Pain relief

Pain relief

After trying all types of natural pain relief, sometimes it’s just not enough. If you need medical pain relief, such as pethidine, remifentanil or an epidural we will refer you to the hospital as you will need extra monitoring for you as well as your baby (i.e. blood pressure, heart rate, blood oxygen rate, fetal condition/CTG). This means your care will be handed over to the hospital staff (medical indication). One exception is gas & air as there is no chance of complications, no referral is needed so we will still guide you one to one.

Every type of pain relief has it’s own pro’s and con’s and is most effective in a certain part of labour:

Gas and air

(Relivopan®): combination of oxygen & nitrous oxide administered by inhalation starting around of 5-6 cm dilation.

 

Pros

  • works after 1 minute
  • it takes the peak of the pain away
  • it won’t directly interfere with your labour helps to relax and reduces anxiety
  • no extra monitoring needed for you and the baby, which means: you will keep our one-to-one care!
  • after administering gas & air, its out of your body within minutes
  • it does not slow down labour

Cons

  • its a mild painkiller, it won’t take all the pain away
  • some women experience nauseousness / dizziness
  • you can’t use it while pushing
  • availability, as it’s only available at the Bevalcentrum and Amstelland Ziekenhuis

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Pethidine

A single shot in leg (or bottom) of morphine type of drug that wears out in 4 hours administered in early labour

Pros

  • works after 10 – 15 minutes
  • helps to relax and reduces anxiety
  • 1 in 3 women are happy with the effect of pethidine
  • it makes you sleepy, sometimes you can even sleep for some time which can help to regain your energy
  • after 4 hours you’ll be under our care again

Cons

  • you can experience nauseousness / dizziness
  • you can’t walk or stand
  • the baby can be sleepy when it’s born within an hour after the injection and on very rare occasions could need medication to help him breath
  • your care will be handed over to the hospital staff for 4 hours
  • you need extra monitoring in hospital for you and your baby (i.e. blood pressure, heart rate, fetal condition/CTG)

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Remifentanil

an IV drip with morphine type drug self dosage, administered from of 5cm

Pros

  • works after a few minutes
  • helps to relax and reduces anxiety
  • it takes the peak of the pain away
  • you can dose yourself which gives you a feeling of being more in control
  • after stopping the IV, it’s out of your body quickly

Cons

  • you can experience nauseousness / dizziness
  • it can affect your breathing, resulting in needing oxygen
  • it can slowdown labour which gives you more chance of getting an IV drip with oxytocin
  • after a 5 hours it doesn’t work anymore
  • you can’t stand or walk
  • you can’t use it while pushing
  • you need extra monitoring in hospital for you and your baby (i.e. blood pressure, heart rate, blood oxygen rate, fetal condition/CTG) your care will be handed over to the hospital staff (medical indication)

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Epidural

A local anaesthetic injected into the space between two vertebra in your back. It usually removes all pain and most feeling from the waist down,  administered by anesthesiologist.

 

Pros

  • most effective pain relief
  • it allows you to rest/sleep if labour is prolonged
  • you’ll still feel clear-headed and more in control of your birth experience
  • it can be administered starting at 2 – 3 cm of dilation

Cons

  • with 1 in 8 women say it doesn’t work properly
  • some women develop a fever or low blood pressure
  • you will need a urinary catheter
  • it can slowdown labour which gives you more chance of an IV drip with oxytocin
  • An increase in temperature, which may lead to antibiotics if it is a sign of infection
  • more chance of assisted delivery
  • you need extra monitoring in hospital for you and your baby (i.e. blood pressure, heart rate, blood oxygen rate, fetal condition/CTG) your care will be handed over to the hospital staff (medical indication)
  • A bad headache after birth that lasts for days or weeks if not treated (one in 100 women)

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