Labor pain relief options

[northernnomad]

Doing my birth plan this week and had thought I was pretty decided on epidural but wanted to get feedback from personal experiences first. Did anyone manage with other combinations or with nothing at all?

Also, where there other things that anyone feels helped them get through the experience?

TENS was really good for quite a long time, but you have to put it on before you really feel anything at all. Very good for early labour (until I got into the water bath and I was around 4 or 5cm dilated then). But hold on to the controls yourself, my dh wasn't fast enough at switching between modes.

Water was truly amazing, got some control back for a while, carried on dilating and past transition I think and into the pushing stage.

It's worth having a go with gas and air early on while you can still learn stuff - I never got the hang of it am still convinced the thing was broken because it worked while I was being stitched

Mine was all too fast for an epidural.

Another vote for the TENS. I was pretty pro-epidural from the word go but I went a long time on just the TENS machine. It's very useful at home - without meaning to scare anyone, you can go quite a while before you are admitted to hospital and allowed anything stronger.

Gas and air was also amazing. I felt like I was utterly pissed, but in a very nice way. Actually between G&A, then an epidural, then a spinal, then the morphine (I assume) after my emcs I remember being absolutely off my face in the recovery room

Water did nothing for me but I think I'm in the minority there.

OK I'm going to say something I have never told anyone before. probably if I checked I would find that I posted it while pissed about five years ago but anyway

I didn't really like having my dh with me in the labour room.

I worried about his reactions, didn't want to worry him, I didn't feel able to shout at him when he was too slow with the TENS or tried to take the pads off while I was contracting, he looked much too calm and comfortable throughout, and the bloody midwife thought he was being so good with me that she retired to the background and just observed. Now maybe she would only have said the same things to me that he said, but I would have trusted that she knew what was going on. It was hopeless HIM telling me that things were OK, how did he know?? She also felt OK to leave me alone a few times because he was there. Then later on, I was clinging to the bed while being stitched, looked round and he was gazing interestedly at the scene of devastation while the midwife stitched away. Not. OK. With. Me.

So think very carefully about what you actually want, and be prepared to be flexible. Because I would never have believed that I wouldn't want him in there.

I was induced and managed with tens, bath and then g&a. To be honest the g&a was amazing and although I thought once they started the drip I'd need an epidural I really felt like I didn't need it. I spent over three hours in the bath and if I could have stayed there I would have, it really helped much more than I thought it would.

I'd say put it in your birth plan if it's something you are seriously considering, but you might change your mind once labour kicks in. Also be aware that while the midwives will try to follow your plan somethimes your body has different ideas, mine had to be completely ignored due to the need for continuous monitoring.

First time I managed with only a tens machine and it was a long 3 day labour.

Second time, it was a super quick labour. From first twinge to birth in less than 3 hours. I literally got into the hospital, water went while checking in, midwife wheeled in yhe g&a, I had a few puffs, then I was pushing without it. I didn't asked for the g&a even as there was no time. I'm not sure if it helped but I did calm down as I was in shock after the water went and the pain became bery intense. But once I was pushing, the pain was gone and I only feel an intense urge to poo. A very very large poo in fact.

I think you just need to keep your mind open on what you need. It might be you only need a tens machine. It might be such a fast labour they can't get your anything but g&a.

Great advice, I didn't realise TENS was so good tbh so will definitely add that to my plan. Does anyone have any negatives for morphine? Bit nervous about it

I don't actually know anyone who had morphine. The thing with morphine is you need to time it quite well, I think it takes a few hours to get out of yours and your baby's system (if I remember properly) so we got told in our NCT class that it's probably best to use if you're knackered and want some relief, because it's not long-term pain relief. It can make some people quite sick.

Anecdotally, most of the labours I've heard about from friends were either quite quick, in which case they managed with TENS, water and gas and air, or really quite slow, in which case they opted for an epidural for longer pain-relief and more rest.

Think a lot of it depends how long you're in labour for & also whether the TENS works for you.

I was in labour for a long time & the TENS was quite frankly annoying! It felt to me like someone was prodding me with a finger saying "oi, oi, oi" in my ear but I may just be very weird! I found warm baths amazing at the beginning.

I ended up being hooked up to the syntocin drip to try & regulate my contractions. I'd heard that if that happens, you pretty much need an epidural, having not got one at the beginning cos no one listened to me I'd heartily agree & would recommend it. I think that's one thing for your birth plan to make very very clear.

Also, I recommend sleep on diamorphine, it's a lovely experience!

Tbh you do have to go with the flow a bit. In my case it was the length of time that meant by the end I'd tried everything, being knackered makes pain hurt more iykwim. If it goes relatively quickly paracetamol, gas & air really will do!

I was induced on drip and had gas and air and then diamorphine. G&A regulated my breathing but did not do anything else for me. Diamorphine helped a lot because it made me feel separate from the pain although it didn't relieve it. It didn't make me sick and baby was born alert even though I had it 2 hours before delivery. If induced this time I may ask for an epidural though. I had unpleasant interventions throughout the birth.

Agree about the length - my.epidural was as much to do with the length of time as the pain

Pethidine and gas and air with no. 1. - the best of the 2 labours
gas and air with no.2 despite begging for an epidural. I would have taken anything if they'd actually given it to me.

Take the drugs, take them all. (is my opinion).

At home with paracetamol, checked at hospital & was 6cm. Offered gas & air but didn't need it for another few hours. Things got very sore & I had morphine injection.

It was sore but I'm glad I didn't go for epidural as I was up & about having a shower a few hours later.

I was pleading for an epidural in the end but I was too late .

I didn't need any stitches either.

I had gas & air which did take the edge off but it made me very ill unfortunately, that said, it didn't stop me wanting more gas & air! I also used water but because my DS was back to back it didn't help me much. I then begged for an epidural but they suggested pethadine which I had when I was about 9cm dilated and was pushing for two hours That part was a bit of a blur to be honest so maybe the pethadine worked! But baby boy was very drowsy for a good few hours after birth. Next time I want an epidural!

I had gas and air, was fine with just that but did have quite a quick labour.

I didnt want anything that could affect the baby like pethidine and I didn't want an epidural incase it meant I couldn't move around.

I found the gas and air quite effective although it took a while to get the hang of having a big breath before the contractions so it worked on them!

I was induced and it got very painful, TENS worked well for a while and G&A was bloody wonderful but when bag no 3 of syntocinon came out and baby nowhere near arriving I went for the epidural, which was pretty much the nicest feeling ever. I was knackered so the pain was getting more severe and contractions less effective. I had to push while unable to feel anything but it worked, somehow! Am now pg again and will definitely go for the epi if induced again (hoping for pool in the birth centre and just G&A if not).

I gave birth in the US about a month ago (so slightly different pain relief options here including no gas and air). I did the first 15 hours with no pain relief, just hypnobirthing. Then when the pain got too much I had fentanyl (an opioid I believe) which was described as lasting about an hour per shot and becoming less effective each time it was repeated. I only had that once since it didn't do that much.

Then I had an epidural. It was lovely. I was begging for help by that stage. I had the epidural at around 17 hours in. Immediate reduction in pain, and very soon no pain at all. But I could still feel the contractions (only without them hurting) so I was well able to participate in the pushing stage which started only an hour later without the nurse needing to tell me I was having a contraction. So it was textbook really.

Afterwards I had about two weeks of back pain. No knowing whether this was due to the epidural or pushing partly lying down due to the epidural or something else. I was 42 weeks and had a big baby and long labour so could have been that or simply how I'm built. But it could have been made worse by the epidural as the lack of pain could have meant I pushed him out faster than I "should" have done.

I would definitely recommend an epidural. Next time (if there is one) I will keep going as long as I can (if the second birth is easier and faster maybe I'll make it to the end on my own). Then I'll have an epidural if I need it.

One thing that interests me is that I often see people saying on here that they were refused an epidural because they were too far on in their labour. I didn't have an internal exam till after the epidural was in so no one checked on me beforehand. It seems like they were willing to give it at any point. When they did check I was at 8cm.

Forgot to mention I also had augmentation of labour with pitocin although the midwife said I never made it past a very small dose so it's doubtful how much it would have contributed to any pain.

Yes I think there's a strong anecdotal feeling on MN that epidural management in the UK tends to be 'it's too early at the moment' 'oh now it's too late' with about a 5 minute [exaggeration] sweet spot in the middle and if you miss that, you tend not to get one. I think the older non mobile epidurals really did slow things down in labour because you had to lie down, and that there seems to be remarkably little agreed evidence accepted in the UK on mobile epidurals, so that there is no culture of early administration. There has to be some reason why epidural use is so low in the UK compared with lots of other countries - if there had been time, I would have liked one, who knows, perhaps I would have had another child??

Yes, I had an epidural (in Ireland) at about 7-8 cm and it was really fine and not 'too late' for anything. 15-20 mins after it was in place I had dilated to 10cms, but I think a combination of no top-ups and midwives making me wait a few hours before pushing meant that I could feel my contractions strongly by the time I pushed and all was textbook w/ no interventions after that.

Hot baths DO give lovely pain relief. However I got a bit fucked off with mine after a while and wanted to get out. G&A made me lightheaded and then puke. Didn't try pethidine as I didn't like the sound of it at all.

joan - I'm really pleased you posted that about your DH. I don't think that I want mine in the room again despite him being great during DC1's birth. I don't know. It just felt like a really female space and I think I felt agitated about him being there and really concerned about the various grotesqueries that he might see at the business end. Most people find that they don't care about that at all once labour kicks in and so they shouldn't - but, annoyingly, I did. He seemed a bit hurt when I mentioned that I'd like the room to myself this time though. I might have to introduce this idea gently...

I have 2 questions if anyone could help me with these, please?

1. What do people think about TENS for second labours, which seem to be statistically much faster? Is there much point?

1. Can somebody please talk me through how to use G&A correctly?! People rave about it but I felt dizzy and lightheaded and headachey like I'd smoked a cigarette or something stronger, and then I had a little vomit. I really hated feeling that spaced out. If I had kept at it would it have gotten better?

I was keen to try without pain relief (hate g&a and a bit scared of morphine and epidural) so just put tens on. When i was still at home I decided I couldn't do it with out pain relief! However by the time I got to hospital I was fully dilated so just got in the pool. That was great for pain relief, unless the pushing stage just doesn't usually hurt much. It slowed everything down though and pushing was a struggle giant headed baby so ended up with episiotomy. I was offered g&a for pushing but didn't bother, had local for stitching up so didn't use then either.

I think a lot depends on how long it lasts, if I'd been told I was only 2cms and still had another 10 hours to go then I would have had some pain relief, it was only the fact that I was almost there that kept me going. Keep your options open basically.

I was induced. Tens was great for ages but once I went on the drip I lasted 4 hours then had an epidural. Gas and air was not cutting it! Glad I did.

With DC1 tried water and hated it, couldn't get G&A to work for me and by the time I screamed out for epidural was told it was too late. With DC2 I was thinking more proactively about pain management and looked into epidural but having to sit still for 30 mins whilst they sort it, plus that you need to stay a bit longer in hosp afterwards made me want to try without. Ended up with G&A that actually worked, and a birth ball to bounce on. And half a dose of pethidine. For both mine have just really wanted to get home ASAP and so tried to avoid any intervention that meant staying longer than necessary. Research the options, have an idea of what you want and be prepared to change your mind a few times when you get there...

An hierarchical plan so I was in control. I knew the steps so I knew what I still had left to try.

Paracetamol
Birth ball
TENS
Visualisations and breathing
Water
Gas and air
Diamorphine
Epidural

With DD1, I didn't go past water. With DD2, the pool didn't fill in time so I went to gas and air.

I knew the last 2 steps were there if I wasn't coping which, perversely, helped me cope!

I am terrified of needles so didn't want epidural. Couldn't go in pool as on continuous monitoring. G&a made me violently sick so settled for paracetomol and biting my lip (and DH when he was close enough). That said, I was rushed to theatre for assisted delivery and had to have spinal anaesthetic (no choice), and the feeling of all the pain going away was very, very lovely.

I started with the TENS machine and it probably worked, though I didn't have anything to compare it to. The only downside really was that I felt completely obsessed with it and didn't want to take a bath because I'd have to take the TENS off. For this next one, I'm planning to forego the TENS and try baths and power showers!

I really really hated the diamorphine. The midwife recommended it because my labour was so slow and I needed sleep, but I felt like it basically made me just pass out between contractions, but the contractions would still wake me up. I then felt groggy afterwards for a long time.

The best 4 hours of my labour were on the gas & air - I started relaxing and moving about a bit.

Finally, as there was meconium in the water (when they finally broke them for me) and dilation was so slow, the doctors strongly recommended an epidural. I remember thinking "why didn't I do this earlier?" - it was a relief to snatch a couple of hours of sleep!

In summary, I like stargirl's hierarchy, though now I'd put diamorphine below epidural and I'd stick water bath in there somewhere

Whatever you plan, you're unlikely to stick to it anyway!

Good luck!