Pethidine would not be recommended if the baby were premature or suspected of being unwell. In these circumstances, the possible side effects of the medication on the baby are undesirable and would prompt efforts by the caregiver to try and avoid them, if possible.
Narcotics would also be avoided if the woman is known to be allergic to them. An allergic reaction is usually a development of a rash or swelling soon after having the medication. The caregiver will usually ask the woman about her allergic reaction. For example, if it was 'vomiting' this is usually just a side effect of the drug rather an actual allergic reaction to the drug. In reality allergies to narcotics are extremely rare (unlike antibiotics). You would only know if you had an allergy if you have had the particular drug in the past, for example after an operation or for a previous birth.
Pethidine can also interact with some anti-depressants, if they were taken in the previous 2 weeks before the labour. If you have been taking antidepressants in the weeks leading up to the birth, check with your caregiver about whether having pethidine in labour is possible.
Women who have used narcotic drugs in the past for recreational purposes (and possibly experienced addiction) are allowed to have narcotics if they wish in labour. For women who are concerned about stimulating an addictive response again, they should let their caregiver know they do not want Pethidine under any circumstances or in any form (or write this on their
birth plan). Disclosing the reason is up to the woman, but is not absolutely necessary unless currently using or on methadone. The woman can use
natural methods or have an
epidural with just local medications, or
gas as alternative forms of pain relief.
Women who have built up a tolerance to narcotics may find that the standard dose does little to relieve their pain. Higher doses would not be recommended because of the possible side effects on the baby.