When to take painkilling drugs
Pain killing drugs can be of great benefit to you when used within the safe guidelines.
In terms of timing:
Diamorphine: in early labour because it has a longer length of action.
Pethidine: in both early labour and a little later on, as its action is shorter and less likely to affect the baby.
Meptazinol: up to late in the first stage of labour because of it's minimal effects on the baby.
Powerful painkilling drugs give good relief of pain. The effect of each injection is around two to three hours. If given often, in big doses, or too close to the delivery of the baby, they can make you and your baby sleepy and may delay successful breastfeeding.
The nerves from the uterus (womb) and birth canal go to the brain through part of your lower back (see the diagram). It is possible to bathe these nerves with local anaesthetic using an injection.
A fine tube is placed in the region of the nerves so that painkiller can be injected. This can be repeated or 'topped up' when needed during your labour.
Positioning of this tube is done by an anaesthetist. Once the tube is in position you will be almost unaware of its presence.
For the second stage of labour, the 'top up' is usually injected with you sitting up. This stops the pain from the lower nerves. This top up will also allow a doctor or midwife to deliver your baby painlessly if assistance is required.
Any stitching can be done while the epidural is still working. An epidural will leave you pain free, but you may still have some sensation of pressure, particularly as your baby is born.
A Standard Epidural
This technique uses a strong local anaesthetic solution. You may find your legs may feel quite heavy with this technique.
A Mobile Epidural
A fine needle is placed in the region of the nerves and a single injection of painkiller is made. The fine tube is then placed in the same region so that 'top ups' can be injected.
The 'top ups' are a combination of two types of painkiller. The local anaesthetic is weaker than a standard epidural and it is less likely that your legs will feel heavy. Good pain relief is achieved by the use of a second pain killer in the mixture used for 'top-ups.'