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!

Best way to remain lucid is to not go for conventional methods - DS2 I did hypnobirthing. For 12 hours it worked and was actually pretty pain free.

I still find the last 3 hours hard to remember I was in that much pain (coincidentally this was when medical staff started interfering).

I've had diamorphine twice in my life: once for a broken ankle and dislocated ankle when it was superb, effective pain relief and although it made me talk nonsense a bit I still felt relatively in control.

So I was quite pro diamorphine when they offered it to me in childbirth but it was a disgusting experience and I would never ever repeat it. My circumstances were a bit different though because my DD was stillborn (which I knew at that point) and I suspect narcotic analgesia is much less effective in that sort of situation - like having a bad drugs trip. Basically if it hadn't made me throw up and completely unable to talk or stand up I would have said they'd given me a saline injection. Worse than useless. No idea if the G&A did anything. I sucked on it for all I was worth but was only conscious during contractions so not well qualified to say. Couldn't feel what I was doing, utterly out of it.

With DS1 I had an epidural (refused all narcotic analgesia so they didn't even offer G&A). It was wonderful. Complete pain relief but I could feel everything. DS1 turned OP at the last minute and I wanted to push too early so they topped up the epidural to make that feeling go away. Totally compos mentis and able to cope with everything - apparently I pushed very well

DS2 was too quick for an epidural, though I had a nice chat with the anaesthetist about all the risks till the midwife sent him away because DS2 was basically suddenly crowning. Was offered G&A tried a couple of puffs but it interfered with my breathing so I flung it across the room. I was in the zone, warrior woman and gave birth very quickly with absolutely nothing.

All three births were inductions (first two with drips and drugs 3rd waters breaking) but proceeded fairly smoothly after that. HTH

I wonder if the time you give birth has any effect on how much you remember. WIth ds, I'd been in labour since 10am and gave birth at 6; a day's work, basically! I remember it all clearly.

With dd I gave birth at 1 am, having been awake since 6am due to ds; that one is already (12 weeks later) a little hazy. I wonder if it's because I was already knackered. Although I do remember trying to have an intelligent conversation with the student midwife in between sucking on g&a, then having to say, 'oh, hang on,' when I suddenly decided to push.

In labour with DS - he was in back to back position, which is apparently more painful, and, being my first I was in labour for about 16 hours. I tried:-

1. Tens machine - did absolutely nothing for me
2. Gas and air - took the edge off for the first few hours until the mw insisted on breaking my waters for me, then the pain just became unbearable
3. Pethadine - made me totally spaced out but didn't touch the pain
4. Epidural - I wasn't given a choice in the matter because they had to take me into theatre and do a ventouse delivery - was absolute bliss, though a bit weird being totally zombified from the pethadine and unable to feel anything as well.

With DD there was no time for anything other than G&A as I was 8cm by the time I got to the hospital . I was coping well with absolutely no pain relief before that and thought I must have ages to go. An almost enjoyable birth experience compared with the first time!

I had pethidine with my first labour. I had been labouring with very slow progress for about 24 hours by this point, hadn't slept and was exhausted. I was also quite tense and stressed, which wasn't helping labour progress.

I had the pethidine and the relief was immediate and immense. I totally relaxed, it felt like I had been submerged in a warm bath. Then I slept for about 40 minutes. When I woke up I needed the loo and discovered my waters were bulging. I was talking to the midwives on the desk, telling them I felt a bit drunk, but happy drunk (!) when my waters suddenly went like Niagara Falls! From that point I was cleaned up (managed to completely soak myself when waters went), then went straight to delivery. I think the pethidine allowed my body to completely relax and get on with labour without me stressing and slowing it down.

DD was born about nearly 3 hours after the pethidine was administered, she was completely fine, not sleepy at all and breastfed right away.

Anyway, that was my experience - I was worried that the pethidine was going to make me hallucinate about giant squirrels or something but it was a very useful tool in the end and I was lucky that I didn't have a bad reaction to it.

I agree with nearlymumofone I found if I kept calm and breathed slowly and deeply, in through my nose out through my mouth, I could completely manage the pain. I used tens for first stage (no idea if it helped but it seemed comforting) and the pool for second stage (water was great) and then I delivered out of the pool as the midwife wanted gravity to speed things up. I wasn't overwhelmed by pain at any stage, although I was overwhelmed by feeling like the baby wasn't moving when I pushed. But it all worked in the end, and my conclusion afterwards was that no available drugs would have helped me. Very grateful for my amazing experienced midwife who gave me so much encouragement in transition and didn't lose faith in me! DS was 9lb and left me with only a couple of small grazes, thanks to water and to clear instructions from mw on pushing/ not pushing during crowning. The main challenge for me was exhaustion, rather than pain.

I had a 40 hour labour and after about 30 hours was induced with the syntocin drip as I wasn't progressing quick enough (was still only 5 cm). After the drip was administered the pain was excruciating. I tried gas and air first and that made me feel out of control and vomit straight away. Then I had pethedine which didn't take the pain away but made me feel really spaced out. I didn't have an epidural. If I were to do it again I wouldn't have any pain relief as they just made me feel worse.

The only advice I ever give in regards to pain relief in labour is keep an open mind. You may find that you can cope with nothing or some G&A or you may want to go the whole hog and have an epidural. IMO if you have a headache you take a painkiller so why be a martyr and go without because you're having a baby? Again just my opinion.

I was induced with a pessary which kicked in after an hour and was... intense to say the least. I started with paracetamol and a bath and when that didn't help I had a go on the G&A which again, didn't touch the pain but it gave me something to bite down on focus on during the contractions. When they examined me and broke my waters I was only 4cm so decided to have an epidural because I was in so much pain and obviously I didn't know how much longer it would take (only thing I said I didn't want was pethidine because I didn't want it to affect the baby). Have to say I LOVED the epidural! Once it kicked in I was able to rest and gather my strength for when I had to push. The only time I wished I wasn't so lucid was when the mw thought I was going to tear badly and said she'd have to do an episiotomy. I think because of the epidural I was able to stay calm and do exactly as she said and I just got away with a graze.

I haven't read this whole thread, but I;d like to join in with my experiences. i've had 3 kids, the last a couple of weeks ago. The first was posterior and so labour was very long - I ended up having gas and air on the first day, diamorphine on the second and an epidural on day 3. I delivered naturally and to be honest there are draw backs and plus points to all methods of pain relief. With my second child, labour stalled at 6 cms and so I had an epidural which I didn't really need as by the time I had it, I was pushing, so I wish I'd held out a bit longer. You don't really want a big needle in your spine unless you really need it! With my third, I read a lot about hypno birthing. I didn't actually take a course as I live abroad and there weren't any. However, it really, really helped and I delivered a 10 and a half pound baby with absolutely no pain relief and [ whispers to avoid sounding too weird] I actually enjoyed it. I think, that a lot of it is in the mind and if you can get your head around not being totally scared and freaked out by the thought of what's ahead, you can actually cope with a lot more than you think. I know that this is not true for all cases - I welcomed the epidural on my first and it meant I could rest for the first time in days - but in my opinion, looking into hypno birthing is a good idea . Good luck!

I found tens very good in early stages and it gives you something to do at home rather than just worry about the pain. I had gas and air once in established labour and found this was enough for me. My labour were 12 and 10 hours from onset of regular contractions so not marathons but not short either. Gas and air is good as it is out of your system straightaway and doesn't affect the baby so you can feel all your endorphins as you're meant to feel them after birth. It is helpful to regulate your breathing during contractions. Also you can feel much better when you need to let go of your inhibitions and push.

I went in with an open mind re pain relief. Luckily for me, I had straightforward labours which were reasonably quick. I had a couple of tokes on the G&A for the first one but not until the pushing stage- I found that really counter-productive as I just sort of couldn't be arsed to push :) If you are using G&A, I would advise putting it to one side for the 2nd stage if you can bear to.

For the second one, I used a TENS until I got into the pool. I found the water wonderful pain relief. It didn't take the pain away but helped me cope with it.

As far as I'm aware, epidural is the only thing to truly stop the pain. Everything else just takes the edge off it a bit.

Good point libranlady I'm a firm believer that our state of mind can affect how we experience pain. My first labour (during which I felt really panicky, frightened and out of control) was far more painful than the second (at home, much calmer, in control, no fear), by a long way.

My pain relief escalated like this:

0-3 (I'm guessing, not in hosp at the time) hot water bottle
3-4 - tens machine (then went to hospital)
4-6 - tens machine and paracetamol
6-8 - birthing pool and g&a
At this point I had to get out of the pool as they needed to break my waters which still hadn't gone...

I put tens machine back on and had that and g&a, however after about 10 mins i knocked the tens machine fell on the floor and it smashed! After lovely warm comfort of birthing pool I was only just hanging on and simply couldn't get back off the bed (I had v bad spd), so I demanded more drugs - got offered pethadine, meptid (sp?) or diamorphine. I went for diamorphine.

It was fab . That and g&a together were super lovely. Still felt all the contractions and the pain, but really didn't mind, all felt like an adventure and quite fun. Which I admit is probably a bit odd. Chatted away to poor midwife and DH, breaking off for a bit of a cathartic bellow when a contraction hit, then resuming said conversation like nothing had happened. I didn't feel dopey or anything.

Gave birth just over an hour after having the diamorphine, kneeling over the back of the bed which I fully profiled.

If I hadn't had to get out the pool, I reckon I would have managed it with just g&a, and possibly if the tens machine hadn't broken I may have done it without the diamorphine. However that little bit extra so near to the end worked out really well. Didn't seem to affect DS at all either as he came out bawling and rooting and started feeding pretty much straight away. Possibly because I had it so near to the end it didn't affect him? Not sure - would be difficult to time it accurately though!

I had TENs only for a long time, until they told me the gas and air was there to be used.
then they took it off me in the pushing stage (not fair, cos i've seen others use it while pushing)
my friend who was at the birth told me it was because i looked like i was too dependant on it (i didn't agree with this opinion - the bloody stuff ran out, and noone believed me because the valve was faulty, but i kept sucking on the mouthpiece because it was quite interesting, sucking with nothing coming out (it just went stiff under the pressure of the suck - it must have looked like i was really really sucking it in.- ) i got them to let me have just the mouthpiece because i wanted to have something to concentrate on.

i was quite appalled by that episode of obem, because the girl was very young, and it wasn't explained to her what would happen, she was just offered it.
she should have been offered TENS or a bath first, i think.

I loved the tens machine for both mine and I wouldn't be without one if I have another child. The first time I found g&a made me nauseous but the second time it helped. Both my births ended in emcs as I couldn't progress after being in labour for days. For DS1 I had an epidural and that felt wonderful but I had to lie down and I don't know if that is why I didn't progress properly. For DS2 I only managed to get to 4cm on g&a and tens and ended up getting a spinal block and a section. The spinal was bliss after all the contractions and I actually enjoyed being in the operating theatre.

First was induced and back to back. Went strait into full labour right away and was born within two hours. Epidural was great so much pain I couldn't bear it.
Second was home birth with an 8 hour labour and only gas and air much more pleasant experience. Although did have to wait for midwife to arrive before I got it. (about 3 hours before birth) Instead of opening the door and saying hello I just said "gas now please"
I think it depends on the labour, position and situation. Friend of mine did hypno birthing and said she felt nothing.

I just had gas and air, it was better than I ever thought possible! I was lucky though - two very fast labours - DS1 was back to back and although I dilated quickly the pushing went on for an hour or so. I had nothing to compare it to though, and as i say, it was quick - not sure how I would have coped with a marathon labour.
With DS2 I barely made it into the delivery room and just had two big 'tokes' of gas. When the midwife went to examine me she said 'oh, there's the head!' (seriously, I thought I was having a large during-labour poo ) I had more gas and air while they were stitching me - marvellous stuff!

Same as post above - gas and air with ours and DC1 was back to back too. Love gas and air. It can make you woozy, but if you stop for a few seconds you go back to normal.

Gas and Air:- made my head feel as though it was just resting on my neck, not actually attached, iykwim. I said to a friend, it's like after a night out, when you are so drunk and get into bed and actually think you'r still in the nightclub. It also makes you say weird stuff, "but DH, I don't know how to say "the head is coming" in Russian, what are we going to do?!" is one of many examples.

Diamorphine:- Actually loved this. Didn't affect me, mentally, but I went from feeling every contraction to only feeling one in three or four. I said to MW "oh no, my contractions are slowing down" and she said "but you are having one right now?" Couldn't feel it.

Epidural: - just numb, from the boobs down. Had forceps (thought I may need EMSC hence the epi) and was cut and had stitches and (obviously) didnt feel anything.

I hated the G&A at first, but had to have my contractions sped up with drip, so I had to learn to like it as it did help the pain.

Had diamorphine for my first birth and it was brilliant (even the coloured dogs which appeared everytime I woke!). Was in labour for 24 hours so I really needed the sleep and was still able to push properly when the time came. As soon as baby born I felt so well and happy. Second birth (18 months later) was so quick I didn't have, or need, any pain relief. Third birth (20 years later) was incredibly painful and the hospital I went to didn't give diamorphine - I did plead for it though. Eventually I had an epidural which took away the pain but meant that I couldn't/didn't know when to/push at all so had to have an emergency ceaser in the end.

Strawberry was also induced and gas and air didn't do anything but had the epidural and it was wonderful. Didn't try pethadine so can't comment on that.

loooooooooooong induced first timer backtoback labour: G&A: hated it. Made me hallucinate. Oh, and it made me sick.

second baby: had regular Alexander technique lessons during pregnancy; had my Alexander teacher present at the birth. 4 hour active labour. No pain relief required at all, she just used her hands to remind me to free my neck muscles between contractions. Highly recommended.

EPIDURAL

That's all

Everything else was just a distraction. Had a great anesthetist and her epidural was enough to numb the horrendous pain I'd been in previous to that point but not so strong that I was immobile. I was still able to move around and get into different positions for labour.

The midwife brought me a matress to lay on and I felt a lot better after that as I was beginning to feel a bit uncomfortable after 12 hours on a chair.

DW had an epidural.