Experience with Intraveneous Pain Relief during Labour ie: Pethidine, Fentanyl, Diamorphine?

[orvis]

Does anyone have any experience  with any of these?  I don' t want to get an epidural because my mother really was a home birth fan and she has been thrilling me with the horrors and dangers of epidurals since I was very small.  So lets just say I really have already been conditioned not to want to get an epidural even though I can't stand the sort of pain that labor brings on.

 I understand that there are different types of epidurals but I really just would rather opt for other types of pain relief and since there is no laughing gas administered during labor in this country which sounds horrible really anyways, I only have the choice of opioid synthetics. And yes I have read Ina May Gaskin's 'Spiritual Midwifery".

Do they really help with the labor pains?

Did any of the above endanger your baby or birth do you think?

Was your overall experience good or bad with the pain being relieved or did it even make any difference?

Thanks,

Edited by orvis - 11/8/11 at 12:19am

[rachieface]

I have not personally used an opiate in labor, but have had doula clients do so.  I would say they definitely are not as effective as pain relief as epidurals.  They sort of "take the edge off" and often make mom drowsy, which can help her relax.  My understanding of them is that you still feel the pain, but not as sharply.  Just like any intervention in labor, these drugs have side effects as well. 

If you're really worried about pain in labor, and have already decided not to go the med-free route (which is OK, by the way!), I would look at what worries you about epidurals.  They do up your chances of a C-section by about 10%, but there is definitely no pharmeceutical comparison for overall pain relief.  Some of the downsides of an epidural, such as failure to progress, can be mitigated by waiting until you are well into active labor to get an epidural.    If you have the resources, I would suggest looking into hiring a doula to work with you during labor, because she is trained to help you relax (and thus handle pain better) and can help you delay an epidural or IV pain medication if that's what you want.  Good luck making your decision! 

[orvis]

I am more scared of getting an epidural then I am of going through the intense pains of labor.  I am also scared of all the side effects and possible complications which I am sure every one does already know about.   I am thinking about hiring a doula.

[Imakcerka]

I had an epidural with Baby number 1.  I had planned on going without.  I'm 50/50 on them by the way.  Since I had been in labor for 3 days.  Started on a friday and didn't hit 5 c until late Sunday night I was literally wiped out.  Still didnt have her until Monday morning at 7 am.  I chose to get it late Sunday night and have my water broken. 

Pros

I was able to relax a little while before the pushing and was able to take a nap.

Cons

I was unable to feel anything.  ANYTHING!  I had no idea if I was even pushing right, I couldn't feel it. 

I was told when I was ready, I didn't know.

Migraine afterwards for 2 days, then again a couple of days later.  I was told by my OB that it was from the Epi

Unable to get up and had to use a catheder, Had numerous UTI's up until 6 months post birth OB said it was possibly from that.

I didn't get an Epi with baby number two she decided all I needed was 2 hours for the whole thing.  And wow what a difference it was to feel her coming out and feel my body work to get her here!  Absolutely amazing. 

[Babydoll1285]

I tell all my doula clients and expecting friends, if you want a medicated birth, get an epidural.  DO NOT use IV drugs.  They do not help with labor pains (with my ds, I couldn't stay awake between ctx but I'd wake up screaming at the peaks).  They do have very negative side effects for baby and mom (my ds was in distress and I lost consciousness after every push).  They are bad news.  In comparison to IV drugs, an epidural is not that bad.  

I think you're on the right track to hire a doula.  You might also consider a water birth and Hypnobabies.  Much easier on mama and baby with the combination of the three!  

[justKate]

Quote:

Originally Posted by Babydoll1285 

I tell all my doula clients and expecting friends, if you want a medicated birth, get an epidural.  DO NOT use IV drugs.  They do not help with labor pains (with my ds, I couldn't stay awake between ctx but I'd wake up screaming at the peaks).  They do have very negative side effects for baby and mom (my ds was in distress and I lost consciousness after every push).  They are bad news.  In comparison to IV drugs, an epidural is not that bad. 

I know you've already said you don't want the epidural, but IME (and I had it all--morphine, phenegran, fentanyl, epidural (3 times, actually) and versed), the epi was the least harmful.  Even though they missed the first time.  Even though it kept me from feeling the need to push.  Because the other stuff kept me from remembering my DD's birth, which is what I wanted most.  They SAY that fentanyl is not supposed to blur your memory, and I can't say truthfully that it was the cause (probably the versed they gave me when I got hysterical), but next time, I'm just going to last as long as possible and then get the epi if i need it.  I really want to be present for this baby's birth, even if it means I'm less likely to get my VBAC.  But that's just where the cards fall for me. 

[nia82]

I had some stadol via IV with DS and let me tell you it was horror. It made me loopy, barely as so much as took the edge off, made me feel like I was REALLY drunk and out of control. I disliked the feeling and it left me with a blackout. I had back labor, DH was supposed to be my doula (he said I can do that, no need to spend money) and he was not supportive at all but super scared, so I got scared and caved in when it so wasn't necessary. I don't blame DH for how he was in labor, he's just not the kinda guy who deals well with it and we had a doula with DD, med free and wonderful experience. If you want to avoid the epi or IV meds, get a doula. No kidding. And retrospectively, I'd rather have an epi than IV meds. Being so drugged up is hell, at least for me.

[happyblessedmama]

I had fentanyl with baby #4 and again with baby #5. only had an epidural with baby #1 (very much disliked it).

I found the fentanyl helped with the pain, my children did not show untoward effects from it (nursed well, were alert) and it didn't have me feeling "high". This is different for every person!

If I were to have another vaginal birth again, I would be open to this medication as an option.

[happyblessedmama]

They do not help with labor pains (with my ds, I couldn't stay awake between ctx but I'd wake up screaming at the peaks)

I'm so sorry that was your experience! It is definitely not universal. Fentanyl very much DID help me in a fast-acting, not necessarily long-lasting way. It took the edge off of ctx so that I could deal with them. The 2 labors that I received that med in were ones where the baby was asynclitic and needed manual rotation and the next one was a very large-for-me baby.

[orvis]

Well its nice to hear about every-ones experiences. I am surprised that so many people seem to say that the iv opiates didn't help take the edge of of the contractions.  I'm glad there is a voice of dissent though, it gives me hope that I may not be passing out through the whole thing and may actually be able to just numb the pain a little.  I hope so because I don't want to spend the birthing going in and out of consciousness or nodding off too much, and then waking up during the worst peaks.  Sounds like a nightmare.  Could this really be true?  I hope this doesn't happen to me. 

There is only 1 person who it helped?  And happyblessedmama I see you have had 6 going on 7 kids so you do have a lot of experience with labor that's for sure.  Though seeing how labor is, I'm not convinced that it isn't different every time and with every women.  Even if you think you know what to expect.  How'd you live through that many births?  I started late having kids and now I'm left in the dust, no fertility treatments are affordable for me so I'll have to be content with whatever the lord decides to give me in the limited time I have.  But wow I really think you must have been through so much pain with your births and joy as well of course.

I had a natural birth the first time and I just don't feel I can handle that level of pain again.  The unbearable and body shaking pain of contractions I can not just trick myself into thinking that its not pain.  It was the worst pain I have ever had and the most transformational experience as well as I feel like it was so close to death thought there was no complications it was the most intense pain which each contraction taking more and more of my strength away till I could barely muster any at all until the actual birth which was actually the easier part of the whole process. That part was pretty automatic, no pushing involved, that was when my body did what comes naturally.  But till the point leading up to that ah what a uncontrollable pain, My body really was not 'mine' at that point, and I became an animal wracked in pain. I think I would be putting myself through a lot of suffering that may be able to be alleviated a little bit.  I really hope it does not endanger my baby, I plan on taking the drug with the least risk to the baby.

I don't want an epidural, unless I got it later on in the labor, because I don't want to risk a higher chance at a c-section.  I also don't want to maybe later on after the birth have numbness in one side of my body, I've heard of that going on before.  I don't want to risk that large needle going in my back and I want to be able to feel a little bit, but even a walking epidural for me sounds like a bit too much of a risk.  I don't want to risk the blood pressure drop, or the killer headaches either, or the longer labor and then the cascade of interventions that can come after that. 

I know anything could happen and I have to be prepared that things may very well not go according to plan, but I  had a healthy and relatively fast first pregnancy and labor-birth experience so I hope to have the same again, with a little more then the Bach Health Remedy I was given for my first birth (didn't help at all duh) 

[orvis]

Oh and justkate, you had memory loss maybe not from the fetanyl but from the

Quote

"(probably the versed they gave me when I got hysterical),"

Whats versed I'll have to look it up.  So are your sure it was this 'versed' drug??? Or do you think it may have been the fetanyl.  I don't want to black out during my birth and not remember any of it at all.

And nia82, I had the same experience with my husband, lets just say that he got really anxious when he sees me in so much pain and can't do a thing to help me.  He didn't like to see the suffering.  I don't blame him.  And the stadol was no to you?  Geez that scares me.

And to everyone else about the epidurals, that was very helpful to hear of as well.

I just don't think I can make myself get one, because it's so ingrained in me how they might be dangerous or life threatening, or debilitating.  So I know its a small small percentage, but still I just can't get over the feeling that they are not safe.

[semmel84130]

I did have a dose of fentanyl. I had typed a bunch of stuff about the circumstances, but I deleted it because I'm not sure it's true. I don't really remember this part of my labor. The positive side for me is that it worked. I was able to sleep and they were able to get the epidural in easily - I was so wracked with Pitocin-induced contractions at that point that I couldn't get a hold of myself at all. I felt panicky and out of control. The dosage of fentanyl must have been pretty low, because it wore off after an hour or so, and my baby didn't show any ill-effects from it (she was alert when born, nursed easily, etc). The negative side is that there is a black hole in my memory around this point in my labor. I think it was a great drug as it was used in this instance, because it gave me enough breathing room to get back on track with my labor. I had no problems with the epidural either, so far as side effects go. And we were able to turn it off when I got ready to push so that I could feel myself pushing, which was great.

[justKate]

I blame the Versed for my memory loss because it was administered during my c-section, and that's when the complete lack of memory is--basically from 3 a.m. when DD was born until 8 a.m. the next morning.  I mean, I wasn't unconscious or anything, but I only remember what DH has told me and a few blips here and there.

I blame the fentanyl less because I had my last dose of that nearly 12 hours earlier (per my medical records).  I had back labor (nothing up front) at all.  FWIW my c-section was listed as "arrest of descent, fetal tachycardia" after 32 hours of labor including 3 hours of pushing.  DD was ROP and double wrapped in her cord at birth. 

[AlexisT]

It was definitely the Versed (a benzodiazepine, related to Valium, Ativan et al). It's often given specifically for its amnesiac properties (e.g. fentanyl + Versed for conscious sedation). It usually doesn't last that long though.

[4midablemama]

I don't remember exactly what I had during my labors-Fentanyl with my first and Phernergen with my second (sp?), I think-but I do know that they got me so much farther than I would have gone had I not chosen to accept them. Both of my labors started out with very strong, painful contractions (and I took Hypnobirthing classes both times, I know that using the word "pain" is discouraged, but "surges" just isn't a strong enough word) and were very prolonged, 32 hours with my first and 48 with my second. I went about 16 hours with my first with just the IV pain meds; PP were right, they didn't completely numb me, I could still feel the contractions, but the meds took enough of the edge off that I could work through them and keep my focus. I ended up accepting an epidural about mid-way through because I was making no progress (baby was async, never descended, C-section after 32 hours of labor) and I was exhausted, pure and simple. I didn't like it, didn't like the fact that it stranded me in the bed and robbed me of my freedom to walk and change positions, but I accept that it was necessary. Second baby, pretty much the same scenario; labor was very intense right from the beginning, I was very slow to progress, the pain meds helped me keep focus and helped me avoid the epi for much longer than I would have without them. Went about 38 of 48 hours without the epidural, got it because I desperately needed rest. It served its' purpose, I was able to sleep and re-energize myself so that I could complete my VBAC, and by the time I was ready to push, it had totally worn off; the nurses had actually started to change the battery in my IV pump, got sidetracked and never finished the task before I was ready to deliver, so my epidural wasn't even on for the last few hours before my boy made his arrival. The one difference between my two labors was that whatever medicine I had with my daughter left me totally alert, and what I had with my son knocked out cold. As in, the nurse put it into my IV tube, I felt a chill as it went into my vein, and 20 seconds later, it was lights out. Both of my babies were born totally alert, nursed beautifully right from the beginning, had no side-effects whatsoever. 

I accept that I am not one of those lucky women who can handle completely med-free childbirth. I need help to cope, it is what it is, and it doesn't make me a bad mother. I really feel like I am now confident enough in my own ability to handle labor and experienced enough with how IV meds work for me that I won't need the epidural next time.  

[happyblessedmama]

ditto that versed is given to help patients forget unpleasant procedures (I've not experienced it in a birth related setting, but did request it for one of my kids for a medical procedure. It did what it was supposed to do, and I'm really glad we had that option!)

[DoubleDouble]

I have experience with opioids for non-childbirth pain, and for me, the reaction ranges from "I'm in such PAIN! but hey, I can function. Pain is there, I am here" to "PAIN PAIN PAIN! and yet I don't care!" - depending on the dosage. So I guess those pain meds might work for me.

I have no experience with epidurals, but I think I would try an IV before having needles in my spine. (And that comes after having a bad IV - I have great veins, and that doctor still managed to screw it up. I jumped and told him to stop, he argued it was nothing, sorry dude, I know what a normal IV feels like, that's not what you are doing here. I had pain in my arm and numbness in fingers for a few weeks afterwards. So I'd take my chances with veins before messing with my spine.)

Epidurals have opioids in them too, right?

[lifeguard]

I had pethidine during my labour with dd. I had been in labour for 19 hours through the night & there had been zero progress with my cervix so we were hoping it would give me enough of a break to get at least a short sleep in. I will be honest it took me a long time to decide 'cause I was really against using any drugs at all but as I was quite far from delivering at that point we decided to try it (if you take it too close to delivery when the baby is born they need to be given an additional drug to counteract the pethidine is what I was told). It wasn't worth it. It did absolutely nothing - there was no change in how I felt things & I didn't get a break at all. I wouldn't do it again. The primary reason I had done it was to try to avoid becoming overtired (which was a key factor to the forceps delivery I had with ds) but as it was ineffective I regret taking the risk to dd.

[AlexisT]

I've been told that pethidine (Demerol) is the least effective opioid for labor.

Yes, an epidural contains an analgesic, usually fentanyl. Because it's administered epidurally, it doesn't affect you mentally and it has less of an effect on the baby. Both my epi and my spinal were for surgery, but I loved that I didn't feel pain but otherwise felt fine. No stoned feeling.

[HypRN]

I'm a labor and delivery nurse (9 years) and I can tell you that IV narcotics don't do much at all for pain.  What they do, do is make you care about the pain a little less since you are sleepy and somewhat drugged.  Most women are able to sleep between the contractions but then wake-up with a contraction and feel the pain though it takes the edge off and you are groggy.  While (and after) you receive a narcotic you have to be on continuous monitoring for your own vital signs and the baby's heart rate (yes its serious stuff!).  The narcotics do effect your baby but the effects usually wear off before birth (if there is enough time).  For this reason narcotics are not usually administered after 7cm or so because the baby could be born with respiratory depression.

Orvis - Have you considered a non-pharaceutical method of pain relief like hypnosis?  I used Hypnobabies for my last birth and it worked amazingly well!  I felt no pain until transition and while transition was intense, it was manageable and I had my sweet boy a short while later.  I know hypnosis can sound really "out there" but it is actually very easy to do.  If you would like to read some stories about Hypnobabies births you can go here: http://www.pregnancybirthandbabies.com/POSITIVE_birth_stories.htm