Sterile Water Injections

[chelleg]

Hey everyone
Just for my own interest, i was wondering how many of you have heard of, or even used Sterile Water Injections for the relief of backpain in labour? For those of you who haven't heard of this, it is a form of pain relief used widely in the Scandinavian countries, and with which alot of positive literature surrounds. It is a very affective and very safe form of relief from back pain in labour. It works extremely well in posterior labours and hopefully diverts the want for an epidural thus resulting in a more active labour and avoiding the whole 'posterior position, back pain, epidural, unable to move off the bed or off your back which prevents babe turning resulting in complicated labour/birth experiece' viscious cycle! The injections are administered by midwives - usually 2 midwives simultaneously, a small amount of sterile water is administered subdermally into 4 spots on the lower back. Apparently there is an intense stinging feeling at the injection sites which lasts for around 20 seconds and that is about as bad as it gets. The theory is that the injections work by 'shutting the gate' on the nerve pathways involved with the pain from the posterior position of baby.
We have just started doing this where i work and we had a woman on Friday who's babe was posterior and she was experiencing back pain of 8 out of 10. She had the injections and almost immediately the pain was 0 out of 10. I'm so excited about this! It's not a drug, so there is no risk of harm to the woman or the baby, it doesn't require any extra monitoring, it doesn't require medical input, it doesn't restrict the woman and it works!!!
So has anyone ever had these injections? Would love to hear any personal accounts of the effects

[Fi]

NOpe - haven't had it but I'm very proud to say that our hospital does it, and was one of the first around I think. Apparently the midwives started doing it on the sly, and then it was so successful they got it endorsed by the hossy.

I have been told it really, really hurts, like a wasp sting, but it relieves the pain for maybe 10-20mins or so?

I suffered from excrutiating back pain in my last labour. I wouldn't know what to rate it, but it was a hell of a lot worse than the contractions. Have been told that if I get even a hint of that this time around they will administer the papule injections immediately.

Great stuff huh? If I had access to then when labouring with my daughter, I would very likely have been able to avoid my epidural (which I only really had for the back pain) and maybe prevented a forceps delivery.

I'm hoping I wont be able to give a detailed report of it in the next few weeks though

[blackbird]

My OB was teling me about this - he attended a session on it at the hospital recently. He thought it sounded great but didn't want to make me his guinea pig. I'm lucky that bubs is positioned well and that I've got great support to avoid being on my back so hopefully I'll avoid the pain of a posterior labour. I am starting to feel a little apprehensive about what the pain will be like but I guess it will all be over in 36-48 hours (I'm due to go in for induction tomorrow at 5pm if nothing has happened). I'll ask around at the hossie to see if anyone has had the injections.

[chelleg]

Fi, i was kinda wondering where our hospital was in the scheme of things with getting it up and running. The research has been around FOREVER but people have only in the past few years decided to take any notice of it! I know that my hospital certainly isn't the first to be doing it, but i'm interested to see how 'up to date' we are! I'm not sure off the top of my head how long it should relieve the pain for but when i came on shift on Friday, the woman had had the injections at least an hour prior if not longer and was still getting good relief. I guess like anything, it's different for every woman!
Blackbird, it's nice to know that there are obs using this as well Who ever would have thunk that plain old water is far better than all the wham bam drugs on offer

[BellyBelly]

I think I have heard of hospitals using it for around 12 months, but it wasn't very many. None of the women I have supported have been offered it anyway. But I do think more are doing it now, as more midwives get trained in it. I also know some women (a small percent) don't like the pain of the injections and don't have more. I know a good trick for back pain in labour though, doesn't hurt as much as injections but you really need two people to take turns at it, as it is exhausting after a bit

[Schmickers]

My word, I hadn't heard of this. I'm off to CIAP to look up some research on it. I think victoria might be quite interested in it - as it's non-pharmaceutical, it would be even be a safe option for pain relief at home.

To those using it in a hospital setting - do your hospitals require a prescription, or is it midwife-initiated?

[BellyBelly]

Midwives do them... there is a training course for it.

[Fi]

Yep - the student midwife I met up with a few weeks ago was talking to me about it. I'm not sure where she is training (Maybe Geelong based?) but apparently they all gave them to each other in class not long ago but used saline rather than sterile water. Apparently it doesn't have the same bitey sting as the sterile, and wont have the same affect. So they are doing it as part of their courses now which is great.
I think Geelong hossy started doing it not long after Jenna was born (bloody typical.....) and she is 20m old now.
Chelle - its my opinion (and I'm not by any means an expert on this ) but if I had been able to get up and move around during my labour with Jenna, I may have been able to get her to dislodge herself from whatever she was stuck on. My back labour had me on all fours for about 2hrs, at home and then in hossy, so I was just stuck and couldn't get off the ground. BY having the epi I was then on the bed and things sort of spiralled down hill from there.
Perhaps all I would have needed was 10-20mins upright to get labour going again, but it was just too hard to even straighten my back up.

Blackbird - great that your PB knows about this, but someones gotta be a guinea pig right? And rather someone else than you during your first labour

[chelleg]

Schmickers, I'm fairly certain the entire thing is purely midwife initiated - midwives recognise the need for it, midwives prepare it, midwives administer it. That's the beauty of it IMO no medical intervention required! Let me know how you go with finding stuff...last time i had a thorough search it was difficult to access alot of the info but since we have just started doing the injections at work we have alot more stuff hanging around at work that i could forward to you.
Fi, i guess it's one of those things, i mean who knows what *could* have happened. But as you know posterior babies need to turn and positioning plays a huge role in this. The back pain from a posterior labour is so intense that some women want the epidural which in turn prevents them from being able to move into positions to help the baby move and thus they kinda get jammed in that posterior position which makes for a more complicated birth Bugger about the timing
Kelly your trick has me intrigued......

[Antheia]

Never heard of it. But wish i'd been offered it when i was having Charlie. Or maybe that was before it came in there Chelle?

[chelleg]

It was Tegan Alot of the girls did the training some time ago but the administraton of the injections had to be approved by the clinical governance people (the powers that be!) and that took ages.

[*Jessica*]

The hospital I am going to does these, and have been doing them for atleast 12mths. My neighbour is a midwife there, she says it hurts alot when being administered but works well. I really should investigate more but to be honest had my neighbour not worked there I wouldn't even know they did it.

[Fi]

Apparently they do the injections at the same time as a contraction. That way it doesn't increase your overall pain, its just a pain at the same time as other pains.
But yeah - apparently it hurts like snot going in.

Its basically making a blister under the skin with sterile water (I think), so I reckon that would be pretty ouchy.

[BellyBelly]

chelle, the trick is to have the woman sitting in a chair and push her knees firmly into the chair (i.e. horizontally not pushing them down). Tried it on a mum a couple of weeks ago, who then wanted me to do it the whole labour - lucky her partner was helping too, my wrists were wrecked - but it worked well. She got to 8cms with such composure, no drugs and posterior bub, but was told she was 10cms and the midwife had her pushing so you can imagine what happened there...

[chelleg]

Wow! How interesting! Will definitely have to give it a go!
I can certainly imagine what happened there...bad recipe. Not a fan of midwives who think they know when a woman needs to push.

[mummato3]

As a student midwife, I was supporting a woman through labour two weeks ago and her baby was posterior so she was in excruciating back pain. She was offerred the sterile water injections as she was not wanting to have any drugs in labour. She was told that it would be painful, but i dont think she realised how much until they did the first ones through a contraction and she went through the roof!!! The midwives told her that in order for it to be effective, they had to do a second lot, but she virtually begged them not to do it again...she was in tears as was I almost as well!! I hadnt seen it done before, but apparently it scrambles the pain messages passed through the nerves in the back for a short period of time, and that is how they can provide relief.