What pain relief (medical) measures are safest for the baby?

[Softheart]

Hello...so I've already posted about being pretty sure I want an epidural with this next one, but in case I can't get one I was wanted to be educated about other medical methods of pain relief that might be offered, and to know which ones might be worse (or not) for the baby...Like--what's Stadol, and Fentenol...? Would these be better or worse for the baby than an epidural...? If my last birth is any indication, my contractions are bearable until transition, and it's really the delivery/ring of fire/tearing that I'm worried about needing pain relief for...

Thanks for any knowledge you have to pass on...

[lisalulu]

Here is a link I found for fentanyl (http://drugsafetysite.com/fentanyl). I'm not familliar with the site myself but it looked like it had some info. I think fentanyl crosses to the fetus but other than that I don't know much. And it makes you feel drunk which you might not like in labor?

[riversmommy]

I didn't read your previous post about wanting an epidural, but there isn't really a "safest" for the baby way to approach medical pain relief. Narcotics like Demerol or Stadol might have a place in early labor where a woman might have a stalled labor due to severe anxiety. But it's really hard to know how your body will react to them. They might just make you groggy and/or hallucinate and you'll still feel it all. They might make your baby groggy too.

There's something very beautiful about those perfect first moments of a mother and baby after an unmedicated labor! It allows your body to produce wonderful feel-good and mothering hormones that promote bonding and help to ward of PPD.

Do you have access to a gentle, patient midwife? This could be the safest way for you and baby to cope with the pain of delivery. Upright position, perineal massage, and good coaching could ease the pain of ring of fire and tearing. Just a thought...

[lyttlewon]

How do you respond to narcotics? Personally I have had to take them post surgury and they render me unconcious. I could not imagine birthing in that state. I would have to force myself to be awake which would totally make me miserable. Although if you need to sleep? As far as the ring of fire issue can they numb you with novacain? That is what they do for episiotomies.

[Beckula]

From what i have been led to understand ALL pain medications including the Epi cross the placenta (which uses a narcotic). They all have risks and all forms of pain medication will make a baby groggy which can interfere with the babies breathing, bonding and ability to suck which can make Breastfeeding difficult. Pain medications can slow or stop labor all together which can result in a c-section. I had an epi for my first birth which was a disaster all the way around, it stopped my labor then it stopped working after 2 hours, Iended up having a c-section which they had to give me a spinal block and a terrible headache for a week that pretty much ruined what was supposed to be the best week of my life and the first week of my Son's life. From what I have heard from other Mom's, is that my situation was far from unique. Have you looked into the Bradly method or Hypnobirthing? I have heard good things about both.

[alegna]

From what i have been led to understand ALL pain medications including the Epi cross the placenta (which uses a narcotic). They all have risks and all forms of pain medication will make a baby groggy which can interfere with the babies breathing, bonding and ability to suck which can make Breastfeeding difficult. Pain medications can slow or stop labor all together which can result in a c-section.

:yeah:

-Angela

[goodearthmama]

Okay, I was about to choke on my cookies & milk (they're organic oatmeal raisin & organic whole milk :wink ) about the epi not passing to the baby comment. YES! An epi definitely does pass thru & effect the baby as does ANY medication. I would suggest reading one or both of Henci Goer's books in regards to the realites of and the effects of pain meds during labor & delivery.

[lisalulu]

Okay, I was about to choke on my cookies & milk (they're organic oatmeal raisin & organic whole milk :wink ) about the epi not passing to the baby comment. YES! An epi definitely does pass thru & effect the baby as does ANY medication. I would suggest reading one or both of Henci Goer's books in regards to the realites of and the effects of pain meds during labor & delivery.


OMG!!! So my bad for saying that. Why did I think it didn't? I didn't use any in labor so I probably don't remember it correctly :bag: Is there one that doesn't that I'm getting confused with? Nitrous maybe? Sorry to op for my misinformation...off to edit my post.

[goodearthmama]

lisalu- not being mean, just I was really shocked. I am used to people around me not knowing a darn thing when it comes to stuff like that, but it just took me by surprise when I read it on here. I just wanted the OP to be completely informed since most OB's don't tell women about the dangers of epi's to baby & mom.

Hey we can just blame it on your pregnant brain:dizzy: - I use that excuse a lot these days.:lol

[Softheart]

Okay, I think my mind is starting to open to the idea of not getting an epi/drugs...Does anyone have any ideas about the novocaine idea to numb the perineal area...? Can you really get something like that...?

[lisalulu]

lisalu- not being mean, just I was really shocked. I am used to people around me not knowing a darn thing when it comes to stuff like that, but it just took me by surprise when I read it on here. I just wanted the OP to be completely informed since most OB's don't tell women about the dangers of epi's to baby & mom.

Hey we can just blame it on your pregnant brain:dizzy: - I use that excuse a lot these days.:lol

I am totally embarassed about not knowing. I read this stuff duing my pregnancy with ds and I don't know how I got it wrong! I am sorry for making you spit out your cookies-they sounded pretty tasty! So when an epi crosses to the fetus-does it have a numbing effect or does it slow them down? Don't want to hijack the thread...

[readytobedone]

none of it is really safe. but from everything i've heard, narcotics like stadol and demerol don't really do jack for the pain anyway. everyone i know who's gotten one of those just ends up getting the epi later on anyway. so i don't think i'd ever try the narcotics. if i were going to get something, i'd go straight for the epi.

[GinaRae]

Okay, I think my mind is starting to open to the idea of not getting an epi/drugs...Does anyone have any ideas about the novocaine idea to numb the perineal area...? Can you really get something like that...?

I just watched a woman on TV get that today. I don't remember the name of it, but they inject your perineum. She was in a lot of pain during the injection - crying out. She didn't cry out during her entire natural laboring process, only upon injection AND she didn't exactly look comfy during pushing.

Do what YOU need to do to make it through. I won't use meds as any I've tried have backfired. I either fell asleep in between contractions and then woke up to feel all the pain of the contraction so I thought I had a two hour long contraction OR my BP fell. I also felt everything during the delivery, so the drugs, including the epidural didn't help. During the epi, my legs were numb, but I felt his body go through me, the ring of fire, etc..

I am totally going to do this naturally all the way this time. I know what I can do.

Have you thought about checking out the Hypnobabies curriculum to help?

[PerennialMom]

Okay, I think my mind is starting to open to the idea of not getting an epi/drugs...Does anyone have any ideas about the novocaine idea to numb the perineal area...? Can you really get something like that...?

I had great experience with perineal massage. I started doing it to myself around 38 weeks....just to get used to that sensation of the ring of fire. My midwife, during labor, used a lot of hot compresses and olive oil and massage. It made the 'ring of fire' only last a few second and then it was over. I had a DO with my first birth and apparently olive oil in a hospital is not something readily available....although it SHOULD be. :lol I definitely noticed a big difference in how my midwife handled my stretching versus my DO.

I'd look into perineal massage. :)

[birthjunkie]

I just watched a woman on TV get that today. I don't remember the name of it, but they inject your perineum. She was in a lot of pain during the injection - crying out. She didn't cry out during her entire natural laboring process, only upon injection AND she didn't exactly look comfy during pushing.

Are you talking about a pudendal block?

[GinaRae]

Are you talking about a pudendal block?

Yes, that sounds right. They inject numbing meds into the perineum when she's ready to push.

[momto l&a]

For pain blocking meds I would highly recommend a nice tub full of hot water.

Its amazing how heat takes the pain away.

For my last birth I didn't have time for a water birth so I used a rice sock on my stomach, worked wonders.

[alegna]

Okay, I think my mind is starting to open to the idea of not getting an epi/drugs...Does anyone have any ideas about the novocaine idea to numb the perineal area...? Can you really get something like that...?

When I last read on that (a few years ago) I read it was a BAD idea because it caused swelling. Swelling made the opening smaller. Caused more tearing damage.

-Angela

[Ks Mama]

For pain blocking meds I would highly recommend a nice tub full of hot water.

Its amazing how heat takes the pain away.

For my last birth I didn't have time for a water birth so I used a rice sock on my stomach, worked wonders.

The best hours (can you have best hours of labor? :lol ) of my LONG labor with my first were spent in the hot shower!
The only negative thing I've heard about a hot water bath is that it can stall labor... anyone else heard this?

Regardless, I'm planning on spending a LOT of time in the bath/shower again this time. :)

Thanks for the reminder on the rice sock.... I need to remember to make a couple of these.

[heatherh]

Another vote for Henci Goer - check out her book "The Thinking Woman's Guide to a Better Birth." It was enlightening - she lists the risks of various procedures and talks about ways to minimize the risks. It's definitely in support of natural birth, but there is a lot of research to back it up.

In the Epidurals and Narcotics chapter, she talks about the risks and gives details on the epidural procedure itself. She details what a narcotic does (how it works). She lists pros and cons of epidurals, narcotics, and avoiding both. She then lists strategies for avoiding pain medications, ways to help decide whether or not to have pain medication, and strategies to minimize the risks and side effects of epidurals.

Drugs or no drugs, a doula might be a huge help and support.

[hubris]

Okay, I think my mind is starting to open to the idea of not getting an epi/drugs...Does anyone have any ideas about the novocaine idea to numb the perineal area...? Can you really get something like that...?
I would expect that to be bad for the perineum. You'd be filling that tissue with the liquid from the injection, which would cause it to act differently than normal, left-alone perineal tissue would, increasing the chances of tearing.

My TOP recommendation for pain relief is your body's own endorphins. If you haven't already read Birthing From Within, please pick up a copy. There's a really nice section that discusses the feedback loop in your own body during labor, and describes how pain medication interrupts that feedback loop and actually makes you LESS able to cope with pain on your own. IMO that book does an excellent job of helping a woman to mentally prepare herself for birth - reducing fear, learning the usefulness of your body's sensations, and lots of great coping method suggestions.

[luckydog]

The only negative thing I've heard about a hot water bath is that it can stall labor... anyone else heard this?

Yes, it happened to me (and my midwives said it's not uncommon). Even when I was in transition as soon as I immersed myself in the tub the contractions spaced out.

The water counterpressure was GREAT during the pushing stage, though! No tears. My third birth, completely unmedicated home waterbirth was my best experience to date. :)

Regarding epidural - I had one with my first labor (induced at 39 weeks for cholestasis) - ultimately I needed a c/s (aside from unripe cervix, the epidural also stalled my labor. I seem to NEED to be in pain for labor to progress lol) and certainly at that level of anesthesia, I had a sleepy baby.

Regarding stadol - I had a few shots of that with my hospital VBAC. In the birth story, I documented that it didn't really make labor less painful. (It blurred the experience, if that makes any sense.) The difference was it made me just not care as much. Very hard to explain. No apparent effect on this baby - she was alert from the get-go (and is now a massively brilliant almost 10 year old).

[Softheart]

Great--I'll ask around more about this pudendal block. I did read somewhere that they can't usually give numbing shots to that tissue right there because it causes swelling which would hurt delievery--but maybe this is different...

[birthjunkie]

The pudendal block has been around a LONG time. There are risks with it, as with every form of intervention. Keep in mind that it won't help with labor contractions at all. It's only to numb the perineum for pushing.

I don't understand why a woman *wouldn't* want to know what pushing a baby out feels like. I *liked* that part of labor. And, personally, I would be too worried that I wouldn't be able to push effectively or "tune in" to my body. I don't like the thought of any part of my body being numbed--especially my girlie bits. That's just me :loveeyes:

[Softheart]

Wow, its so amazing to me the huge range of birth expereince...My pushing stage wasn't like ME pushing or trying to push at all, it was like something shooting out of me on it's own, and an excruciating, agonizing tearing in the process...Maybe it could be different for me this time...? I just feel like I can't face going into this thinking that the delievery part could be even half as painful as it was the first time...I wish I had a crystal ball!

[dannic]

Pushing was more difficult for me the first time...actually, everything was. The second time around wa much better--not because it hurt any less, really. More because I knew what was happening, I had done it before--my body had done it before. And the pushing was much easier/shorter second time around. It was a very empowering experience. So, you can't always expect it to be the same. At least, that was my experience.

[birthjunkie]

Yes, every womans' experience is different (in some way). Even the same woman should not expect each of her labors to be the same.

You might want to consider laboring (and birthing) in water. Most women I know who've had a waterbirth (myself included) don't experience the burning sensation (as the baby's head is crowning). Must be the equalized pressure from the water. Also, you're less likely to tear in the water: I tore with my singleton but not with my twins (one of which was frank breech and 8lb3oz).

Is waterbirth an option for you?

If not, you could try learning some relaxation techniques for helping you "breathe" the baby out. Slowing things down a bit can help avoid perenial trauma.