Pain relief options for labour – Pharmacological part 2

We would all like to give birth in the most natural way when possible but sadly, the course of nature doesn’t always run smoothly.

Pharmacological pain relief for labour

When you need something extra to help you through your labour and cope with the pain these are some of the more heavy-duty methods of pain relief:

What is Diamorphine/Pethidine?

Diamorphine is a powerful narcotic drug derived from opium and produced for use as a powerful painkiller and sedative. It seems to work better at relieving labour pain than other similar drugs such as Pethidine. The best time to have it is in established labour, as if it is given too early labour may slow down!

How does it work?

They work by blocking the pain receptors in the brain, however it doesn’t get rid of the pain completely. Check with your local hospital or birthing unit, which opiate pain relief they offer, as it may vary in each area.

How is it administered?

The normal dose of Diamorphine is 5-10mgs and between 50-100mgs of Pethidine. The most common way to have it is as an intramuscular injection into your buttock or thigh. It takes about 20 minutes to take full effect, so you may want to use some gas and air until it has taken effect.

What are the Pros and cons?


  • Available in most hospitals or birthing units
  • It can be given by a midwife and is available immediately
  • It only takes between 10-20 minutes to take effect
  • Can be given approximately 4 hourly during labour
  • May reduce the need for an epidural, or tide you over whilst you wait for an epidural
  • It won’t slow down your labour if labour is well established
  • You can still use the birthing pool but not within two hours of your injection


  • It doesn’t provide complete pain relief
  • It may make you feel sick and/or vomit during labour
  • It can make you feel drowsy and out of control
  • If given too close to delivery the effects on your baby may interfere with establishing breast feeding in the first few days
  • The drug crosses your placental barrier and can affect your baby’s breathing efforts at birth, and make him/her drowsy for several days

Amanda’s Tips

  • Ask for a check to see how far you have progressed before having an injection, as you may feel you can cope if you
    have progressed more than you thought
  • If you react strongly to drugs, or you are very slight ask for a smaller dose initially
  • Be kind to yourself and be patient if you and your baby are a little sleepy after birth and the first few days as the drugs can take several days to be excreted from your bodies
  • Drink plenty of fluids to help the body flush out the drugs for a few day after birth
  • Ask for extra help in the early days after birth to help establish breast feeding if your baby is a little sleepy

In Conclusion

Research all the options available to you for pain relief during your pregnancy, and opt for the one that you feel may benefit you the most. However, be prepared to keep an, ‘open mind’ when you are in labour. Remember the action of any opiate drug is unpredictable, and the side effects can cause some problems for you and your baby in the early days after delivery. Having said that it may still be the best options for those of you who wish to avoid an epidural.

Photography: Mamma Loves @Flickr

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