What is diamorphine?

(BNF 2015)

(NHS 2015)

(Ullman 2010)

(Wee et al 2014)

(Wee et al 2014)

(NICE 2014)

(Redshaw and Henderson 2015)

(NCT nd)

How is diamorphine given?

(BNF 2015)

(OAA 2012)

When should I have diamorphine?

(NCT nd)

What are the advantages of diamorphine?

(Ullman et al 2010)

(Ullman et al 2010)

What are the disadvantages of diamorphine?

(Wee et al 2014)

It only provides limited relief from the pain of labour (NICE 2014, Ullman et al 2010) .

. It may affect your baby's breathing for several days and interfere with breastfeeding (NICE 2014) .

. It may make you feel drowsy or sick (Ullman et al 2010, NICE 2014) , which in turn may make coping with labour more difficult (RCOA 2008) .

References BNF. 2015. Opiate analgesics. British National Formulary. www.evidence.nhs.uk [Accessed March 2016]



NCT. nd. Pain relief in labour. National Childbirth Trust. www.nct.org.uk [Accessed March 2016]



NHS. 2015. Pain relief in labour. NHS Choices, Health A-Z. www.nhs.uk [Accessed March 2016]



NICE. 2014. Intrapartum care: care of healthy women and their babies during childbirth. National Institute for Health and Care Excellence, Clinical guideline, 190. London: NICE. www.nice.org.uk [Accessed March 2016]



OAA. 2012. Pain relief for labour. Obstetric Anaesthetists Association. www.oaa-anaes.ac.uk [Accessed March 2016]



Redshaw M, Henderson J. 2015. Safely delivered: a national survey of women’s experience of maternity care 2014. National Perinatal Epidemiology Unit. www.npeu.ox.ac.uk [Accessed March 2016]



RCOA. 2008. Anaesthesia explained. Royal College of Anaesthetists. www.rcoa.ac.uk [Accessed March 2016]



Ullman R, Smith LA, Burns E, et al. 2010. Parenteral opioids for maternal pain management in labour. Cochrane Database of Systematic Reviews. 9: CD007396. onlinelibrary.wiley.com [Accessed March 2016]



Wee MY, Tuckey JP, Thomas PW et al. 2014. A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial. British Journal of Obstetrics and Gynaecology 121(4): 447-56.



Diamorphine is a powerful opioid that's used for pain relief. It's a semi-synthetic drug that's partially derived from the opium poppy plant, or heroin.When diamorphine is used to relieve pain in labour, it doesn't result in a dependence on the drug. So don't worry, you're not going to become an addict if you have it during your labour.Diamorphine helps to relieve pain and make you feel more relaxed, and may have fewer side-effects than similar drugs, such as pethidine However, diamorphine can make your labour longer. Diamorphine is thought to interfere more than other opioids with the release of oxytocin, a helpful hormone for labour. So you may end up experiencing more pain overallOpioid drugs, such as diamorphine and pethidine, should be available wherever you choose to give birth . About one woman in four uses an opioid such as diamorphine in labourCheck whether diamorphine is available at your hospital before writing this method of pain relief into your birth plan If you choose to give birth at home , ask your midwife whether diamorphine is an option for you. Midwives working in different areas may have different rules about what they can offer during a home birthNormally, your midwife will give you an injection in your thigh. The usual dose is between 5mg and 10mg, depending on your body size.You can also have diamorphine via a drip (intravenously) if your anaesthetist thinks it would be more helpful. She'll insert a fine tube into a vein in your arm and the other end of the tube is attached to a pump.In some hospitals, you can have what's called patient-controlled analgesia (PCA). With PCA you can control the flow of painkiller yourself. A similar opioid called remifentanil is generally used for PCA, because it clears more quickly from your body than diamorphine.You're most likely to be offered diamorphine during the first stage of labour . This will give you extra help to cope with strong contractions. Opioids can really help if your early labour is long and uncomfortable and you need to get some restYour midwife may suggest a vaginal examination to see how far your cervix has dilated before giving you diamorphine. If you are further on than you thought, you may decide that you can cope without it.In general, diamorphine has the same advantages as pethidine . However, you may be less likely to feel nauseous or be sick with diamorphine than with pethidineDiamorphine can give you a longer labour than you might have with pethidine. Otherwise, diamorphine has the same disadvantages as pethidine , mainly:Whatever type of pain relief you'd like to use during labour, speak to your midwife to discover what options are available in your area.In the meantime, learn more about these other types of pain relief:Or visit our community for a sneak peek at .