Anyone else 'tricked' out of epidural? (part 2)

[Chynah]

For those that feel the discussion still had some way to go........... please continue.....

[EmptyCrispPackets]

I've said to DH this time that firstly that midwife will NOT be involved at ANY stage of the birth, and secondly that we will make it plain to them when I'm admitted that if I am left alone with an epi for so much as a second I will SUE THE PANTS OFF THEM.




So who will be delivering your baby?

Sue? Yeh thats a good idea then the NHS has even less money, and so the vicious circle continues.

Or are you not UK based?

[snowcake]

I can echo what samarcanda said on the previous thread:

"i really do not understand why this mostly happens in UK.
I'm from Italy and all my friends (including one that is an anesthetist herself) gave birth with epidurals and highly recommended it...
for some labor progressed fast and there was no time but for most of the others there was and they had great experiences without slowing down labour or needing forceps (which by the way is not used in other countries, only by the barbarians in the NHS as a cheap alternative to expensive EMCS!)

people here seem to make of childbirth an ideological issue, with midwives fighting political wars to regain responsability about childbirth away from doctors. (by the way, did you know that you cannot sue a midwife, but you can sue a n OB GYN consultant?) and everyone treating women in a very patronising way,

with women making you feel guilty if you want to feel less pain or want to have the certainty and the lack of hassle of an ELCS. )both epidurals and ELCS are commonly recognized to have very low risks these days in most other countries... but if you listen to people here, they are really demonized)

I keep on meeting very opinionated people that just cannot rationally talk about childbirth and breastfeeding without a large dose of ideology.
My experience in other countries (i lived in France, Italy and USA) is quite straight forward. You choose your birth if you want, if not you delegate to an infrastructure that is funded well enough to be able to provide what's in your best interest. And when it can't (some hospitals abroad are also understaffed) they admit they cannot do that , so you try and hire a private anesthetist if you want an epidural.

why does it have to be so difficult here and full of all these rage, guilt, almost religious devotion to ideas like natural births, no pain relief etc ?"

I have read most of the first thread and I am horrified how many women have been let down by fellow women and lack of resources. Surely there is a good dose of chauvinism involved, if it was men giving birth they would make sure the NHS delivery wards looked like the Portland.

[noisylurker]

I wondered if this would open up again.

I wanted to reply to fifitots post on the last thread:

^"'Nobody seems to be supporting the upholding of that tradition; in other areas of medicine, cleaner, sanitised, and managed pain in medical care seems to be generally accepted as a Good Thing - why should it be any different for childbirth?'

Because it's not an illness maybe? Interested to know in what ways you would make it 'cleaner' or 'sanitised'. the majority of women on here are not saying that but there is an implication on some posts."^

I assume this was directed at me as it's my post you're quoting. I was actually referring to the following post by DrMcDreamy (sorry, I haven't worked out how to quote properly on here yet):

"However I'm pretty sure that if the 'Epidural no matter the costs' gang get their wish, maternity services in the UK will be taking a massive step backwards. back to the days of routine shaves, enemas and episiotomies, in a bid to keep childbirth sanitised, clean and painless. Fine if that is what the majority want but I for one think it's that way that madness lies".

My point wasn't really that I would make childbirth 'cleaner' or 'sanitised'. My point was that medicine has moved on. Childbirth may not be an illness, but neither is getting teeth extracted, cosmetic surgery or needing stitches. I just find it bizarre that even when problems occur, so many of us have been expected to brave it out for our own good. Not only by some medical staff but apparently also by a number of women who have been lucky enough to have a more straightforward birth.

[PedEgg]

"For later labour you need a denser block - I've used 20ml 0.25% plus 100mcg fentanyl, or 10ml 0.5%. At fully I'd put a low dose spinal in first - instant analgesia plus less movement when putting epidural in. I then top the epidural up after an hour or so if they've not delivered by then. You get a lot of motor block with that level of analgesia but by this time most women don't want to be able to move, they want the bloody pain to stop and go away and someone to pull the baby out because they've Had Enough It's one of the joys of being called at 3am that by the time I leave they are looking forward to their baby arriving again."

The above post was made by technokitten on the previous thread. I am absolutely astonished that some people find that acceptable. Is no one thinking about their baby that they have spent 9 months nurturing, presumably time planning prior to that and then because you want an epidural at the last minute it is fine for the baby to be dragged out by it's head - and the anaesthetist walks out the room congratulating themselves on a job well done??? Mental. Totally mental.

[PedEgg]

"For later labour you need a denser block - I've used 20ml 0.25% plus 100mcg fentanyl, or 10ml 0.5%. At fully I'd put a low dose spinal in first - instant analgesia plus less movement when putting epidural in. I then top the epidural up after an hour or so if they've not delivered by then. You get a lot of motor block with that level of analgesia but by this time most women don't want to be able to move, they want the bloody pain to stop and go away and someone to pull the baby out because they've Had Enough It's one of the joys of being called at 3am that by the time I leave they are looking forward to their baby arriving again."

The above post was made by technokitten on the previous thread. I am absolutely astonished that some people find that acceptable. Is no one thinking about their baby that they have spent 9 months nurturing, presumably time planning prior to that and then because you want an epidural at the last minute it is fine for the baby to be dragged out by it's head - and the anaesthetist walks out the room congratulating themselves on a job well done??? Mental. Totally mental.

[PedEgg]

Oh not sure how that happened. Sorry.

[Margles]

I wouldn't be too harsh on Technokitten - she has posted some thoughtful posts on how epidurals are administered and some reasons when they are contra-indicated.

[PedEgg]

I'm not getting at technokitten, more the me me me culture that we have here that puts our wants and needs above anyone elses, even our unborn children.

[herethereandeverywhere]

pedegg I can only assume you have never experienced that level of pain. I can honestly say that if they'd have told me my unborn DD had to die for the pain to stop then I'd have agreed. I know I would. The unrelenting pain literally demented me. If I could have hauled myself out of the window and jumped I would have. I resorted to hitting myself extremely hard on the head, repeatedly, because the concussed feeling took the edge off.

This was at ZERO cm dilated but part of an induction going wrong (5 hours of hyperstimulation, constant pain, 7 contractions in 10 minutes, back to back, 1st baby, baby large for my height) The pain was constant and hideous. I can completely relate to what those women in transition were saying. You would to ANYTHING to stop the torture.

I eventually got an epidural that worked (it took 4.5 hours following them agreeing to give me one). I dilated 0 to 10 cm in 6 hours, waters broke spontaneously and I slept through all the horror that others have told of (on the previous thread). Unfortunately DD was stuck in deep transverse arrest and I ended up with Kiellands delivery.

[GetOrfMoiLand]

Pedegg - I think you have misread what Technokitten said. When she said 'just want someone to pull the baby out' she was (I think) referring to the utter breaking point of a woman in severe pain, loads of women shriek out 'get this bloody baby OUT' in labour. She was not referring the actual procedure used.

Women are not birthing machines as well. Yes, they have nurtured a baby, but the mother's health (and that includes mental health) is as important as that of the child.

[GetOrfMoiLand]

Can we not ask MN to extend the other thread? Seems a pity to have 2 threads, would be nice to continue the other one.

Would anyone mind if I asked?

[PedEgg]

Ok fair enough perhaps I did misread it. I just thought it was a bit of a shitty attitude for an anaesthetist to have.

[EmptyCrispPackets]

I wouldn't be too harsh on Technokitten - she has posted some thoughtful posts on how epidurals are administered and some reasons when they are contra-indicated.


Ok fair enough.


But it is a shame that some of the posters havent had the same attitudes towards some of the midwives thoughts on this subject instead of dismissing everything they have said.

[Chynah]

Getorfmoiland - as far as I'm concerned please feel free to ask MN to extend the original thread. I only started this one as I felt people hadn't finished the discussion and the thread was closed. Would make much more sense to continue in the same place if posible

[Margles]

I fully agree with you EmptyCrispPackets.

I also wonder how many of the other posters have wanted their epidurals because of inductions, and whether the induction was the root cause of the problem?

[GetOrfMoiLand]

Have requested an extension to the other thread - will report back when MN get back to me.

[Sassles]

Hi,

I've read a fair chunk of the other thread and thought I'd share my experience if that's ok.

I had an induction with the synotocin (or how ever you spell it) drip. I had planned to have a natural birth as possible although I was always consultant led. I did however, have the attitude that I would take whatever I needed.

The contractions with the drip were horrendous instantly. I would like to compare with a natural contraction as maybe I'm just a big wuss, but MAN it was sore. Contractions lasted a few minutes and very quickly I was only getting 20 secs tops relief in between the next one. I was 1 cm when they started the drip (having had two lots of the hormone over 14 hours) and lasted on gas and air for about 3.5 hrs. The G&A only works if you can take a break in between otherwise it loses it's effectiveness. I then took the diamorphine jag and it did nothing for the pain as far as I could feel.

At the start I was told it would take a while for an epidural to be inserted and if too far along would be declined. Nice and open honest information right at the start.

I probably could have held out a bit longer, but in my head, being at it for 4 hours I was likely to be nearing the "too late" period and it was only getting worse.

The moment I confirmed absolutely that I wanted an epidural the anethesiologist came although it took 3 attempts. When they examined me I was only 2 cm dilated!!! and I cried!!

TBH at this point they called it a failed induction, but DS heart rate had been slowing since the first round of hormone. It dropped again rapidly and they whisked me off for an emergency section.

This was all a bit scary, but the staff up to this point were great and no issue with asking for the epi, although this was during the day and in CLU.

Trouble started the next morning when I had the most awful pain in my neck. I was asking for medication for it from the moment I woke up. I thought I had pulled a muscle breastfeeding in an awkward position as I couldn't get out of bed due to the section and epi.

It got worse and turned out that I had a Spinal Puncture Headache from the epidural. I have never felt anything like how awful this was. I was in agnony the moment I lifted my head from the pillow. It took 3 days (we were in longer as DS needed antib's for strep B) for the anethitist to be paged to speak to me and he was horrid to me. The one the next day however, was very lovely and explained everything to me.

Basically, my dura holding my spinal fluid was punctured during the epidural and had been leaking out over the 3 days. When lying down the fluid is balance, but when you sit up your brain has no fluid to hold it up, cue the worst debilitating headache you have ever had. I couldn't sit up for 30 seconds without crying it was that sore.

They tried to repair it by redoing the epi, but pumping my blood into the area to try and seal the hole. It didn't work and I had to have an MRI to check everything was ok (this was another horrible experience).

In short I had the headache for 2 weeks. Two weeks where I couldn't get up and hold my baby and had to feed lying down.

I should have googled epidurals before I went in and feel that it wasn;t properly explained. It just sounded like something everyone got. I didn;t know the risks. TBH I would still have taken it had I known as the pain was unbearable. I just got really unlucky.

Statistics online say 1 in every 100 epidurals have this side effect, but sounds alot to have not heard of it before.

Aftercare was great for the first 4 days and the midwifes were amazing. however when the shift changed they were awful and I could hear people buzzing and being ignored. I had to buzz everytime DS cried, needed fed or nappy changed and the midwifes made sure I knew what an inconvenience it was. It got so bad that I discharged myself from hospital after a week as I felt myself sinking lower and lower into a depression. Moods had been great with the first midwife shift.

I did however, find DS bith notes on the 3rd day to find that he had been rescucitated as the cord had been wrapped round him. No health professional to this day has mentioned this to me.

After my experience, i can appreciate why health professionals would want to ask women to consider the implications of an epidural and think that other pain relief should be taken and epi used as a last resort, but I do agree that it is the women's choice if given all the facts after they have tried other less risky methods and they should not be lied to or fobbed off. I think anyone would be reasonable if advised the anaethitist was busy elsewhere especially if this is outlined at the beginning of the labour to minimize expectations.

[TechnoKitten]

PedEgg, you misunderstand me.

I am talking about being faced with women who have mentally lost the plot, are exhausted from hours of unrelenting agony and are begging for CS, general anaesthesia, someone, something or anything to make it all stop and go away. Perhaps "pull the baby out" was the wrong choice of words but often they are crying "get it out, make this stop, I can't go on".

So yes, when I have taken the pain away, given them some time to get their heads back and allowed them some damn dignity - I will congratulate myself on a job well done. Because if by allowing them some reprieve from the pain I have helped turn a negative birth experience into a good one, that's a good thing. Isn't it?

Or would you rather I let them suffer in that very dark and frightened place because I wouldn't want to pander to their desire to put themselves before their baby?

How dare you accuse me of a shitty attitude.

GoML - yes, that's what I meant.

[FunkyGlassSlipper]

PedEgg - I found your attitude awful. Of course we want what is best for the baby, and to suggest otherwise is insulting. A mother with PND for a year because she isnt listened to in labour isnt really good for the baby either....

Each woman is different. Each labour is differnt.
What works for one woman wotn work for another - i believe this is where the 'intuition' comments from midwives come from. There needs to be a degree of flexibility on all sides during the labour process.

Women shouldnt be regid with their pre-planned birth plans - I wish I hadnt been. Midwives should be prepared to advise contrary to the birth plans if necessary. And we shouldnt stigmatise epidurals or Csections as some kind of failure, as opposed to the natural way. It should be intergrated into the care plan if needed, not seen as an absolute last resort meaning it would come too late or not at all.

We have come a long way with medicine and the reuction in mortality rates during birth. Why cant we use the same medicine to make labour a less traumatic experience too.

[FunkyGlassSlipper]

Technokitten - I begged for a c-section at least 5 times prior to my eipdural in birth no 1. After 2 days, I kept being told i was nearly there.....I finally got the epidural and about 8 hours later had the baby, after fetal distress, induction, ventouse etc. Then baby rushed to SCBU.

You are absolutely right that it is the best course of action for a woman in that situation. And I repeat - I wish you had been in my delivery unit. :)

[TheChewyToffeeMum]

I understood exactly what you meant Technokitten. The level of pain I was in meant I would have considered anything to make it stop, including suicide, as several other posters have said.

I am hugely grateful to the registar and anaesthetist who agreed that I needed an epidural when the midwive was dead against it. They did give me my dignity back.

[snowcake]

PedEgg, I find your POV thoughless and coldhearted. I tried for a VBAC and ended up with an EMCS. I experienced strong deferred pain down my thighs which was an indication of a silent rupture and the hectic, worried faces of the midwives and doctors still haunt me as they went against time and oxygen starvation to get the baby out never mind the blood loss to myself.

I wouldn't have given a flying toss how they got my dd2 out at point, I just wanted a living baby and survive myself.

Just to let you know that any doctor having to chose between the mother and the baby will chose the mother unless the odds for her survival are seriously going against her.

[wahine12]

Bravo TechnoKitten. I really appreciated your contribution based on professional experience. Nice to have some posting based on science rather than anecdotes.

I have 2 weeks to go to my second birth and just decided not to attend the rest of my antenatal classes based on the utter lack of clear data on the relative risks of interventions. The list of contraindications for epidurals was enormous and included no statistics on these risks. Yes, there are risks associated with epidurals, but there are risks associated with childbirth in general.

At my first birth in France there was no question that pain relief was my right and an epidural was the superior option. Going to visit the maternity ward in NZ for my second birth the midwife was proud to say that it was her decision whether I was in enough pain for an epidural and, besides, they might have to get the anaesthetist out of bed and he had theatre in the morning (i.e. proper operations) and really shoudln't be disturbed. However, she was quite happy to give our fentanyl injections and self-administered dia-fentanyl to 'take the edge off' (please don't quote me on the names of the drugs, I was seeing red by this stage). Now, forgive me if I'm being stupid, but isn't this just the same drug (or a variety of an opioid) administered differently? So where's the difference? It's the fact that the midwife has to let someone else into the birthing process. It's not about my health - it's about the politics of birth.

As a result, I am now angry that some midwife who met me 30 minutes prior presumes to know how much pain I'm in, I'm anxious about the birth as I'm not sure whether I'll get the help I need and I feel really sorry for the rest of the class that is going to be incredibly disappointed if they don't get through their births on a cup of tea and a biscuit.

My great disappointment is that women are not being given the choice. In France, the birthing process is captured by the doctors and it is very difficult to birth naturally as the midwives were not trained to do so (or insured). In NZ (and I fear the UK), the birthing process is captured by the midwives and women are made to feel ashamed for wanting not birthing naturally. Why do we have to have such extreme views? Why is women's choice not at the centre of the equation?



For the record: first birth I laboured without pain relief for 20 hours (0-7cm), then G&A once they broke my waters as the sack had not ruptured properly for a further 2 hours (7-10cm). Then they discovered DD was OP and tried to turn her. Then they said they would need to do ventouse, episiotomy and I would need pain relief so an epidural was performed and DD was delivered two hours later. It was fantastic, but at the time of making the decision to have the epidural I would have accepted them digging DD out with a tin opener if it made the pain stop. For the next birth I will see what happens. I don't have any preconceptions except that I want the choice to have an epidural if a similar situation arises.

[PedEgg]

I am well aware of that snowcake thank you. I was talking specifically about women in transition, specifically about an epidural being sited at the last minute and Technokitten being happy to do this despite as she said the baby being 'pulled out'. I have also accepted perhaps I misread what Technokitten had written and for that I apologise.

However the way I read it (and I accept I didn't read it in the way it was intended) meant that I did find Technokittens attitude surprising but then an anaesthetist is always going to come at this from a different POV from say a midwife, their job is done well if a woman is pain free, everyone has a different role to play so sorry for calling your attitude shitty Technokitten, however I am entitled to an opinion and I'd prefer it if you didn't talk to me like a 3 year old.

I'm not against epidurals, I had one myself in my 2nd birth, I wouldn't have died if I hadn't got it though and I don't expect I would have been traumatised either, but that is just me I guess. Everything has it's place but I do respect what a difficult job a midwife has, it must be a complete nightmare having to please everybody all of the time with limited resources and no crystal ball.

[TechnoKitten]

I didn't talk to you like a 3 year old. I don't use words like "shitty" with my 3 year old.

I don't consider my job well done if someone is pain free, my job consists of a hell of a lot more than merely removing pain.

There are some midwives who see anaesthetists as purely epidural technicians, there are others who treat us as part of a multi disciplinary team whose ultimate goal is the safe arrival of a well baby with a healthy and happy mother. Good pain relief is a part of this but it's by no means all. You can work out for yourself which type I get on better with.