OBEM - why are they so anti-epidural?(151 Posts)
Just watching OBEM and I've been wondering every time I watch it, why are the midwives so anti epidurals? Is it the same all over England? There was another episode recently where a girl was practically begging for one and they talked her out of it (at 3cm) & I just don't know why. I know there are risks but they are minimal and thousands of women give birth every day with epidurals but watching that show would make you think they're a last resort.
I'm just curious really. I'm from Ireland where it's more normal for first time mums to have an epidural than not and it's almost presumed you will. Having had two kids I am a big fan of epidurals and secretly think giving birth without one is a bit mental!
(ps don't want to start a big debate, just wondering!)
it's just this patronising tone that irks me.
I'm all for informed decision but his was all a bit one sided (the bits that were shown at least).
It is just so patronising not to let women choose. I have had 3 epidural births, two successful epidurals and one that just numbed my legs. All were inductions and the failed epidural was back to back baby, tearing and a nine pounder. Would not wish that on my worst enemy and I am no wimp! Epidurals rock!
I gave birth in Leeds with one of the midwives that features on the show
we had a discussion about epidural, she was very matter of fact, explained the risks but was happy to support my decision to have an epidural with dd1 -but then she could see I was exhausted (3 day induction anyone?) I certainly didn't feel any pressure not to have one
I think they get annoyed with the women who don't give it a go so to speak, asking for epidural very early on, won't try moving around etc
IMO if you can talk through a contraction you don't need an epidural
This is why I don't like OBEM - I think it fetishises the idea of childbirth being inevitably painful. I get very upset when I see or read about women being denied pain relief. It feels like we're going backwards - it's like the Victorian resistance to anaesthetics in childbirth because women "ought" to suffer in labour.
I think I'll delete this episode from sky plus as I kind of quite like watching it but it makes me really angry sometimes there are a couple of midwives I switch off when they are on duty.
Anyway back to the point the obsession with natural childbirth is ridiculous. It should be patient centred (like best practice in the rest of the NHS). Why are women considered incapable of choosing?
See, now I was watching OBEM when a woman had an epidural, and she was not feeling her contractions, so I believe she was pain free. Looked good, until she came to pushing the baby out and was doing his for an hour with no joy.
My two came out with a couple pushes like rockets. Don't know if that's what they mean though???? But also they were both quick labour s 7 and 3 hours from first contraction. Didn't really want an epidural, but towards the end of dd1s birth I wanted one.
I was throwing myself out of the birthing room to get home with dd2. Glad I didn't have one tbh. Who wants to be sat in a hospital, when home is where you'd be better settled with baby. And ewww to the needle in the back <shudders>
It's all about personal choice, and not everyone deals with pain effectively as others. We all have different thresholds.
I was denied pain relief in labour for 6 hideous hours during which i wanted to die, once I got it I dilated a lot faster. I had other complications but the withholding of pain relief was a huge factor in the severe PND and PTSD I suffered from. I am pregnant with DC2 and have been been diagnosed with secondary tokophobia as a result of my first experience so will most likely be having an ELCS. I really believe that if the midwives had been more humane and sympathetic I would not have suffered so badly mentally.
If it's a cost issue that is insane as I have cost the NHS a fortune since the birth, although on the mental health side.
I'm Irish as well and really envy my sisters managed birth experiences where pain relief was offered before she even asked.
When I say it's the norm, not everyone has one and they don't have them ready & waiting when you come in or anything. But if you ask for one and you're in active labour, it's not a huge deal.
For those saying they didn't have one/didn't want one etc, that's great for you but do you not agree that women who do want one should be respected and given one without making them feel it's a negative thing?
I was talked into an epidural at 3cm and I have very mixed feelings about it tbh. I had been having contractions for 2 days to very little avail and it actually speeded things up - I was fully dilated within the hour. But then the birth stalled and I ended up with a syntocin drip (!), ventouse and episiotomy. I found it disorientating to lose the pain and almost even the sensation of the contractions, although it was a blessed relief to have a break from that unproductive pain. I think I would have preferred to be helped, at that stage, to help progress the birth by being active - I walked around a lot when I went into labour the second time and turned up at the hospital at 9cm.
Oh I got a right catsbum mouth when I insisted on an epidural with DS - the midwife actually said to me "you can't just come in and ask for an epidural" (I'd stayed at home for a while and then it was snowing so it took longer than planned to get to the hosptial, so I'd only been there about an hour at this point) I replied with what DH calls my "death stare" and "I think you'll find I just did, get someone in here to sort it now." I think she got that it wasn't going to be something she could talk me out of - but she was a right moody cow for the rest of her shift. Was very glad that I got someone else a few hours later who actually was rather cheery.
Our NHS trust won't offer any other pain relief apart from paracetamol or tens until you are 5cm, then you can have entinox/epidural/diamorphine. So I'm always amazed when watching OBEM that they get entinox at such early stages or other pain relief.
I think they are because:
They know that women often manage birth best when they feel empowered to do it naturally ie not made to feel the pain is unmanageable or that you have to have pain relief to cope.
I gave birth to DS at 9 lbs plus with only g and a for the first stage and nothing at all for the last 3 hours which were augmented on the drip. I am so glad I didn't have an epidural!
I think if I was a mw i think as a first step I'd be saying you can do it yourself to try to empower the woman giving birth.
BUT only the labouring woman knows how much pain she is in. If she is adamant she wants one even with the best support then every labouring woman should get one immediately.
At the unit where I gave birth the average time from requesting an epidural to getting one is v short. However, their rate of epidurals is much much lower than the national average because they offer almost 100% one to one support in labour, so women cope much better with the pain.
I think you know if you want one, and we shouldn't be treated like children asking for biscuits before dinner.
I wasn't happy about the whole needle thing, but when a shot of morphine hadn't touched it, I hadn't slept in 3 days, and the syntocin was all the way up I changed my mind - the amazing relief from the continuous, unproductive pain actually had me giggling (or perhaps that was the morphine still hanging around)
This time around I shall be asking my consultant about what all these chances are so I can factor it all into my choice of VBAC or ELCS
For those saying they didn't want an epidural I totally respect that but it should all be about informed choice. Some of you made informed decisions not to have an epi, you got supported in that choice, why can't women who make the opposite choice be equally supported? I'm fed up with the idea that women panic and want an epidural and its not a rational decision, for many it is very rational.
Before my first epidural I'd been in labour 36 hours and was in so much pain and so tense that I could not wee. The fullness of my bladder prevented the baby descending and without the head coming further down I wasn't dilating. The epidural sorted all that, I relaxed and everything speeded up. It was a sensible decision. Thank God I made that decision as it later turned out that my 10lbs baby was the wrong way round with her head titled and I needed forceps, if I hadn't had an epidural in place already I'd have probably ended up with a general anaesthetic and a CS.
With both my epidurals I chose to let them wear off at 9cm so I could feel to push. It's that sort of tip the midwives should be giving rather than just disapproving. As a result of the informed choice to let the epi run down I could feel to push. Epidurals can be managed sensibly.
I am now 7 months with DC3. This time I will ask for an epi as soon as I am 4cm and labour is established. Knowing my past history I will probably have been in pre-labour for over 24 hours by this stage. The epi will allow me to stay calm and regain by strength. At 9cm I shall ask for it to be turned off and I will push with sensation. If I give birth to my third baby that has a 99% head and weighs over 10lbs then I know I will tear again and I will be thankful the epi is still in place and can be cranked up again for stitching. These are my choices and the midwives should support me in them. Is that too much to ask??
All this disapproval, judgyness and one-up-man ship is so bloody English and so bloody female. I hate it.
I haven't read all through this thread, but in my case, I had a nasty long labour, needed epi, everything slowed down completely and I stalled, and then needed intervention in the form of forceps.
This caused me to tear right through my back passage and now 2 years later I still bleed when doing a bowl movement, sex is painful, and I sometimes can't contain my "gas" in public, utter embarrassment. I'm so worried I've done permanent damage and incontinence is a permanent issue.
How I wished I had just coped with a few more hours of pain to have stayed mobile, and possibly not have torn and have these issues now. This is my own experience and opinion though.
Babyblabber - can I ask whether you/your friends went public/private/semi-private in Ireland? Because as far as I am aware, there is a huge difference on availability of epidural depending on that, and depending on what hospital you attend (particularly in Dublin).
The plural of anecdote isn't data - but I certainly know of people refused/talked out of epidurals in Ireland. (I was kind of talked out of one - by the time I asked for one I was told it was too late) I certainly wouldn't hold Irish maternity practices up as hugely enviable to be honest.
viola I didn't want to say it, but the treatment of the Indian dentist was particularly distressing. IMHO way worse than the push for natural birth here.
I got a midwife trying to talk me out of a dose of codeine post section! I think some of them have it ingrained to treat us like naughty children.
I only saw the bit where she said she wouldn't go in the water because she wanted an epidural and the mw said 'you can do it without an epidural' and the american woman said 'no way, i am the sort of person who takes drugs at the first sign of a headache, i want an epidural' and the mw said 'ok then'.
What happened after that? was she refused one? I think that exchange was fair enough tbh and not patronising.
I want to try to avoid an epidural as i want the pool and walking around as much as possible, but if i end up immobile for any reason (spd, monitoring, whatever) then i will want an epidural.
OLTT - I genuinely hadn't even thought about that and to be honest think that's a whole different issue than the general treatment of women in labour - but there's certainly a lot of interesting attitudes among midwives in Ireland too
(Saying that, all the midwives I had were incredible - with the exception of one who was just too "nice" and sickly sweet. So I'm not sure I'm qualified to speak directly about the failings, although they are well known and I've heard some very hard stories from friends)
Viola no I don't think Irish hospital are in any way enviable but just compared to watching OBEM I think they seem more open to epidurals. Most of my friends have been private or semi private but the consultant would be no where near them at the time of the epidural. Most in Dublin hospitals. The only person I know who was talked out of one had said she didn't want one all along, then the pain got so bad she asked for one but she was 8cm so they told her the baby would be born within 2 hours and did she think she could go without and she agreed. Another friend was told to get it before they started a syntocin drip as her contractions would be so intense so the midwives almost pushed it on her but she had planned on having one all along.
I gave birth in France where it was an epidural or nothing when it came to pain relief. They laughed their heads off when I mentioned gas and air - "Like your Queen Victoria". I had one - though felt slightly wary in view of having read lots of English books on childbirth - I had a 7 hour labour from start to finish, pain free, pushed my dd out with about six pushes. LOVED IT!!!! Ds was even quicker and just as enjoyable. I also stayed in for five days in my own room (standard in the public hospital in Paris where I gave birth) - bliss. I think the reason we are so anti-epidural in the UK is cost pure and simple. More epidurals means more anaesthetists and I think as someone mentioned down thread there is an expectation that women should suffer. There is no such expectation in France - giving birth without an epidural is not referred to as natural childbirth it is referred to as giving birth without an epidural and quite frankly why would you.
I went the natural route for both my DC and was quite adamant I didn't want an epidural. And I am not mental!! But I totally understand that every woman is different, deals with pain differently and is entitled to decide how they want their childbirth to go. I would never treat someone in a negative way because they want to choose the epidural route.
I do however think that there is a problem with some woman getting so worked up about what a horrendous experience childbirth it as they only hear the horror stories and so they go into the hospital dead set on epidurals. Its all very well the NHS wanting to promote natural childbirth but they also need to change the way the childbirth is talked about generally. I found my antenatal classes quite vague in discussing pain and I think it would be useful to have mothers talking about their positive birth stories alongside the pain relief options.
I was offered a water bath and also (later) an epidural, but in the event had neither due to lack of time. I'm glad I didn't have an epidural as the catheter and potential problems were much more frightening to me than a bit of pain. I think I have a high pain threshold and low fear threshold
As for the midwive's attitude, the younger midwife at my labour was bl**dy awful, and the older lady had a very enlightened flexible approach and was very supportive and reassuring. As with any job there are good employees and bad ones. I'm glad I had one good one, and she was senior, as the other midwife insisted I mustn't push as I was only 4cm dilated. I was actually 10cm, needed to push and using all my energy to fight against the contractions was not a good idea.
I think it's an in and out thing as well as slowing it down, it also stops an active labour. I had one btw so I'm not anti at all!
The midwifes at leeds seem amazing very encouraging and involved I had none of that. So I wonder if they 'know' you can do it with a bit of encouragement, which has been proven when you watch the show.
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