What are the pain relief options, pros and cons etc?

[Sparrowlegs248]

37wks today and have been discussing elcs v vbac. No mention of pain relief for vbac yet though other than they try not to give epidural due to increase risk of scar rupture.

I had the spinal for my elcs, and did react badly as expected due to a medical condition. Low heart rate and bp, vomiting. Was under control quickly though as expected.

I know you can have gas and air - how best to use it?

Pethidine I've heard of but no idea about.

What are the good and bad points and what else is there?

this is just based on my experience:

Tens machine - best money I ever spent. Used it from 3cm til they made me take it off at 10cm. Got a 2nd hand one on eBay. Amazon currently have the mama tens for £30. No danger to you or baby just distracts from the pain (sounds rubbish but it worked amazingly for me)

Gas and air: worked really well for me. There is a way you need to do it for it to work properly. I think the mw said you start breathing it before the peak of the contraction so that it has time to kick in before the peak. It makes some women sick. I'm not sure if this passes through to baby or not. I'm sure I read that it does but as it's out of your system after a min it's considered fine for baby.

Pethadine - diff people react differently. It didn't stop the pain for me just made it too out of it to care. I hallucinated and thought I was a child playing in the garden. I was so drugged I couldn't move or talk coherently for several hours. This concerns me. If they had needed me to push or if there had been an emergency I wouldn't have been able to react or work with the hcp. Also I was immobile so probably the same risks as epidural because I wasn't moving. But that's just me. if u can still move and stay coherent I guess it would be better than an epidural. It's an opiate and baby gets a big dose of it too so baby can be very groggy when born and may struggle with feeding etc

Epidural - don't think it passes through to baby. Having a big needle put in your back doesn't sound pleasant but it was nothing compared with the contractions so didn't care. Complete pain relief but u r immobile which increases risk of assisted deliver/ cs

If u google there's lots of info on pros and cons of pain relief

Tens is helpful in the early stages when you can still move around.

I used pethidine in 2 of my labours both were long (1 27hours, 1 9 days) & I used it fairly early on to get some rest as I was exhausted, my experience was similar to Fabs I could still feel the pain but I didn't really care & I was able to get some sleep. It had worn off before transition so I felt 'with it' when I needed to push.

I've had 4 singletons & apart from knowing I definitley didn't want an epidural I haven't really gone in with any hard & fast ideas. It's worked for me, I have high risks pregnancies but seem to labour quite well.

Oh half my paragraph about tens isn't there. I used it with dc who was premature so I was only able to move around right at the start. We were trying to slow the labour so I spent a lot of time in bed. It did still work but not as effectively. It worked well towards the end when I was on all 4's though.

I have long labours (23 hours from waters breaking was my quickest), so my experience will be different to others.

I would without question have an epidural and have it early (4cm dilated is the earliest my hospital will give it). But that's because I've had four children each with 3+ contractions every 10 minutes for 24 ish hours. Staying awake over 36 hours is therefore a significant issue and epidural have allowed me to rest.

Having said that, I only got my epidural for two of the four. I have also used:

• Tens. Pointless in my view.

• Gas & Air. No reason not to. It definately helps take the edge off. My DH says I get possessively aggressive about holding the sucky-thing though. In that I will go ballistic at anyone who tries to take it off me.

• Pethadin. I would refuse this. All it does is make you act drunk. I couldn't make myself understood when I talked because of slurring, I felt very woosie, out of it and not in control. Exactly as you'd feel after 10 vodkas. I was glad when it wore off after an hour or so.

Thanks all. Should clarify, I have already been told they are not keen on epidural as it will be vbac and it increases risk of scar rupture.

I worry that I'll not like pethidine. I vomit very easily!

Gas and air then........ Yikes.

The hospital I gave birth at gives an anti sickness injection at the same time.

FATE your description of what you're like with g&a just made me laugh . I've never used it in labour but found it fairly useless when having a dislocated shoulder put back in.

I found breathing exercises and hot water to be best for pain relief. I had an epidural, but it only took away the pain on one side, not the other :( And it slowed down my contractions, so I had to get on a drip to speed them up, which apparently makes it more painful. Should've skipped the epidural.

www.labourpains.com/home

The obstetric anaesthetic association overview of pain relief options. Also goes over c section anaesthesia.

Has anyone tried remi- something or other?

Don't forget water can be a great pain reliever, and it doesn't affect baby at all. I had a waterbirth with my second child. I got in when in established labour (important not to go in too early but midwife can advise) and OMG the relief! It doesn't take it away by any means but it does soothe you abit and there's something calming about warm water.

It's your choice to stay in and give birth or get out and birth on dry land. But giving birth under water has a lot of benefits, particularly when it comes to not tearing. I used gas and air and the pool but you can use the bath too if you're just using it for pain relief and not the birth.

I'm pregnant now and I'm planning on gas and air and the pool. (Will be at home so only other choice would be pethidine but I have heard not so many great things about it)

Sadly water birth is a no go apparently. Which I'm really disappointed about.

You could always use the bath at home for some light relief until you leave for hospital, or if there is a pool there you may be able to use that for a while?

I think if water wasn't an option for me, I would be trying the Tens machine. I've never tried it before but I think having something is better than feeling like you have nothing.

I didn't have anything but used hypnobirthing techniques. I was long and bloody boring. Thank god for radio 4.

I've heard a lot of good things about ten machines though.

I had an epidural for vbac. And gas and air and diamorphine. No mention of scar rupture risk. Ended up having a spinal and baby born in theatre via forceps delivery. If they hadn't been able to get him out I was prepped for emcs. Go with the flow and good luck!

I used my tens machine since my contractions started getting too much to handle with nothing (I had irregular contractions for 4 days, day and nights). I had a sweep on the Friday afternoon at 40+5, and only needed the tens machine after that when the contractions started getting stronger. I used that from when I got home until I left for the hospital at 7pm. Once in the birth centre I used it until 2 in the morning, when the midwife wanted me to use the ball to try and break my waters and get the baby moving.
I tried a bit of gas and air but it made me feel sick and gave me a banging headache. (It's used my breathing it in. The idea of it is more to distract you from the pain of the contractions I was told).
I then went in the birthing pool for an hour. It was the nicest feeling ever. I felt relaxed and would happily of stayed in there and even delivered in there.
I was given a pethadine injection to make me rest/ sleepy. After 4 days of contractions I was physically exhausted. So the midwife gave me a pethadine injection. I slept from 4 until 5.45. You are still vaguely aware of what's happening, and you can still feel the contractions, but for me it gave me a much needed energy boost. The downside of it is I pushed involuntary a few times and gave myself a few minor tears. But I still think I needed it.
I didn't want an epidural at all, so can't comment on that, if they work or how it feels.

But in terms of what worked FOR ME, tens machine as long as possible, ball, birthing pool (and pethadine because I needed it). Next time I hope for the same pain relief, hopefully minus the pethadine.
But everyone's different. It should really have been discussed though

Thanks all. I was all geared up in my first pregnancy for water birth, tens, hypnobirthing etc. Did NOT want an epidural - squeamish about the needle in the spine. Ended up with a spinal and c section. I was happy with that though, it went well, and I had a great recovery.

I have no yearning desire to give birth vaginally, I am happy with the safest option. But vbac is appealing as there is the chance of no stitches, birth injuries etc and being up and about quickly which will make it so much easier with ds.

But there's a hell of a lot that could happen and I'm wondering if elcs would be more straightforward.

Plan thus far is to have an examination on due date and book c sec if nothings happening. They don't want me to go overdue.

Of course it could all change if my bp raises any more.

Don't have more than 1 dose of pethidine as it makes the baby drowsy and may need resuscitation

Epidural twice - ok but wouldn't do it again if had to do it again.
Best of all Pethadine. Fantastic . But have a anti sickness with it.. they tell you it makes baby sleepy. Fine by me - I've just given birth, so your point is ?? . The reality. She was born at 8, had a feed at 8:30. Went back to sleep at 10.. pm . Midwife poked her at 3 am but she just squawked and went back to sleep until 6.
Has NEVER woken in the night. Slept through from the day she got home but I did co sleep and breast feed.
As a toddler, got cross if woken before 9.
14 now and still impossible to get out of bed...

Pethidine all the way

I'd definitely have it if it guaranteed a sleeper!!

I'm trying for vbac (currently 38 weeks). My entire birth plan is EPIDURAL!!. Anesthetist was fine with that. My cs was 3.5 yrs ago so maybe that's why. They won't induce due to rupture risk though, so it's vbac or another cs.

I have a very low pain threshold. With my first I found tens and gas and air did nothing for me. Breathing and hugging my teddy bear helped more! If I could have the cs without the longer recovery I probably would but I hate hospital stays.

It's odd about the epidural, I'm worried that I'll get to a stage where I need/want more, and won't be able to have it! Also, never having been in labour I have no idea what to expect.

Saying that, every single midwife and consultant has told me different things, so not that odd I guess.

I don't mind the hospital stay, it's attempting to look after ds once I'm home that's my issue.

I've got one DS. My labour was pretty quick (8 hours total) so, although I begged for one, I ended up being too late for an epidural. That was one of the worst bits of labour for me.

Gas and air I found almost completely useless. It didn't touch the pain and the mask made me feel claustrophobic. I did get a bit woozy but that was all.

Pethidine also made no difference to the pain but it did make me relax between contractions, which was nice for a while (until I stopped having space between contractions).

Good luck

I should add - the pethidine made the baby sleepy so he didn't want to feed for a good while after delivery.