Pethidine

[ShoeJunkie]

DH and I are writing the birth plan at the moment and having a debate about pethedine.

Could some lovely mn-ers give me their opinions please - positive or negative!

Thank you!

I was given two doses of pethidine which completely knocked me unconscious. Did nothing for my pain at all though, and although I was comatose in between contractions, I was screaming bloody murder when they came.

I love the stuff...with DC3 the midwife timed it just right and it took the edge of the pain so got a break (of sorts) I had enough reserve to push.

I had to be induced (waters broke but no labour and I had tested positive for strep B) so for me pethidine was a good alternative to an epidural.

I'd say not to rule any thing out...(well, anything legal anyway). Good luck!

They do nothing whatsoever for the pain but impede your ability to complain about it or even figure out strategies for dealing with it.

You are trapped in your own pain.

But my labour was extremely painful at 2cm.

Funily enough my second labour didn't ever get to the level of pain that I was in at 2cm with my first, and although it hurt I remembered that pethedine and gas and air didn't do a thing so didn't bother with them.

I think it is a mistake to call anything other than epidurals pain relief. It sets up expectations that you can reduce or stop the pain and to find out when you are most desperate and relying on this to be true to discover it is all bollox for at least some women can affect you for the rest of your life and trigger PTSD.

I had it with all 4 of mine. And that second the needle goes in, I was in a wonderful pain-free happy place - but then it wore off - very quickly. It was worth it just to have that moment of remembering what it was like to be pain-free.

No problems with feeding - yes, babies were all sleepy the first day but that was a good thing.

Things you do when you are pregnant - take your folic acid, attend antenatal appointments, avoid alcohol and smoking and drugs, stop eating certain foods - everyone possible to help ensure a healthy baby.

Then, when once in labour, you can be offered a drug which has very poor pain relieving qualities, and which we know will pass through the placenta and could affect the breathing and responsiveness of the newborn (can also affect the mother's breathing too) - I do wonder how on earth that is ethical.

"I do wonder how on earth that is ethical."

It's not. Particularly when it's not very effective as an analgesic.

And that's why lots of hospitals no longer routinely offer it.

They use loads of it at my local hospital, which has major staffing issues. In stupidly busy maternity units where the staff are on their knees from exhaustion there can be great value in heavily sedating the noisiest and most needy labouring women.

From the Cochrane review of evidence pethidine:

"up to two-thirds of women who received opioids reported moderate or severe pain and/or poor or moderate pain relief one or two hours after administration."

That doesn't sell it to me personally.....

I liked it. I felt spaced out to the point that whilst I could feel the pain (I wanted to be able to feel contractions etc) I didn't care about it!

Had no problems with dd being drowsy, and she fed within a half hour. But I don't know when I had it, it was a few hours before she appeared.

Disclaimer - my experience is 24 years old. Pethidine may have moved on since then....

I had pethidine and it really helped. I didn't feel too out of it, just sort of numbed. Until they gave me the second injection. My labour wasn't that long - 13 hours - so why I got 2 injections I don't know. There are large parts of the later stages of my labour that I have completely forgotten. Not unusual after 24 years but I couldn't remember it the day after! I hallucinated - nothing too bad, the very obese obstetrician presented herself as a hot air balloon floating into the room, which didn't bother me one bit, I was very impressed - and I talked utter rubbish. I honestly have never met anyone who owns a pub called the Horse and Trumpet nor have I ever had a candy floss stall anywhere, ever. DP still reminds me of these things.... bless him.

The majority of my labour is a bit of a blur, pethidine really did help with the pain of the major contractions towards the end but did nothing to ease the final ones or the horrendous chinese burn pain of crowning which I still remember. Am too old now to have another but I would have had pethidine again. The hallucinations and the talking crap seemed like a small price to pay at the time.

ime it was crap. Didn't dull the pain at all (I had 2 doses). Knocked me out between contractions so I missed all the space between them - it just felt like one long bloody contraction!

oh yes and knackered me and DD out. Looking back am convinced it was partly the reason why I ended up with the em c/s :(

Had epidural with DS1. Never again (if I can help it!).
Had pethidine with DS2 and I had same concerns, but mostly about possible negative effect on feeding. DS2 fed amazingly and we never experienced any problems.
I had it about an hour before giving birth and to be honest, it was still bloody painful. However, I'm not sure if it was a placebo effect, but I certainly felt like I was managing the pain better with it. I'd have it again in the case of needing something beyond G&A and TENS.

It didn't do anything for the pain for me but it meant I did manage to fall asleep between contractions, which was good as I was exhausted. But really I would never have it again, I felt like a zombie and completely unable to communicate or even think clearly. I had no clue what was going on and I really didn't give a shit when they told me I needed an EMCS as DS was in distress (still feel guilty about that). Took about 24 hrs for me to feel 'with it' again and I was so so tired.

I would avoid unless you are in desperate need of some sleep, and make sure your DH knows how it is likely to affect you and he is ready to take charge and make decisions on your behalf.

I used g&a, tens and natal hypnotherapy for ds. Unfortunately, I couldn't finish what I started and had to have an emcs.

The me gave me a shot of pethadine before I went to theatre. I hated it - felt very out of it, couldn't focus, just horrible.

Anyone have any idea as to why I was given it in the first place? I was too exhausted to ask why at the time, but have always wondered. Was it to relax me before the epidural? Give me a break? Pain relief? All three?? :)

*mw

The only thing that occurs to me is that they didn't think you'd be able to sit/lie still enough to put the epidural/spinal in if they didn't give you the pethidine? But I'd have expected them to at least try first.

Sounds like using pethidine is a bit marmite - some it really suits, others wouldn't touch it with a barge pole. Am not sure on calling its use unethical though - the effects are, to my understanding temporary, and using pain relief in labour is in general a balance of the risks and benefits (like most medicine).

For what its worth, I really didn't want pethidine in labour having reacted badly to a similar pain relief drug previously and due to the concerns raised by NCT (although tbo they raised concerns about everything!). In labour for my first my MW recommended it as I was very tense and in her view this was slowing down my labour. I had half a shot to see how I got on. Did the trick, relaxed me and labour progressed from there but did nothing for my pain.

I had the dose a few hours before my baby was born and no problems with sleepiness.

I would say have a look at the pros and cons of the different pain relief available so if you need it and/or its offered at least you know what you are saying yes or no to.

For me the ethics are about it's efficacy, and whether women are able to make a properly informed choice about using it in labour.

It's NOT a good analgesic, although it has analgesic qualities.

It does provide good sedation.

It would be more ethical if this were made clear to women at the point of use.

I had it at about 3 or 4 cm, and hated it - was hallucinating wildly the whole time, can still remember being convinced that BIL was in the room, and also that the painting on the wall was of Bison, which hugely distressed me for some reason. It wasn't...). DH hated it too, he said I kept coming round and screaming every few minutes, then collapsing back into a doped up stupor. Not having it this time. DS was never a sleepy baby though, and even 2 years on is not a sleepy child (grr), so it didn't affect him.

My mum had it with me though, same stage, and said it was great - gave her a break in ealry labour, and she didn't dislike it at all. I was apparently a very sleepy baby though, so she didn't use it again for subsequent births (and then found that all 4 of us were just sleepy for the 1st 24 hours of our lives!!)

Hated it, hated it. Hated it.
Felt completely out of control. I couldn't move. Pain of contractions horrendous, same level of pain. Never again. Interesting my mw and dh said I was coping better although I've never been so afraid in my life. Also meant DS1 was out of it and couldn't latch, although we'd cracked bf by 12 weeks.

I wouldn't touch pethidine or diamorphine. Go for as many active labour techniques as possible (natal hypnotherapy brill) , water birth excellent, gas and air can be great.....
With epidural as back up

I know this is against mn rules ( posting 3 in a row) but forgot to say
Good Luck!

My hospital doesn't allow pethidine any more, only meptid. I have in my birth plan (am 37+4!) that I don't want either, I hate the thought of being sedated and possibly hallucinating during birth, at least gas and air wears off very quickly!

I had it for dcs 1 and 2. It was a MASSIVE relief.

^ like!