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Pain relief

A number of conditions apply to any form of pain relief. We will transfer you to the gynecologist / clinical midwife and will therefore not supervise your delivery further. We will withdraw and will not see you again until you go home with your child. Before you actually receive pain relief, a heart film of at least 30 minutes is needed to see how your child is doing. You should also not be too far in opening up. The possible options and their advantages and disadvantages are also discussed with you.

EPIDURAL (BACK)
In principle, you feel little or no pain with an epidural. The epidural that is administered during childbirth will sedate, but you can still move your legs. The epidural is the best form of pain anesthetic, which is why Tergooi and Diakkonessenhuis prefer it.

Disadvantages of an epidural are: no control over the bladder, you will receive an indwelling catheter to keep your bladder empty, the strength of the contractions often decreases, so that you often receive an infusion with a contraction stimulant to make it stronger again, you often feel less well that you have to push, which increases the chance of an artificial delivery (vacuum or forceps), you have a risk of a drop in blood pressure and in some women you develop a fever, which requires antibiotics and you have to stay in the hospital longer.

PETHIDINE
This is a morphine-like drug. You will receive it via an injection in your thigh. It works for about 4 hours and ensures that you can relax well and therefore handle the contractions better. Pethidine is often used in women who are not yet giving birth properly, but who are very tired due to a long run-up to the delivery.

During 4 hours you will be under the care of the hospital (gynecologist / clinical midwife). If you give birth within that time, they will supervise your delivery. Then you will be transferred back to us and we will guide you further.

REMIFENTANYL
Ook dit is een morfine achtig middel. Je krijgt het toegediend via een infuus. Werkt pethidine na verloop van tijd uit, doordat dit middel continu wordt toegediend blijft de werking ook redelijk gelijk. Bovendien kun je jezelf elke 5 minuten een extra dosis toedienen wanneer de weeën erg hevig zijn. Dit is een beveiligd systeem, je kunt jezelf dus niet teveel toedienen. Remifentanyl wordt gegeven vanaf 3 a 4 cm ontsluiting.
Remifentanyl neemt niet alle pijn weg, maar zorgt ervoor dat je de pijn beter aankunt, dat je beter kunt ontspannen. Wanneer je mag persen wordt het infuus uitgezet, het middel is dan met een minuut of 10 grotendeels uit je bloed verdwenen.

The disadvantages of remifentanyl can be: because it is a morphine-like substance, you may become a bit drowsy, you can experience this as if you have had too much wine. You get a blood pressure monitor and a clip on your finger to measure the oxygen in your blood. The latter because you can sometimes breathe more shallow. In a number of cases, the contraction activity may decrease somewhat, so that you need a contraction stimulant. Remifentanyl can only be obtained in Tergooi if there is a reason why you are not allowed an epidural. For the Diakonessenhuis in Utrecht, the nurse must be able to sit next to you to see how you are doing. This is only possible during the day and when the department is not too busy. If the nurse cannot sit next to you, unfortunately you cannot receive remifentanyl.

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