Talk to me about pain relief!

[PurBal]

Especially if you have experience of an epidural and without. I had a long labour with DC1 (39 hours from waters breaking) and chose to have an epidural for respite. I had a really positive birth experience, felt in control, empowered and euphoric. But the postnatal ward afterwards was hell on earth. My goal this time is to leave ASAP. I had minor complications with the epidural which meant I had to stay longer than the recommended 12 hours.

I had a water birth plus gas/air. Errr lots of G+A. Arrived about 9:30pm, he was born about 5:30am and we were home by 4:00pm that same day- would have been about by 2 but they took ages with the discharge papers.

Other than back labour and a minor tear with stitches it was straightforward and I was quite lucky. He never left our room and because it was "off season" I was in the NHS birth centre private room and not labour ward a few floors up.

No every birth goes this way but the less interventions, the less side effects and knock on effects (eg this pain relief slows down labour; this one doesn't but baby might be lethargic etc etc). An epidural is only done is labour ward.

I was the only one in our NCT that went to this plan. The others had a variety of experiences and challenges out of their control but all seemed to want to get off the labour ward asap.

I'm grateful the pool was an option that night. If I got out of it to be checked it was absolutely excruciating.

Whatever birth plan you have and pain relief you decide, remember you can change your mind on the day based on how you feel and that you are in charge of these decisions about your body.

I've had 2 emergency c-sections.

First I had an epidural at 7cm after labouring for 20 hours. It was an absolute gift of medical science because the pain was horrific due to dd's position.

Second birth I arrived at hospital at 9cm from first twinge. Had no pain relief at all by that point. It was very painful but a completely different experience to first labour and I wouldn't have felt that I 'needed' an epidural as such.

@MyMilkshakeScaresAllTheBoys thank you for sharing, I didn’t have the intention of having an epidural but it was right decision for me at the time.
@Chanel05 I know second births have a tendency to go more quickly so I suppose the factors are varied. I went in at 2cm with DC1 and they wouldn’t check me again as waters had broken. I ended up ok a drip as I had stalled. But I was fully dilated 2 hours before they expected me to be.

I’ve been “helpfully” advised to avoid a c section because I might need an operation on my bladder (unrelated to birth) and the scar would get in the way 🙄 but obviously that’s ridiculous.

Interested if you don't mind at 9cm why you had emc with your vbac @Chanel05 very similar situation as me and I'm still bitter about it and can't decide what to do third time I absolutely hate sections

@MyMilkshakeScaresAllTheBoys they should
If examined you in the pool! Sometimes the midwives like to make life easier for themselves even when we are in agony !

@mrssunshinexxx so I arrived at hospital 3 hours after first contraction and to my utter shock (even though my contractions were very long and frequent already) I was told I was 9cm.

Back waters had gone but front were still in tact and bulging. I was told if I flipped onto my knees then waters would pop very quickly and baby would be coming with them. My dh and I had agreed to me having an elcs (which was scheduled for a week later) but at the time we asked what was the safest thing to go for. As my water was still there, consultant said vbac vs section had no upper hand either way. On that basis, I went for section as I knew what I was getting into. I asked if I could have an epidural if I went for vbac and they said yea, but I knew that they wouldn't really do it because I could feel baby moving down my pelvis and he would be out quickly. I waited 3 hours for theatre but held onto baby and waters, whilst contracting heavily. Perhaps I'm mad! For me, it was just about being listened to, respected and having control.

They took me out to examine... and also try to flip him 😵

I had pethidine with my second, which really relaxed me and labour went really quickly and smoothly after that

Sounds like you had a lovely first birth experience. You could always plan for the same again? I heard from many sources that postnatal wards were utterly awful so I didn’t go there, I wouldn’t have been able to handle it.

My second birth took longer than my first birth because second baby was back to back and with hand above head, so there are other factors.

I somehow always assumed going into giving birth that I wouldn’t have access to pain relief, I guess because of so many stories from others about it not working or being denied or not arriving in time.

I had one 9lber with gas and air and another one in the pool with gas and air.

Before my water birth I'd have laughed in your face if you included warm water as pain relief in labour. But oh my god it was amazing! As soon as I got in it was wonderful. The water was so nice and warm. I didn't feel heavy any more. With the gas and air I had quite a few contractions where I felt pressure but no pain. This was close to transition as well so at the business end.

I was also in my own pool and no one could touch me. I went very primal in my first birth and wanted to rip out the cannula and monitors. Being alone in the water helped with my mental state too.

Second births they can discharge you quicker anyway. I was ready to go 2 hours after birth but they still needed me to do a big wee. Daughter was born at 5:30am and I was discharged at 10am.

@cosmicgarland id be interested as to whether you had any negative feeling towards the pethidine? Forgetfulness or drowsy baby / problems feeding.
@Twizbe weeing was the problem. I was in retention and couldn’t go properly despite 3 massive wees. When they scanned my bladder there was an audible gasp, my bladder was impossibly full.

If they know that from your first birth though they might scan you much sooner and catheterise you if needed.

That's one of the good things about later births, they know so much more about how you give birth.

I had just the pool twice, it makes a big difference.
birth 1
In pool dim lights, it’s like your own cocoon and takes the pressure feeling away if not the pain. On my hands and knees the whole time so knees achey afterwards.
No gas and air as they wanted me to focus (rapid)
birth 2
nothing
lent over a birth ball on my bedroom floor
stuck in front of a mirror which was annoying
pressure and stuff coming out much more noticeable than in water, which I really didn’t like
birth 3
In pool again
No gas and air as didn’t arrive
Had fairy lights but it was day so bright anyway
Made a mood board with favourite photos of sea etc on a big piece of card- idea was if I got stranded on a random floor again I’d have something to look at. Didn’t need it but enjoyed making it.
Did loads of affirmations before and had cards stuck up round the house (then replaced this with little dots as pelvic floor exercise reminders). Things like ‘just as body knew how to grow this baby, it knows how to birth this baby’. Actually thought of a few in labour and found helpful. Also kept me calm in run up.
This time I moved around and stretched out in the minute between contractions and then assumed my favoured position when they started again.

Pools aren't hygienic - there's a reason we use sterile gloves and lube to examine. You don't want to be introducing icky pool water during an examination, we don't just do things to inconvenience people!

Doi anaesthetist

Pain relief options (can read more on the website written by anaesthetists called Labour pains)

-tens machines really effective esp in early stages, can hire them just need to say in advance but only 20quid go buy

• paracetamol codeine liquid morphine (only in early phases)
• gas and air
• pethidine or diamophine injection into the muscle (more likely to former as national shortage of diamorphine) - makes you more spacey/out of it/drowsy than true pain relief
• remifentanil patient controlled analgesia - clicky button that you press soon as you feel a contraction. Not all labour wards have it, there's certain reasons you can't have it, prem/ small babies/severe obesity
• epidural

Epidural is the only option if want true pain relief that you can sleep with and has least negative implications on baby. Would be my choice

Epidural for my first (waters broke 20 hrs before, pessary induction failed so Syntocin (sp?) drip). From no contractions to every 30 seconds from the off!

The only downside was drips in both hands so I couldn’t hold then partner’s hands (he was being a turd so no loss really). Fabulous midwife, had the epidural increased for the 50+ stitches afterwards!

Second time, waters broke (again) at 5am, nothing happening until 12am when the best midwife ever did a quick sweep before I went for a shower.

I didn’t even reach the bathroom! Stage 1 to stage 2 in 2 hours, DD was born at 2.05am (and I was in the car park going home at 2.05pm the next day lol).

I had a friend who was an anaesthesiologist who I’d chatted to through the day (it was his day off) & he warned me that Egor was on call that night - so named as he was the spitting image of Bela Lugosi. Lovely guy but he could get distracted easily!

We’d all been watching horror films together in the ante natal ward (in the old days with day rooms & TVs), so to see ‘Egor’ shamble in to prep me for an epidural (and with a good dose of Pethidine on board making me, quite frankly, off my tits - daughter was back to back & I have a spinal deformity& disease, pain was epic that night)… DH said my scream of horror will forever haunt him 🤣

Got prepped, ‘Egor’ shambled off to get something, and just sitting up for the epi prep must’ve got things moving & by the time he returned I was holding my daughter in my arms!*

I much preferred my first time, but that may have been because my son wasn’t presenting back to back so the initial contractions before the epidural were not as bad as those with my daughter. The only real negative was not being able to feel & control the actual birth (hence why son shot out of me like a cannonball at the Edinburgh Tattoo & the third degree tear that reopened with my daughter’s birth & episiotomy).

*Egor, through our mutual anaesthesiologist mate, became a great friend & really wasn’t offended by the Egor moniker! An absolutely epic guy at the Rock Nights we’d run at the theatre I teched at! So please don’t think I’m taking the piss with the nickname.

I had a planned early epidural. Didn’t see any benefit of being in pain or discomfort. Got plenty of sleep, did my nails, watched Wimbledon and had DT’s. Perfect birth experience.

I had pethidine and epidural with dc1, baby was very drowsy for a day or so afterwards so didn't want to do it again. DC2 I bought a tens machine and was able to stay at home until 6-7cm dilated with that. I had a couple puffs of gas and air at the hospital and had a 10lb baby. Don't get me wrong it stung but I would definitely opt to do that again, the guilt I had after the birth of dc1 was horrible, I hadn't even considered the pethidine would make the baby drowsy. Hope all goes well with your baby

First birth was just gas and air til 10cm when I had an epidural to be prepped for section. (forceps worked) After labouring for hours the relief was pure heaven.

2nd was lovely, gas and air in the pool. Was lovely being able to move about more freely.

3rd no time for anything, only just made it to hospital. I'd say out of all it was that one that sort of knocked me tbh. It was so fast I didn't have any build up or anything.

DS was born after 80 hours. I refused gas and air as it made me feel sick when I had it at 6 months for a dislocated knee. After about 78 hours I was exhausted so they gave me a shot of diamorphine which didn't really make much difference.

@Someo mine were all super speedy which everyone thinks is fab, but it’s really not. Midwives have described my labours as ferocious. I would have liked more faffing time and a bit of pain relief.

First labour very long and ended in an emcs had gas and air and hated it, pethedine and went all trippy and then an epidural and emcs.
second labour ended up an unplanned VBAC but I gave gas and air and pethedine another go and both were great. Really helped. I used my tens machine until pushing whereas I didn’t first time. I got a lot of relief from a hot water bottle first time but they wouldn’t keep refilling it second time I should have taken a flask!
in the unlikely event I have a third I would have pethedine again

I didn’t have pain relief with either (not my choice, both too fast). I had to stay overnight both times so don’t count on getting home asap. First time waters broke 12h before labour started so needed 24h of observations for me and DS post birth to ensure no evidence of infection. Second time DD had her baby check very quickly after being born and her duct hadn’t closed yet and she had a murmur so needed to have a further examination 24h later to ensure all ok. I guess my advice would be to get pain relief if you want it, you can’t count on getting home that day if you go without.

First time I had pethidine after an hour of horrific strong and close together contractions but was only measuring 1cm (induced with pessary a few hours earlier). Made me feel completely out of it and drowsy to the extent apparently I kept falling asleep on the toilet leaning on DH... But from that 1cm examination to birth it was 3 hours so still very much under the influence of the drugs and didn't feel in control during labour at all. DS however didn't seem affected by it - no issues feeding and whilst he had a good sleep that night he still fed without issue.

Second time, had been admitted for induction but no drugs given as it was too busy, but waters had broken in the morning anyway and occasional contraction throughout the day. 30 mins of frequent strong contractions just before visiting hours kicking out time so was examined but only 3cm but with a soft cervix so advised to walk around for an hour. Did that and contractions were thick and fast so re-examined whilst screaming like a banshee (mortifying....) but STILL only 3cm. Had paracetamol and screamed out for pethidine if it was still so far off but they wanted the paracetamol to have a chance. However less than 20 mins later I had involuntary pushing and DD was out 5 mins after that, before DH had even made it back to the ward from the car park!

That was shortly before midnight, and because all had been smooth and simple (despite the ludicrous speed) I was asked if I wanted to go straight home instead of post-natal ward, which I did and was tucked up in my own bed by 2:30am. So if things are without issue second time round and you're happy you can be out of there in no time at all!

1st birth- induction, horrific long lasting pain until epidural.

2nd birth - naturally started but needed an epidural due to not coping with pain on just gas and air.

3rd birth - only thing on my birthing plan was epidural. However the anesthetist was busy...the midwife came in with a shot of diamorphine but I was ready to push so never got it. 2 pushes and he was out.

I think pain wise it was only about 10% more painful than where I had got to with the previous births before I had the epidural - but it was much quicker this time so I had less time to be in pain.

Didn't even feel the 'ring of fire' when pushing him out, only relief. And that was the bit I had dreaded the most.