best they can.

I have to suggest, for those who believe the rise in CS rates to be a problem, that they might consider that one of the reasons why a so far small but rising number of women choose a cs is that they don't trust hospitals/midwives to offer sufficient pain relief. I know that I couldn't allow myself to be put at risk of experiencing the kind of agonizing pain so many people describe on this site, but as even Mears admits, if epidurals wear off, they often aren't topped up. I have read the chilling comments on the AIMS site where midwives boast that they'd rather do anything than organise an epidural and that they are very proud of women who refuse them (very strong implication that they rather despise the ones who don't). They also talk a lot about persuading women not to have one, which I suggest accounts for a lot of women told, 'no you are too far along' only to find they have hours and hours of pain ahead of them, or being told 'oh you don't want you, you're doing so well.' I would find this totally unacceptable, myself - in fact, it makes me feel very angry at this patronising high-handedness. I personally know friends who have gone straight for cs because they don't beleive they will get adequate pain relief otherwise. I thinks AIMS positively fetishises pain.

I think there is a bit of confusion here about 'mobile ' epidurals. There epidurals are at such a precise low dose that you can indeed walk around, supported ofcourse. However, when they need topped up it must be done immediately or any pain relieving effects are lost. Not all midwives are trained in top-ups and the anaesthetist may be unavailable in theatre. At our unit we do not provide mobile epidurals for those reasons.

Sam29 - the type of epidural given in our unit sounds like the ones you describe. Mobility is still retained so that you can move about fairly well in bed, but you would not be able to weight bear. After the epidural is inserted and a dose of local anaesthetic is given to ensure it is effective, a continous infusion of low dose local anaesthetic is started which keeps the epidural effective. Sometimes additional top-ups are needed which are given by the anaesthetist. Mixed with the local anaesthetic in the infusion is a drug called fentanyl which is a painkiller. Not all units do the same thing because they all have various degrees of success with different methods. I think though that the aim is to ensure pain relief with as much retained ability to move as possible around the bed. I remember the epidurals from 20 years ago and women were 'dead' from the waist down. That is only the case now with epidurals and spinals prior to C/S. HTH.

Jaytree, an epidural or spinal block are painkillers that don't make you feel out of it at all. Completely yourself and lucid, in fact.

gingernut, that sounds so much like me, espec. falling asleep between contractions, only to be jerked awake by the pain of the next one.

ok, susanmt, have it your way. be as smug as you want.

Aloha - the problem with mobile epidurals is that they require 2 people attending the mother (that includes usually the partnert+ MW)... because she still needs to be supported (at least to avoid any risk of her falling!) That is why some hospitals aren't keen.... At least that's how I understood it... Mears?

I'm not saying I am pleased about feeling smug about not needing an epidural. What I meant was that an epidural was the one thing that I was sure I didn't want (given the problems a lumbar puncture had given me) and even with the other complications I had I know an epidural would have been wrong for me. I am pleased that I managed to stick to something I had planned when so many other things went differently to that which I had hoped.
There are things about most our birth experiences which we are pleased with ourselves about, no matter what kind of experience we had. I was pleased with myself second time round as I didn't have an assisted delivery. I think we should be allowed to be smug about the things we managed the way we wanted.

Sam29,

I think I had a `mobile' epidural. I was never given to understand that I would be able to walk, just be able to move a bit on the bed, which I could (certainly couldn't have walked). But by that time I didn't care as I just needed some effective pain relief so I could sleep (I had a very long labour, and pethidine was no good for me - see my earlier posting). I think it is impossible to predict what will work for you until you are actually in labour. I started off with TENS (which I think worked), then gas and air (very effective for me, but some people hate it), then birthing pool with gas and air (great). But eventually I gave up as I was so exhausted that I was falling asleep between contractions (dropping the gas and air tube in the water) and then waking up mid-contraction, at which point gas and air no longer works (you have to start inhaling it as you feel the contraction starting). So I opted for the epidural which gave me total pain relief (and a chance to sleep) but I think it slowed things up even more.

I think you are wise to find out as much as you can about the different pain relief options available to you but be prepared to be surprised by your labour, one way or another!

Incidentally, my labour was probably so long (about 48 hours - sorry, I don't mean to scare you) because ds' head was not in the optimal position. You may improve your chances of a straightforward labour by going around on all fours before the birth.

Good luck!

Agreeing to Pethidine was the biggest mistake of my labour. It wasn?t on my game plan as I was uncomfortable about it crossing the placenta etc. etc. I was coping really well on gas and air but the labour was very long and I was knackered but ok! My midwife broke my waters (despite previous midwife who finished her shift advising her that I was coping fine and should be left alone). She seemed rather impatient and wanted to get on with it regardless of my feelings...Be warned, be prepared if they break your waters as it can immediately lift the pain into very new realms of agony. I was so unprepared for it that I pannicked and agreed to any drugs she could offer. I couldn?t sit still because it hurt so much and the idea of an epidural seemed ridiculous - there was no way I could hold any position for more than 2 seconds. I was so angry that she hadn?t warned me of how much it could spped things along and offer pain relief beforehand. Against my better judgement, I agreed to pethidine. It had no effect on the pain, just made me feel sick and slightlydrunk - I was was unable to speak and yet my brain was still functioning. I remember the midwife leaning over me and telling my husband in a loud voice not to worry as I was out of it and likely to talk nonsense. I was so furious - I was not out of it, in a lot of pain and unable to communicate my distress. I am sure the pethidine was also responsible for my daughter to become distressed and sleepy - her heart rate became very erratic 20 mins after taking it and it has been text book perfect up to that point. This created panic amongst the midwives, suddenly the room was full of people discussing options loudly, ignoring me and my husband and frighteming us both to death.....turned out ok (avoided c section by 2 mins, ventouse and inevitable stitches..) and she is truly wonderful, but the whole situation was awful. I really regret not standing firm and allowing my body and gut instinct to stand up to the midwife and not have my waters broken - at least ask her what to expect and get prepared for it. Taking pain relief is a great option for many but please be aware that it can take away your clarity and therfore your feeling of control and communication - this can be a very scary experience. I don?t want to frighten you, but I feel really strongly about this and feel cheated that my special event was so badly managed and so frightening. I guess what I am trying to say is stay in control of your labour - for some that might mean pain relief to help cope, for others this could well mean as natural as possible and allow your body to guide you. Just make sure that you get to choose what speed it goes at, not your midwife.

Fantastic if you can do without an epidural... but so blooming what if you can't? We all have different pain thresholds and, more importantly, we all have different labours. I had an epidural after 24 hours - most of which was spent stuck at 4cm. Yes the pain was bloody awful but, more importantly, I was shattered and been told that I had at least another 12 hours ahead of me (which proved an underestimate). If I'd been told that I was a few hours away I might not have bothered, but I equally wouldn't be kicking myself now if I had.

But I don't think I "failed" in any way - or that I'm weaker than those who managed to go without. Comparisons are only valid when they are on a like for like basis - use them when trying to select a package holiday, a new car or a mobile phone tarrif. Don't waste your time trying to apply them to something so fundamentally unique as giving birth.

I tell you, the 'interfering' in your back is a lot less noticeable and no more painful (though possibly less pleasurable) than the interfering in your front that got you pregnant in the first place

me too !!

i really get cross with people who are smug about not having had an epidural.