[Eeyolet]

With DS I had gas and then when i needed more I had pethadine as I didn't think I needed an epidural but needed more than the gas. The pethadine only worked for about an hour and thay can't give you anymore for 4 hrs which meant i laboured with only the gas.

With DD I went straight to the epidural, the midwife asked if i wanted to try something else first but was happy to organise the epidural when I said no. I wasn't pressured at all to try anything else. I actually expected more of a fight so I was suprised when the anaesthetist showed up about 10 minutes later.

Both labours were with a syntocin drip so contractions strong from the start (although DS I had been in early labour for a few hours prior) and also prosterior births so maybe that had influence on the situation.

[Lokum]

I reckon pethidine shuts you up and gives everyone else relief from your whingeing too.

I wanted the epi and peth was pushed on me. I doubted myself, and caved. They said it was too early, and labour wasn't sufficiently established for the epi, since I was only at 2cm and hadn't progressed in nearly 3 hours.

But I had been induced!!! The contractions were 90 seconds apart from the get go, and after my waters had broken they were tough!!! I had no chance to rest between them, and no hope of 'relaxing.' I believe if I'd had the epi I would've relaxed, but I was terrified and shocked and the whole thing was going nowhere.

The peth didn't take away the pain, only my ability to complain. I had my c/s 40 mins later, and feel like I was stoned and out of it at my DS' birth. It is the single thing I resent and regret about my disastrous induction-emerg c/s- baby-in-SCN-given-formula birth.

No more PETH for me!!

[CallMeProtart]

They probably thought it was too much of a PITA to call an anaesthetist in when they can give the peth themselves. In the case of public at least it is probably hospital policy to save $$$.

You're probably right! They did have that sort of attitude...

I can't answer your question, but have an additional related one. I had gas, and needed more, asked for and was given morphine. That wasn't stopping the pain so I asked to have the epidural. They wouldn't let me have the epidural until I was at 4 cms (I was in hospital from the word go as I was induced - hence also the massively painful contractions). Is that normal? I've heard from others that got epidurals as soon as they were asked for them, before the 4cm mark. Is it a private vs public thing?

Some data says epidurals can stall labour (other data says it relaxes the person and can hasten labour) - possibly at the early cms there is a fear that labour may stall. Possibly applicable in my case too. My labour actually DID stall once I got the epi and relaxed - but interestingly it also seemed to stall when I got really into the zone in the bathtub pre-epi and sort of into my relaxed state. So I'm not sure if it was a dangerous stalling as such, or just the labour slowing a bit when I was relaxed.

Wouldn't it be something to do with the danger of fetal distress and a stalled labour with an epi? particually early on .Not to mention the risk of spinal injury?

My research sugested that an epi was actually quite risky, more risky than the other two anyway.

Good points, yes.
It's funny, if they'd said that to me I might have held out with the gas till I'd got to 4cm or something - I just knew that I couldn't wait for 10cm on gas at the rate I was going!
But it seemed like they didn't actually know WHY I should have pethidine before getting the inevitable (given my dilation speed) epi... just that I SHOULD.

I found that the Pethidine didn't reduce the pain at all, but made me too confused and out of it to coherently complain about the pain - so in effect, it seemed to just be a "shut her up" drug.

This was exactly my fear!

[Bluie]

I was given gas and then went straight to an epidural - no pethadine here!

A friend told me she was basically asleep between contractions on pethadine so maybe it's so they can rest between contractions if in or near active labour?

[Swahili]

With my first labour I went from using the gas to an epidural. Pethidine was never offered, not that I wanted it.

There are so many factors- doctors preferences, hospital protocols, type of labour-length, amount of pain, that there is no clear cut answer to what you are asking. IME, I am unaware of a gas, pethidine, sequence- I only know of one friend who had pethidine in her labour and it's rarely given where I work.

They probably thought it was too much of a PITA to call an anaesthetist in when they can give the peth themselves. In the case of public at least it is probably hospital policy to save $$$.

Sorry, but this is complete codswallop. It would be completely unethical to deny appropriate pain relief due to laziness. And I've NEVER heard of any hospital policy designed to save money by reducing epidural frequency.

[CallMeProtart]

Lokum - you make me so glad I held out when I was being pushed towards the peth! Thank heavens for my SIL's and them answering the phone at that hour - that honestly made the difference when I was finally worn down to caving in point. I'm so angry on your behalf! One of the things I would have really resented would have been being zoned out at the birth, whatever sort of birth it was. For some reason I have a big thing about memory and wanting to remember stuff accurately.

[CallMeProtart]

Sorry, but this is complete codswallop. It would be completely unethical to deny appropriate pain relief due to laziness. And I've NEVER heard of any hospital policy designed to save money by reducing epidural frequency.

I agree with the money bit, but not the laziness bit. IMO the midwife and Dr I had that night were extremely unethical and I wouldn't put it past them being lazy. I suspect I was being too 'high maintenance' on the gas at 2am in the morning, otherwise I can't think why they were pushing pethidine on me before I'd even signalled that I was considering any escalation of pain relief.

[MAGS24]

I found pethidine very useful during my first labour because it was a long labour and helped me get some sleep in between contractions and even though it didn't take the pain away, it made it feel like it was happening in a dream. I also used the gas pain relief.

After reading about people who have developed spinal cord problems after an epidural, I decided that I didn't want an epidural during either labour. I didn't want anyone sicking a needle into my spinal cord.

Second labour was quicker and lot more painful so the pethidine didn't seem to do very much for me. The gas seemed to help a lot.

I read that pethidine doesn't have much effect on the baby if it's given early enough during labour so both of my boys had no issues after they were born.

This post has been edited by MAGS24: 07/06/2012, 12:41 AM

[tibs]

Sorry, but this is complete codswallop. It would be completely unethical to deny appropriate pain relief due to laziness. And I've NEVER heard of any hospital policy designed to save money by reducing epidural frequency.

My sister is a registrar in a public hospital and they are repeatedly reminded not to frivolously call in specialists due to budgetry constraints. Maybe your state govt is richer

[Swahili]

My sister is a registrar in a public hospital and they are repeatedly reminded not to frivolously call in specialists due to budgetry constraints. Maybe your state govt is richer

Getting an anesthetist to put in an epidural is hardly frivolous. It's pretty routine in this day and age. Considering the high rates of epidural and c- sections, I don't think it's an area where staff are being urged to cut back.

OP- ''extremely unethical" is a big call!