Pethidine Injection for homebirths

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This leaflet will provide you with information about pethidine. It will give you information about its supply and storage as well as administration and disposal should you decide to use Pethidine for pain relief during your homebirth. This leaflet will provide you with information on what it is, supply, storage, administration, disposal and side effects of Pethidine injections.

What is pethidine injection used for?
Pethidine is a strong pain killer that is used to relieve pain during labour. It is given as an intramuscular injection. If required, it can be given up to a maximum of four times during labour, at intervals of 1-3 hours. Pethidine will start to have an effect from about 10 minutes of administration and effects normally last up to four hours. It can make some women feel sick, forgetful or drowsy. We offer you an antisickness medicine with the Pethidine to help with the sickness. Pethidine comes in glass ampoules.

Assessment
Pregnant women who decide to birth at home will have a discussion with their Midwife at 36 weeks gestation. At this appointment pain relief will be discussed including Pethidine. If you decide you would like to have Pethidine available this will be recorded in your electronic notes and homebirth assessment paperwork. Your Midwife will then arrange a doctor from the hospital to complete a prescription for the supply of the Pethidine.

Supply
A prescription for Pethidine will be completed by a doctor responsible for the patients care. The prescription will be for a maximum of two ampoules of Pethidine. The prescription will be written by the doctor and sent to Pharmacy for dispensing. The patient’s midwife will take the prescription to Pharmacy where the Pethidine will be dispensed. The Midwife will then collect it from Pharmacy and take it to the patient’s home.

Storage
Upon delivery to the patient’s home, the patient should be informed to store the Pethidine in a safe place away from the sight and reach of children. Keep the ampoules in the outer carton in order to protect it from light.

Administration
The Midwife who attends your birth will administer the Pethidine when it is requested. Any unused Pethidine remains the responsibility of the patient and should be stored in a safe and secure place away from the sight and reach of children.

Disposal
If the patient did not request the prescribed Pethidine during birth then the unused Pethidine should be returned to a community Pharmacy for disposal.

Side effects
Common side effects include dizziness and drowsiness which can affect the performance of tasks e.g. driving or operating machinery. Other common side effects include headache, constipation, feeling sick (nausea) and vomiting. Most babies should have no side effects from the pethidine, however some may experience side effects. If the child shows signs of increased sleepiness (more than usual), breathing difficulties, difficulty breastfeeding or limpness then seek medical attention or advice immediately. It is safe to breastfeed after having used Pethidine during labour.

Birthing pool and Pethidine
Pethidine can be used alongside Gas and Air in labour, however using a birthing pool is not recommended for two hours after administration of Pethidine due the effects of drowsiness. If you require further information please speak to your midwife.