UK Midwifery Archives

These archives contain extracts from discussions held on the UK Midwives and Consumers email list, a discussion group for people interested in midwifery in the UK. Open to midwives, students, mothers, and anyone interested in improving maternity services in UK. Posts in these archives express the views of the individual authors, and not those of the Association of Radical Midwives.

Pethidine (Demerol) as pain relief in labour

Recently I have been thinking about the use of pethidine in labour. My interest was aroused by several multips who had had pethidine in a previous labour and stated that they would not have it again because it did not help with the pain of labour and, for some, made things worse.

I started to read around it a bit more and discovered that some units have banned the use of pethidine on labour wards. Does anyone work on such a unit? The evidence I am beginning to collate is now suggesting that pethidine is not an effective analgesia in labour and that there is no evidence to support its use!

Rebecca

The hospital I am training in does not use pethidine – we offer Diamorphine with an anti-emetic. Works better for some than others.

Linda

I had pethidine when I had my eldest, before I had my 2nd son. I thought it helped as I pretty much slept through labour, which was 11.5 hrs long and induced with the works, so it was intense throughout. I used just gas + air when I had Dillon and realised that it didn’t help as I sort of slept in between contractions anyway without pethidine. The difference was I felt more with it and I made more noise (well what you can with a mouthpiece in!) I know I swore more! I don’t feel that gas + air helps with the pain either, just helped me concentrate on breathing. I actually found that thinking of certain things helped the most! Weird I know but I tried to think of stars in the sky, my son Tyler and that all this pain was worth it as he was so gorgeous and I thought of babies, little babygros and cuddles!! It really helped!

Tracy

From my own personal experience of pethidine in labour, it is a drug that renders you unable to communicate, doped up and out of control. The pain felt worse rather than better but I was unable to work with the contractions as I was so out of it. I was given it to “shut me up” in labour. It is a hideous drug and if you are the type of person who hates the feeling of being out of control it can be very damaging psychologically.

Laura

I totally agree with Laura. Pethidine is totally not to be recommended – it is horrible! I had it during my first labour and it rendered me totally useless and out of control and in retrospect I believe that my having had pethidine was directly responsible for my ending up with an episiotomy – I am damn sure that I didn’t need it but was not helping the labour along due to the drug even though it made not a jot of difference to the pain that I felt.

Polly

A bit about my own experience of Pethidine….

I was given Pethidine when I was in labour. The midwife asked me how I was, I told her I was in pain (well, of course!!!) and she gave me Pethidine. At no point did she offer an alternative such as gas/air; she gave me an injection, no explanation. It was only afterwards she told me it was Pethidine, and that if I wanted any more I could ask them when I was moved to delivery suite. I was horrified!!!

All it did for me really was to make me sleepy, and I did in fact sleep for an hour. And although I could feel the pain and knew full well that I was in labour, all I could think about was sleeping. It took a lot of willpower to fetch the midwife, who after examining me rushed me across to delivery suite, where I delivered within the next hour! (I am glad that I did let her know, as I am sure I may have given birth in my sleep otherwise, LOL!)

Further to this I feel that Pethdine was partly responsible for my failure to breastfeed. My baby just would not latch on, and in fact drank nothing for the first 24 hours. He just wasn’t interested, and this persisted for quite some time.

In short, I really regret that I was given pethidine. I don’t feel it helped with the pain. And I am convinced it affected my baby.

Just my humble opinion..I have no qualifications to back this up, other than being a Mum!

Sara

What do you mean you have no qualifications to back this up….you have been through this, you are a Mum….thank you for sharing your experience with us. We need women like you to share with us to help us to inform our practice.

It is interesting that many women are sharing with us that Pethidine doesn’t really seem to help that much….I can’t imagine Midwives giving something that they know will affect the baby in such a negative way but I am sure that it does happen, and I’m equally sure that it is given with the assumption that it will help the Mum… While I think that women need to have access to this pain relief I also think that they need to understand that pethidine may just sedate them rather than help with pain relief, and that it may well affect their baby, may mean they have to stay in hospital for longer etc etc

Annemarie

I had pethidine in my first labour – actually , I doubt I was even in established labour, as an hour and a half after the pethidine I was only 2-3cm dilated. I was however, in a right state – didn’t believe pain could be any worse.( ha ha ha ) ( and I’d had my arm almost severed in an accident some years before, so I did have serious pain to compare it to) Lots of v strong contractions, but OP baby…..

The pethidine did absolutely nothing for me at all – I remember lying there ( yes! why didn’t someone get me off my bum and moving??? Why didn’t I?? ) thinking “When is it going to work?” but my notes comment on how distressed I was pre-pethidine, and that I was more relaxed after. I certainly didn’t feel it, though. In fact, if someone had come along afterwards and said to me “We’re terribly sorry, Brenda, but we made a drug error, and gave you saline instead” I would have believed them without question. I’d have said the same thing about the last epidural top-up I had too.

Baby born (avoiding ventouse – but not episiotomy – by the skin of our teeth) Meconium pre-birth, baby acidotic (pH 7.18 – do recall being a bit horrified, and hoping fervently that newborns tolerate it better than adults – which, of course, they do….) decelerations sounding really awful to me, absolutely terrifying, actually, down to 70bpm. Baby suctioned (me thinking – “no please don’t” but too late.)

He seemed sleepy to me ( the pethidine was given 14 hours prior to birth) and not interested in feeding or me – which was a shame, really, as I was a) interested in meeting him and b) had a boggy uterus which was “trickling blood steadily” which stopped when a contraction was rubbed up. For some strange reason, I hadn’t been given my baby to hold – I was given a quick look, and then he was dressed and placed on the resuscitaire – but not to be resuscitated . Nobody was even looking at him,apart from me, a bit longingly…. it was just a convenient place to put him, it seemed to me. He did wake up, without narcan, and his apgars were fine and we did establish b/f eventually that day.

Definitely wouldn’t have pethidine again, although I certainly don’t hold it solely responsible for the hideous cascade of interventions.

Brenda W

Links to other sources of information:

Meptid versus Pethidine – another page from our archives

AH updated 29 October 2002

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