Remifentanil During Labor: What You Really Need to Understand

Bee Midwives Lelystad we believe that your delivery should fit what you want and need. Painkillers play a big role in that, and one option you can consider is Remifentanil. But what exactly is that? How does it work, and what are the pros and cons? In this article, we will take you through everything you need to know about this painkiller, so that you can make your choices with a good feeling.

Who decides whether Remifentanil is right for you?

Whether you get Remifentanil depends on a good conversation with your midwife or doctor. They will check whether it matches how your delivery is going, what your medical history is, and whether you have any allergies. They will also check how your baby is doing – because that counts just as much. You only get this stuff in the hospital, so if you want to stay home, it is not an option. It is tailor-made – your situation determines whether it gets the green light.

A bit more: your midwife or gynaecologist weighs everything up. Have you been busy for hours and is the pain too much? Or do you have something in your history – such as a previous difficult birth – that plays a role? They also look at practical things: how far are you, and can the hospital handle it? It's a team thing – you tell what you feel, they bring the knowledge.

Who is Remifentanil a match for?

Remifentanil is great for women who want strong pain relief, but also want to stay in control. Maybe you don’t want an epidural, or you can’t because of your health. Or you’ve been struggling for a while and the pain is getting to you – then this could be your savior. It’s for those who want strong stuff, but still want to be in control.

Bonus: It’s also useful if you don’t want to be “off” for too long. Maybe you want to be sharp again quickly after a contraction, or you don’t like the idea of a needle in your back. It suits women who want to stay flexible – you can still move and feel less pinned down than with other options. It’s a happy medium between 自然 and heavy-duty.

How does Remifentanil work?

Remifentanil is a big boy from the opioid family – a strong painkiller. It is administered via an infusion pump that you operate yourself, also known as PCA (Patient Controlled Analgesia). You get a button with which you can take a shot when the pain strikes. It works very quickly - you feel it within a minute - and it is gone again quickly, so that your body is not "under sail" for long.

What does it do? It dims the pain signals in your head, so those contractions don’t hit as hard. It keeps you awake and in the moment – no hazy high, but a softer experience. It’s a quick fix that you control.

On a technical note, Remifentanil goes straight to your nervous system and blankets the pain. It’s short and powerful – it subsides after a few minutes, which is nice if you want to be clear-headed in between. It’s different from a paracetamol – this is heavy stuff, but you’re in control.

How do you get it in?

If you choose Remifentanil, they will put an IV needle in your arm. A pump with the stuff in it will be attached to it. You will get a short lesson: press here, wait a moment, and you can do it as often as you like. It is foolproof – you can’t take too much, because the system is monitoring you. Safety first.

While you are using it, they are constantly monitoring you and your baby with a CTG – which measures your contractions and your little one’s heartbeat. This way they know that everything is going well, even when you are in your own world for a while.

More details: that IV is a small prick, but after that you barely feel it. The pump beeps sometimes – a sign that it is working – and your midwife keeps an eye on things. The CTG keeps everything tight – if your baby's heart rate dips, they can intervene immediately. It's a team effort, but you have the button.

Benefits of Remifentanil

Quick kick: Within a minute the pain is less – instant relief.
You are the boss: With that button you determine when it is necessary.
Short but sweet: It's out of your system quickly, so you'll be back in no time.
Free to move: No numb lower body like with an epidural – you can still shuffle.
Less hassle: It will delay your labor less than some other methods.

What makes it so great? You don’t have to wait for a doctor – you push, it works. And because it’s gone quickly, you’re alert when you have to push. It gives you air without completely shutting you down.

Disadvantages of Remifentanil

It's not all hoosanna - Remifentanil has its downsides. We'll break them down: what it does to you and what your baby will notice.

Disadvantages for you

Dullness: You may feel a little sleepy – sometimes a little too much.
Nausea: Some people have to vomit or feel sick.
Itch: That opioid thing – your nose or chest might start to itch.
Breath dip: In rare cases it will slow your breathing somewhat (see below).

Extra info: that drowsiness can make you a bit hazy – you are there, but not completely focused. The itching is usually mild, but annoying. And nauseous? That can make a contraction just a bit harder. It is not for everyone, but good to know.

Effect on your baby

Remifentanil can pass through the placenta to your baby. That can slow down his breathing or heartbeat for a while. After birth, they keep a close eye on your little one, but the stuff is gone again quickly, so you hardly ever see any real long-term misery.

What’s more: that transition to your baby is small, but noticeable. It’s not a drama, but they check it out – a few minutes of extra attention, and it’s usually okay. It’s a trade-off: your rest, their brief dip.

Influence on breathing

One thing to be aware of: Remifentanil can slow your breathing down a bit. It makes you calmer, but sometimes too calm – you breathe less deeply. That’s why they keep an eye on you with monitors. The pump is clever – you can’t overdose, so the risk remains small.

Want to know more? This happens mostly when you push a lot in a row, but the system has a limit. Your midwife will monitor your oxygen – if it drops too low, they will adjust it. It is rare that it really goes wrong, but they are not taking any chances.

Side effects

Apart from these disadvantages, some additional issues may arise:

Dizzy: Your head may become light – sitting down for a while helps.
Low pressure: Your blood pressure may drop, making you weak.
Headache: Typical opioid thing – can happen.
Peeing trouble: Sometimes your bladder just doesn't cooperate.

Good news: these ailments are often mild and gone once you stop. It's a short ride - you'll be over them in no time.

Conclusion

Remifentanil is a strong, safe choice if you need painkillers during labor – as long as you are monitored closely. It gives you the power to control yourself and tackles the pain head on. But you need to know what you are choosing – weighing the pros and cons carefully is important.

At Verloskundigen Lelystad in De Koploper we stand by your side to understand this. We talk it through, see what suits you, and make sure you go into that room with a good feeling. It is your delivery - we help you make it a beautiful day.

Want to know more about painkillers? Call Midwives Lelystad or come to an information evening – we will explain it to you!

Just a little extra: every birth is unique – you may not even need this, it may be your lifeline. Whatever it is, you deserve a team that thinks along with you. We are here to make you feel strong, however you do it.

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