Epidural or Diamorphine - please help!

[lucy101]

Hi there, I am in a scary and difficult position where I will have to be induced 4-6 weeks early (which could be tomorrow or Weds) as there is a problem with my baby which could be serious.

The midwife is saying that this means as my body will not like the induction process (and it could take some time) and I need to consider which is the best pain relief: Epidural or Diamorphine (because of another health issue - which is partly why I will definitely need pain relief - gas and air won't be suitable).

I was just going to ask any of your opinions/experiences of either Epidural or Diamorphine just so I can have a little more understanding of how I am likely to feel/recovery /how out of it I might be/ if Diamorphine will really deal with the pain/if either of them will slow things down etc.

Thanks ladies, for any and all replies, feeling very low and scared... especially as I had been planning a home birth....

I had an epidural with both of my deliveries. First baby was forcep, second was C section.

It took me half a day get feeling back and a long long time before I could take a wee. But had no problems with epidurals.

Has your midwife given you the pros and cons too?

It may take a while for your Breast Milk to come in, if the birth is induced and or you end up having a C section by the way. Just keep persisting with putting baby to you for a few days and it'll come in the end.

Wanted to tell you that now before the big event x

epidural is totally different to diamorphine

diamorphine is given via intramuscular injection with doses given approx every 4 hours. it can make you feel sick/be sick, esepcially if you are sensitive to opiates, it is supposed to be much better pain releif than pethidine too. it can make you feel spacy and alter how you feel, so that you can cope better and relax between contractions

epidural is much more complicated, it is done by an aneasthatist rather than a MW who can give diamorphine, you are given local anaesthetic in your back and then the epidural catheter is sited in your back, it can be topped up to keep you from feeling much until it is time to push

with an epidural you will be pretty much confined to bed which can be a big hindrance for labour where being active and mobile is a big help in getting and keeping things going

diamorphine can also make you too dizzy to stand much either, but it can help you dilate as it is a relaxant, however if given too close to delivery it can make the baby a bit sleepy and slower to breathe

also, have you been told how long you iwll have before you will have to have a c.section? induction in a primip where you are not near to your due date can mean days of being given prostin gel and no progress and then a c.section anyway

I'd go for an epidural or a spinal over diamorphine. Although there's a very very slight risk to the baby's blood pressure with an epidural and an increased risk of further interventions in the birth, diamorphine is known to make little ones very dazed and sleepy unless it is given in exactly the right window and can have an impact on their breathing rates and also ability to feed. Not a fun choice, but good luck!

The only pain relief option that will totally take away all the pain is an epidural. If you have an epidural you will need to be monitored all the time, but chances are you will be monitored all the time if your labour is that early. You have a higher chance of needing a forceps or a ventouse with an epidural.

Diamorph doesn't take all the pain away but for many women it lowers the pain to an acceptable level. You won't know unless/until you try it. If you try it and it isn't enough you can still have an epidural. Diamorph crosses the placenta and can make baby a bit sleepy for 24 hours and therefore affect breastfeeding.

Diamorph can knock contractions off for a while. So can an epidural, mainly due to not been able to mobilise. If you're been induced though if they're giving you the synto drip then it doesn't really matter as the drip will keep contractions going.

Good luck with it all and try not to feel scared. You'll be meeting your baby soon.

Thanks ladies - it is just good to hear other people's experience of this.

I had an epidural and i loved it.

i couldnt feel no pain but it is meant to numb you from waist down, i could feel 1 of my legs but the other leg was completely gone, it was a dead weight!

Because i had an epidural i was in a wheel chair. my baby was in scbu (special care baby unit) They done a fantastic job with him.

They done a fantastic job with him. I was in a wheelchair for about 2 days while recovering from the epidural!

good luck

I had both last time actually, one after the other!

Had diamorphine first, when labour had been going on a very long time and I was starting to struggle with just gas & air - but I didn't find it that great for me personally, it made me feel dizzy (had to be careful when standing/moving about) and spaced out but I didn't find it helped me personally with the pain that much. Think I will try to avoid it this time round - but other people seem to have better experiences. If you have ever had it or similar things before for other reasons, you may have some idea how you react already?

Later MW wanted to give syntocin as wasn't progressing, so she advised epidural. With epidural some things to consider are: it will mean you are flat on your back and less able to use gravity/own efforts to help, so may lead to a longer labour and/or more intervention. Also the level of pain relief is a bit variable, it doesn't apparently work 100% on everyone. You will have to have a catheter (which can cause some problems I believe, though I was fine) and it will take a while afterwards before you can get moving again. I can't comment as much on epidurals as mine went a bit wrong so ended up as a spinal instead though.

Proper info leaflet here:

www.oaa-anaes.ac.uk/assets/_managed/editor/File/Info%20for%20Mothers/PR_leaflets/200 9ed3octoaapain_labour.pdf

As others have said Diamorphine won't take all the pain away but has fewer Side effects than an epidural.

If your epidural works well it gives total pain relief, however about 20% don't work that well so people get left with sore patches or breakthrough pain.

Epidruals also have more side effects.

Just seen that my link isn't working - go to the oaa webpage
www.oaa-anaes.ac.uk

You want the "info for mothers"

then "leaflet-pain relief".

You can download it from the site for free.

HTH.

I've had both - diamorphine doesn't exactly take the pain away but it disconnects you from it in a good way. I felt like I was pissed and sang alot (kate bush for DS1, Thomas the tank engine for DS2)- after 40 weeks of sobriety it was a welcome relief. I had it in 1st labour and then went for epidural after 48 hours of not progressing - ended up with emergency section. I had it in second and was too late for an epi and ended up giving birth naturally as wanted. Glad with hindsight that didn't have epi as the liklihood of sections/forceps/bad tearing is increased. Babies a bit woosey afterward but DS2 had no trouble latching on 10 mins after birth and fed just fine. DS1 after c section very different story!!! Although I may be screaming for epi with this forthcoming labour I'm instructing hubby that I don't want an epi and that I can manage on the diamorphine. It's a toughy - it makes some people feel sick and you won't know that until you've had it but maybe try ir first and then go for epi if it's not for you?

I had an epidural after very long labour and back-to-back baby, with no problems whatsoever. Feeling came back in my legs after a few hours, DD was fine and no problems with feeding, etc. Good luck!

I had diamorphine to allow me to sleep during a v. long labour. The baby was unaffected and breastfeeding was not a problem, even after a spinal block and emcs.

I loved the diamorphine.

Hi,

I had an induction (and went from 0 to 9 cms but big baby in face forward position meant that I had an Emercency C Section).

I held out for a long time with just gas and air but was getting double contractions as they pumped up the induction cocktail as my body clearly wasnt ready at all). When the epidural came it was wonderful. After going from being beside myself with pain I was chatting and was still able to push. The Anasthetist was great and although delayed (!) made it pretty painless.Certainly compared to what I had been through it was only as painful as an injection in the arm (the gas prob. helped this feeling).

I would thoroughly recommend an Epidural. Also, you might want to take into account the fact that diamorphine does cross over to the baby
(my brother's wife is a doctor and tells they dont like to use it in NZ). Additionally, if you have lots of changing (and variable quality) midwifes as I did - I ffound it reassuring (since i was having such unfortunately medicalised experience anyway) to have a doctor adminster the pain relief. You'll be monitored anyway so prob. no chance of moving around much (no matter what they say!) so this is perhaps less of a factor when deciding to have an epidural or not.

Hope this helps. Best wishes for the birth.