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Sacroiliac joints – pain relief in labour
I’m a mother of two, approaching 40 and pregnant with my third child. I suffered a sports injury in my twenties, which left me with damage to the sacroiliac joints. In my previous pregnancies this did not cause me any problems. However, this time, I see the physiotherapist continually because the lower joints have slipped and locked. My concern is that the birth will be painful. I have been told that I will not be able to have pethidine, and I worry that the pain is going to be too great to bear. What sort of pain relief should I consider?
Deborah
I don’t understand why you will not be able to have pethidine or even an epidural if you need one. I suggest you make an appointment with the hospital anaesthetist and ask him or her their opinion as to whether an epidural is possible in your case.
If the anaesthetist advises against an epidural, you are left with Entonox, which is also called Gas and Air. This is available in all delivery rooms, and is self-administered via a mask or mouthpiece. You use it at the beginning of a contraction (as there is a period of about 15 seconds before it works) and stop taking it when you are about ten seconds over the peak of the contraction. Gas and Air really does suppress the pain effectively if you get the timing right. The only problem is that you don’t want to use it for more than three hours. Ideally, you need to be about six centimetres dilated before starting it. (Mrs Average on her third baby should dilate about one to one-and-a-half centimetres an hour.)
I should also make sure that the midwife who is delivering you knows about your sacroiliac problems, as this is important when you are at the second (pushing) stage. It might be worth asking your physiotherapist if she thinks there is any particular position you should be in when you deliver your baby.
Best wishes
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