This week I had the appointment with the anaesthetist to discuss pain relief during labour. This was particularly important due to the spinal surgeries I’ve had in my lumber spine and the concerns I have over an epidural. In addition to these methods there are also natural, no-medical pain relief options you may want to consider.
I had the boys in 2007 & 2008 before I had the back problems and spinal operations. Both labours were spontaneous and I had normal deliveries, which was great. With the first I was begging for an epidural but the hospital was to busy with emergencies, so instead I had gas and air and pethidine. The second labour was more manageable and this time I was fine with the gas & air and pethidine, I think I had more confidence I could get through labour this time round!
Gas and Air
This is also called Entonox. Some women find it really helpful and I was one of them, it helps in the earlier part of labour and although it didn’t take the pain away completely it made it much more manageable. It works really quickly and left my system just as quickly, it just made me feel a bit drunk and very very thirsty. Other women don’t like this as it can make them feel sick. It’s an easy option to try and if you don’t like it, it won’t be in your system making you feel ill for a long time.
I had this with both the boys and it was an injection into my thigh, it works within about 20 minutes and lasts for between 2-4 hours. This was great and really helped me control the pain and focus on being in the correct position and also the pushing when I got to that stage. I didn’t experience any side effects from this and in fact remember telling the midwife how much I loved her once it had kicked in, it certainly put me in a much happier and calmer mood.
An epidural is a type of local anaesthetic that is injected into the spinal canal, it numbs the pain signals and nerves and can offer women complete pain relief.
My concerns about having an epidural
Since the pregnancies I have had an epidural for back pain and unfortunately had a dural tear and needed a blood patch to fix this, I was seriously ill for about 6 weeks after this. I’ve also had an epidural after the first 2 spinal surgeries to help with pain relief, although they didn’t really work too well and after the second one they ended up taking it out.
With the fusion and surgical scar in the area the epidural or spinal would be put I don’t have a lot of confidence the anaestist would get the correct position first time, there’s a higher risk of infection and no guarantee that it would work. With the surgery I’ve been through I’m very protective over who I let near my back and it’s just not a risk I want to take.
The anaesthetist was great at listening to my concerns and has written in my notes that I’m not to have an epidural or spinal. If I need an emergency section then I will have to have a general anaesthetic which comes with it’s own risks, but ones I’m happy to accept.
We also discussed pain relief whilst in labour. I’m planning on using the gas & air and also the pethidine as per the last labours and am hoping that this will be enough to get me through the whole process.
I have been offered another type of pain relief called Remifentanil which would be administered intravenously via a PCA (patient controlled analgesic pump). I hadn’t heard of this before but understand that it’s a very strong and fast acting analgesic. If I want to use this then I can’t take it within 4 hours of pethidine and I must have a midwife with me at all times to monitor me.
This is a good option to have as I don’t know how much my back and pelvis are going to hurt during the labour due to the current problems I have. I’m really please to understand all the options available to me and have it all written in my notes so I can make whatever decision is best for me on the day.
If you want more information about pain relief in labour check out these links;
To see information about epidurals vs remifentanil click here
To look at the overview of medical pain relief from the NHS click here