Diamorphine? pethidine..pain relief?

[MissMartin10]

I've got a long way to go yet and always said ill never have a epidural so ive been looking at other pain relief, has anyone got any experience of diamorphine or pethidine and What did it enthrall? would you have it again ect?
Thanks x

I didn't have diamorphine so can't offer a perspective there, but I would keep in mind OP that gas and air can make you feel pretty out of it too!

I had some weird...not hallucinations as such, it was definitely all in my head, but my contractions took on physical properties towards the end and one was shaped like a house So, y'know, still a bit odd!

I had pethedine with my first, labour wasn't long or looking back, particularly painful but I was very scared and young. They gave me a smaller dose than usual because I was quite a way along when I asked for it. It had a very bad effect on me, made me very very out of it and actually slowed and almost stopped my contractions I ended up having the drop. I've had pethedine since after an operation and the effects were worse with the full dose. It's actually written in my hospital notes that I have an adverse reaction to it.

My other 3 labours I just had gas and air it does little for the pain but breathing it gavel something to concentrate on other than the pain, and the mouthpiece is useful to bite down on. My labours were all short, 7 hours with the first just shy of an hour with my last. I couldn't bear the thought of an epidural as I hate the thought of not being in full control of my own body.

I also gave birth abroad (a week ago) where they don't even offer G&A. But then again, nobody will try to talk you out of an epidural, or claim that they are too busy, or that it's too early..oh no, wait, now it's too late.

Had an epidural as soon as I got to the hospital. It was amazing. Didn't feel it going in. Didn't affect my legs at all, so I could happily walk around and also gave birth standing up. But in about 15 min, I went from incoherent with pain to happily chatting, reading my book etc. And baby was born 3 hours after we got to the hospital, so I don't think it slowed anything down.

I have not seen research showing that epidurals as such lead to more interventions - the other theory is that women with more difficult labours (that would lead to more interventions) are more likely to ask for an epidural.

I have not seen research showing that epidurals as such lead to more interventions - the other theory is that women with more difficult labours (that would lead to more interventions) are more likely to ask for an epidural.

The thing is, it's very difficult to separate causation and correlation. I had a long, long back to back labour. They broke my waters to try and encourage things (which I have since learned they should have done with a back to back baby), which stopped things entirely, which resulted in drip and epidural. Which, because it meant I had to lie down and the back pain was stratospheric if not upright, I had to keep topped up (couldn't get through the pain barrier between allowing it to wear off and being mobile again). Which in turn directly contributed to not feeling anything on pushing and needing forceps.

You could argued that it was a difficult birth which was what resulted in forceps (though I'd argue that they also fucked it up). But at the end the position I was in also, I believe, directly resulted in me being unable to push her out uphill. Very intertwined.

In relation to the OP- do bear in mind that not all hospitals offer mobile epidural.

As I understand it (based on the info the anaesthetists give the women who deliver in our hospital) an epidural will not increase the risk of an EMCS however they do come with a slightly elevated risk of needing an instrumental delivery.

With regards to opiate analgesics in my spiel I explain that they won't take the pain away entirely the way an epidural will (if it works correctly). However what it will do (for many women not all) is put you in that state where you've had a few drinks and you stub your toe and without a drink in you you'd be hopping all over the room crying, but because you're a bit drunk you're aware it hurts, but it's tolerable, you're removed a bit from the pain.

I also explain that it can make you feel sick but to counteract that we will also give an anti-emetic but we can't reverse the effects of the drug once you have had it.

I then explain the effects it has on the baby, I explain the sleepiness, dopiness etc you might feel and how it has a similar effect on baby and how due to this we try and avoid giving it to close to delivery as sometimes the babies are slow to notice they have been born and can require resuscitation. As that sometimes scares women I explain that there are always babies that catch us out and come sooner than expected so there are lots of measures we can use if a baby is born very affected, we just try and avoid it if we can as it can be quite scary for parents.

I explain doseage (we generally use diamorphine) and how there are 2 different amounts 5mg and 10mg and the amount of time we can leave between doses (3 hours for 10mg) and the maximum does I as a midwife can prescribe (20mg).

Opiates aren't for everyone but do your research and come to a decision that works for you. Good luck!

thanks everyone! Wow what a lot of different experience's and knowledge! i apreciate everyone taking the time to tell me their experiences .. i am open to whatever may happen and what ever is best for baby.. i don't think its possible to have a birth plan is it?..as so much can change... Thanks again Everyone xx

I think the problem with birth plans is that people think that they can use them to control their birth.

What a good birth plan will do is help it be the best it can it whatever the circumstances. E.g. on another thread a woman who'd had an expected GA for her section said she would have asked for her DH to have skin to skin. My birth plan by DD2 was the long sort that gets mocked on here. But that's because there were a couple of points about various scenarios. Plus some stuff I knew about myself from previous births.

*unexpected GA

Have you thought about remiphentanil? It's controlled by you and apparently far superior pain relief to pethidine or diamorphine. I've not had it myself as I think it's quite new but the 2 women I know who have had it swear by it.

The main thing putting me off an epidural is having to have a catheter inserted! I can imagine that being more painful/uncomfortable than anything else! Isn't it agonising when they take it out..!?

I was open to anything apart from an epidural (unless I needed a CS)

For me it was the thought of not being mobile. I have given birth upright each time (4) never on the bed and I spent all of labour pacing around furiously simply because that's what my body seems to want to do. If your body wants to lie on the bed and rest then maybe an epidural would be nice.

But then I'm always amazed that people go in and have them early and go to sleep. My first labour from first twinge about. 40hours. But I didn't go in until they lasted 1min and were 2mins apart and I was screaming in pain unable to stand up. I was gutted that it still took another 40mins for ds1 to be born. There is do much conflicting advice. Mw said to stay at home as long as possible until couldn't take the pain anymore. Then she happened to be on duty and told me off for staying at home so long. I think you just wait and see and go with what your body wants and needs.

Skeppers I'm sure friends who have had epidurals had temporary catheters just put in to empty the bladder then removed- after they had the epidural so they couldn't feel anything. I think catheters need to stay in for a section but i don't see why they wouldn't wait until after the spinal block to insert them.

Skeppers I didn't have a catheter and could use the toilet when labouring just fine. Are mobile epidurals really not commonly available in the UK?

Skeppers, I was terrified about having the catheter removed but I didn't feel a thing.

Morphine/pethadine Is an indirect pain killer. It doesn't stop the pain but it makes you very relaxed so it's perfect if you have a very long early labour and need sleep to carry on. However it only lasts about 3 hours and you can't have it within about 3 hours of pushing as it goes to baby so you need enough time for placenta to return it, if you see what I mean.

I found it very good for exactly that- enabling me to get some sleep after 48 hours contractions. You can still feel them though.

I didn't have an epidural but did have a cathatar for c section and yes, the insertion was the most pain I experienced. Was petrified to have it out but it didn't hurt at all

We don't use Remifentanyl after a woman went into respiratory arrest using it. Was stopped pretty sharp after that.

Everyone's different though - I had a catheter inserted without any pain at all (baby had got into an awkward position and was squashing my bladder so that I couldn't pee. Oh, the relief of that catheter!) and removal was painless too. :-)

Nope didnt feel cathetar at all. Was only bit that didnt hurt

Ilove Why don't they wait until you're numb to insert the catheter? I don't understand the reasoning?

I thought they put the catheter in after the epidural? If not, I didn't notice it. Taking it out was a momentary sting but fine.

That's interesting, mcdreamy. I was led to believe by the 2 friends who used it that it was the bees knees! Both were on their 3rd labours and both said it was the best pain relief they'd experienced for labour. Is there stats showing if that's a common side effect or is it an exceptionally rare thing to happen? I guess there's a tiny chance of extreme reaction to any drug.

Phew. That's epidural back on the birth plan then!

I had my gallbladder removed a few years back and they had to put in a drain during surgery to get rid of all the excess fluid; I remember being terrified because all the comments I'd read said that having the drain tube removed was the MOST painful thing...but when it came to it, it didn't hurt a jot! Just a slightly hot, tugging sensation, but no pain. Maybe the catheter will be the same, if I need one.

Thanks everyone!

Hazel - not everywhere no. 6 years ago when I had my first even less so.