No idea of pain relief

[LouM10]

I am 27wks pregnant with my first, and unsure what pain relief I want. I've heard a lot of the painkillers may leave the baby drowsy when born, which I want to avoid as it may cause breastfeeding problems. I also think I don't want an epidural, as I want to get out of hospital asap. Grrr... I hate not knowing about things

read books - thats how i became a fountain of knowledge first time round. Am prenant again, 23 weeks gone, and i dont remember all of it but i would definately recommend gettingna TENS machine, they are amazing!i actally dont think i wud hve got thru the early stages without it.

Mine was really good, had a + and - button which wud turn it up and down when a contraction came on and generally as u got further into labour u would turn it up a notch every hour or so. u can rent them for like 4 to 6 weeks around ur due date or do what i did - buy one on ebay, better still a car boot sale. that way u can resell it and make a bit of money back on it.

i also had gas and air, which again i loved. these are the 2 things i was on the whole time thru and together provided me with lots of distraction from the pain.

the midwife kept moithering me to have some pethedine (becos i was so happy in early labour they was sure the pain wud kick in soon and id be in agony- it never did!) so in the end i just said yes to get her off my back but i dont believe this did anything - an injection in my bum by the way, which hurt and i didnt feel any different after it!

i avoided an epidural like the plague, hate needles and the thought of one in my spine...no way.

thats my experience anyhow! whens ur due date?

ooh thank you. Never thought of a tens machine. I'm due 27 September and bloody terrified haha. I am also especially miffed as I have a lot of dizzy spells, but my bump looks like I've had a large meal. I'm standing there angry with everyone for not offering me their seat, even though I know it's not their fault as they obv. don't realise I'm pregnant. haha

ur 27 weeks pregnant and people dont even realise yet?! how lucky r u!? i look about 6 months pregnant already. are u eating the same as pre pregnancy? im scared im eating too much, went from one meal a day plus snacks to 3 meals and snacks and seem to have put loads of weight on altho i dont seem to have put it on anywhere other than my belly luckily.

To be honest, i had fun during the first stages of labour, the only painful hard work bit was the pushing which took me an hr and a half first time round. and went much faster than that. ul be totally fine. would defo suggest tens machine tho, best 20 quid i ever spent.

I'd also recommend a TENS machine. They don't work well for some people, but if they do work for you they're brilliant because they're the only thing you can use in really early labour, before you even go to hospital.

Gas and air: brilliant.

Pethidine: works by kind of woozying you up and distancing you from the pain, rather than reducing the pain. An anaesthetist once said to me that it shouldn't work, but some women like it. Others really hate the sensation. I went into labour thinking I'd avoid it, but not ruling anything out.

Don't rule out epidural. If you don't need it, it's a good idea to try to do without it. If you do need it, it can be fabulous and can, in some circumstances, make it more possible for you to have a straightforward labour and out of there quickly.

Bottom line: read up on the different forms of pain relief and their pros and cons. Go in trusting your body to tell you what you need. You may be lucky and not need much (some women are!). You may work your way through the whole menu and be very grateful for the lot. Be flexible.

Good luck! Hope you have the birth you're after.

Honestly? I'm totally pigging out. I think what little bump I do have, is mainly fat anyhow haha. Luckily I'm quite tall so I can put on a lot of weight before it shows.

And I was thinking that in the early stages, to just stay at home in a bath, as I've heard of a lot of 1st time births taking ages, and they just end up getting sent home till they are further on. God, there's so much to think about haha

I wouldn't rule anything out but this time round I have told my husband that whatever happens he must not let them give me pethidine.

I had it last time and it didn't work on me but ds came out and slept solidly for 3 days! No problems with breastfeeding or anything but the 'baby doctor' decided we needed to stay in for tests as it wasn't normally for baby to be so sleepy - I'd had pethidine and a quick labour FGS! Had to stay in 2 nights whilst my son was treated like a pin cushion only to be told there was absoltely nothing wrong with him!!

Sorry - rant over - but it really ruined what had been a fantastic birth experience

I would not have diamorphine again - it doesn't actually numb the pain and I found it very difficult to concentrate on the contractions as I was basically off my tits, so ended up being slighty panicy.

Also, though I have no proof of this, I think it may have made the initial stages of breastfeeding more difficult. DS wasn't latching on properly, but because I couldn't feel it I didn't do anything to change his positioning - my nipples were already cracked by the time I got home.

There are lots of websites and books with ideas to cope with pain in labour.
Good preperation (So you feel confident) like hypnotherapy, antenatal classesw
Good support on the day, possibly a Doula or a calm experienced female friend or relative with you can help.
Distraction, water, movement, tens
Gas and air (passes out of your system within seconds of breathing without it and does mnot cross the placenta.
All other drugs can have more serious effects on you and your baby effecting breathing and often breastfeeding behaviour
e.g.

Pethidine: EFFECT ON BABY- a depressant effect on the fetal respiratory system (2-3 days to get out of the system), problems with breastfeeding,More likely to cry in first month EFFECT ON MUM- Drowsiness, loss of control, disorientation and dizziness, Hallucinations.
Diamorphine (AKA Heroin) : EFFECT ON BABY- Depression of breathing, Fetal heart rate changes, Distress, Jaundice, Reduced sucking reflex, EFFECT ON MUM- Sedates. Has a secondary effect as a muscle relaxant, which may lessen pain and reduce muscle tension, allowing faster dilatation. May reduce pain .Nausea, Vomiting, Dizziness, Depression of the breathing (reducing oxygenation of the blood)
Epidural: EFFECT ON BABY- four times more likely to be persistently posterior, Hypoxia leading to fetal distress., Visual skills and alertness decreased, Adverse effects on motor control, breastfeeding behaviour, EFFECT ON MUM- Fever. Itching. Shivering., More likely to need assistance with the birth., Interferes with the release of hormones that control breastfeeding/bonding and normal labour.
10% only work partially or on one side.
Drop in blood pressure
Some rare but serious complications from long term back pain and headaches to paralysis and death.
Lowest level of perceived satisfaction after birth

More info here-
www.homebirth.org.uk/pain.htm

Selina

I would read up on all the methods and then keep an open mind. I used gas & air for one of my labours and gas & air + pethidine for the other. I wanted to avoid an epidural because pretty much everyone I know who had had one went on to have an assisted delivery.

Gas & air is brilliant, pethidine doesn't help with the pain but makes you feel very drunk. It didn't stop the baby breastfeeding at all in my experience.

Your questions about pain relief for your first baby are totally acceptable. But in reality you won't know until you are in labour what your pain threshold is. At the point that you feel you can't go on, you would willingly be hit over the head with a blunt object if it meant you didn't have to go through another contraction.

Pethadine and epidurals have their advantages and disadvantages and everyone reacts differently to them. Some people swear by massage, warm baths etc which just didn't work for me. The difficulty with a first baby is that you are trying to make a decision when you are totally lucid and rationale. When labour kicks in big time, you go totally off your head and the fact that you read some research about the impact of epidurals on breast feeding etc etc becomes completely irrelevant.

I had an epidural and it was a bloody miracle of modern medicine as far as I am concerned. I had endured 9 hours of intense pain and within 20 mins it had all gone away. I got some sleep, had a cup of tea and some food. My DD was born by ventouse but you know, it's not the end of the world to have an assisted delivery! I was fine and she was fine and we had no problems with breastfeeding or bonding.

Final point - despite the pain - being in labour and giving birth is by far the most exciting and amazing thing that I have ever experienced.

I would definitely read up on all the options so that at least you know what you're asking for when it comes down to it. E.g. some people don't realise that epidurals aren't always successful (only 90% judging by SelinaDoula's post) and if the epidural doesn't work properly, you can be stuck in bed unable to move but still in pain. That happened to a friend of mine and she wished she hadn't asked for it - it hadn't occurred to her and no-one had told her that it wouldn't definitely work.

I'm hoping for a water birth and am aiming for a home birth as well, partly to ensure that a pool is available. I'll also have a TENS handy. Gas and air, and pethidine, are options I'm open to but would prefer to avoid as I hate the drunk, sick feeling you can get from that kind of drug. I have some weird health issues that mean an epidural would be more difficult and more likely to not work, so I'm putting it in my birth plan that I would really prefer to avoid one as I don't want to deal with the complications and side effects when it's quite possible it won't work.

As someone else said, read up on it all, so that you know the side effects and risk factors.

Think about the heirarchy of pain relief - there are so many graduated things you can do which will help, from warm baths to massage, aromatherapy etc. Gas and air worked well for me, it doesn't stop the pain but alters your perception. If you don't want things which affect the baby, best avoid pethidine and epidural. Don't fight the pain - it will hurt like nothing you have ever experienced, but try to work with the pain rather than feel scared of it.

Also - and I know this might sound daft - breathing through your contractions helps massively!! At my ante-natal classes we had 2 sessions with a physiotherapist who showed us how to breathe and various positions that would help and that we would feel comfortable in which was really useful. It all felt a little false and uncomfortable in the Health Centre, but once we actually got down to the real thing was very helpful.

Your MW should be able to give yo a list of the ante-natal classes and tell you a bit about what happens in each one. I think they can vary from one Trust to another.

Breathing really works, it can get you very far.

I had an epidural with my 1st and deeply regretted it as it made the pain worse for me as baby was prosterior and remained so until the birth. Awful experience.

With my second I only had gas and air for the last 15 or so mins (accidental home birth) it was great, wouldn't call it so much painful as more fast and intense, I stayed focused on my breathing, luckily all was fine.

Tens machine was useful to me during the home stage of the 1st birth.

Oh and buy Maire Mangan's book with the rainbow relaxation set, good luck

I used the birthing pool at the hospital and it got me to about 7cm! Then they broke my waters and then my contractions really got started.

As Tootingbec said, you don't really know what you can cope with until you get there. Definitely go in with an open mind.

My 'birth plan' (if you can call it that) said "take it as it comes". That way, if I ended up with an epi or cs I wouldn't be disappointed (for want of a better word) that it hadn't gone the way I wanted. And you can do without the pressure of pain relief/threshold targets.

FWIW, and please bear in mind that individual cases do not disprove huge studies, I had pethidine and DD breast fed fine after a 20 hour 'kip'. We did lots of skin to skin cuddles on that first day, and I offered her feeds every couple of hours. After a sleepy start, she woke up and hasn't looked back (back to birth weight after 10 days, over 1.5lb on after another fortnight, and counting).

Good luck! And enjoy your last 13 weeks of a baby free household. Make the most of it

I read everything I could find about different kinds of pain relief. Was prepared to try anything as needed, and go along with what the midwives recommended.

In the end, I got to 7cm dilated at home by sleeping a bit (it was the middle of the night)and breathing through the contractions plus 2 long baths and paracetamol.
Then got to hospital and pushed DD out without any relief in the end. It did hurt, but only a stingy feeling and only momentarily. What people don't tell you is that inbetween contractions, you actually just feel normal, so you can gather yourself for the next one.
Just go with an open mind. Enjoy your baby free days, life changes like you'll never know (but it's bloody brilliant).

Thanks everyone. Part of me wants to say I won't rule anything out as I have no idea what I'm going to be like. (I almost pass out if I stub my toe, so probs. not great.) Think I will read up and try and pick a few things so I have a few options if my first choice isn't doing the trick.

Liking the idea of a waterbirth, just found out I can rent my parents house they have been trying to sell, so shall be moving in there within the month. Because of this, I am now going to look into a home birth as living in a small upstairs flat with 2 kittens, this wasn't really a possibility before.

So much to think about. Thanks for all the info and opinions though. I know that different people can react differently to the same drug, so it's still all a little bit 'AARRGGHH' haha

Just remember, nearly everybody ends up, at some point in labour wanting drugs.
Usually I find around trasition, I think it triggers this feeling of 'I just want it all to go away' Usually I nod/wink at the Dad's because its often a sign things are progressing well and the pushing etc might start soon.
If you are in hospital it is very tempting to just have something, as its there and easily available, and somk of the midwives even push women to have drugs, even if their birth plans say they don't want them!
Women in labour can be very suggestible, so a midwife commenting
"Ooh, looks like you've got a long way to go, or you're not coping so well' better have some pain relief" can make you doubt yourself and end up having something even if you don't want to.
I keep toying with the idea of startying a class for Dad's/birth partners in natural ways to help their partners get through labour and releive pain.
Would be interested in anyones views about whether
1 You think it would be a useful course
2 If you're partner would go to it!

Selina

SelinaDoula, that sounds like a wonderful idea.

It's not just about your pain threshold. Baby's position and various other factors are relevant. Coping without pain relief is in part down to luck so the competition that some mothers get into is best ignored.

I had epidural which was ineffective and then pethidine in my first. I didn't do skin to skin and ds was sleepy and bf was a disaster. For me either pethidine or an epidural were not an option in future labours. With dd1 I spent time in the bath, then used TENS then G&A. It was very relaxed and calm - in hospital. With dd2 - 5 wks ago - labour was faster and her head was high so twonk of midwife tried to convince me I wasn't in labour until my waters went. It was less than 3 hrs after that and I just used G&A. Twonk kept trying to convince me to have more pain relief. No idea why as I felt fine. Even at transition although I did vomit everywhere - sadly not over the twonk!

Read up, insure your birth partner is knowledgable too. Keep an open mind and if it doesn't go according to plan there is still no reason why bf won't be ok even if it takes some time to establish.

Most important thing is to stay calm.

SelinaDoula... that sounds like a good thing to do. I think a lot of things concentrate on the mother and baby, so something like that would be great.

And mollycuddles... I can't stay calm haha. You hear all these different stories, and I'm pooping myself now so God knows what I'll be like when the time comes haha. Trial and error i guess till you find what works for you. Thanks for your help

LouM10 - i really thought i would panic when i went into labour (history of anxiety) and what actually happened was i descended into this zone of absolute calm. I honestly don't think i've ever been so serene and confident in my whole life. I managed the first 4 hours of labour by standing at the end of the bed and rocking through contractions, and the latter half with just G&A....though i had a local anaesthetic just before an episiotomy.
I did get to transition and wobble a bit, but had great midwives who talked me through it.

As others have said, arm yourself with the knowledge of what is available to you. And when the time comes you will do what is right for you at that moment in time.

SelinaDoula - sounds like a great idea. My OH is up for learning anything that will help.