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Experience with Intraveneous Pain Relief during Labour ie: Pethidine, Fentanyl, Diamorphine? - Page 2

post #21 of 41

ooh, jumping on the hypnobabies bandwagon! My hypnobabies baby ended up as a necessary emergency c/s, but the tools - they were awesome and really helped!

post #22 of 41
Quote:
Originally Posted by happyblessedmama View Post

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.

 

This was the same for me. DS was alert and nursing right from the start and had no problems. He was born 2 hours after I received my only dose.


Quote:
Originally Posted by HypRN View Post

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


This was totally the case for me, and I'm really thankful for that.  I had planned a homebirth, but ended up having to transfer to the hospital after 6 hours of pushing when I started to give up. By the time I got to the hospital (1.5 hours of driving), I was out of my mind with anxiety and completely exhausted, so I didn't have the confidence or stamina to keep going. As much as I had planned on a homebirth, I was asking for an epi at that point. The midwives there said that I didn't need one since I was so close, since they could feel baby's head... I told them it had been like that for hours with no progression, and I couldn't imagine how I could go any longer. They gave me a dose of fentanyl and put in an order for an epi, but said it was at least an hour's wait. About 5 minutes later my head had cleared, my ctx weren't right on top of one another, and with their amazing coaching, I felt like I could keep pushing, and 2 hours later DS was born. It didn't hurt any less than it did previously, but I felt like I could DO it again.  Later, DH told me the anesthesiologist came in while I was pushing and the midwifes told her she could leave, since I was doing fine. 

 

The other thing I have to say about reducing your need for pain meds is to have a care provider you trust. I totally trusted my homebirth midwife, but we both got to the point where we thought it would be best to transfer to a hospital. Because it wasn't an emergency, I had the option to going to the hospital 1.5hours away where there were amazing midwifes who trusted me and coached me in my weakest moment.  If I had gone into the closer hospital (5 min away), I would have been wheeled into the OR within minutes of my arrival. The trust and support I got gave me an amazing amount of strength that I never knew I had!

 

post #23 of 41
Thread Starter 

Wow its all a lot to digest, thanks for all the replies. Guess its quite the debate, I guess everyone has different birth experiences.  I hope I fall on the side of it helping me.  

 

I have not looked into hypnotherapy, I had a midwife for my first but had to go to the hospital because of the pain, but it was too late the doctor said for any relief at all even the epi I was begging for, so I had to do it, no other choice.

 

cat13 trust is very important, I have to say I trusted the assitant more then the midwife, though I trusted the midwife up till I was in labour and she started getting all tough.

 

Getting in the bath did nothing for the pain for me. 

 

I hope the iv is a good choice.  I have picked the one that will have the least likely effect on the baby's breathing and my blood pressure, I just hope it helps somewhat a least any little bit would have helped me, I just need to not be totally exhausted with the pain.  So scared to do this again.  Then again some women do it twenty times and keep on, still its pretty heavy stuff.

post #24 of 41

Orvis...  I'm sorry if I'm not reading closely enough, but are you saying you've "picked" an IV drug that you'd prefer IF you use it?  You haven't just decided on using it, right?

 

What you describe with your previous birth is exactly why you'll probably want to look into hypnosis and such.  There are many times when drugs will not be available or practical even if you want them (before you get to the hospital, if you get there "too late," etc.)-- that's exactly why it's so important to have self-directed, practiced coping mechanisms, like Hypnobabies or whatever.  Because you can take those with you wherever you go, there are no real side-effects and you can start and stop them at any time.  It sounds like you have a lot of fear, which is normal, but isn't necessarily helpful.  I think hypnosis could really help you a lot-- and it certainly couldn't hurt-- KWIM?  If it doesn't help you "enough" you will usually, eventually, have pharmaceutical alternatives.  But why not give it a shot? 

 

Like my mom (an MD who had two/both unmedicated births) said to me-- "If you learn coping mechanisms, at least you have a choice.  If you don't, you don't really have a choice.  Don't you want to have more options, not fewer?"

post #25 of 41

The epidural affects the baby less than the IV drugs. I have had both, IV drugs and epidurals. I had planned to do an epidural this last time, but I never dilated and ended up in a csect. I did try the morphine and fentanyl when I first was admitted to the hospital, but my contractions were so bad that they did not touch the pain.

post #26 of 41

I will say though, my plan was to try to hold off on the epidural as long as possible. So, I had planned to use IV drugs as a first resort and an epidural when things got too much for me. Well, my OB refused to admit me even though I was in horrendous pain. I had had vbacs before so I knew how things were supposed to be and that was not how they were supposed to be. By the time I was admitted, I had been in labor for over 40 hrs and was in extreme pain. By then, the IV drugs did nothing for me. Stadol will put your mind in lala land and negatively affect the baby so cross that one off your list.

 

Good luck!

post #27 of 41
Thread Starter 

I just hope that the iv will 'touch' the pain and make it a little less intense but maybe that's hoping to much.

post #28 of 41
Thread Starter 

 

Yes, I do have a lot of fear, because for me labor is the most intense pain I'd ever had in my life and I was  completely unable to ride it out.  I would look into hypnosis, though I do not know if I am in the non suggest able group or not, but I really can't afford to do so.  I would like to think I can be all strong but being in the water did nothing to cut the pain for me, the back pain was the worst, and I couldn't just breathe it through during the second stage.  It is like nothing imaginable to me and not something I want to masochistically put myself through again because I know when it comes down to it I'll be screaming like an animal for the pain to stop.  Midwives like to say that its a natrual process and our bodies are made to do just that, but you know what?  Death is a natural process to oand I'm sure that doesn't make it any more bearable when it comes down to it, not to get all morbid or anything but it is the flip side of the coin isn't it?   I am not getting an epidural so that I can be proud about being a natural birth person, but because I am actually scared of getting an epidural because my mother was very pro home birth and I heard many epidural and epsitaome horror stories to say  nothing of the c section horror stories and I really just hope that doesn' t happen to me because having a baby changed my body so much that I couldn't imagine trying to tone up my stomach after a c section or lift a baby.  If I was a celebrity and could afford the best doctor with the least little cut then maybe, but there would still be the Anastasie to worry about and the baby and I don't know if it would be worth it just not to be stretched out.  I wish I could look at the birthing in a positive light, and believe that I am powerful enough and strong enough to not be a whimpy little girl about it, but I already know that even if my body is able to do it, that my mind just can't take the pain.

post #29 of 41
Thread Starter 

Ok I'll check out the link but I don't think I can afford the hypnobabies thing.

post #30 of 41

I had Staidol for my first birth.  It was awful.  Didn't take the pain away and only made me feel loopy, weak and "out of it".  I hated it.  DD was sleepy was not as alert.  My 2nd and 3rd were natural and those were much better experiences.  Much better.  I've never had an epidural so I can't compare, but I would never get IV painkillers again.

post #31 of 41
Originally Posted by orvis View Post

Ok I'll check out the link but I don't think I can afford the hypnobabies thing.



Hypnobabies has two different options....you can take a class (variable rate by region) or do the home study (fixed rate of $145, but 20% off this weekend only through their facebook store).  In your case, I'd really recommend the class.  Many instructors offer scholarships for families in need.  Don't let the price deter you from Hypnobabies!  It's worth it. 

post #32 of 41
Thread Starter 

Well I was sent a link to get some sort of free torrent but I don't want to sighn up for the torrent service, and I can not afford anything right now at all.  I am very weary of accepting charity from others and I just won't feel like its ok to get a 'scholarship' for such a thing. 

post #33 of 41
Quote:
Originally Posted by Babydoll1285 View Post

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.  


With my first, I went from 0-7 VERY quickly (was given pitocin) and it was horrible.  I really didn't want an epidural, so I tried the Fentanyl first.  They told me up front that it wouldn't really take away the pain but I'd care a lot less about it.  So I tried it.  They were right:  it didn't TOUCH the pain, all it did was make me loopy as heck.  I ended up with an epidural and it was the sweetest relief ever.  I know you're worried about getting it, but I honestly didn't even feel them doing it.  I think it did slow my labor down a bit, but I could really rest and relax so I didn't mind.  Despite the epi and the Fentanyl, DS had no bad side effects whatsoever.  He was born alert and active with great apgars and nursed wonderfully from the start.

 

With my second, my labor was lightning fast -- about 45 minutes from the time the contractions started to get uncomfortable -- so there was no time for anything.  And you know what?  It was great.  I was able to push her out in 6 minutes (2.5 hours with DS) and I was up and walking around within 20 minutes (whereas with DS I still had some trouble moving my legs the next morning!).

 

If I had to do it over again, I might get another epidural if I felt I needed it, but I wouldn't even consider IV pain relief.

post #34 of 41

I was a homebirth transfer and the hospital refused to give me an epidural (too lazy to call the anesthesiologist in). Needing something, I accepted IV narcotics and it was awful. I blacked out and have no memory of this, but apparently I was running around the room with every contraction, completely uncoordinated and barely aware of my surroundings. DH had to chase after me to unplug me from the fetal monitor and get the IV pole in range so I didn't tear out my IV. I could go into more detail, but it was awful. I will NEVER accept IV medication for labor again.

 

Stay away from the IV drugs, seriously.

 

Edit: They gave me nubain and phenergan. I think my reaction was primarily to the phenergan as I've had that independently (hyperemesis) and it is the most evil drug known to man.


Edited by sunflwrmoonbeam - 12/3/11 at 8:54am
post #35 of 41
Quote:
Originally Posted by sunflwrmoonbeam View Post

I was a homebirth transfer and the hospital refused to give me an epidural (too lazy to call the anesthesiologist in). Needing something, I accepted IV narcotics and it was awful. I blacked out and have no memory of this, but apparently I was running around the room with every contraction, completely uncoordinated and barely aware of my surroundings. DH had to chase after me to unplug me from the fetal monitor and get the IV pole in range so I didn't tear out my IV. I could go into more detail, but it was awful. I will NEVER accept IV medication for labor again.

 

Stay away from the IV drugs, seriously.

 

Edit: They gave me nubain and phenergan. I think my reaction was primarily to the phenergan as I've had that independently (hyperemesis) and it is the most evil drug known to man.


I'm so sorry this happened to you. :(

 

post #36 of 41
Quote:
Originally Posted by HypRN View Post

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

 

I too am a labor and delivery nurse, and HypRN's experiences are exactly the same as mine when it comes to IV pain relief for my clients.

 

The mama's who elect for IV pain medications usually end up groggy, tired, and still feeling every.single.contraction, but then they forget that they felt them until the next one hits.  We too do not give IV meds after 7 cm of dilation, and often not after 6 cm in multi-gravidas due to the risk of respiratory depression in the infant.  Our greater concern is for the health of mom and baby rather than mom's comfort in the later part of labor.  Generally, IV meds will be refused if the baby is not tolerating labor perfectly (meaning, the fetal monitoring strip is class 1 - reactive, moderate variability, reassuring accelerations, no variables, no periods of minimal variability, even during sleep cycles, no late decelerations, etc.)

 

Just to consider - your IV drug of choice may not be available at the hospital you deliver at, or may not be one your physician or RN is willing to give you, as each drug has specific benefits, risks and side-effects that will be balanced against how you are laboring and how the baby is responding to labor.  eg. stadol AND phenergan to an anxious and in pain mom whose anxiety may be causing some of her pain; morphine to a mom with simple contraction-peak pain with a baby with an excellent tolerance of labor.

 

I too studied hypnobabies for my last birth, but did not find it very useful...I ended up getting an epidural after 15+ hours of active labor with minimal progress and a cranky OB, and I'm glad I did, though I too was terrified of the big but rare risks it included (none of which I experienced, thank God!)


 

 

post #37 of 41
Thread Starter 

I am worried about not getting the iv medication because I am too much into the labour and too dialated.  From what I have read, Fetanyl (i know not spelled right but I can't look it up right now)

Has the least risk of respirtory depression to the infant.  I don't want to put the baby in any danger, but I also know that I do not handle the pain of labour well.

post #38 of 41

I didn't read many of the previous posts, so sorry if I am repeating what others have said.  I had some fentanyl during my labor (no epidural until after I had pushed for over 2 hours, the baby hadn't descended at all, and I needed a c-section - he was almost 10 lbs).  I can't say it really took away too much pain for me, but it did really help me to relax which is what I really needed!  My entire labor felt like one long intense contraction, and I just wasn't getting any breaks in between.  Everyone always told me to rest between contractions, that they would be a nice break, but it just didn't happen that way for me.  I was having pain between contractions!  They were so long and so close together, mentally I was more beaten down than anything...  But then my midwife suggested some fentanyl try to slow my ctx down and give me a bit of a break, and I liked it.  If on a scale of 0-10, my worst pain was a 9 then the fentanyl took it probably to an 8, but it took away the pain between contractions and helped me to relax.  Yes, it did make me groggy, but I could sort of sleep/zone out a little in between.  It gave me the mental break that I needed to help avoid an epidural.  Definitely I still had pain, don't get me wrong, it still hurt (!) but I didn't really care as much that it hurt.  It was like I was there, and I felt the pain, I knew it hurt, but I felt like I could just relax at least a little and ride it out.  I have heard otherwise from other people.  Other women that I know that have used narcotics said they hated them!  Their experience was that they fell asleep in between and then woke up to the pain of contractions, they were gorked out, groggy, etc.  Wasn't like that for me.  If I need some help in future labors, I will likely do fentanyl again over an epidural. But, I guess what I really want to get across is that the difference the fentanyl made for me wasn't helping with the pain, it was helping me deal with it.  If you are looking for actual pain relief, you had best look elsewhere! 

Oh, and my son didn't have any respiratory depression, wasn't groggy at all.  Actually he was incredibly alert, breastfed well, and was a pretty vigorous guy.  My last dose of fentanyl was when I was getting my epidural for the c-section and he did fine.  Fentanyl is a fast on/ fast off drug.  It really only lasts about half an hour or so, so it is a pretty good choice to try to avoid respiratory depression. HTH!

post #39 of 41
Quote:
Originally Posted by orvis View Post

I am worried about not getting the iv medication because I am too much into the labour and too dialated.  From what I have read, Fetanyl (i know not spelled right but I can't look it up right now)

Has the least risk of respirtory depression to the infant.  I don't want to put the baby in any danger, but I also know that I do not handle the pain of labour well.



Fentanyl is shown via studies to have fewer respiratory effects on the neonate if given earlier on in labor, but high/frequent dosing will still cause respiratory depression.

However, because it's also a sedative, some hospitals require EKG and oxygen saturation monitoring while it's in your system : (  which further restricts your ability to use movement to cope with pain.

It's also anecdotally reported to interfere with breastfeeding due to sleepy baby and shallow latch.

 

I'm not trying to discourage you from your decision, I just want you to make sure you are fully informed of whatever it is you choose to use for pain relief, as everything has both risks and benefits, and people often try to play up the benefits of what they like and downplay the risks, ya know?

 

On that note, an anxious and distressed mama in labor also has risks, because she will likely not be providing enough oxygen to her baby to enable to baby to tolerate labor well, which can lead to it's own cascade of interventions.

post #40 of 41
Thread Starter 

Thanks.

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