Tell me about drugs during labour...

[hamncheese]

So, after watching OBEM and seeing that girl completely spaced and barely awake post-diamorphine I'm wanting your opinions on the effect different pain relief has.

This is my first and would obviously like to have as little as possible and take it as necessary but not naive enough to expect not to need anything. One thing I really do not want though is to be out of it and not remember the experience. Would rather be with it and lucid as long as I can manage the pain.

So anyone got advice as to which pain relief they liked/disliked and why, as well as which to avoid if wanting to be mentally as normal as possible during labour and birth?

Thanks!

ooo good question, yes do tell.

To be honest, I had diamorphine and it spaced me out for the whole day, I hated it and would never have it again. This time if I need more than gas and air I will be going straight for an epidural because I can't stand feeling spaced and like I am not really there. I do, however, think that people react differently to it and my friend said that it only lasted a couple of hours on her. I am sure more people will be along soon to give you a more balanced view. Good luck

You only start getting drugs once you get to the hospital (except tens), so between 1-3cm you have no drugs, only contractions. I believe it is during this time you start to establish the amount of pain you can tolerate and which drugs are best suited for you.

If you are in absolute agony, I'd go with the epidural as the pain only gets worse. However, I found the contractions to be more like period pain so I only used gas and air from 1-10cm. I only had to have an epidural at the end as my contractions were not coming quick enough and they had to give me a hormone that required an epidural.

I also had diamorphine, last minute so they nearly didn't want to give it to me! Think I was already spaced out with all the pain and even gas and air!! But not anything like as much as the girl on OBEM. It did help - I didn't even feel the stitches afterwards - but what totally freaked me out was that my little one came out not breathing and I was told they thought he was being lazy due to the diamorphine. He was also 7 weeks early though so that would have contributed (they were ready with the resus table)... but still, to have your baby come out and not cry like you always think they will is enough to put me off having it next time! Gas and air is great. Really great. I think I will cope with just that next time.

First labour- long and slow. Gas and air and pethidine x 2 Right choice for first dose- enabled me to rest and get 15min blocks of sleep. Ineffective 2nd dose- too close to end - didn't alter pain.

Second labour - pool with a little gas and air. Fantastic birth.

The main thing is staying mobile and having a good midwife who you can trust. First pethidine was given at birthing centre and they rarely offer it. I was dead against having it. Midwife explained why and how it could help. Second dose- hospital after being transferred. Given to shut me up.

I loved the epidural, it was worn off when i got close to pushing so i could feel everything, i then had gas and air which was ok but made me talk shit :) I couldn't manage a whole labour on gas and air because it gives me a drunk feeling that i'm not keen on.

Just read milk's post. Yeah I was induced with hormones from 5cm (due to bleeding) and the contractions then came right after each other with no rests between and that was just awful. Before that was easily manageable.

I had pethidine (opiate), it left me so out of it that I was talking about chasing cats up trees. It also did nothing for the pain. Too much gas and air made me vomit at one point, but breathing in and out of the tube helped me focus through the contractions at other points. This time round (37 weeks now) I am going to try TENS and gas and air only. Won't do epidural as I know several women who had one and pushed too hard as they couldn't feel anything and ended up having a lot of recurring pelvic and abdominal pain afterwards.

I went into labour with similar hopes to you op - no drugs (other than g&a unless I really need them or am advised to take). It helped that I stated on my birth plan (which mw read) that I didn't want drugs offered - I would ask if I wanted them. Ended up coping with just g&a, which helped a lot though my labour was very fast and I might have felt different if it had been prolonged.

The triage nurse suggested I have pethedine (sp!) when I arrived in pain but only 2cm. I refused as had heard of 'space out' which I also wanted to avoid. Good job as it turns out, as I delivered within the hour and if I had taken the drugs may/would have affected the baby.

I also used a tens machine to start with - fairly helpful for early labour but I quickly forgot all about it when things really kicked in!

Best of luck.

I only had g&a up to about 8cm. It was a long labour though - it took 6 hours for me to go from 5 to 8cm (in the birthing pool), 24 hours to go from 2 to 5 cm. And contractions for two days before that.

I had pethidine at 8cm, just to give me chance to rest, and semi-doze (I think I managed to close my eyes for about 5 mins) before the final push, so to speak.

I was completely aware of what was going on around me, but in a "I've drunk too much and want to go to sleep" kind of way - DH was talking to the student MW who was with us, and I kept thinking of things to join in the conversation with, but just couldn't be bothered to make my mouth move.

By the time it wore off, about 4 hours later, I was pretty much at the pushing stage. I couldn't even inhale the g&a at that point though, so the way I see it, I did the 'important' bit without pain relief. There's absolutely no way I wouldn't have got there without something earlier on though.

By the way, I also used a 'just 3 more contractions' promise to help put off the drugs (DH kept saying 'just 3 more' and this helped delay me begging asking for an epidural for just long enough not to need it). Not possible for some, granted, but as I said before I didn't have to go through hours of pain.

I was induced and found the pain unbearable. Started off on gas and air, I didn't think it did anything for pain relief and made me feel sick. Then had a shot of pethidine, was still in awful pain and started talking rubbish, It was like being in a weird dream. Finally had the epidural...bliss!

I had an induction with syntocinon.

I loved the G&A, and had that on it's own for about 5 hours.

Lovely stuff. Will be having that again this time (planned homebirth so it's one of the things I can get here) Wears off very quickly, doesn't affect baby. Takes you away from the pain for the duration of the contraction rather than taking the pain away.

I was offered an epidural by the MW (was expected to be another 12 hours or so on the synto drip)

Whilst it was lovely for pain relief, an epidural generally means that you are no longer able to be active (my hospital won't 'allow' women to stand next to the bed with one in, even though they are supposedly mobile epidurals and other hospitals DO 'allow' you to stand). I had absolutely no pushing sensation at all with one in so had to be told when to push rather than follow my body. An epidural also means that the muscles that help to turn your baby in labour don't work as effectively, so it's harder for your baby to descend in the correct manner (they almost all follow a set movement pattern during birth).

I wouldn't opt for an epidural again unless I knew I was going to theatre.

I had pethedine. Was dead against it but not sure I could have done without it. Had had contractions and no sleep for four days and still progressing slowly after waters broke. It got me totally wasted but it gave me some much needed time to rest. This time round id love to do it without it but I'm going to see how things go.

Difficult birth had gas and air to begin with, the pethedine for transfer honestly say it did Nothing at all, when i got to main hospital (started in a maternity unit), i was given a drug called Remifentanil, not sure how many hospitals use this, and ended up like the girl of OBEM, but i could rest for the first time in 2 days and don't have any memories of being wierd although i'm assured by DH and BF i was :), finally had Epidural for forceps/possible EMC delivery. slept like a log that night

For me I used G&A and had an Epidural. I didn't want any pain relieving injections as I don't react well to opiate based pain relief, they make me too spaced out and I go a bit crazy which doesn't help labour for me.

G&A didn't help with the pain, my contractions were coming on too strong too quick, I was on the induction drip. I used it for quiet a bit, made me feel quiet drunk which at times did help, also gave me something to bite on.

Epidural was great once it was in, took two attempts. At first I could still feel my legs and the contractions, it just wasn't horrendous anymore. The downsides were that the epidural site was painful and I was stuck lying on the painful part so not comfortable. Another downside was that it didn't last long enough, I had it in for 24hrs and towards the end was having it topped up every hour which meant it was wearing off every hour and it took 20mins for it to start working again once the midwife had gone and gotten the top up, so for me it wasn't constant.

ayearoverdue apparently an epidural contains opiate - I learned this myself on MN just last week!

yeah the dr discussed that with me but something to do with the method of infusion or mix of drugs meant it didn't give me any mental side effects, nothing like pethadine which has literally had me climbing walls before :)

Not all epidurals contain opiates, you can get them without. Thanks for reminding me of that though flisspaps I am now going to ask my midwife if they use ones with opiates in or not.

i was induced. we started with the pessaries which produced little result and eventually moved on to the synoticin drip. i requested and received a epidural at the same time as the syntocin as by that stage i had been in hopsital for 4 days, was exhausted and really wasnt up for a further pain fest i knew the syntocin would bring.

the pessaries did start contractions which grew in strength but never really progressed my labour. i did have some pethadine and was really disappointed by it actually. I had had pethadine before and found it wonderful. it was like floating on a cloud of soft kittens and fairy floss. this time it didnt do anything but make me really sleepy and grumpy in that "i am drunk and want to go to sleep" way. i was unimpressed and remember asking the midwife if they had given me Pethadine light.

THe epidural on the other hand was a gift from the heavens and the most magnificant thing ever to have been invented. I loved it! i had a mobile epidural which meant that while i couldnt walk, i could move my legs around the bed and i could feel the pressure of every contraction roll through but without the bone splitting pain that had accompanied the contraction. I progressed really fast with the syntocin. i think my labour was about 3 hours from 1-10cm. i ended up telling the midwife that i could feel loads of pressure and thought she had better check and low and behold DD was ready to be born. MW thought i would have had a couple of hours yet.

Someone upthread said epidurals slow the uterine muscle function. Not according to the consultant anethetistist i saw last week in the hospital. Her advice was that the epidural only affects the passage of pain messages along the nerves of the spine. A spinal block however CAN affect muscle effectiveness but you wouldnt normally get a spinal unless you are going into surgery so probably less of an issue.

Hope that helps. good luck. i am sure that you will do fine :-)

G+A is either fantastic at simply making you calm and not really feeling pain, or it makes you feel sick and out of control. The good news is either way it wears off in a couple minutes so you can stop if you don't like it.

Pethidine again can be different for different people - in my case I was off my face as if drunk for the next 3 days (but not for labour... my finals...) and threw up everything I ate for a week. So was told not to have it during birth! Some hospitals use similar but different drugs like Meptid so ask what will be available.

I was coping fine with the contractions after 14 hours but had to get out of the pool after 8 hours, at which point my SPD got so bad I was screaming for anything - I'd written on my plan I was terrified of an epidural but not 100% ruling it out. As I wasn't even noticing contractions, the MW suggested talking to the anesthetist about an epidural. After a long chat about my various allergies/bad reactions to drugs, he put the epidural in.

Quite simply, I stopped feeling anything from the waist down, except when it wore off every few hours. I ended up on max synotocin and admittedly couldn't feel much when I tried to push, but with the pelvis I had there was no way I could do anything else. In the end ds popped out with one push and a ventouse.
I had the 'shivers' for a couple days after the epidural, but no other side effects.

So if g+a and a pool don't cut it, I'll do the same again in the next couple weeks...

Thanks for all the advice all really helpful... going to take this info in my head with me when discussing with the midwife!

Anyone else feel free to add too :)

I went for tens machine and gas and air. I delivered a big baby but it all went really well. It bloody hurts but it's pain that you can totally manage (if dc had of been back to back or there had been other complications I would have gone for epidural though!). The best advice I can give is to remain calm and maintain deep relaxed breathing. I'm so not a calm person normally (at all!) but managed to surprise myself. I did have my mum with me who is a super-relaxed-calm-yoga-pilates type person whiich helped massively so i recommend if you have a mum/sister/close friend like that maybe they would be a good birthing partner (dh just got on my nerves!!). Good luck and don't worry.

G&A - bloody love it. Didn't want or need anything else despite a big OP baby it was that good at taking me away. I did talk an awful lot of crap though and towards the end the pain was constant so I was struggling without it but not very able to communicate with....

G&A didn't work for me. I just felt really pissed and was laughing manically even though I still felt like I was about to die. Felt really out of control and horrible

I had an epidural at about 7cm dilated, just after my waters broke. The way they did it was so that I couldn't feel anything in transition (and got a few hours rest) but I could totally feel to push (so that bit hurt, but I had a long pushing phase and I'm glad I could feel it so that I wasn't wasting energy not timing my pushes with the contractions).

My Obs doesn't believe in pethadine. She says there are too many downsides to justify it these days (i.e. now they've invented epidurals)