Pain Relief
While preparing for a natural birth it is useful to educate yourself on all types of medical pain relief; their uses and their effects. It is helpful to learn before your labour when and why you could be offered medical pain relief. You do not want to be introduced to these methods for the first time during your labour.
Page Contents:
Epidural Anaesthetic, Written by, Jane Palmer, Midwife - Australia
Nitrous Oxide for Pain Relief in Labour, Written by, Jane Palmer, Midwife - Australia
Pethidine for Pain Relief in Labour, Written by, Jane Palmer, Midwife - Australia
EPIDURAL ANAESTHETIC
Written by, Jane Palmer, Midwife - Australia
(20th January 2000)
An epidural anaesthetic is a procedure that is performed by a specialist doctor known as an anaesthetist. Epidural anaesthetic is where an injection of local anaesthetic (sometimes mixed with an opiate such as pethidine or fentanyl) is given into the epidural space (an area located around the spinal cord). An epidural anaesthetic is given to relieve pain in labour, to help reduce high blood pressure (if it is a problem in labour) and prior to a caesarean birth. The effects of the epidural anaesthetic on the woman depend on the type of medication used. A woman may be numb from the waist down and unable to move or she may be able to move her legs but not feel the pain of the contractions. An epidural anaesthetic takes between 10 to 20 minutes to be put in place and then the medication takes around 5 to 20 minutes to become effective. An epidural catheter is left in place after the procedure is completed. It is through this catheter that regular doses of medication can be given to help keep the woman comfortable (Robertson, 1999).
What happens during the administration of an epidural anaesthetic?
Firstly the anaesthetist places a needle in the woman’s hand and attaches a bag of intravenous fluids. These fluids are to help counteract any drop in blood pressure that can occur. The woman is then positioned either lying on her side or sitting up in bed in a curled up position. An area of the woman’s back is swabbed with an antiseptic solution such as betadine. The woman is given a local anaesthetic to numb the area where the epidural catheter will be introduced. A special needle is inserted into the appropriate space and the very fine epidural catheter is passed into the needle. The epidural catheter is left in place and the special needle is removed. The epidural catheter is then taped carefully in place so that it cannot move. The appropriate medication is given into the epidural catheter.
What are the advantages of an epidural anaesthetic?
The advantages of an epidural anaesthetic include: The most effect form of pain relief available, mother can see the birth of her baby during a caesarean, provides adequate pain relief if a forceps or vacuum birth is indicated, helps control high blood pressure (Robertson, 1999).
What are the disadvantages of an epidural anaesthetic?
The disadvantages of an epidural anaesthetic include: Being confined to bed, increases chance of a caesarean birth, increases chance of forceps or vacuum extraction by three times (around 50% of first time mothers will need this type of assistance - statistics between hospitals can vary), approximately 1:100 women will experience a severe headache afterwards, 1:550 women will experience small numb patches on their legs that persist after birth for up to three months, 1:4000 women will experience a life threatening emergency from an epidural (paralysis is extremely rare), labour can be longer (approximately three times more likely to need medication to speed labour up), more likely to need a catheter to help pass urine, some women experience itchy skin (as a result of some of the medication used), some women do not achieve adequate pain relief or partial relief on one side, mothers temperature can rise resulting in the need to give the baby antibiotics after birth (Enkin, Keirse, Renfrew & Neilson, 1995; MIDIRS and The NHS Centre for Reviews and Dissemination, 1997; Robertson, 1999).
Are there any long term effects on my self or my baby if I choose an epidural anaesthetic?
Remarkable there has been little research done on short or long term effects of epidural anaesthetics. So the effects on mothers and babies remains unknown at this stage. All research can say at this stage is that epidural anaesthetic provides the most effective form of pain relief to date but it substantially increases the risk of operative births ie. caesarean section, forceps and vacuum extraction (Enkin, Keirse, Renfrew & Neilson, 1995).
Reference List
Enkin, M., Keirse, M. J. N. C., Renfrew, M. & Neilson, J. (1995). A guide to effective care in pregnancy and childbirth (2nd ed.). Oxford: Oxford University Press.
MIDIRS and The NHS Centre for Reviews and Dissemination. (1997). Epidural pain relief during labour: Informed choice leaflet for professions . United Kingdom: MIDIRS.
Robertson, A. (1999). Preparing for birth: Mothers. Sydney: ACE Graphics.
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
NITROUS OXIDE FOR PAIN RELIEF IN LABOUR
Written by, Jane Palmer, Midwife - Australia
(25th September 2000)
Nitrous Oxide (N20) is otherwise known as laughing gas. It is an anaesthetic gas that has been used since the beginning of the last century. It is commonly used during surgery and as a pain relief method during labour. A lot of people will have come in contact with Nitrous Oxide at their dentist. Nitrous Oxide is mixed with oxygen. The concentration of Nitrous Oxide that a woman in labour receives varies between 30 to 70%. Nitrous Oxide is breathed into the lungs and there it very quickly enters the blood stream. Nitrous Oxide reaches the brain within 15 seconds. The amount of Nitrous Oxide that reaches the brain varies, depending on the strength administered and how long it has been used. The normal function of the brain is depressed to varying degrees. However the way Nitrous Oxide provides pain relief is unknown.
The effectiveness of Nitrous Oxide as pain relief in labour varies from woman to woman. Less than 50 per cent of women find it a satisfactory form of pain relief, 20 per cent obtain some pain relief for some of the time and around 30 per cent find it totally ineffective. There have been reports regarding the declining use of Nitrous Oxide as a pain relief in labour in recent years, due to its inability to provide a reliable form of pain relief.
How is Nitrous Oxide and oxygen administered?
Nitrous Oxide and oxygen can be given from either a fixed or portable apparatus. The fixed apparatus is attached to the wall and varying concentrations of Nitrous Oxide and oxygen can be given. The midwife adjusts the dosage to what is required. However as it cannot be moved, a woman in labour cannot use Nitrous Oxide in the shower, bath or at a homebirth. Nitrous Oxide and oxygen can also be given from a portable cylinder. The dosage is fixed (a 50:50 mixture of Nitrous Oxide and oxygen is in the cylinder - this known as Entonox). With Entonox it is not possible to alter the concentration of Nitrous Oxide that a woman receives.
Nitrous Oxide is breathed in by the woman either using a face mask or mouth piece. To use it correctly the woman begins breathing on the mouth piece or face mask deeply at the beginning of a contraction until a rattling sound is heard. The Nitrous Oxide and oxygen mixture is then breathed in throughout the whole contraction and is stopped as soon as the contraction is over. Nitrous Oxide can be given at any time during labour, but is most likely administered during transition.
How long does the effects of Nitrous Oxide last?
Once Nitrous Oxide enters the blood stream, it is very quickly distributed around the body. It passes just as quickly across the placenta and into the baby’s circulation. Nitrous Oxide (unlike drugs like pethidine) is not broken down by the liver and therefore does not leave by-products. Nitrous Oxide is able to be eliminated quickly from the woman’s body entirely by her lungs. Nitrous Oxide is also eliminated quickly from the baby’s body. When using Nitrous Oxide it is important to start using it as soon as the contraction starts due to the 15 seconds it takes to become effective. Once the woman stops breathing the Nitrous Oxide and oxygen mixture and begins to breath air again, the effects of the Nitrous Oxide wears off quickly.
What are the advantages of using Nitrous Oxide during labour?
The advantages of using Nitrous Oxide during labour is that it provides some pain relief for some women. Women using Nitrous Oxide remain awake and in control of their own pain relief. Nitrous Oxide does not interfere with contractions, the time Nitrous Oxide remains effective is short and there are no obvious short term effects on mother and baby that have been noted to date.
What are the disadvantages of using Nitrous Oxide during labour?
Disadvantages of using Nitrous Oxide during labour include:
Reference List
Enkin, M., Keirse, M. J. N. C., Renfrew, M., & Neilson, J. (1995). A guide to effective care pregnancy and childbirth (2nd ed.). Oxford: Oxford University Press.
Jacobson, B. et al. (1990) Opiate addiction in adult offspring through possible imprinting after obstetric treatment. British Medical Journal, 301: 1067-1070.
Robertson, A. (1999). Preparing for birth: Mothers. Sydney: ACE Graphics.
www.manbit.com/obstetpain/n201.htm (Website no longer active)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
PETHIDINE FOR PAIN RELIEF IN LABOUR
Written by, Jane Palmer, Midwife - Australia
(25th June 2000)
Pethidine is a widely used drug for pain relief in labour. Pethidine is a similar drug to morphine and heroin. These three drugs are from a family of drugs known as opioids. Opioids basically are morphine-like drugs. Morphine is a natural drug that can be extracted from the opium poppy, where as pethidine is synthetically made. Pethidine was first used in Germany in 1940 to reduce pain in labour and its use has continued to the present day. Initially when pethidine was created, it was thought to be non addictive but we now know that this is not true.
Pethidine works my mimicking the effects of endorphins - the body’s own morphine-like substances. One of the functions of endorphins is to act as the body’s natural pain killer. Pethidine (like endorphins) attaches to special sites on the outside of nerve cells. These sites are known as opioids receptors. Once pethidine attaches to these receptors, a chain of events occurs that results in the depression of normal activity for a little while. Pethidine’s effects are far more dramatic than endorphins. The effects pethidine has on a woman’s body can readily observed after it has been administered. A woman may become dizzy, drowsy, her eyes may change in appearance and she may experience an altered level of perception of events around her. Pethidine acts on the central nervous system by inhibiting the pain signals that are sent to the brain. The subsequent result can reduce the pain experienced by the woman in labour. Pethidine can also increase the amount of pain a woman can tolerate.
How is pethidine given to a woman when she is in labour?
The most common way that pethidine is give to a woman in labour is by an injection into the muscle (usually into the thigh or buttock). Occasional pethidine is given into a vein via a drip. Pethidine usually has to be ordered by a doctor, but is then given by a midwife. The dosage a woman receives in labour varies, usually ranging from 50mg to 100mg. The total volume injected into the muscle is one to two millilitres.
How long does pethidine work for?
If pethidine is given via an injection into the muscle, it usually takes around ten to twenty minutes to begin working. Pethidine’s effects, when given by this method, last two to three hours. If pethidine is given directly into a vein via a drip, the effects are a lot more rapid. Pethidine begins working within two to three minutes. When pethidine is given via a vein it enters the blood stream directly and only takes a couple minutes to circulate around the entire body, therefore pethidine reaches the brain and the nerve sites rapidly. The problem with giving pethidine directly into a vein is even though the effects are rapid, they only last for a short time. The effects of pethidine injected into a muscle last a lot longer.
Will pethidine provide me with adequate pain relief while I am in labour?
This is not an easy question to answer as women report varying responses to pethidine. Some women say that it provides adequate relief while other women say they achieved no pain relief whatsoever (48% of women in one survey said this). Women report pethidine provides greater relief in early labour rather than in later labour (when the contractions are a lot stronger). The bigger the dose of pethidine, the more effective the pain relief. But the bigger the dose, the more side effects a woman and her baby may experience. One piece of research said that pethidine does not provide adequate pain relief during labour, but ends up heavily sedating the woman. Overall pethidine may reduce pain experienced during labour in some women. If a woman is tired, pethidine can provide sedation (and sometimes much needed sleep). Pethidine can act as a muscle relaxant which can in some cases result in faster dilation (opening) of the cervix.
What are the disadvantages of using pethidine for pain relief in labour?
Pethidine may not provide adequate pain relief for some women. Nausea and vomiting are common, a medication may be mixed with the pethidine to help reduce these effects. Some women report feeling drowsy and confused. The effects pethidine has on perception may make the contractions difficult to deal with. Other potential side effects for the woman in labour include difficulty passing urine, dry mouth, hallucinations, respiratory depression, low blood pressure and allergic reaction .
There are no advantages to the baby if the mother has pethidine. Pethidine is known to cross the placenta and is present in breastmilk. The major problem for the baby is that pethidine can cause breathing difficulties after birth due to its depressive effect on the baby’s respiratory centre. These effects are at the worse if the baby is born one to three hours after an injection of pethidine has been given. This is the reason that pethidine is ideally avoided when the birth is perceived to be close. An antidote can be given to the baby to reverse the effects of pethidine, however the effects of the antidote only last a short time and when they wear off the baby may re-experience breathing problems. Baby’s are more likely to have jaundice if their mothers have pethidine. Pethidine effects the baby’s sucking reflex and can cause breastfeeding difficulties for the first few days. Baby’s may require special care or neonatal intensive care from the effects of pethidine, resulting in separation of mother and baby.
References:
Guy Hospital. (1994). 1994 Nursing drug reference 2nd ed. Mosby: London.
Robertson, A. (1999). Preparing for birth: Mothers. ACE Graphics: Sydney.
home.intekom.com/pharm/quatrom/q-pethid.html
www.manbit.com/obstetpain/peth2.htm - (Website no longer active)
www.manbit.com/obstetpain/peth3.htm - (Website no longer active)
www.manbit.com/obstetpain/peth4.htm - (Website no longer active)
www.manbit.com/obstetpain/peth5.htm - (Website no longer active)
www.manbit.com/obstetpain/peth6.htm - (Website no longer active)
www.qub.ac.uk/nur/research/rogan.html - (Website no longer active)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
Page Contents:
Epidural Anaesthetic, Written by, Jane Palmer, Midwife - Australia
Nitrous Oxide for Pain Relief in Labour, Written by, Jane Palmer, Midwife - Australia
Pethidine for Pain Relief in Labour, Written by, Jane Palmer, Midwife - Australia
EPIDURAL ANAESTHETIC
Written by, Jane Palmer, Midwife - Australia
(20th January 2000)
An epidural anaesthetic is a procedure that is performed by a specialist doctor known as an anaesthetist. Epidural anaesthetic is where an injection of local anaesthetic (sometimes mixed with an opiate such as pethidine or fentanyl) is given into the epidural space (an area located around the spinal cord). An epidural anaesthetic is given to relieve pain in labour, to help reduce high blood pressure (if it is a problem in labour) and prior to a caesarean birth. The effects of the epidural anaesthetic on the woman depend on the type of medication used. A woman may be numb from the waist down and unable to move or she may be able to move her legs but not feel the pain of the contractions. An epidural anaesthetic takes between 10 to 20 minutes to be put in place and then the medication takes around 5 to 20 minutes to become effective. An epidural catheter is left in place after the procedure is completed. It is through this catheter that regular doses of medication can be given to help keep the woman comfortable (Robertson, 1999).
What happens during the administration of an epidural anaesthetic?
Firstly the anaesthetist places a needle in the woman’s hand and attaches a bag of intravenous fluids. These fluids are to help counteract any drop in blood pressure that can occur. The woman is then positioned either lying on her side or sitting up in bed in a curled up position. An area of the woman’s back is swabbed with an antiseptic solution such as betadine. The woman is given a local anaesthetic to numb the area where the epidural catheter will be introduced. A special needle is inserted into the appropriate space and the very fine epidural catheter is passed into the needle. The epidural catheter is left in place and the special needle is removed. The epidural catheter is then taped carefully in place so that it cannot move. The appropriate medication is given into the epidural catheter.
What are the advantages of an epidural anaesthetic?
The advantages of an epidural anaesthetic include: The most effect form of pain relief available, mother can see the birth of her baby during a caesarean, provides adequate pain relief if a forceps or vacuum birth is indicated, helps control high blood pressure (Robertson, 1999).
What are the disadvantages of an epidural anaesthetic?
The disadvantages of an epidural anaesthetic include: Being confined to bed, increases chance of a caesarean birth, increases chance of forceps or vacuum extraction by three times (around 50% of first time mothers will need this type of assistance - statistics between hospitals can vary), approximately 1:100 women will experience a severe headache afterwards, 1:550 women will experience small numb patches on their legs that persist after birth for up to three months, 1:4000 women will experience a life threatening emergency from an epidural (paralysis is extremely rare), labour can be longer (approximately three times more likely to need medication to speed labour up), more likely to need a catheter to help pass urine, some women experience itchy skin (as a result of some of the medication used), some women do not achieve adequate pain relief or partial relief on one side, mothers temperature can rise resulting in the need to give the baby antibiotics after birth (Enkin, Keirse, Renfrew & Neilson, 1995; MIDIRS and The NHS Centre for Reviews and Dissemination, 1997; Robertson, 1999).
Are there any long term effects on my self or my baby if I choose an epidural anaesthetic?
Remarkable there has been little research done on short or long term effects of epidural anaesthetics. So the effects on mothers and babies remains unknown at this stage. All research can say at this stage is that epidural anaesthetic provides the most effective form of pain relief to date but it substantially increases the risk of operative births ie. caesarean section, forceps and vacuum extraction (Enkin, Keirse, Renfrew & Neilson, 1995).
Reference List
Enkin, M., Keirse, M. J. N. C., Renfrew, M. & Neilson, J. (1995). A guide to effective care in pregnancy and childbirth (2nd ed.). Oxford: Oxford University Press.
MIDIRS and The NHS Centre for Reviews and Dissemination. (1997). Epidural pain relief during labour: Informed choice leaflet for professions . United Kingdom: MIDIRS.
Robertson, A. (1999). Preparing for birth: Mothers. Sydney: ACE Graphics.
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
NITROUS OXIDE FOR PAIN RELIEF IN LABOUR
Written by, Jane Palmer, Midwife - Australia
(25th September 2000)
Nitrous Oxide (N20) is otherwise known as laughing gas. It is an anaesthetic gas that has been used since the beginning of the last century. It is commonly used during surgery and as a pain relief method during labour. A lot of people will have come in contact with Nitrous Oxide at their dentist. Nitrous Oxide is mixed with oxygen. The concentration of Nitrous Oxide that a woman in labour receives varies between 30 to 70%. Nitrous Oxide is breathed into the lungs and there it very quickly enters the blood stream. Nitrous Oxide reaches the brain within 15 seconds. The amount of Nitrous Oxide that reaches the brain varies, depending on the strength administered and how long it has been used. The normal function of the brain is depressed to varying degrees. However the way Nitrous Oxide provides pain relief is unknown.
The effectiveness of Nitrous Oxide as pain relief in labour varies from woman to woman. Less than 50 per cent of women find it a satisfactory form of pain relief, 20 per cent obtain some pain relief for some of the time and around 30 per cent find it totally ineffective. There have been reports regarding the declining use of Nitrous Oxide as a pain relief in labour in recent years, due to its inability to provide a reliable form of pain relief.
How is Nitrous Oxide and oxygen administered?
Nitrous Oxide and oxygen can be given from either a fixed or portable apparatus. The fixed apparatus is attached to the wall and varying concentrations of Nitrous Oxide and oxygen can be given. The midwife adjusts the dosage to what is required. However as it cannot be moved, a woman in labour cannot use Nitrous Oxide in the shower, bath or at a homebirth. Nitrous Oxide and oxygen can also be given from a portable cylinder. The dosage is fixed (a 50:50 mixture of Nitrous Oxide and oxygen is in the cylinder - this known as Entonox). With Entonox it is not possible to alter the concentration of Nitrous Oxide that a woman receives.
Nitrous Oxide is breathed in by the woman either using a face mask or mouth piece. To use it correctly the woman begins breathing on the mouth piece or face mask deeply at the beginning of a contraction until a rattling sound is heard. The Nitrous Oxide and oxygen mixture is then breathed in throughout the whole contraction and is stopped as soon as the contraction is over. Nitrous Oxide can be given at any time during labour, but is most likely administered during transition.
How long does the effects of Nitrous Oxide last?
Once Nitrous Oxide enters the blood stream, it is very quickly distributed around the body. It passes just as quickly across the placenta and into the baby’s circulation. Nitrous Oxide (unlike drugs like pethidine) is not broken down by the liver and therefore does not leave by-products. Nitrous Oxide is able to be eliminated quickly from the woman’s body entirely by her lungs. Nitrous Oxide is also eliminated quickly from the baby’s body. When using Nitrous Oxide it is important to start using it as soon as the contraction starts due to the 15 seconds it takes to become effective. Once the woman stops breathing the Nitrous Oxide and oxygen mixture and begins to breath air again, the effects of the Nitrous Oxide wears off quickly.
What are the advantages of using Nitrous Oxide during labour?
The advantages of using Nitrous Oxide during labour is that it provides some pain relief for some women. Women using Nitrous Oxide remain awake and in control of their own pain relief. Nitrous Oxide does not interfere with contractions, the time Nitrous Oxide remains effective is short and there are no obvious short term effects on mother and baby that have been noted to date.
What are the disadvantages of using Nitrous Oxide during labour?
Disadvantages of using Nitrous Oxide during labour include:
- Nausea and/or vomiting
- Not a reliable form of pain relief
- Women can become drowsy, confused or disorientated. Some women experience these feelings as quite unpleasant
- The face mask can make some women feel claustrophobic.
Reference List
Enkin, M., Keirse, M. J. N. C., Renfrew, M., & Neilson, J. (1995). A guide to effective care pregnancy and childbirth (2nd ed.). Oxford: Oxford University Press.
Jacobson, B. et al. (1990) Opiate addiction in adult offspring through possible imprinting after obstetric treatment. British Medical Journal, 301: 1067-1070.
Robertson, A. (1999). Preparing for birth: Mothers. Sydney: ACE Graphics.
www.manbit.com/obstetpain/n201.htm (Website no longer active)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
PETHIDINE FOR PAIN RELIEF IN LABOUR
Written by, Jane Palmer, Midwife - Australia
(25th June 2000)
Pethidine is a widely used drug for pain relief in labour. Pethidine is a similar drug to morphine and heroin. These three drugs are from a family of drugs known as opioids. Opioids basically are morphine-like drugs. Morphine is a natural drug that can be extracted from the opium poppy, where as pethidine is synthetically made. Pethidine was first used in Germany in 1940 to reduce pain in labour and its use has continued to the present day. Initially when pethidine was created, it was thought to be non addictive but we now know that this is not true.
Pethidine works my mimicking the effects of endorphins - the body’s own morphine-like substances. One of the functions of endorphins is to act as the body’s natural pain killer. Pethidine (like endorphins) attaches to special sites on the outside of nerve cells. These sites are known as opioids receptors. Once pethidine attaches to these receptors, a chain of events occurs that results in the depression of normal activity for a little while. Pethidine’s effects are far more dramatic than endorphins. The effects pethidine has on a woman’s body can readily observed after it has been administered. A woman may become dizzy, drowsy, her eyes may change in appearance and she may experience an altered level of perception of events around her. Pethidine acts on the central nervous system by inhibiting the pain signals that are sent to the brain. The subsequent result can reduce the pain experienced by the woman in labour. Pethidine can also increase the amount of pain a woman can tolerate.
How is pethidine given to a woman when she is in labour?
The most common way that pethidine is give to a woman in labour is by an injection into the muscle (usually into the thigh or buttock). Occasional pethidine is given into a vein via a drip. Pethidine usually has to be ordered by a doctor, but is then given by a midwife. The dosage a woman receives in labour varies, usually ranging from 50mg to 100mg. The total volume injected into the muscle is one to two millilitres.
How long does pethidine work for?
If pethidine is given via an injection into the muscle, it usually takes around ten to twenty minutes to begin working. Pethidine’s effects, when given by this method, last two to three hours. If pethidine is given directly into a vein via a drip, the effects are a lot more rapid. Pethidine begins working within two to three minutes. When pethidine is given via a vein it enters the blood stream directly and only takes a couple minutes to circulate around the entire body, therefore pethidine reaches the brain and the nerve sites rapidly. The problem with giving pethidine directly into a vein is even though the effects are rapid, they only last for a short time. The effects of pethidine injected into a muscle last a lot longer.
Will pethidine provide me with adequate pain relief while I am in labour?
This is not an easy question to answer as women report varying responses to pethidine. Some women say that it provides adequate relief while other women say they achieved no pain relief whatsoever (48% of women in one survey said this). Women report pethidine provides greater relief in early labour rather than in later labour (when the contractions are a lot stronger). The bigger the dose of pethidine, the more effective the pain relief. But the bigger the dose, the more side effects a woman and her baby may experience. One piece of research said that pethidine does not provide adequate pain relief during labour, but ends up heavily sedating the woman. Overall pethidine may reduce pain experienced during labour in some women. If a woman is tired, pethidine can provide sedation (and sometimes much needed sleep). Pethidine can act as a muscle relaxant which can in some cases result in faster dilation (opening) of the cervix.
What are the disadvantages of using pethidine for pain relief in labour?
Pethidine may not provide adequate pain relief for some women. Nausea and vomiting are common, a medication may be mixed with the pethidine to help reduce these effects. Some women report feeling drowsy and confused. The effects pethidine has on perception may make the contractions difficult to deal with. Other potential side effects for the woman in labour include difficulty passing urine, dry mouth, hallucinations, respiratory depression, low blood pressure and allergic reaction .
There are no advantages to the baby if the mother has pethidine. Pethidine is known to cross the placenta and is present in breastmilk. The major problem for the baby is that pethidine can cause breathing difficulties after birth due to its depressive effect on the baby’s respiratory centre. These effects are at the worse if the baby is born one to three hours after an injection of pethidine has been given. This is the reason that pethidine is ideally avoided when the birth is perceived to be close. An antidote can be given to the baby to reverse the effects of pethidine, however the effects of the antidote only last a short time and when they wear off the baby may re-experience breathing problems. Baby’s are more likely to have jaundice if their mothers have pethidine. Pethidine effects the baby’s sucking reflex and can cause breastfeeding difficulties for the first few days. Baby’s may require special care or neonatal intensive care from the effects of pethidine, resulting in separation of mother and baby.
References:
Guy Hospital. (1994). 1994 Nursing drug reference 2nd ed. Mosby: London.
Robertson, A. (1999). Preparing for birth: Mothers. ACE Graphics: Sydney.
home.intekom.com/pharm/quatrom/q-pethid.html
www.manbit.com/obstetpain/peth2.htm - (Website no longer active)
www.manbit.com/obstetpain/peth3.htm - (Website no longer active)
www.manbit.com/obstetpain/peth4.htm - (Website no longer active)
www.manbit.com/obstetpain/peth5.htm - (Website no longer active)
www.manbit.com/obstetpain/peth6.htm - (Website no longer active)
www.qub.ac.uk/nur/research/rogan.html - (Website no longer active)
Jane Palmer, Midwife - Australia
Website: www.pregnancy.com.au
back to the top
