Valerie Gommon Midwife’s Blog

Pharmacological drugs for labour

Posted on: July 24, 2009

ENTONOX

Also known as “gas and air” (50% oxygen and 50% nitrous oxide).

Self administered through a mask or mouth piece

Used to breathe in and out during contraction

Helps you cope with the pain and also acts as a distraction by giving you something to focus on

ADVANTAGES

Helps take the edge off the pain

Does not affect baby

Can not overdose

Can stop using it at any time

DISADVANTAGES

Can make you nauseous or vomit

Can make you feel “drunk” or out of control

MEPTID

A pain killing drug similar to pethidine.  It is given by injection either into your bottom or thigh.  It usually relaxes you a bit and takes the edge off the pain.  This drug has to be prescribed.  We give an amount proportionate to your weight.

ADVANTAGES

This drug helps some women

The effects on the baby are probably slightly less than pethidine

The nausea/”drunk” feeling may be less than pethidine

Can be given again after 2 hours

DISADVANTAGES

It can make some women feel nauseous and vomit

Some women do not to feel “out of control”

It may affect the baby’s breathing/ability to breastfeed if given shortly before the baby is born

Can not have meptid if having a waterbirth

PETHIDINE

A pain killing drug, given by injection into your bottom or thigh.  It takes about 20 minutes to take effect and lasts for up to four hours.  It usually takes the edge off the pain and relaxes you.

ADVANTAGES

Effective pain relief for some women and relaxing if nervous

Can help you to sleep

DISADVANTAGES

Some women do not like the “out of control” feeling

Can cause nausea and vomiting

For some women it has no effect at all

Pethidine crosses the placenta and can affect baby’s breathing/ability to feed (antidote is available)

Can not have if having a waterbirth

DIAMORPHINE

Similar to Pethidine – A pain killing drug, given by injection into your bottom or thigh.  It takes about 20 minutes to take effect and lasts for up to four hours.  It usually takes the edge off the pain and relaxes you.

ADVANTAGES

Effective pain relief for some women and relaxing if nervous

Can help you to sleep – long lasting

DISADVANTAGES

Some women do not like the “out of control” feeling

Can cause nausea and vomiting

For some women it has no effect at all

Diamorphine crosses the placenta and can affect baby’s breathing/ability to feed

Can not have if having a waterbirth

EPIDURAL

An epidural is where painkilling drugs are passed into the small of your back via a fine tube. It is called a regional anaesthetic, which means the drug is injected around the nerves that carry signals from the part of your body that feels pain when you’re in labour. The result will be that your belly feels numb, giving you very effective pain relief

ADVANTAGES

Good pain relief – especially if labour is long, or instrumental delivery is required

It can be used during a caesarean section and therefore avoids the use of a general anaesthetic

DISADVANTAGES

You need to remain very still whilst epidural is being sited

It causes a drop in maternal blood pressure:

You will need an intravenous drip to counter this drop in blood pressure

Drugs used pass through the placental barrier

Your baby will need to be continually monitored – in extreme circumstances the baby can become distressed necessitating an urgent caesarean section

You will usually need a urinary catheter to empty your bladder

It can slow the labour necessitating a syntocinon drip to get contractions going again

It restricts your movement – usually you will be confined to bed and it can be harder for the baby to get into the best possible position for birth, this can make the labour longer, and make it more likely that you need help (ventouse, forceps or caesarean section)

It may not be 100% effective and you can have “break-through” pain

There is a lack of sensation to ‘push’ in the second stage and this leads to an increased need for ventouse or forceps deliveries

The effects can take some time to wear off


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