Pethidine may be offered to the woman by the caregiver or given at the woman's request. Having the medication will usually take into consideration how long the caregiver estimates it will be, before the baby is born. (Although some women will continue to defy even the most experienced estimates!). To help them do this, caregivers will usually need to perform an internal vaginal examination.
The aim of the caregiver would be to provide a level of pain relief for the woman, but minimise any possible side effects. If the woman accepts the pethidine in the last 1 to 4 hours of the labour, the baby may be affected by the medication. This can include suppressing their breathing and interfering with the baby's ability to suckle and feed in the first few days following the birth. These and others are discussed in more depth, later in this section.
The injection should be available to be given to the woman within 5 to 10 minutes). It will take a little while for the caregiver to check, record and sign for the medication with another caregiver, because the drug is classified as 'restricted'. These procedures may delay the caregiver if the ward is busy.
About 1 to 2 mls of the pethidine (usually equal to 100mg) is drawn up into a sterile syringe and needle. The caregiver wipes an area of the woman's muscle (buttock, thigh or arm) with an alcohol swab to clean the skin. The injection is then given. Occasionally an
anti-nausea drug (such as Maxalon) is mixed with the pethidine and given simultaneously, to help prevent nausea and vomiting. Alternatively, the caregiver may delay giving this additional medication, only administering it as second injection later, if the woman starts to feel nauseated or vomits.
It will take approximately 15 to 30 minutes for the pethidine to take full effect.