[CallMeProtart]

Just a random thing that popped into my head. Sorry it's long. When I was researching pain relief options in hospital, it was very much seen as an escalation where you start with gas, then try pethidine if you need more, then to epidural if you need more again.

After my research, I decided to try to avoid the pethidine option, largely due to it's effects on the baby (as compared to gas and epidural, which I believe has fairly minimal effect on the baby), it's duration (in that at my hospital it was offered as an injection not a drip, so if I didn't like it I was stuck with it for 4 hours), and the experiences of my SIL's who had it, and hated it (nausea, feeling out of control, feeling it didn't reduce the pain, but reduced their ability to cope with it).

Once I got to hospital, I laboured for almost 24 hours only to find I was still only a couple of cms dilated, so at that point I knew I couldn't do another 24 hours on gas and figured I was going to end up with an epidural anyway, so I thought I'd go straight to that and avoid the nastiness of pethidine in my bub. I was also already 'hooked up' to a drip due to having ketones, so I wasn't able to have a free and active labour at that point anyway.

Anyway this was strongly opposed by the midwife and Dr on shift, and they heavily pressured me to take the pethidine (even when I was happy with gas and hadn't mentioned epidural!). They pushed and pushed until I started to doubt my own judgement, but thanks to the wonderful support from the previous midwife who respected my preferences, plus a midnight call to the SIL's to strengthen my resolve, I ended up saying no and got my epidural. I'm pleased I did, as I had lots more labour to go!

ANYWAY I'd just put this down to bad luck in the Dr and midwife that were on shift (which it certainly, partly was).

Last week, a friend of mine reported the same sort of experience. I had told her my story so she was rather against pethidine as well, but she was also heavily pressured by the midwife to take pethidine, and even after saying no she was interrogated, and pushed, in much the same way I was. Luckily they ended up calling her ob (she was private), and he respected her wishes.

Two different hospitals, one private one public, similar treatment and lack of respect of the mothers decision regarding pethidine.

Why is this? I'm just wondering - is there a good reason for there to necessarily be a progression THROUGH pethidine before epidural? Or is this more of a 'tradition'? Is there any reason why staff should be so keen on it that they will be very pushy and attempt to override the mother's choice? Or is it a case of bad staff?

I was just surprised that she should come across someone so innapropriately pushy, and on the same issue as me, and was wondering
1) is this common, and
2) why might it have happened?

[Lightning_bug]

Pethadine has a more relaxing component to it. From what a midwife friend told me is that it's introduced at a time when it's believed vaginal birth is still possible but the mother is getting weary or stressed.

So mum calms down, her body relaxes and baby comes out. In theory.

The gas pretty much does nothing but an epidural will seriously increase the chance of having a c-section.

It's all heresay and opinion though for a coffee session with a midwife friend and some of her coworkers when I was asking about pain relief options.

[tibs]

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 $$$.

[Roselet]

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?

[SnazzySass]

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.

[MakesMeHappy]

I can't really answer your questions but thought I would share my experience.

I was induced by synto drip. I started with gas and when I started asking about pethidine my midwife said/suggested that if I already felt the need for pain relief that I should have the epidural. After discussing it a but with her first I decided on the epidural.

So maybe it has to do with where you are at in your labour? But I think it would be more up to the individual midwives/drs


**Edit to add- I was public

This post has been edited by popple: 06/06/2012, 11:58 PM

[Gonewiththewind:...]

I had a very long LONG labour. I was in hospital for over 30hrs & progressed (dilation wise) very very slowly.

I had pethidine fairly soon after being admitted. I was totally exhausted (24hrs of pre/early labour at home with less than 1-2hrs broken sleep). I also had phenergan & found the combination semi effective in letting me get sleep between contractions. I still woke up for contractions but fell back to sleep immediately & it enabled me to rest. I didn't need gas as it was SLEEP I needed not pain relief. I ended up having 2 doses of peth/phenergan over an 8hr period & then laboured for another 13 or so hours drug free before taking an epi about 22hrs after arriving in hospital (over 40hrs into contractions!!). I did have gas when they were putting the epi in as my contractions were on top of each other & I couldn't stay still/ Following the epi they pumped in the syntocin for another 8-9hrs before DS was delivered via vontuse.

For me it wasn't so much a progression, it was more than the peth helped with sleep vs pain. If I have a similar labour next time I'll be taking an epi & starting the drip WAY earlier!!

[Gonewiththewind:...]

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?

I also wasn't offered an epi until 4cm (private) even though it took me a long long time to get there (I think it was about 4hrs between 3cm when they said I was in "established" labour until I reached 4cm!)

[SCARFACE CLAW]

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. It was too late after that to get an epidural

Also the actual injection stung like a b**ch!

[Regular Show]

I was given pethadine first but that was to sleep because I refused sleeping tablets. I was then given an epidural and never offered the gas. (this is with my first).

Id think your experience was probably from dr preference or hossy preference??

eta; I was public

This post has been edited by Cadie: 07/06/2012, 12:13 AM