Im confused about the drugs for birth help please!

[*Belle*]

Hi girls

Im a bit confused after seeing my OB today and also reading a lot of posts on here about little intervention of drugs during birth. In my personal circumstances my OB told me its better for me to steer clear of morphine/pethidine for allergic reasons as I have allergic reactions and she believes I would have less of a reaction having an Epi. Ok I take that on board to consider if necessary but I told her that I would prefer not to use any drugs and have a drug free birth, the only drug I would possibly try if I needed was gas. She is fine with that. However of course if by chance I said if I need to have emergency c/s then I will deal with having an Epi. She is fine with my choices and also does not do episiotomy unless emergency which I am thankful about.

Im confused as some of my friends and some people that post on here who have given birth still talk about using gas and pethidine/morphine and class this low intervention? I thought any drug was intervention? I thought pethidine/morphine would be worse than an Epi for the baby and your body as it goes through your whole body and baby but seems people prefer this over an Epi so I am curious why?

Im sorry I waffled on a bit I hope you girls can shed some light. Is it normal to be confused by this? Thanks for listening girls, I look forward to hearing all your thoughts on this so I can get a clear picture.

Thanks
Bel

[Melinda]

Belle,

As far as I understand it, the administering of any drugs is indeed considered intervention and therefore the birth may be vaginal, but not natural IYKWIM? Natural birth means no medical intervention? (I'm sure Kelly will come and clarify this for you once she sees your post - she will be able to explain it to you much better than I would and is far more qualified to do so! )

Pethidine in terms of how it is administered has different affects from what I can recall. If the birth of your baby is more than around 4 hours away, they will give you an injection of pethidine in the leg (if you request it of course!) and this method means that it takes longer to actually take effect, but the effects last longer. If birth is less than 4 hours away and pethidine is to be administered, it is usually done via IV and the effects are felt much more quickly, but they leave the system more quickly, therefore having less effect on the baby? (Quite often pethidine will make the baby sleepy I think).

Kelly will probably be able to give you a clearer picture of the effects of an epidural also - obviously it can be effective in terms of pain relief for you, but I think sometimes it can slow labour? I'm not sure.....

I had every form of pain relief available to me (gas, pethidine - both in the leg and IV, followed by epidural and subsequent spinal block due to needing the emergency c/s).

Kelly - come and help us out! LOL I think I've confused Belle more here?!

[Pandora]

yep, I am pretty sure a nautral bith is no drugs, inductions or other interventions.
I had a vaginal birth, with an inducion via gels & I had gas.

The midwife told me that if I had had an epidural, it would probably have affected my ability to push as well as I was able to, and would have likely led to further interventions like forceps/episieotomy/ventouse

[BellyBelly]

I wouldn't stress so much about the technicality of it if you do need it. I think most of us would love to have a normal physiological childbirth, but it's not always possible, especially with things in the current state they are - hospitals today are not set up to give you the best chances possible.

A natural birth is one which involves no outside help in terms of pain relief, assisted delivery (forceps, vacuum etc) - but to have only gas or something like that is low intervention, but just not classed as 'natural'. For some gas is the only thing they need to distract them to avoid other interventions. For some it's not an option because they know it does circulate to the baby.

It's not the be all and end all, I think the most important thing to focus on is getting yourself informed and supported so you can best prepare for all this. 'New Active Birth' by Janet Balaskas is great and covers each type of pain relief well, so perhaps this might be a good book for you to grab. Another way to help with reducing the likelihood of pain relief if to get a Birth Attendant or Doula (click the link in my signature to find out the stats), and other things, but I see those as the main two. Get informed as best possible and get some trained, continuous support to help you work towards your birth intentions. Your Ob might agree with your intentions, but she wont be there until it's time to catch the baby (if she makes it) and you never know what midwife you will get and her philosopy, which will shift change around 2-3 times during a birth.

[tommygirl]

hi i hope this helps,

I had my son in 2000. And i wanted to have a natural drug free birth.However it didnt go that way. After 15 hours of labour, which i had gas first which didnt do a thing for me, then followed by a shot of pethadine which calmed me and i fell asleep for an hour or so, then as i pushed again they told me that myson was to big for me and i had to have a c section so i had an epi. My ob said i should take the Epi asap as i am only small and i would tear pretty bad and i would have to be cut. So i had never read anyhig about Csections and i got whisked away very quickly to have one. I recovered very quickly from it and i was up the next day. My son was very healthy he was 9 pounds. and got top scores on the apgar scale had no jaundaice (cant spell) Im now 8 weeks pregnant with 2# and i am going to have an elective C section again. My advice with would be to listen to your midwife and Ob expect nothing because every birth is different, i had no idea what was happening but they do this all day evry day so they know what is best for you and your body. Go in with some knowledge about every possible option because its up to you and your bub on the day, if you think about it to much it will stress you out. So take a deep breath and just go with bub and go with your instints, good luck and go with the flow.

[BellyBelly]

Some of what you posted is a little confusing... but I can't believe your Ob made the decision for you to have a caesar by looking at you and deciding you were too small! Also, if you are too small and the baby wasn't going to fit, an episiotomy would be performed when the baby was crowning, so that would mean it would have fit through your pelvis! 9lbs is not huge for a pelvis! They cannot tell you if you are going to be able to birth a baby or not, or tear just by lookng at you, that is absurd. Your body produces stacks of hormones in labour, and this enables the perineum to stretch adequately to birth your baby. It produces stacks of relaxin to allow your pelvis to stretch and open.

Its the private hospital settings and obstetric attitudes which result in the high levels of intervention that we have today. He could have said to you, okay, I know you can do this, lets get you upright and give you the best chance at birthing without a caesar - private midwives extremely rarely do episiotomies, some none, some one in their life! However with an epidural you wouldn't have been able to do that, still, there are more optimal positions you can do.

Argh sorry the system really peeves me off. I wish there were more angry women out there demanding answers, demanding improvements and not thinking that their Obs did the best for them that they could - just look at the stats I posted about outcomes with homebirth vs hospital - and thats not an argument of whats better but what we are truly capable of. Then ask yourself if your Ob truly did the best thing for you. Some do, but for most, the only solutions they know are ones involving tools and incisions.

If anyone is interested, you can join the Maternity Coalition for around $30 odd and they are fighting our battles behind the scenes. They are working so hard for better birthing outcomes and environments.

Check THIS out, then check THIS out.

And some info on caesareans HERE.

[bon]

Bel personally I would rather have pethidine than an epidural, only because my experience with epidural was it made me unable to move from the waist down, I couldn't push (thankfully my body did this for me) and I couldn't walk properly for a good few hours after the birth, plus I needed a catheter in which wasn't that pleasant. Having said that, though, I would rather have no drugs except for the gas. But, given a choice I would opt for pethidine first and only go for an epi if it was really necessary, like in an emergency.

It is good to keep an open mind before labour but I don't think it is good to just rely on your Ob and midwife to make all your decisions for you, usually they will go with your best interests but not always so it is good to be informed.

[BellyBelly]

Bel has an allergy though so it looks like it might not be an option...?

[tommygirl]

I started off at 50kgs when i fell pregnant and i hit 82kgs. My DS was so big for me that i ended up at 7 months having fractured ribs. And i worked everyday of my pregnancy hairdressing till 8 days before i had him. I went 4 days over, and i wanted to be induced, but he said to go home and either go for a walk or have sex....GREAT. my waters broke that morning at 2am.My DS head also crowned and because his heartbeat slowed down they pushed him back in and did an emergency C section. Right or wrong i dint care as long as my DS was ok. At my last OB visit (he is a private DR in brisbane very popular, and has since retired as he has been practising forever) he said to me as you can hardly move i personally think this bub is going to big for a girl of my size. You could tell by just looking at me, trust me. he advised at my last visit that i should take an epi as soon as they offer it to me as he thought i would struggle. And thats what i did. I was a private patient at the mater in brisbane and they were so awesome. I was 22 and i had no idea what to expect. He let me go as long as i could hoping i could have a vaginal birth but obviously after my DS getting a bit distressed aswell i wasnt meant to go that way. My OB did everything i wanted, and my point i was trying to say is "YOU NEVER KNOW WHAT WILL HAPPEN" My sister has 2 beautiful children both born naturally, my sister had her son at 3am and was home 10am getting my neice lunch. So you just have no idea whether you will need drugs or not.

[BellyBelly]

wow tommygirl - how big was your son? I have had smaller babies, but my mum reckons smaller babies are harder to push out as bigger babies tend to do more of the work hehehe! Just goes to show you how we perceive things I guess!

Yes it's true, you never know what might happen in labour, everyone says that, but just as a general statement, get yourself informed and empowered before the birth and you never know what your body is truly capable of You just have to focus on what your body is capable of, instead of what it might not be capable of.

[David Vernon]

The potential side effects of an epidural are more significant than pethidine and although rare (paraplegia 1:100,000 cases, nerve damage 1:10,000 cases and dural puncture 1:100 cases - leading to servere headaches for up to several months) they are worth taking into account when considering a C/S. This may be why some women would prefer opiates (even though they enter the baby's bloodstream).

Best of luck with your decisions and hope it all goes well,

Cheers

David

[*Belle*]

Kelly, firstly I want to say thank you so much for all the information and advice you have given me, it has been very helpful. I have the New Active Birth book by Janet and I love it! thank you so much! I will do my best to be prepared by the time I go into labour. I start my antenatal classes next week and am reading Janets book.

Tommy Girl, Mel, Bon, Rayray, David, thanks so much for your advice and experiences it is great to hear them all to understand what happens and yes I will definately keep an open mind during labour and trust myself and my instincts and prepare myself.

You girls are so great! thank you so much! and thanks David for the stats too

Bel
xxx