Pethidine for pain relief in labour

What is pethidine and how does it work?
When can you use pethidine?
How long does pethidine last?
What does pethidine feel like?
What are pethidine’s side effects?

We’ll also be sharing stories from our mums who used pethidine during their own births.

Now, you can click one of the links above to skip ahead for the answer to your chosen question.

But if you’re still deciding whether or not you’d like to use pethidine in your own birth, we’d recommend giving the whole piece a read, so you’ve got all the facts ✊

What is pethidine?

Pethidine is an opioid drug, a painkiller similar to morphine and diamorphine.

It’s the most commonly used drug derived from morphine for pain relief and relaxation during labour.

Pethidine is both an analgesic (painkiller) and an antispasmodic, so may help you feel relaxed as well as reducing pain.

How is pethidine given during labour?

The drug is usually administered via an injection into muscle (bottom or thigh) and occasionally intravenously. With the latter, it’s likely you’ll have some control over the pethidine pump.

Pethidine’s often given with an anti-emetic drug, to help prevent nausea and vomiting – one of the not-so-brill side effects of using pethidine.

When can I use pethidine?

Pethidine is usually given in the 1st stage of labour, when things are clearly underway but the birth is likely to be more than 3 hours away.

You should be examined before pethidine is given, and if it looks like the birth is less than 3 hours away then you will probably be discouraged from having the drug.

All opioid painkillers ‘cross’ the placenta, meaning they can affect your baby’s breathing or cause drowsiness. The closer you take them to the delivery, the more chance you have of this happening.

How long does pethidine last?

Once you’ve been given pethidine, it takes about 20 minutes to kick in, and usually wears off after 3 to 4 hours.

In some cases of extended labour, you may be given another shot of pethidine.

Who can use pethidine?

Most women can have pethidine, and it’s often available in hospitals.

Still, always discuss your pain relief options with your midwife to ensure there’ll be some handy on the big day.

Pethidine can be made available for home births, too. Midwives can administer it without the help of anaesthetist, unlike an epidural.

However, not all midwives will be super keen on giving you pethidine at home, so we’d suggest you’re best off checking with them in advance.

How effective is pethidine as pain relief?

The normal dose of pethidine given to relieve pain is 50-100mg.

Many mums-to-be find it more effective as pain relief when the contractions are not at their strongest, closer to the beginning of the 1st stage of labour.

Lots of mums find it helpful, but there’s no one-size-fits-all when it comes to giving birth, or pain relief, and some may find it’s better at helping them sleep or relax, rather than eradicating pain altogether.

Regardless of whether it helps in that early stage, it still wears off after a few hours, which means you might find you need another form of pain relief if your labour keeps going on.

However, it’s thought a small dose will be enough to relieve a bit of your tension and any anxiety.

So, it might better prepare you for the final stages of labour to come…

Pros and cons of using pethidine in labour

There are pros and cons to every form of pain relief option available to you during labour.

Here’s some of the things to think about if you’re considering pethidine as an option for you…

Advantages of pethidine are:

Pethidine may help you relax and regather strength for the later stages of labour
Pethidine can be given by a midwife without a prescription and so doesn't require a doctor
Pethidine may be used for home births, although not all midwives will offer it as an option

Disadvantages of pethidine are:

Individual reactions to Pethidine vary greatly, so it does not have the same pain-relieving and relaxing effects for all women. While some women will find the drug fantastic, others may find it is of limited use against the pain, or that the side-effects outweigh the benefits

Some women will find that Pethidine makes them very nauseous, whether or not they've had an anti-emetic

Some women will feel dizzy and/or drowsy under the influence of Pethidine

Pethidine may make you feel out of control or disoriented during labour and afterwards you may even discover that you have no memory of labour and birth at all

Pethidine is a powerful drug that passes through the placenta and can affect the baby to varying degrees. This is more likely if the pethidine is given within three hours of the birth. Your new baby may be drowsy and in the most serious cases may require an injection to counteract the effects of the drug and assistance with breathing at the outset

Although most of the drug should be out of your baby's system within 24 hours, the effects of the drug may linger for several days, leaving your baby sleepy and less responsive and so making it more difficult to establish breastfeeding.

What does pethidine feel like?

Pethidine will alter your mood, making you feel relaxed and sleepy.

The dose depends on your weight, stage of labour and degree of discomfort.

Some women prefer ‘half a dose’ of this pain relief, which means they won’t feel too sleepy during labour.

Many mums-to-be report that although pethidine helped them to relax by making them sleepy, it didn’t remove the pain – and therefore they felt out of control during labour.

It can also cause your blood pressure to drop, which can make you feel light-headed and faint.

“I’ll never forget the two very different experiences of pethidine I witnessed in the space of a week when I was training to be a midwife,” says midwife Anne Richley.

“The first was a woman who slept through her own labour! She woke with each contraction, but dozed off in between.

“She’d had a hefty dose of pethidine and when I talked with her afterwards, she had no recollection of labour, which I remember thinking seemed a bit odd.

“Shortly after, I helped to look after a pregnant woman who was so anxious that it seemed to be ‘holding back’ her labour.

“The midwife said that half a dose of pethidine might help, and the mum-to-be readily agreed. It certainly seemed to do the trick.

“She relaxed and then laboured quite quickly. She seemed to be very much in control – in total contrast to the previous woman.”

Lots of our mums have tried pethidine – and its safe to say some had a good experience, and others found their experience to be really negative.

“I couldn't cope with just gas and air in the end. As others have said it didn't help with the pain so much but it did knock me out,” says Kim, who is a member of our MadeForMums community. “I seriously have no recollection of my labour from pethidine injection to pushing stage!

“Haiden came out not crying and they were a bit concerned, but she just didn't want to cry - she was absolutely fine xx”

“So I opted for some pethidine and it was very good,” says Breighlin. “It did not take the pain away, but made me being able to rest in between contractions.

“I still remember everything, I know what I said and when I said it. If needed I will use it if there is ever a second time.

“I had Pethidine with my 1st son, it knocked me out and I literally woke with each contraction to push, and then fell asleep again for 2 minutes!!” adds Dorothy.

“With my 2nd son I had a [similar] morphine based pain relief, it was early in the induced labour and it helped me sleep, but when I was ready to push I was wide awake.

“The only side effect of that one was that I was throwing up for a couple of hours after the baby was born as it was still in my system, but with no pain to target!! X”

Erin said she had a great experience of it combined with gas and air – even though it made her feel fuzzy.

“I had pethidine during both my labours and it worked really well for me, it did make me feel 'fuzzy' and I could still feel pain, it just didn’t seem so horrible.

“With the first dose of pethidine the mw will also give you an anti sickness injection.

“Pethdine never made me feel sick, but gas and air made me sick both times, then once I got use to the gas it was a lifesaver!”

“I had pethidine with my first, along with gas and air, and found it really helpful,” says Linda from our MadeForMums community.

“I did feel a bit fuzzy but it distanced me from the pain and I was actually able to sleep through the contractions. It had worn off when I came to pushing, but by that point my BP was so high I was on the verge of fitting so I don’t remember anything anyway.

“I was really sick after the birth and put it down to the pethidine… but 2nd time round my labour was so quick I think I had gas and air for about the last 15 mins of it and again I was sick after the birth, so thought it must have been the gas and air, not the pethidine, that had made me sick before.”

We should stress that birth is always a totally different experience for everyone – even when you DON’T consider how each individual reacts to the different methods of pain relief.

We’ll leave you here with this gem from Suzy, who says:

“It's clearly not for everyone, but it may be just the thing you need to keep yourself calm in the thick of the pain… which in turn could speed up your labour if you are relaxed.

“The important thing is to go with it and not get scared by the sensation.”

Images: Getty Images

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Elizabeth Atkin