Should women have to PAY for********epidurals********....................watch the ITV1 news .............NOW

[RTKangaMummy]

now

[RTKangaMummy]

Midwives call for epidurals fee

Epidural is one form of pain relief used during labour
Women having babies would be asked to pay for epidurals under a proposal from the Royal College of Midwives.
Its education and research committee says too many have the pain-relieving injection, given to a fifth of pregnant women.

Critics said the proposal, to be debated at the RCM conference, would discriminate against poor women.

And the Department of Health ruled out charging for the treatment - which can cost up to £500 in private clinics.

An epidural is a local anaesthetic injected into the spine which numbs the lower half of the body so a woman does not feel pain of contractions during labour.

Epidurals provide effective pain relief, but they can significantly raise the likelihood of other interventions such as Caesarean section occurring

Louise Silverton


Should women pay?

The education and research committee's motion states that epidurals should be "free to women who have a definite need of it" but says a fee should be "levied for all other women who desire an epidural".

Sue Macdonald, chairman of the RCM's education and research committee which came up with the proposal, told the Daily Telegraph: "There is quite a lot of research around which suggests that although it is an effective form of pain relief, an epidural means women will have to spend longer pushing the baby out of the birth canal and are more likely to need other interventions.

A review of 21 studies carried out last year comparing women who had had epidurals with those who had not, found those who had the injection were 40% more likely to need interventions such as forceps or a ventouse vacuum pump.

Ms Macdonald added: "Epidurals have become a kind of norm for a lot of women.

"Sometimes women think 'I just want to get rid of the pain, how fantastic'."

The leadership of the RCM says this is an issue which members are concerned about - and the motion would therefore be debated at its conference in May.

If it is passed, the RCM would lobby health departments in a bid to persuade them to implement a charge.

'Normal birth'

Louise Silverton, RCM Deputy General Secretary, said: "Epidurals provide effective pain relief but, where there is no clinical indication that they are necessary, they can significantly raise the likelihood of other interventions such as Caesarean section occurring.

"The UK already has an extremely high Caesarean rate and, as the acknowledged experts in normal pregnancy, labour and birth we midwives need to debate ways in which we might help to bring this rate down."

Ms Silverton added: "This is a very serious issue and one that is likely to raise significant debate but also something that needs to be debated if we are to improve the normal birth rate."

But Mary Newburn, of the National Childbirth Trust, said: "The NCT does not support the proposal to charge women for an epidural.

"This would be adding insult to injury when women are often denied access to other options that would help them cope during labour.

"It is also an impossible judgement call to decide some women 'need' an epidural for pain relief and others don't.

"We need to build up women's confidence so that they can cope with the pain of a normal labour rather than take away one of the choices that they have come to expect."

A spokesman for the Department of Health ruled out the idea of charges altogether.

He said the government had pledged to introduce a choice of pain relief for all women by 2009.

But he added: "We would not charge for pain relief."




.

[expatinscotland]

let's penalise the poor and working poor even more by slapping htem w/more debt and financial burden when they're at their weakest, most vulnerable point!

what the hell is this country coming to?

what next, charge everyone for anaethesia?

an entirely unconscionable idea.

[Esmummy]

Absolutely ridiculous. Spokeswoman for GP's said this morning on GMTV that why should it be that a single stay at home mum with 3 children alreayd should have to suffer 44 hours of awful agony yet a woman married to a successful banker or a woman who is a successful banker being able to have an epidural - or something along those lines anyway.
RIDICULOUS

[blueshoes]

We should levy a fee - but only on midwives - since they are the ones asking for a fee and clearly feel they are able to cope with pain. A lot of women do not feel adequately supported by the succession of midwives who are supposed to attend to them during labour (just take a look at any Childbirth threads on mumsnet) and that significantly contributes to the feeling that women don't feel they can cope.

In fact, when I was being induced, I felt subtle pressure to take an epidural - the impression was that it would keep me quiet and easier to manage whilst letting them crank up the volume faster. Midwife did not spot my dd was in distress for a full 15 minutes because her nose was buried in her book. Good work!

[coppertop]

My MW wouldn't let me have an epidural, even though it was an induced labour (ARM and the drip cranked up high). She insisted I was just having "a few twinges" - right up to the moment that dd's head actually appeared. It's bad enough going through all that because a MW couldn't be arsed to check my progress at all but it would be even more galling if it was because only the rich are deemed worthy of full pain relief.

[meowmix]

heres an idea - when men have prostate surgery they should pay extra for anasthetic too.... Like we have a choice whether we're in pain or not when in labour?!

[LucyJones]

Oh yes, you can be sure that this is a man's idea

[MeAndMyBoy]

Absolutely bloody disgusting!!!!!

They want to lower the C/S rate how about having enough midwivies to give labouring women the support they need and training them properly so that they can do their jobs effectively.

Typcial of this country treat the symptom rather than the cause, and what happened to freedom of choice?

[meowmix]

actually maybe they're right, we're all being terribly self-indulgent wanting pain relief at all. If i ever do it again I will simply think pleasant thoughts and will not swear or even perspire(or else will mug someone wealthy on the way in).

[pacinofan]

It's not just about paying for epidurals either, at my hospital if you want pain relief using a TENS machine you pay for that too as they cannot guarantee you'll get one in hospital. It's not that I can't afford it (cost me £50, £25 refunded on return) but there will be women who sadly can't raise the funds even for a TENS machine, let alone the cost of an epidural.

[TuttiFrutti]

This makes me FURIOUS , even though luckily it is such a mad idea that I don't think it would ever get taken seriously by the Department of Health.

How can anyone judge the pain that someone else is going through? How dare midwives tell us we're not really in pain, when we are? And so what if epidurals might make labour take a bit longer, or is this more of the conveyor-belt apporoach to childbirth, to "process" us all more quickly?

Incidentally, Louise Silverton is wrong about epidurals making Caesareans more likely, as according to NICE guidelines on epidurals they make them neither more or less likely. They do increase the risk of forceps or ventouse deliveries, but that may well be a price worth paying.

How about actually asking the women involved who've had epidurals what they think about them?

Rant over.

[Kathy1972]

This was in the Sunday Times the other day as well: \link{http://www.timesonline.co.uk/newspaper/0,,176-2168569,00.html\here}

I do find it extraordinary what tactless and stupid things some midwives come up with when they get onto this subject. They quoted one saying 'When you add up all the time in pain, it is normally only about 45 minutes in a 10-hour labour.' Now, I could be wrong, but I imagine the women having epidurals aren't the ones with the 45 minutes of pain/10 hour labours....

[MamaMaiasaura]

this is twaddle - NHS is free to all citizens as part of the NI we pay.

To charge people for medication required during labour is ridiculous. Some peoples pain thresholds differ, but those on lower incomes would have to do without as couldnt afford? NO equality of care there. Why dont they cut wages to GPs and fat cats instead?

grrr

[MamaMaiasaura]

tuttit frutti- after having my son by emerg c/s, heomoragging and having a flacid uterues hence the bleeding i was 4 lots of drugs to cause contraction. As epidural wore off the contraction began. I thought i was dying - seriously. IT was very trautmatic and the consultant was furious with the midwife as she was refusing pain relief and the epidural had been taken out when it shouldnt have been. The midwife rammed needle into my bum and told my then dp that i wasnt possiblely in that much pain and i was just playing him along. Very distressing and traumatic and still upsets me know. I complained later on and was given the impression that this m/w has had alot of complaints.

[Highlander]

I get really bloody annoyed at midwives criticising the high CS rate in the UK. Surely the whole point is to deliver a baby safely without compromising the mother's physical or emotional health?

[juuule]

Disgusting. If someone needs relief from pain they should get it.

[Uwila]

They are positively bonkers. If I was weighing the options of elective caesarean vs. vaginal delivery and then found out an epidural might not be on offer, you can be sure I'd opt for that elective caesarean.... will they still offer pain medicine for caesareans?

And, another thing, does the NHS charge for any other service? Just one, name it. Or is this the very first service to be worth a fee? Can I have single jabs for a reasonable fee?

[Rach69]

Argh! this makes me so angry I am going to deflect the rant I feel coming on?

Why are RCM undermining women instead of empowering them?

Is there some research all this crap is based on?

My first birth was a forceps with only a local anaesthetic - it traumatised me so much I could barely hold my son. WHy should pain make you bond? My second birth used only gas and air and had a second degree tear - was physically shattered but bonded ok. My third was a face presentation with a medically indicated epidural - FANTASTIC BIRTH! My fourth was a failed induction, ARM, syntocin etc and I demanded an epidural - ended up with an ECS but this was nothing to do with the epidural and everything to do with fetal distress. I could still take a machine gun to everyone involved in decision-making that birth but I've bonded fine with ds3.

[Normsnockers]

The RCM should be truly ashamed of themselves and this very public display of the average intelligence level of their members.

They are displaying a very uneducated, shallow knee jerk "opinion" and coming across as naive in the extreme.

They possibly believe that as they are in possession of statistics which they believe demonstrate to them that more epidurals = more intervention/c-sections and hence the number of epidurals must be reduced in frequency, the informed option is to make epidurals less obtainable.

An individual an be "informed" on a certain issue (as midwives presumably feel they are on this one) but it still doesn't make them the person(s) best able to see the possible social effect or other potential impact of a decision.

So to making epidurals chargeable will reduce the numbers won't it ?
Well, no, it's not as simple as that, it will leave midwives providing a 2-tier service with different quality of experiences for lower earners in addition to perhaps reducing the numbers slightly. (I'm assuming that as with most NHS charges, there will be an outcry on behalf of the non-eanrners and hence the unwaged will be exempt anyway.)

How can a midwife who has never given birth decide who clinically "needs" pain relief and who doesn't but can have it if they are prepared to pay for it.

Has there been research into the effect of epidurals/painful labour on PND ?

It really pisses me off that so many midwives ignore the emotional needs of a woman due to give birth. Just quoting me the statistics of c-section mortality rates compared with vaginal delivery rates is
a) misleading because failed vaginal deliveries leading to c-sections and any subsequant mortality will be included in the c-section data.
b) failing to address the issue that I have no desire for a vaginal delivery and expecting that I will make the right "informed" decision once I have a few, selected, politically correct statistics in front of me is failing to understand/empathise with the emotional needs of your patient.

Call me a cynic again but as epidurals lead to more monitoring and that means more midwife time spent with each patient, aren't there some hidden NHS motives here?

[Uwila]

"Sometimes women think 'I just want to get rid of the pain, how fantastic'."

Could someone please explain to me how this is a bad thing?

[FairyMum]

Old dragons!

[Highlander]

We get a free militant rag round each week called Hospital Doctor. From my hazy memory, on this very subject a few weeks ago, an aneasthetist wrote in saying he dreads his OB on-call as it invarabely involves the midwives being very anti-epidural and denying labouring mums analgesia when they really need it. He said he hated going into the delivery room and seeing the utter fear and terror on these poor women's faces.

My midwife said at my booking, 'you don't fancy a VBAC then?' You must be f*cking joking.

[Normsnockers]

LOL, Highlander, have visions of anesthetists riding to the rescue of damsels in distress (in the clutches of wicked midwives anyway) on their white horses.

Totally understand your thoughts on VBAC.

[Highlander]

Normsnockers, been meaning to mention it for yonks - LOVE your name

[Normsnockers]

Thanks Highlander

Anyone else hoping the news time has been dropped for something less offensive by this evenings news programmes.