CHILDBIRTH: Aussie research finds a less invasive pain relief solution that is better for both mum and bub

Exciting new research coming out of South Australia offers good news for expectant mothers looking for pain relief options during childbirth.

Having options and being in control of the choices made for your care during this exciting time are two of the key factors in ensuring your childbirth experience is a positive one. And now it looks like there is another choice on the table.

The world-first research coming out of the University of South Australia looked at alternative administrations of fentanyl – one of the pain relief drugs used during labour – on both mother and baby and the outcomes were great, particularly for those who don’t like needles!

“The strength of this research is that it confirms that fentanyl can be used safely for both mother and baby – regardless of whether it is administered nasally or via injection,” says Lead researcher, UniSA’s Dr Julie Fleet.

The study was the first to look at the effects of administering fentanyl nasally, and the findings confirmed that both nasal and subcutaneous (injected) administrations of fentanyl were a safe option for both mothers and their babies.

Unlike other labour pain management medications, pethidine and norpethidine which other studies have have shown babies to have levels of the drugs comparable to their mothers in their systems, fentanyl when administered via injection was known to show reduced levels in the infants.

What the study has now found is that despite nasally administered levels of fentanyl being significantly higher than those by injection, all babies still had lower levels of fentanyl in their systems than their mothers, regardless of administration method.

Dr Julie Fleet says the findings are an important step in understanding less invasive pain relief options during labour.

“Many women worry about managing pain during labour and the impact that their choices might have for themselves and their newborn child,” Dr Fleet says.

“For women who choose pain relief in labour, there are still very few options available – the most common are ‘gas’ (nitrous oxide and oxygen), injection of a narcotic or opioid (such as fentanyl, morphine or pethidine), or an epidural ­– but as with all analgesics, there are side effects.

“Negating and managing side effects is critical for both mother and baby, which means the need for choices in pain relief is all the more essential.

The benefits of Fentanyl as pain relief during childbirth

“Fentanyl is a popular choice for regulating pain during labour because it provides rapid pain relief while not restricting mobility and reduces incidents of adverse side effects such as nausea, vomiting or sedation,” says Dr Julie Fleet.

“Importantly, for women who choose pain relief in labour, fentanyl has been shown to reduce pain intensity while enabling women to work with the contractions.

“Additionally, women report it provides increased autonomy and satisfaction in birth – both important factors for ensuring a positive birthing experience.”

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The sciencey stuff:

• Testing fentanyl levels in 30 mother-baby pairs (via maternal and cord blood samples taken with 30 minutes of birth) the study found that despite nasally administered levels of fentanyl being significantly higher than those by injection, all babies had lower levels of fentanyl in their systems than their mothers, regardless of administration method.
• All babies had 5-min Apgar scores within normal ranges; none required admission to the nursery for special care and levels of the drug were considered very low, well below those shown to depress breathing.
• This is in contrast to cord concentrations of pethidine and norpethidine where other studies have shown levels have been shown to be comparable to their mothers and significantly supressed a baby’s behaviour in the first few weeks of life.