Pethidine is a widely used drug for pain relief in labour. Pethidine is a similar drug to morphine and heroin. These three drugs are from a family of drugs known as opioids. Opioids basically are morphine-like drugs. Morphine is a natural drug that can be extracted from the opium poppy, where as pethidine is synthetically made. Pethidine was first used in Germany in 1940 to reduce pain in labour and its use has continued to the present day. Initially when pethidine was created, it was thought to be non addictive but we now know that this is not true.
Pethidine works my mimicking the effects of endorphins - the body’s own morphine-like substances. One of the functions of endorphins is to act as the body’s natural pain killer. Pethidine (like endorphins) attaches to special sites on the outside of nerve cells. These sites are known as opioids receptors. Once pethidine attaches to these receptors, a chain of events occurs that results in the depression of normal activity for a little while. Pethidine’s effects are far more dramatic than endorphins. The effects pethidine has on a woman’s body can readily observed after it has been administered. A woman may become dizzy, drowsy, her eyes may change in appearance and she may experience an altered level of perception of events around her. Pethidine acts on the central nervous system by inhibiting the pain signals that are sent to the brain. The subsequent result can reduce the pain experienced by the woman in labour. Pethidine can also increase the amount of pain a woman can tolerate.
The most common way that pethidine is give to a woman in labour is by an injection into the muscle (usually into the thigh or buttock). Occasional pethidine is given into a vein via a drip. Pethidine usually has to be ordered by a doctor, but is then given by a midwife. The dosage a woman receives in labour varies, usually ranging from 50mg to 100mg. The total volume injected into the muscle is one to two millilitres.
If pethidine is given via an injection into the muscle, it usually takes around ten to twenty minutes to begin working. Pethidine’s effects, when given by this method, last two to three hours. If pethidine is given directly into a vein via a drip, the effects are a lot more rapid. Pethidine begins working within two to three minutes. When pethidine is given via a vein it enters the blood stream directly and only takes a couple minutes to circulate around the entire body, therefore pethidine reaches the brain and the nerve sites rapidly. The problem with giving pethidine directly into a vein is even though the effects are rapid, they only last for a short time. The effects of pethidine injected into a muscle last a lot longer.
This is not an easy question to answer as women report varying responses to pethidine. Some women say that it provides adequate relief while other women say they achieved no pain relief whatsoever (48% of women in one survey said this). Women report pethidine provides greater relief in early labour rather than in later labour (when the contractions are a lot stronger). The bigger the dose of pethidine, the more effective the pain relief. But the bigger the dose, the more side effects a woman and her baby may experience. One piece of research said that pethidine does not provide adequate pain relief during labour, but ends up heavily sedating the woman. Overall pethidine may reduce pain experienced during labour in some women. If a woman is tired, pethidine can provide sedation (and sometimes much needed sleep). Pethidine can act as a muscle relaxant which can in some cases result in faster dilation (opening) of the cervix.
Pethidine may not provide adequate pain relief for some women. Nausea and vomiting are common, a medication may be mixed with the pethidine to help reduce these effects. Some women report feeling drowsy and confused. The effects pethidine has on perception may make the contractions difficult to deal with. Other potential side effects for the woman in labour include difficulty passing urine, dry mouth, hallucinations, respiratory depression, low blood pressure and allergic reaction .
There are no advantages to the baby if the mother has pethidine. Pethidine is known to cross the placenta and is present in breastmilk. The major problem for the baby is that pethidine can cause breathing difficulties after birth due to its depressive effect on the baby’s respiratory centre. These effects are at the worse if the baby is born one to three hours after an injection of pethidine has been given. This is the reason that pethidine is ideally avoided when the birth is perceived to be close. An antidote can be given to the baby to reverse the effects of pethidine, however the effects of the antidote only last a short time and when they wear off the baby may re-experience breathing problems. Baby’s are more likely to have jaundice if their mothers have pethidine. Pethidine effects the baby’s sucking reflex and can cause breastfeeding difficulties for the first few days. Baby’s may require special care or neonatal intensive care from the effects of pethidine, resulting in separation of mother and baby.
(25th June 2000)
25 comment(s) on this page. Add your own comment below.
hi, i have 24 days old baby and i m having problem of low milk production is it because of pethidine i took during pregnancy if so couldyou please tell me any solution
Pethidine interferes with the baby's sucking reflexes in the early days after birth. Sucking is critical in helping establish a good supply of breast milk. The Australian Breastfeeding Association have a good article on ways in increase your breastmilk supply. To see the article.
I had pethidine when I gave birth to my first child 4 months ago. I have just read this article and am leaving a comment to say that I didn't experience any negative side effects. I had pethidine and then gas during my 6 hour labour - pethidine helped me a lot and gas didn't seem to have any effect at all! My contractions didn't start after my waters broke, so they had to be induced and I went from zero to 10 cms dilated in just 3 hours. Pethidine helped relax me in between contractions - so much so, I started cracking jokes (for a short while anyway). For 'Neerja' re. low milk production: talk to your doctor. You may be prescribed 'Motilium' also called 'Domperidone'. This is effective in getting your breastmilk up.
I suffered terribly with pethidine I was completely off the wall and delusional my one sister had same experience in labour
I gave birth last week. I was induced at midnight and by 5am was well on my way and pretty close to fully dilated. I was expecting a very big baby so epidural wasn't an option, so I have gas and pethidine. Kayla scored well on her Apgar test, was a bit slow on the uptake but they gave her the antidote and she recovered fully within a brief moment and is a beautiful healthy baby. Not the biggest fan of having to work for her milk, but doesn't have a problem latching at all - she latched within minutes of birth. Must say my only side effect has been that my butt is so sore where the injection was given...
I had pethidine very close to the time of my baby's birth. My child is now 10. He has always had respiratory problems. When he gets a cold he has an asthma sounding cough for at least a week. I am constantly told that it is not asthma it is just a virus. My gut feeling is that it had something to do with the pethidine or the Narcan that he needed to reverse the effects of the pethidine. Could I be right and what can I do for him?
Hi Susan - Research into the long term effects of pain relief in labour has not been carried out. So the answer is we just don't know what effects it can have. Have you thought about seeing a complementary therapist such as a naturopath, oesteopath, acuptucurist or similar? They may be able to offer some alternative ideas on how to manage your sons respiratory problems.
Hi my son is now 8 yrs old and just like susan,jun 20 2011. my son has symtoms of asthma when he gets a cold ,,i was given the pethidine 100mg 30mins before giving birth ...when he was born he did not cry-out..and was given the narcan...same anti-eating symtoms for the next few days...my son is fine now very athletic ,,but the wheezing is present sometimes...does the pethidine have any long term effects or can it hamper whith a new born babys brain developement..
Hello, I also used pethidine, i have never had problems with my son jett and he is 9 months old now, but what i want to say is that i had no idea about these side affects, and the point i wanna make is i think they should warn us before offering it. i had no idea! if they had told me about the side affects i would have said NO!
Hi, I had pethidine about 3 hours before I gave birth. I only resorted to it after a 27 hour labour, where all had to that point was gas and it was having no effect. I did feel very drowsy for about 2 hours (I was so exhausted it was actually a nice feeling) but no other side effects. My daughter cried instantly when born, scored 10 on Apgar scale and latched pretty much straight away. She's now 3 months old, no health issues and I'm still breast feeding with no probs. I think all medications effect people in different ways but you have to do what best for you at that time.
Pethidine cannot be given if a CTG is abnormal as there are already concerns with the baby and to give a narcotic drug on top could further compromise the baby.
Hi I had the pethidine injection when I gave birth to my first child 12 days ago. The injection was in my right thigh. Is it normal to have an achy type pain in my right thigh when I bend down on me knees or is it possible it caused deep vein thrombosis? Does the injection bruise the muscle? How long does it last?
Hi, i had pethidine while i was in labor and im just wondering if anyone has had side affects with their tongue? Mine seems to be very numb or the feeling in it seems to be different, sounds strange i know.. also i seem to have developed a small bit of a lisp. Please help!
I used pethidine & it was very effective in relaxing me between contractions. No nasty side effects for me, my breast milk supply is great & baby is fine, scored 9/10 apgar. I would use it again.
I have had pethidine for 2 out of 3 of my births so far, and intend on having it for this birth as well. I would rather have pethdine than an epidural. None of my children have asthma problems - and it runs in our family. Can I just say that for those who were not told before hands that it could have these effects, that is probably because there has been no research done to this, so midwives/doctors can only tell you the facts. And if it is an issue, it is up to you to do the research before you get to that point so you know all the risks, and put it in your birthplan and discuss it with your partner.
I was given pethidine just 35 minutes before my baby was born. The midwife thought things were going to take much longer but soon after i had the injection my waters broke and i gave birth very quickly. The pethidine resulted in my baby needing to be resuscitated and me feeling so out of it that i couldnt understand what was happening to him. Once he was breathing he was very very sleepy and unable to latch on because of this. He couldnt feed at all and ended up losing12% of his body weight. My advice would be not to touch it. Although i know people who have had it and loved it, i wasnt told at the time that it was potentially dangerous for my baby. Even if the midwives give it to you thinking you are in the very early stages of labour nobody knows how quickly things could speed up. For the very little relief it gave me from the pain it was certainly not worth the trauma of watching my baby being resuscitated.
I used pethadine while in labour and i wont be using it during my next as it made my babies heart beat drop, which scared the crap out of me! But baby came out fine and is now 3 with no problems. I also didnt find it to help with pain either.
My experience with pethadine was quite good. While it didn't exactly take the pain away, it sedated me enough to get some sleep. I think it also assisted the induction by helping open my cervix a bit faster. 4 hours of contractions, had the pethadine, slept for the majority of the next 3 hours then boom baby was born :)
Pethidine was given to me at the age of seventeen when i was in labour. i wasn't asked if i needed or wanted it. It was just administered to me, i was too young to question what it was. My pain was so severe i passed out several times, i had severe hallucinations, i was sick and drugged up. my son was born normal and healthy. However 20 years later he developed a serious addiction to heroin and i believe it is because i was given this drug during labour. I firmly believe this to be the case and in years to come it will be proved. after all pethedine is the same form of pain relief as heroin and morphine.
OMG I totally agree that I should have been informed about the possible side effect to the baby. Like a few of you have mentioned my son is now 14 yaers old and the exact same senario as Susan and Christine, he has respiratry issues when he gets a cold in addition to asthma and wheezing during those times. I am really upset. I had no idea nor was I told of the possible effects. As far as the no long term studies, well it seems that this is evidence of long term effects.
I had high blood pressure when I was pregnant and was given pethedine at 34 -35 weeks pregnant ( and during the birth). I remember the doctors arguing at my bedside about the amount I was being given. My son is now grown up but has always been very anxious and suffered from depression. Is there any evidence that pethedine can affect development of a baby at that stage? I was induced at 36 weeks.
I was given pethidine about 1 hour before the birth of my second child. She is now 8 and healthy, however she has the exact same respiratory / asthma type wheezing (as susan and christine)every time she gets a cold. We have no other asthma symptons in our family.
just reading the comments about pethidine and breathing/asthma problems later in life.i had an induction for my first baby so epidural was the only pain relief needed obviously and my daughter who is now 9 has no asthma problems and hardly ever gets sick.had my son 20 months later and i was given pethidine during labour, my son was a big baby 10,9oz but has suffered asthma problems ever since and been hospitalised for it aswell.there is no one else in the family with any breathing problems.i cannot help but think now after reading all this that his problems are due to the pethidine.! i am 25 weeks pregnant with my third child and was wanting pethidine for this labour as it was effective in distancing me from the pain but now am not going to even consider it.any other suggestions would be greatly appreciated.
I had no pethidine for my first child but did use gas, and was a good birth with no complications. My second birth I used gas and then later on had pethidine, I also was unaware of side affects to my baby. I personally found pethidine not to be a good experience because it made me nauseus and extrememly drowsy in between contraction to the point of sleeping and I feel like I missed the labor. I became so sleepy. I would not use it again. At the time it was a split second descision as yes childbirth is painful. However I would really reccommend having a very supportive bith partner: if hubby or boyfriend cat hack it then bring a girlfriend! The support makes all the difference and helps you stay strong which in turn reduces the amount of intervention needed. Thanks.