Pain relief with medication

For pain relief with medication we have to refer you to the gynecologist in the hospital. We will therefore no longer be able to assist your delivery.
Medication can have side effects and therefor close monitoring of  your heart rate, blood pressure and breathing should is required. The baby’s heartbeat should also be closely monitored. This equipment is only available in the hospital.

When we refer you we will always ensure that the gynecologist has your medical file  and is updated on the course of the delivery up to that point.

 

Epidural

Epidural medication temporarily numbs the nerves carrying pain signals during labor. The anesthetist inserts a needle in your lower back under local anesthesia. You have to bend over and sit still as  possible. A thin, flexible tube is placed in your back via a needle. The needle wil be removed, the tube remains. Through this tube you will receive pain-relieving medication during the entire delivery. Within 15 minutes you will feel that the pain is reduced.

Advantages and disadvantages of the epidural

Advantages of the epidural

  • The epidural is the most effective way of pain relief.
  • Most women feel little or no pain during contractions.
  • An epidural does not make you drowsy, so you experience the delivery completely.
  • The epidural sometimes gives more time to strive for a natural birth delivery.

Disadvantages of the epidural

  • In 5 to 10 out of 100 women, an epidural is insufficient. The epidural is then sometimes performed again.
  • You can get a fever. Your body temperature can rise due to the epidural. But then it is difficult to determine whether this is due to the epidural or whether it is due to an infection. To be on the safe side, you will then be given antibiotics. Sometimes the baby has to be admitted on the pediatric ward  and he or she is also given antibiotics.
  • The contractions are often less powerful and you need extra medication to make the contractions stronger again.
  • You often have low blood pressure. For that reason you get an IV drip with fluids and sometimes medication to prevent your blood pressure from dropping.
  • As you have less feeling in your legs you are immobilized due to the epidural. This will slowly return after the administration of the medication has been stopped after birth.
  • Because of the anesthetic you do not feel the urge to urinate. So you will receive a bladder catheter. After the delivery, the catheter will be removed again. Sometimes it takes a while before you can urinate spontaneously yourself.
  • Sometimes women experience a general itch during an epidural.
  • The pushing stage can be prolonged. As a result, you have an increased chance of giving birth with a suction cup or vacuum pump (a “vaginal artificial delivery”).
  • The initiation of the production of breast-feeding may possibly be delayed somewhat.
  • Sometimes women suffer from headaches after an epidural (1%). This is caused by a leak in the meninges. These headaches can be treated.
  • Serious complications such as nerve damage, bleeding, paralysis and infections are very rare.

Click here for a video about the epidural.

Remifentanil

Remifentanil is a short acting morphine-type drug that is administered through an IV drip that is attached to a pump. You can determine the amount of remifentanil you will receive with a push button. The pump is adjusted in such a way that you can never give yourself too much. Remifentanil only works well for a few hours and is therefore often used during the last part of labor. It takes the peaks off the pain, so you can still feel the contractions, but experience them less severe.

Advantages and Disadvantages of Remifentanil

Advantages of Remifentanil

  • Remifentanil can be administered within 15-25 minutes, hardly any waiting time.
  • Remifentanil works quickly, often after just a few minutes.
  • Remifentanil is metabolized quickly in your blood during the delivery.

Disadvantages of Remifentanil

  • Remifentanil can affect your breathing and the amount of oxygen in your blood. That is why you and your child should be continuously monitored carefully while using this medication.
  • Remifentanil only reduces the pain partially, so you are not completely pain free with Remifentanil.
  • You have to stay in bed as you feel drowsy.
  • The effect of Remifentanil on breastfeeding has not yet been researched.