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Fobbed off with no epidural, how do I guarantee one next time?(38 Posts)
My labour was classed as 'quick' with apparently 2.5 hours of active labour. The thing was that I was examined and told I was only 2cm dilated and could be in this latent phase for 24 maybe 48 hours. I told them all the women in my family go from 2- fully dilated very quickly and that I was in a lot of pain. I was found my best to talk calmly, after (excuse me) emptying myself from both ends completely! And getting short gaps between contractions to be able to talk. I felt like I was a fraud and that noone believed I was having the baby, and I was treated like a child who was complaining about a grazed knee. I refused to go home as I knew I couldn't make it to the car, after just over an hour on the ward (of sleeping women, I felt very guilty as I couldn't keep quiet, and had to kneel on the floor of the toilet for most of the time in tears) I begged to be reexamined and the midwife said calmly 'just breath' I felt like I was totally alone as my husband was sent home. Anyway, they examined me and suddenly realised I was 7cm or more and had had no pain relief. I was honestly in agony. I have had root canals without pain relief and thought that was nasty but that was nothing!! The gas an air that I eventually got did nothing except make the little gap between contractions ok, but that wasn't what I wanted, I wanted pain relief! I asked for an epidural so many times it felt like noone wa listening, they said I could have a birthing ball!?! Are you kidding me, I was under the impression if you asked for it in time you could have it. I even remember begging them, I said 'I am begging you please' and I am not that sort of person, I had zero dignity in saying this and I felt like no one thought it was that painful. One midwife even said 'you chose to have this baby!!!!!' how can people talk to you like that. I had quite a bad tear at the end and had post traumatic stress, I could barely talk and couldn't talk about the labour for weeks after, even now I feel like I new want to go back into hospital, even though I want more children. I felt like they thought I was being dramatic and that labour was nothing. Even though I held most of the noise in by biting through my lip so that it was brused, bleeding and swollen and I cracked my front tooth.
Please, anyone who knows how to make sure that you get an epidural, tell me! Even afterwards there was no reason given why I didn't get one. They just kept delaying it until it was too late. I felt like a child. Only women who have felt pain like that know what it's like, I try to tell my husband, I would have done anything to stop the pain and I have never felt anything close to it. How can I make sure I get proper pain relief? I don't even want to get pregnant until I know and I hate th hospital. I want to be 100% sure that I won't experience that treatment again. It scares me to think that no-one listens and you can't do anything yourself. Thank you anyone who can help or if you have had a similar experience, I feel alone in this and feel really down.
I've never had an epidural but all I will say is that it doesn't hurt half as much the second time round, or at least that was my experience and I appreciate everyone is different.
What I'm trying to say is just because you felt like you needed one last time you might not feel you need one this time, every birth is different so try to just be open minded.
But maybe this time explain that you laboured very quickly and that there wasn't time for an epidural when you felt that you needed one so ask that they get the aneathasist ready just in case.
I think there should be more anesthetists available, or something! Because I would have done anything to reduce the pain, I didn't feel any pain when (sorry to be graphic) my vagina ripped, which I am sure everyone would agree, had the other pain not been so unbearable, in normal everyday life I am pretty sure I would have noticed, I could not describe the pain to someone who had not felt it, or something similar, I was in a state of desperation that comes back to me when I fall asleep at night. I hadn't lived a pain-free sheltered life before, expecting an easy ride, women arnt wimps, which is what I was treated like. I am just about to go to sleep, for the hundredth+ time after my labour dreading the thought of it happening again, scared, if giving birth is so common, why isn't it the thing we make sure we can make bearable?
That sounds awful! Especially as the more complex the situation I imagine the more complex the notes, and the more the woman will need you with her. A big legal document was shoved under my nose just before I went in for my c-section. Something about risk of serious harm/ death. Very poor timing when I was terrified and confused anyway.
Terrible how litigation can end up obstructing best practice.
Sorry OP for diverting original thread! I don't know how to guarantee an epidural, but if I am pregnant again I will try to get the same midwife I trust and discuss my worries in the first appointment, and try to get a c-section probably.
We're told to write so much it's untrue. Obstetrics is the main area in medicine for complaints and litigation. If it isn't written down it didn't happen. We have to write when we offer someone a coffee because someone complained once she wasn't offered one for the whole of her labour!
I could be in court in 24 years time defending myself against allegations from a birth this year. I won't be able to remember it, so all I will have will be my notes.
And stuff like "mum is coping well" isn't good enough. A lawyer will pull that apart, you have to write why you think she's coping, or that she's said she's coping. It is a pita, but defensive practice is here to stay. And yes, sometimes I feel I'm spending more time writing notes than supporting the woman. It's shit.
Our notes are checked by managers frequently and you can be disciplined if your notes aren't detailed enough even if nothing has gone wrong.
Oh, ended up with c-section!
Viva, reading what you say about midwives needing to write up notes gave me a flash back to lying on a bed hooked up to an epidural (waited 3 hrs to get it BTW, emergency prevented me getting one earlier, an awful experience). Finally after 12 hours I was ready to push. Midwife needed to tell me when to push due to epidural, but spent her time typing up my paper notes from previous midwives (wasn't moved to correct ward for ages... long story) and left me guessing and asking, should I push now??? now??? Bloody notes. When I read through them after they weren't even right in places. ('Mum coping well...' um...)
Not meant to be personal to you obviously, your post just made me think of that experience and it makes me wonder whether so much note taking really is essential or should be done in that way.
Bit shaken up thinking of it all actually.
Ushy, as a midwife I don't think I do anything which isn't a vital part of my job, certainly not doing rotas, etc. the ward manager will, but not the midwives on shift. The majority of paperwork I do can't be delegated, I write as I go along, contemporaneous notes and as its my record of what's happening, my defence incase anything goes wrong then I need to write it.
Currently after the woman has delivered it takes me ten minutes max to input the birth details on the computer. Soon however were all getting tablets computers in the rooms so all notes will be electronic, so we will save those ten minutes afterwards.
Nice, did say one to one care in labour and it hasn't happened. But idont see women kicking up a fuss and refusing to accept it? Do you mean kicking up a fuss when they come in in labour? Because that won't make a difference, if the midwives aren't there then they're not there. I don't see the campaigns, etc and the hounding of politicians over the issue.
Viva but that's the same issue isn't it? NICE said all women should have one to one care. Should we compliantly and obediently accepts the unacceptable?
I just love the Mners who kick up and don't put up with it.
It doesn't even need to cost more money - midwives just need to look after women in labour and freed up from all the other rubbish they do.
Interesting fact I came across - UK has some of the best maternity statistics in the world. How much time do midwives spend doing stats and filling forms, risk assessments, staffing rotas....? Do we our midwives need to spend so much time doing data entry? Is that actually anything to be proud of?
The paperwork may be great, the care, IMO, is sometimes rubbish.
I don't think, though, it is necessarily the midwives - its the system. Systems can change but only when enough people refuse to agree to be treated like second class citizens.
Ushy - it isn't always about the availability of an anaesthetist either. Most hospitals will insist that a woman with an epidural needs one to one care from a midwife. If you have 11 labour rooms and only 5 midwives there will be shifts where that's impossible.
Agree with QTPie, when my dad was in a general ward vomiting and crying with pain I asked a nurse to bleep a Dr to prescribe more pain relief. She tried refusing as she said the on call SHO wouldn't prescribe further analgesia due to concerns about my dad's liver function.
I let her know pretty damm quick that I have medical knowledge and that what she was telling me was a load of bollocks. For some reason she just didn't want to bleep the SHO. I told her if she didn't I would, that I worked in the hospital and knew how to bleep a Dr.
But how bad is that? Other people would have believed her.
Actually, I think "inadequate pain relief is a failing of the NHS as a whole and not just maternity care.
Having seen my mother, each day, after having a third of her lung removed because of lung cancer, I am very frightened about access to adequate pain relief on the NHS. I had to always beg to see people (escalating to an Anaesthetist a couple of times) to try to stabilise her pain. Each time I left her, her pain was managed. When I arrived the next day she was in agony again. If I hadn't been there...? I just think that there is enough resource to manage pain on the NHS (not enough anaesthetists to manage really acute pain and nurses too busy to really monitor a patient's pain levels).
It only takes 20 minutes to put an epidural in. A consultant units should be staffed to provide an epidural within 30 minutes from request.
It is a quality marker.
But how would you guarantee them for all women who want them? You'd have to have an anaesthetist for every woman in labour.
"I'm afraid there's no guarantee of epidural. If anaesthetists busy with emergencies then they might not be able to get to you in time. Sorry"
Well that's ok then.
Women just bite on the bullet and scream? Isn't there a bit of an equality issue here? Would men put up with this? Childbirth can be indescribably agony - you can have the flesh sheered off your pelvic bone by the forces of labour and the baby's head. It is severe enough to leave you with PTSD.
It is inhumane that epidurals are not available on request to all women who want them.
I don't mind people swearing when they're in pain, etc. I don't take it personally. But if someone couldn't have an epidural for reasons beyond my control I'd be upset if someone was swearing at me.
But yes, unfortunately I think there are midwives who think its their job to try and keep women going without an epidural and then see it as a success if the woman doesn't have one. I don't, if a woman asks for one I try and am normally able to sort one. If they ask mid contraction, I'll wait for the contraction to be over and ask if they're sure. That's the most procrastinating I do.
Just wanted to share this....
I had an elective c section with my ds 5months ago. When they opened me up they realised I had completely undiagnosed placenta previa. I had had 3 scans during my pregnancy the last one at 35 weeks for something unrelated and not once did anything seem odd. I had chosen to have a section due to a previous long labour.
Basically I had at first one anaesthetist in with me. When I began haemorrhaging severely 3 others rushed in to try and stabilise me for the duration of the operation. I lost 3 litres of blood.
If anyone had wanted an epidural during that time (I was in theatre for 5 hours) I would imagine no amount of swearing or shouting would have got them one.
I nearly died.
And I would imagine several other incidences like mine were no doubt happening in other areas of the hospital.
You simply cannot demand or guarantee an epidural. I think every woman should know that. And that's whatever they tell you.
If you want absolutely guaranteed spinal or epidural you will need to be booked in for a cesarean which is why I chose to have one and it's a good job I did as I absolutely would have died otherwise with the complication I unknowingly had.
Whilst I'm quite sure that you viva, would be happy for anyone to have an epidural who requested it, many midwives will procrastinate if the woman seems at all unsure, in fact in my second labour I was told I didn't need one and should be able to manage without one, and that there was no one to do one at the moment. I'm afraid I did rather lose my rag at that point, me being in a lot of pain and all that, and having someone tell me that I didn't need an epidural when I felt I wanted and needed one was just a shade too far. Funnily enough the chap was in the room with the kit within about 15 minutes and shortly afterwards I got my sense of humour back and apologised profusely for being a grumpy cow.
There's really no need to swear at the staff though.
I mean really? Why do people think its ok to swear at midwives? Believe me if I say I can't get someone an epidural its because the Dr is busy. Swearing at me is not going to change that.
I'm afraid there's no guarantee of epidural. If anaesthetists busy with emergencies then they might not be able to get to you in time. Sorry.
I had a similar birth to yours with my first - I was more scared of the epidural than the contractions so didn't have it!
My second labour was much quicker - DD arrived 10 mins after arriving at hospital! You may find there isn't time for an epidural!
As said upthread, epidurals take time to kick in can slow things down.
I would make it very clear to your midwife that you want an epidural as soon as you arrive and have been examined - and do what clam did!
Tell them as soon as you get to labour ward, don't take no for an answer, keep telling them, very loudly, swearing if necessary until you get it. Trust me when I tell you, if you make enough noise they will get it sorted.
It was hearing tales like yours riva that made me discuss with my midwife at my very first antenatal appointment that I was adamant I wanted one. Fortunately for me, she was very open to the idea and wrote it down. It became a running joke between us as every time I saw her I'd remind her, "you got my epidural booked yet?".
Eventually, when I rang her (with second baby) to say I was in labour and I'd be coming in in due course, she met me in the foyer, had already called the anaesthetist, and he was in my room unpacking his things even before I got there.
Mind you, dd is now 14, and I suspect
money has run out things have changed since then!
To be honest, it was fear of not being able to get adequate pain relief that made me flee from the NHS to private maternity care. There are no guarantees in this world, but the better availability of staff (both anaesthetists and also guaranteed one-to-one midwife care) - plus the fact that you are a directly paying customer - gives you the best chance of getting it.
Bare in mind that I love in Bath and the nearest private maternity options are/were London, you can see that I was pretty terrified about the lack of pain relief. In the end, DS was an early diagnosed breech (so ELCS): so availability of epidural was not an issue.
My first labour was augmented with syntocinon after 48hrs stop-start labour with a back-to-back labour. Your description of the pain sounds like what I experienced. I couldn't make myself understood between the contractions to even ask for water. I think I had/have PTSD from it but not bad enough to get counselling.
It put me off having my second child for longer than we'd planned & eventually I got pregnancy semi-accidentally. I mentioned I was interested in having an epidural all the way through my ante-natal appointments. I eventually had to have an induction with syntocinon again & had an epidural at the same time, thank god. It was pain-free until pushing when they let it wear off a bit, but much, much better than before. However, I will not be having another child as I do not want to experience giving birth again (or a CS).
It's true that nobody can ever guarantee you an epidural - my births have also been very fast. I have three children and epidurals have always been available in the unit but nobody could get there quickly enough (with my first - Second and third births were even faster and I knew there really wasn't any point!) Epidurals take time to set up and administer. They don't always work. Have you thought of birthing pool, tens, back massage? In any event many friends I know who had epidurals said they have to wear off to push anyway.
Something that was suggested to me that was an option for very fast labours was being induced, then they can set you all up with an epidural at the same time and ensure you are managed - but I didn't want that at all even if it meant enduring that pain again (and may well lead to more interventions/medicalised labour). Yes it is the most appalling pain and nobody can ever prepare you for how much it hurts - but at least it is over when the baby is born.
I wonder if dealing with the trauma you have suffered might mean that you can face another labour again as I don't think an epidural is necessarily the answer - instead I think you need help to deal with the bad experience, and set yourself up for a properly managed labour with supportive staff next time.
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