Really struggling with decisions surrounding pain relief - anyone else?

[IGetIt]

Anyone else struggling deciding on what they want to do in this respect. I appreciate it can't be set in stone anyway but I am being asked to look into and make some provisional decisions for my birth plan.

At first I was all 'ill have anything and everything, epidural etc...'

But the more I read about it, I'm just not sure.

The main concern with the epidural seems to be the possible side effects of longer labour, higher risk of needing assisted delivery etc...

I just don't know what to do for the best.

Just go with the flow when you get into it!! You might find it fine or really difficult so you can't really plan ahead too much. Good to understand the pros and cons of each though.

I would say you won't need to plan to have an epidural but don't completely rule it out just in case!

I'd say decide once in labour. I thought I'd want everything under the sun but I actually birthed both babies with no pain relief. Don't get me wrong it hurt like hell but id do it again too.

It hurts a lot. I've done it without and I wouldn't recommend it to my worst enemy. Personally I'd put down epidural and then you are in the right place to start with. If you feel you can do it without then great, they will try to put you off getting one. I couldn't push it was so painful. I was cut and ended up having ventouse.

Second baby epidural and great birth. No interventions, no cuts. I know second baby should be easier.

I think the best thing is to take a ‘see how it goes’ approach.

I had my baby 10 days ago. I was wary of an epidural for the same reasons you say - slowed labour, etc. However in the event, I had agonising back to back contractions for 10 hours and was no further dilated at the end than I had been at the start. My midwife therefore suggested an epidural because the pain was really unmanageable and she said the likelihood of me having the strength / endurance to see out Labour with no further pain relief wasn’t great. And she was absolutely right, and the epidural was absolutely the right choice for me. But had labour progressed more speedily, I might not have needed it.

You won’t know until you’re in it how it will go, so I would just be prepared to discuss with your midwives and listen to their recommendations, based on how labour goes for you.

I knew a few people who had had bad experiences with pethidine and I was firm I didn't want that. However there was a lot of pressure to have it as when you ask for pain relief the midwives can administer it and don't need anyone else so I was offered it a lot despite it being on my birth plan not to. I was also pretty against having an epidural however I was in so much pain I screamed for one. When the anaesthetist finally came I wouldn't let me touch them so didn't end up with that either! So truth is you can plan but you don't know what will happen. I am glad I stuck to no pethidine though. Just educated yourself and make a plan, you don't have to stick to it but it's there if you want to!

I would just read up on all of the options but make no decisions in advance

In my first pregnancy I wanted an epidural, i didnt note it but i made a mental note of it.. so when my contractions increased and i was shattered literally falling asleep in between contractions, i told the midwife 'epidural' she checked and told me i was too late as i was ready to give birth.. a relief in itself! Ended up on gas and air had an assisted delivery at th end. So yeah u cant really plan too much. See how u go...

If you're being pressured for a decision I'd just say yes to an epidural now as you can always decline at the time if you don't feel you need it.

It's hard to predict, loads of mums of more than two have completely different birth experiences.

I would agree with what every other poster has said - make a decision on the day and see how you feel.

I made a very extensive birth plan and it didn't even leave the hospital bag! I'm not sure any of it went to plan! I did, however, have gas and air and pethadine at 2cm as I was in a horrendous amount of pain for what I now know was dd's position. I had an epidural also and the anaesthetist was my favourite person in life by that time! It was wonderful.

Something to note - requesting an epidural doesn't mean you'll have one immediately, it depends on the availability of the anaesthetists in the hospital. I waited around two hours for mine but a friend at the same hospital a few days later got hers within 15 minutes.

I said I would go with the flow, essentially increasing the pain medication with how I was feeling.

Ended up with an epidural (tried diamorphine first, did nothing) however at the time I was only 4cm and I was getting back to back contractions with no break due to the drip. Funnily enough it was actually the midwife who suggested it to me, as she saw the state I was in. I asked her how long labour would likely take and she basically said based on 2cm every four hours, I was looking at another twelve hours.

Hells no. I requested that epidural and got it (I think) about 30 mins later. The guy was lovely administering it and I was the last person on his shift. Actually saw him again later on at the start of his next shift as I ended up needing a top up epidural for forceps in theatre, as my daughter was stuck.

Just go with it. With my first, I didn’t have any pain relief because it wasn’t actually that bad. It wasn’t necessary. I’d have had pain relief in a heartbeat if I needed it though.

I felt the same when I was pregnant with my first.

I felt so much pressure from the midwives to have a birth plan and have intervention (sweeps, booking in for induction when I wasn’t even overdue!)

I found this book really helpful

www.amazon.co.uk/Helping-Birth-Choices-Interventions-Childbirth/dp/1984249622?tag=mumsnetforu03-21

It gives you info and the pros and cons of each medication and things like sweeps and induction.

Like everyone else said, it’s probably best not to have a definite plan but at least you are informed.

I have had two babies OP, I wrote a birth plan with my first, I don’t think it was ever looked at by my midwife as I was 9cm when I arrived at hospital with my first DS.

Birth is not something anyone can plan on IMHO.

Both of my labours were fine, I didn’t need pain relief or gas & air, fortunately I had short labours with both of my two.

My advice to any new mum to be is not to focus too much on the birth, I was pleasantly surprised by my experiences of labour, but it is different for everyone.

Good luck.

I'm due next week and when asked about pain relief a few weeks ago I was all for "everything" as well.
Now I've decided on a water birth with gas and air so I'm likely to be allowed home sooner as partners are only allowed to be with you on labour ward. If you get moved to post natal you're on your own x

Having given birth twice, honestly wait and see.

I decided on no drugs with my first - ended up begging for an epidural. Didn't get one, but did take anything which was on offer (which in my case was pethadine and gas and air).

Didn't even bother writing a birth plan with my second. Had her at home with no drugs (hypnobirthed).

I personally think it is much easier to say you want all the drugs and then, in the moment, say no I'm ok for now than it is to put no drugs on your birth plan and then ask for them during.

@L4uz

I'm due next week and when asked about pain relief a few weeks ago I was all for "everything" as well. Now I've decided on a water birth with gas and air so I'm likely to be allowed home sooner as partners are only allowed to be with you on labour ward. If you get moved to post natal you're on your own x

I may ask about the pool, thanks.

I've already asked my hospital about birth partners.

He's allowed in from beginning to end and then he's allowed on the ward between 8am-10pm but it's only him who's allowed, he can't bring family and things which is fair enough.

Fortunately the hospital I'm with has been fantastic throughout Covid, they have never had any rules about waiting till 4cm etc.., he's been allowed to my scans and stuff.

I'm seeing my midwife again next week so sounds like the best thing to do is say I'll be open to all and not rule out anything and see how I am at the time!

Thank you

From my experience as a midwife and a mum - start from the bottom of the pain relief ladder and work your way up, you may respond really well to something like the pool. Look at something like the positive birth company if something like hypnobirthing appeals (I did it and loved it, online course), yes be open minded but also don’t doubt yourself. If you’re genuinely unsure then start with gas & air, water, a TENS machine, if they’re not working for you then you have other options.

I caveat that with - if you want an epidural, then have one! Zero judgement, your birth your choice!

Good luck!

@IGetIt that's brilliant that your partner is able to visit every day :) I wish the hospital I'm going to had that policy mine is one of those where you have to wait til you're 4cm then the partner is allowed in for the birth but then has to leave if you get moved onto post natal.
They're also forcing covid tests on everyone before they get admitted xx

In my birth plan page of my maternity notes the midwife put start with gas and air and pool, very open to other suggestions.

The instructions I gave my partner was that I wanted to make pain relief options based on keeping me as calm as possible.

In the end I laboured mostly at home with 2 paracetamol. I was fully dilated when I arrived at the hospital. I gave birth in the pool with gas and air available on and off. When I arrived at the hospital I was expecting to be only 3-4 cm as it has only been 2h since i was last examined and was going to ask for all the drugs. The midwife was as surprised as I was that I was so far along.

Something else to consider is that pain relief isn't just there to help you cope with the pain but also to allow you to conserve energy to get through the labour. A friend's labour ended up 4 days long following an induction. She was managing the pain with gas and air but on day 2 she had pethidine to allow her to get some sleep in order to get through to the end in better shape.

My experience is a bit different. I had a homebirth and knew I wanted to do it without drugs. Around transition, I started to feel desperate and would’ve taken anything but obviously couldn’t at home. Baby was born swiftly after and now I’m so glad I didn’t. So I suppose what I’m saying is it’s not a bad thing to decide you don’t want something. Going with the flow of how you feel on the day can be a slippery slope, if you don’t want that.

Be knowledgeable about your options, have preferences, but be open-minded. The situation sometimes dictates and you shouldn’t beat yourself up about the decisions you make when you’re suffering!

My first was a planned Homebirth with hypnobirthing. He was back to back, and I had strong contractions for days. I ended up having all the drugs I could because when you get tired, your pain tolerance completely deteriorates. He was a cesarean in the end (got himself wedged in an awkward position so I never progressed beyond 9cm).

My second (VBAC) was much quicker (about 5 hours), in a better position, and I just used the pool and a bit of gas and air.

@Joeyandpacey I've been considering a home birth purely because I don't want the covid swab stuffed up my nose, I'll be stressed enough as it is without worrying about that!
Weren't you worried about any complications? Are you far from the hospital?

@L4uz honestly the Covid swab is no worse than picking your nose. I can understand not fancying the idea and even being anxious about it, but in reality the the thing they use is tiny. I did mine myself, inside the mouth to back of throat/ tonsil and then up nose. It was as absolutely fine, thought it might make me gag, but didn't it was worse thinking about it.

For me, pethidine was a godsend. Allowed me to rest through 3-4 hours of a long and painful labour, waking up only for contractions, then drifting back off, totally mellow. I loved it,

@L4uz the swab is only round the edge of the inside of the nose, very simple . I had a Covid test in labour before any drugs and I don't even remember having it!