Need info about medications during birth

[tribalmax]

Hi there,

I am asking that you please read this entire post with compassion and keep all judgmental comments to yourself.

I am a few weeks pregnant with my second. This was not planned. My first birth was horrific. I had a planned home water birth and ended up transporting to the hospital where I was under the care of an absolutely horrible and abusive OB. I ended up giving birth vaginally to my daughter who was 9 lbs 6 oz. Before her birth, I was adamantly against medical interventions and VERY PRO natural birth (to a fault probably). So I am very nervous about being judged for asking this question here. I hope that you can realize that I am coming at this question from a very different place -- I was emotionally and physically damaged during my first birth and am doing my best at coping with the anxieties I have about this baby's birth.

I am going to plan a hospital birth -- I feel like this is the best option for me given my experience. With my first baby, I didn't really educate myself about pain relief and medical interventions because I wanted all of my attention to be on having a safe, natural home birth.

I am also finding that I really need to give myself emotional permission to use pain relief (an epidural etc) if I need it. With my first baby, I hadn't done this so much of what I felt had to do with feeling like a failure when I ended up needing one.

I am very well educated about all of the natural pain relief and child birth techniques. What I need is the other side. Are there any sites out there that present this information in a balanced way?

Specifically I am wondering:
1) What are the best options for medical pain relief (in order) and what are the side effects/risks of each one?
2)Are there any medications that can safely be used for anxiety during labor? I am really worried that I am going to just freak out because of my past issues -- especially if -- god forbid -- I am in need of a c-section.

Thanks in advance -- and again, please don't judge me. I simply can't take that right now and there is no way I could convey the horror of the first birth. If I could, I am sure you would all understand where I am coming from. So please just take my word for it.

Thanks,

[jennyfah]

NO judgment here, mama. With birth, we all need to do what is best for ourselves based on our experiences. I was induced with my first and I *needed* that epidural, and I have no regrets about getting it. : (I do have regrets about the invasiveness of the induction in the first place, but that's another story.)

I don't know very much about medications from a clinical standpoint, but I will tell you the anectdotal stuff I know:

I think the first medication offfered is usually Nubain via IV. My friends who've had the Nubain say all it did was make them feel drunk/"out of it" and didn't do anything for the pain. It might allow you to rest, though, so if you're exhausted that might be an option.

Epidurals seem to vary vastly from one hospital/anesthesiologist to another. Everyone has their own "cocktail" of drugs. One of the doulas we interviewed mentioned that in her experience, Fentanyl in the epidurals seemed to cause a lot of lethargy and nursing problems in the newborn, especially if it is given very close to delivery, so maybe you would want to avoid that (and be sure to ask what is in the epidural cocktail if you get one!)

As far as the risks of epidurals. . . you can Google 'Henci Goer' and 'epidural' for a complete explanation. I would say that pushing a baby out when you are numb is much, much harder than if you are mobile and able to change positions. (Delivering in the lithotomy position w/ internal monitor, IV, catheter, etc. is NOT fun! Also increases risks of tearing and the 'need' for episiotomy.)

As far as meds for anxiety--- sorry, I have no idea what would be offered. (Paxil or Valium?) No idea if either of those given orally would be appropriate or effective. . . definitely something so confer with your OB/MW/care provider about before labor.

Best wishes, mama!
jen
due any day with #2

[jengacnm]

No judgements here-my practice is about half home and half hospital births, and keeping an epidural in your back pocket can be an empowering decision. Especially when/if you end up not needing it.

The list is a bit short-iv meds, or an epidural. IV meds are good for early labor, but given too close to the birth can have negative effects on the baby's vigorousness at birth. Epidurals CAN cause lethargy in the baby, but not universally and to a lesser degree than iv meds. Reading Henci Goer's site is a good idea, because the list of other epidural effects is long. Most importantly, I'd ask your provider if, when you are 10 cms, if you feel no urge to push, if you can "labor the baby down" and not push until you can feel it.

Regarding anxiety-Phenergan can be given along with Nubain or Stadol, and it has some anxiolytic properties as well as enhancing the effectiveness of the narcotic. That being said, it also enhances the effect of the narcotic on the baby. Again, it can be given in early labor, but it does wear off later and ideally should not be given too close to the birth.

I know that your question is regarding pharmacologic pain relief, and I have shared some of my knowledge. However, if you've not done so already, I'd strongly recommend getting hypnosis or bodywork done to release your fear. Epidurals and meds can take away pain, but they can't take away fear, distress, or anxiety.

HTH-
Jennifer

[mamabadger]

There's also Entonox gas, if your local hospital offers it. I get conflicting information of its side effects (maybe someone here can help with that?) but some women find the fact that it is self-administered as needed very helpful psychologically.

[stacey2061]

hi ~ i think there are lots of options for medicated pain relief before you even get to an epidural. for me, i had an intense induced labour and i just needed a few seconds to gather myself. i tried the gas, which just made me feel weird, like i wasn't myself, which i hated, but luckily the effects only last as long as your breath. some women love the gas ~ it takes the edge off enough to get them through labour.

i ended up really liking fentanyl. as with everything, it effects people differently. some women completely fall asleep with it, for me, it just relaxed my body and mind for afew moments so i could sort of gather myself and carry on labouring. one thing though, it was administered too close to ds' birth and he was very sleepy for days and we had real troubles breastfeeding.

i ended up having an epidural after ds was born for surgery, and though it felt really good, i can't see it as something i would enjoy labouring with ~ i didn't enjoy the lack of control of my body, and complete dependency on other people ~ that's something to keep in mid if you are concerned about anxiety in labour. for some people it might be just fine, for someone like me who is really stubborn and independent, it physically felt nice, but psychologically, it was hell.

good luck and good for you researching this ahead of time! who knows, maybe you won't even need pain meds

[mom2talus]

No judgement here - do what you have to do to have a healthy baby! I went into my birth determined to have a unmedicated homebirth...42 hours later, I was thrilled to get an epidural, I'm not ashamed to say!

It's important to have all your information, but more important to do what you have to do at the time.

[tribalmax]

Thanks for the info and the support. I was really worried about posting this question here. In an ideal world, I am a strong supporter of natural birth -- but I also have come to realize that this is far from an ideal world -- and you really have to do what needs to be done during your birth -- and I strongly believe that no other person can tell you what that is because everyone experiences birth differently.

Thanks for the information!

[SublimeBirthGirl]

Rescue Remedy is good for anxiety and safe during labor. I have a very thorough risks/benefits sheet on the main pain meds used in US hospitals if you'd like to see it. Email me, [e-mail], and I'll send it to you.

One thought: have you considered a planned hospital (or birth center if you have those) birth with a really supportive midwife? If I had to give birth with an OB I might just skip to a c-section to be honest. You can still get an epidural if you want one, even with a midwife, but you'd be more likely to avoid the abuses that so often come with hospital birth.

[cosmotion]

the birth of my son sounds very similar to your experience
( i was planning a UC, but ended up transferring to a hospital and taking whatever OB was on-call.. and wow, was he abusive)

i was given a very small dose of stadol, which made sleep a possibility after twenty four hours of nosleeps labor.
stadol was interesting. it didn't knock me out
because i could still hear what was going on around me
i just felt more relaxed.
when the dose wore off
i was feeling the urge to push
so, i was very satisfied with my experience with stadol.

i understand your fear about posting something on a subject like this on MDC
but, in my opinion
every woman is completely different from every other woman
and for one woman to bestow judgement upon another woman because of a choice she made during her personal labour experience
makes absolutely no sense to me.

i had planned something totally different than what i got.
in the end, i did what i thought was best for myself
and for baby kinetic
and i wouldn't change it for anything.

good luck, momma

:]

[georgia]

Hi, everyone Just a friendly reminder:

Mothering.com is the website of natural family living and advocates natural solutions to parenting challenges. We host discussion of nighttime parenting, loving discipline, natural birth, homebirth, successful breastfeeding, alternative and complementary home remedies, informed consent, and many other topics from a natural point of view.

From the MDC Web Statement of Purpose:

The MotheringDotCommune discussion boards serve an online community of parents considering, learning and practicing attachment parenting and natural family living. Our discussions on the boards are about the real world of mothering and are first and foremost, for support and information.

Some subjects regularly covered in the magazine and on these boards include:

Natural Pregnancy
Drug-Free Childbirth

Just so there's no confusion, Mothering Magazine/MDC advocates for drug-free birth, and information provided about the risks of drugs during pregnancy and labor and the benefits of natural birth is a POV inherent to The Natural Family Living Community. Since MDC is mainly for support and information, please understand that sometimes information provided might feel unsupportive or judgemental if the topic is something that may be outside the focus of the forum.

That said, if one is faced with the possibility of a medicated birth, there is a wealth of medication information in the cesarean support threads which detail many options which can serve to minimize the negative effects on the mother/baby dyad. Also, in this B&B sticky here.

Any questions or concerns, please PM me Thanks!