Pain Relief in Labour cont...
6. Painkilling drugs
Pethidine, diamorphine and meptid are pain relieving drugs given by injection into the thigh. Some hospitals offer remifentanil, which is a very strong, short-acting painkiller given via a drip that you can control yourself using a machine.
Pros
- Opioids may help you to relax and get some rest; especially if your early labour has been long and uncomfortable
- Pethidine, diamorphine and meptid can be given by a midwife, so there's no need to wait for a doctor although they may have to prescribe the drug. Remifentanil infusions are set up by an anaesthetist
- These drugs don’t appear to slow labour down, if you're already in established labour.
- They may help you to postpone or avoid having an epidural if you're finding your contractions hard to cope with
- Not all opioids are available at a home birth so talk to your midwife about what you could have if you’re planning to give birth at home. In some areas, drugs like these are prescribed in advance by a GP. Remifentanil is not available at home or in a midwife led unit/birth centre
- It is possible to still use a birth pool or bath during labour, but not usually within two hours of a single dose of an opioid, or if you feel drowsy. Protocols vary so it’s good to check with your midwife if you are considering using a painkilling drug in labour
Cons
- Once you’ve had an injection of an opioid the effects last for up to four hours, so if you don’t like the sensation you can’t do anything about it. For instance, it may make you feel out of control, and feel sick. (This is not the case with remifentanil, as the drip can be turned off and the effects fade away more quickly.)
- All opioids pass through to a baby and can occasionally make them slower to breathe at birth. This is particularly if your labour progresses more quickly than expected and your baby is born within two hours of you having the drug. (Effects on babies are less likely with a remifentanyl infusion than they are with the other opioids because remifentanil is active in the body for a much shorter amount of time.)
- Your baby may also stay sleepy for several days, making breastfeeding harder to establish
Pregnancy & Birth BirthPainkilling drugs
5. Gas & air cont...
Cons
- It may make you feel sick and light-headed initially but the nausea usually passes
- It can dry your mouth out if you use it for long periods
- Keeping hold of the mask or mouthpiece may stop you from moving around and getting into a comfortable position
- It can take a few contractions to get the hang of it so that it's effective at the peak of contractions
- If used with pethidine or diamorphine, it may make you feel even drowsier