Why is the service so bad at times? It just seems astonishing to me that the basics aren't even in place everywhere.

I ended up in the unfortunate position of having to have an epidural, not requesting one. I had been pushing for 6 hours with no descent (attempted homebirth) and after a hospital transfer found that dd was presenting ear first. Ventouse, episiotomy and manual rotation didn't work so I had 2 choices. GA and em cs or wait for an anaesthetist and have spinal block and cs. I opted to wait. Took 2hrs. I have PTSD and think those hours of waiting with 2 minute long contractions every 30 seconds after 2 days of labour contributed massively to this. I understood that the anaesthetist was busy but it being the middle of the night, there was only him available and I wished desperately that they could have had another anaesthetist available.

Some hospitals don't have an anaesthetist on the premises overnight. A friend of mine (on her third child) desperately wanted an epidural, but they only had one anaesthetist between paediatrics and the whole maternity unit, and there was a paediatric emergency. She's filed an official complaint.

I'd never make 'Want epidural' a core part of a birth plan, simply because if your hospital is understaffed or underfunded, it really might not be your choice. (Women who have epidurals also need closer attention from midwives - when you've got one midwife split between two or three labouring women, she's not going to want to give ANY of them an epidural.)

I have the pregnancy and labour book by Dr Sears, who is a big natural birth guru from the USA. Even though he has been spearheading the movement away from a traditional US delivery with women strapped to a bed and refused food and drink, he strongly agrees with woman having epidurals if they need them. And he believes that epidurals can be a big factor in a "good" delivery in a lot of cases. My own experience was that after active labour and upright positioning didn't work and I was hysterical with pain, that an epidural was the only saving grace of my medicalised delivery.

So I think that there is a bit of a false dichotomy between having a "natural" delivery and having an epidural. I suppose that the split into MLU and CLU has just exaggerated it too.

Actually my epidural was not really connected to pain per se, but due to the fact that my body was making me push down on a not quite open cervix.

Having spent 2 hours on all fours with my head down and panting through/resisting the urge, an epidural was the only thing that could relieve that. If it happens again, I'd take the epidural again.

I agree it's not always the midwife's call and I also agree that these units are understaffed. If men had babies, or we complained more, this would all be a lot better I'm sure.

I think what this thread shows is how every hospital or unit is completely different? (as well as every experience).
FWIW my DH wasn't allowed to stay outside of visiting hours whilst i was being induced. Once I was in "active labour" he was allowed to stay - but he was firmly persuaded to go home about 2 hours after DD was born because it was outside of visiting hours...

I think anyone who believes that labour can be pain free is nuts. It's not helpful to peddle the myth that if you use hypno birthing, whale music etc then it'll somehow be a piece of cake. Labour really really really hurts like fuck!

HOWEVER... I do believe that various strategies such as breathing, hypnobirthing etc can HELP, and encourage a woman to go for a drug free birth if that's what she wants. Personally, I didn't want an epidural because of the associated risks, and there's no doubt that a good supportive midwife and using breathing techniques helped me achieve a natural birth. But imagining it won't hurt like fuck is absolutely setting yourself up to be badly disappointed!

Am I the only one who thinks it's downright pathetic that women even have to wait, sometimes for hours, whilst anaesthetist is in theatre?

Wot, there's only one?

Guess that's one way to slash costs.

I got told he was in theatre for four hours.

It's a good thing I'm a stubborn enough person to wait.

My cousin is a mw, and she says that often there will be 6 women screaming for epidurals but only enough staff to allow 2.

As a midwife I would never say no to an epidural unless I had my gut feeling that a woman was fully or very close to fully, as I have had that happen and anaesthetists give me the evil for asking them to attend to only scrub up and have to disappear again.

Getting an epidural isn't a 5 min job, first we have to cannulate you, get all the equipment needed (CTG, BP machine, drip pole and pump, epidural drugs which need to be checked by another midwife and not forgetting an anaesthetist) If anaesthetist is in theatre we have to then wait for anaesthetist, so please don't always think it's our fault and that we're just being mean.

Indeed bumper. Control and trust are big issues here and all too often we're being left feeling let down.

Coming back to this thread late. My biggest issue with people like Abigail is that I HATE this attitude that you can just think you way to a pain free labour.

I read Active Birth and Sheila Kitzenger and was assured that birth was an empowering experience to be relished and that I had choices. I felt I was prepared, had listened to some natal hypnotherapy CDs, had all my aromatherapy massage oils and relaxing music ready.

What actually happened is I went into labour at around 10.30. The hospital advised me to stay at home as long as possible. An hour or so later I went in against their wishes because I was desperate to know what was going on. It transpired that they didn't want me coming in because they were full, so I was stuck waiting on an ante natal ward, contracting like hell and nauseous for an hour before anyone came and examined me (though they had checked the baby's HR). Finally a midwife examined me and said 'The only thing stopping you having this baby is your waters'. This was about 3 hours into labour.

As they were full I was rushed into a room on the ward, not a delivery suite, not a proper delivery bed where I wasn't allowed to get off the bed (because of the carpets). 2.5 hours of pushing DD was born. As she had meconuim (sp?) in her waters she was rushed of to a resuscuitaire (sp again?) in another room (would usually be in the delivery room) with me screaming to DH 'Follow that baby - don't let her out of your sight!'.

This is all after I had practically fought off the midwife trying to give me whatever it is they give you to speed up the delivery of the placenta because I didn't need it as I had had a natural birth with no intervention.

Even though my birth was normal and quick (about 5-6 hours in the end much to the surprise of the MW ) I hated the whole experience, felt out of control, and had flash backs for a long time. I have no idea what I am going to do next time, the thought fills me with dread.

This is all despite feeling really positive and prepared. And you know what? When people tell me that it's all in the mind and you just need to think through the pain and all that shit it makes me feel like a bit fat failure. Like I didn't try hard enough

Oh Lord - I'm not saying people who get epidurals are wimps! Just that I most definitely am. Hence my being quietly certain I'd need one, and equally certain that my labour wasn't that bad. (I'd take an epidural to get my legs waxed if it were risk free, cheap and on offer. I have a rubbish pain threshold.)

<reads thread, brings CS forward >

I expected to be in utterly unbearable agony: figured I'd start off in the MLU, slowly up the pain relief as the hours dragged past, and then end up with an epidural, because I am a wimp not a masochist. So what I got, with an easy and manageable labour in water, was a lovely surprise. It was also pure blind luck. Reading threads here, some women's luck breaks on their second, so I'm still nervous about next time.

Abigail needs to stop trying to teach her grandmother to lay eggs.

Well it might be better if they outright refused you an epidural. At least that way you'd know. The biggest problem is that they just fob you off until it's too late.

My waters broke early so I was induced at 7pm at night for my birth having had contractions for 36 hours. It was horrific. My partner was sent home for the first 6 hours of unbelievable pain and I began asking for an epidural when I was around 4cm. They were so short staffed, nobody could stay with me for long. My midwife kept fobbing me off stating that she was "just about to ring the anasthetist" every time I asked. I couldnt even find her most of the time and nobody came when I rang the bell. I was asking for the last 8 hours of my labour, surely they could have got somebody by then!
Eventually it was too late as the anaestetist had gone into surgery. The midwife even recommended that I have an epidural as I was put on a monitor to track the heartbeat and a drip to speed up the contractions. I was strapped to the bed therefore couldnt move or go to the toilet. Hardly a natural labour anyway! I was so exhausted as the labour lasted all night and I couldnt cope with the pain. I honestly think it would have been far less painful if they had left me alone. I felt that they had interfered but then had no staff to make sure I had adequate pain relief. The gas and air made me vomit, they had no tens machine, they were useless. At the end of the day, I survived it and am extremely grateful that I have a lovely healthy daughter, but women should NOT be refused epidurals.

Forgot to say, - I made a lot of noise about DH staying too, which resulted in me moving next door to the mlu, which meant foregoing my epidural.

So you see......

mummiesnet With my first I was at 2cm and in so much pain it caused ptsd. My dh wasn't allowed to stay with me because I 'wasn't even in active labour' and it was outside visiting hours. They were trying to arrange an epidural because of the amount of noise I was making but DH was absolutely not allowed to stay.

If I was in a mlu, he would have, but they wouldn't have been able to arrange an epidural.

The point I was trying to make IS the point I made.

expat I can completely understand that choice. I turned down a MLU option that was fantastic, but meant a much shorter transfer than that. Even so, I knew that DD1 was so stuck that it was quite likely that DD2 would get stuck to (as she did), and I didn't want the extra stress of worrying about how the transfer would go (even before I needed it).

I had a spinal with Ds1, Dh there throughout

and an Epidural with DS2, Dh there throughout

ensuite loos, he wouldn't have dared taken long in there.

I agree that labour was the most painful thing I have ever experienced. With DS2 anyway, he was big and got stuck (as had his 2lb lighter brother 2 years before). I had a ventouse and it felt like medieval torture, my DH was holding my leg down, I vomitted my way through it, they turned my epi off before the pushing stage, so that was nice.

We have consultant led and miwdwife led on the same corridor in the hosp. Midwife led have birthing pools etc but epidurals available. Then there is a separate birth centre somewhere else where no doctors are around so no epidurals and if you need doctors it's ambulance time. So lots of choice really.

Sounds like the have very different arrangements around the country.

I'm really shocked that there are places where your dh can't be with you outside of visiting hours, whilst you are in labour!

Re "I just wish that this wasn't the only scenario perpetuated on the tv or by people trying to scare the crap out of first time mothers."

I don't know, whenever I see birth on the TV it seems to be a woman lying down on a bed, glowing with perspiration, gripping her partners hand and going, "Aaaaaagh", then squeezing out a nice clean 3 month old baby rather than a sweaty, knackered woman making a noise like a fucked off buffalo whilst wrestling with a giant beanbag (ahem)

I wish that I could magically project my first labour and delivery into Abigail's head. It's all very well using hypnotherapy to help you deal with contractions, but if the baby is lying on your back it's still going to hurt. And when you haven't slept for 3 days, and haven't had any food or drink for 24 hours (as you're vomiting constantly) you tend to get a bit exhausted. Funny that.

Mind you, knowing some of the women that I do, she'll probably be one of the ones that has a simple 4 hour labour and goes around telling everyone that she doesn't know what all the fuss is about. In which case, I pity her future daughter in law.

I did not want to give birth in the only MLU in the region because the CLU is 1.5 hours away.

Oh, and if you missed the last ferry that meant you had to go by chopper, if it were available.

So, effectively, there would be no chance of epidural.

I didn't like that chance.

A friend from my antenatal class wanted to deliver in a birthing unit but ended up being induced. She was in early labour for three days and was desperate to have her Mum with her, but the HCPs threw her out as only her partner could stay. Even though we had all been specifically told that we were allowed two birth partners if we wanted. I felt so sorry for her. So I can well believe that a CLU would have the only loos for men 15 minutes away.

Sorry, that was rude and sarcastic.

I understand the point you're making starlight, and it's a good one, that mlu are much more flexible in terms of who can be there and the kind of atmosphere etc.

But plenty of people don't live near mlu or have access to them and give birth without epidurals in the same kind of conditions so really think you should have clarified that you were really just waxing lyrical about the benefits of midwife led units vs consultant led units.

James - I've read birthplans for 10 years and I have never had a giggle over one. Ever ever ever, and nor would I. I'd consider it very insulting.

That's not the same as, 'If you have an epidural your husband or birth partner will have to leave.'

Riiiiight

We had a double bed in our room btw.

Put it this way: I gave birth at 11pm in a pool with underwater lighting, with my mum, my DH and a doula there. We all had a cup of tea and my DH and I retired into an en-suite room with our new dd, that had patio doors leading onto a private garden. We had full access to the kitchen and free tv.

If I had wanted an epidural, I would have had to give birth in a clu, where my DH would have had to disappear for 30mins every time he needed the toilet, my mum wouldn't have been allowed there as she was a 3rd person, and they would have both been chucked out soon after the birth.

Starlight - seriously, at what hospitals does it happen that you can only have a DH during visiting hours and why are only those who have epidurals singled out for this treatment?

At our hosp your DH is there the whole time visiting hours or not if you're in labour, along with a second birth partner if you want. Epidurals are available.

Have not heard about anyone having to choose before.

FWIW I had a section on Tues and am up and about feeling great no pain at all. The midwife came yesterday and reminded me I was supposed to be taking it easy! It is a myth that CS recovery is always worse - it depends on lots of different factors and with natural birth people can be a right mess afterwards if they've had tears etc etc...

BTW the article was v funny I certainly agreed with the sentiment

mf - recovery from a CS is not necessarily harder than from a VB. Feel pretty similar to you wrt to my secdnd due in 5 weeks.

Wow I've never heard that about not having a DH around if you have an epi.

My DH was certainly there for the whole thing.

True about the perception on pain being subjective. My birth notes were priceless - they grade the pain you're in on a scale and mine was recorded as 0-1 (none-to mild) during the second stage when I was begging them to top up the epidural which had worn off four hours before.

'IF, you are lucky enough to be in labour during visiting hours, you might get an epidural and a DH. A lot of the time, you can't have both.'

My DH was with me for the entire 24 hours of my labour. During hte epi at 6AM and thereafter.

I travelled nearly 60 miles - it takes 1.5 hours by ambulance from here - in order to get an epidural with DS, my third.

They fobbed me off and fobbed me off for HOURS. I got there about 10PM and didn't get my epi till 2AM.

Kept asking me did I want to move around, etc.

I was giving birth on my own as my husband had to stay with our other two and I told them, 'No, I have fucking post-traumatic stress disorder from giving birth drug free so guess what, I will NOT have this baby till I get the epidural. So you can page the anaesthetist again.'

My waters were breaking as it was administered, but I was not going to go through the pain I felt giving birth to DD2 again.

And that was with my third child!

If I had had the means, I'd have paid for an elective CS.

IF, you are lucky enough to be in labour during visiting hours, you might get an epidural and a DH. A lot of the time, you can't have both.

In a birthing unit your partner has 24/7 access, but of course, no epis available.

I think that is terrible!

I had a similar labour experience to JamesAndTheGiantBanana and nickytwotimes with my DS 9 years ago. I went into it expecting it to be painful, but under the impression that the staff were there to help you with that. How wrong I was. It was awful and excruciatingly painful. I was treated abysmally by pretty much all the staff (the midwife who eventually delivered me was lovely though) and no one even pretended to listen to what I wanted.

I asked for an epidural repeatedly and they wouldn't give me one. Eventually they decided that I was 'allowed' some pethidine, which they gave me without any anti-sickness drug. Cue me throwing up/dry retching until it wore off (also, it made me feel really horrible beyond the vomiting - I knew I was in pain but I didn't care about it, and that wasn't in the least bit pleasant). Once that wore off, they finally decided that it might be a good idea to call an anaesthetist but by that point I couldn't sit still for the 15 minutes it takes to put one in. So I got the option of gas and air, which also made me feel sick (and brought back memories of the continuous vomiting from the pethidine). By this time, I was utterly exhausted and in agony (and my stomach was obviously empty). I struggled through the rest of the labour somehow without any pain relief and tore badly. The whole experience was unbelievably horrific. The only mercy was that I recovered quickly and my stitches healed well.

I'm due in August with my second and, to be honest, I'm really quite scared that it's going to be so awful again. Weirdly, I actually started crying while I typed that (I guess that's just the hormones). I've told my OH in no uncertain terms that I want an epidural this time as soon as we get to the hospital and that he's to absolutely insist that they page the anaethetist immediately (and not take any excuses from them). Apparently the baby is breech right now, so we'll have to go and see the consultant to discuss options if he doesn't turn in just over a week. The terrible thing is that part of me almost wants him to not turn so that I can have an elective CS and avoid the whole labour experience. Of course, that's really silly as recovery from a CS would be far more painful and difficult than recovery from a vaginal birth. Oh well, I'm sure the baby will make up his own mind about turning and I'll just get through whatever kind of childbirthing experience I need to get through.

That's horrendous, James

I've done it three very different ways. The last one was the most physically painful and completely drug free (not really by choice, just because I refused to go to hospital so I had no medication options and no G&A!), but I have good memories of the day because I had good support and did it the way I wanted. It was effing agony at the time though. I remember dreading each contraction and don't believe I could have done it without the doula I had who kept the pain manageable. If she hadn't been there, I think I'd have been out of control.

I don't think you can separate out the physical labour pain from everything else - the caregivers, the environment, your mindset beforehand (including previous birth trauma) and even the postnatal period etc. If any of these factors are difficult, the delivery is likely to be more traumatic.

Perceptions of pain are very different and that doesn't mean 'it's all in the mind' or anything like that. But there is a great deal of mental work involved in dealing with pain and this needs the right environment to happen. Healthcare providers could save a lot of money if they recognised that and made hospitals more suitable for birthing. You wouldn't expect any other mammal to labour effectively in medicalised conditions.

Same as nickytwotimes, exactly.

All these so called birth choices - it's bollocks. It's not us who makes the choices, it's midwives, doctors, consultants. And you can talk til you're blue in the face as a first time mum and they won't listen to you or your birth plan, which are basically a fucking joke. I think they only ask you to draw up a birth plan to give midwives something to giggle over during the boring bits.

I had a straightforward birth 3 yrs ago.

The trauma is still fresh and puts me off having another child tbh.

I approached it in a calm, this-is-okay-I-am-designed-for-this way but NOTHING ever prepared me for the horrific pain. Awful, truly awful.

CherryChoc is bang on. For DD2's vbac, I wrote a birth plan about how I wanted a really really natural birth. During transition, I was all, "No! I cant do it, I want a caesarean!" which was absolute bollocks. I didn't and the midwife recognised that and helped me through it. It wasn't that long afterwards that DD2 popped out. It's very natural to have a crisis of confidence at transition and I am very, very glad she recognised that I didn't really mean it.

This sort of thing is so difficult for midwives though - pain is very subjective. For some people, labour is relatively easy. For others, it's near unbearable. Weighing up what a woman really needs and wants while she's in pain is hard for both her and her caregivers. This is why birth plans are a good idea and why ideally, a woman should know her midwife well and be able to communicate the sort of birth she wants and to discuss the possibility of epidurals in a calm state before she's in labour. If the midwife and mother both understand her feelings beforehand, they can renegotiate more effectively during the birth.

Sadly, with the NHS, you can't guarantee who your midwife will be and your baby will likely be delivered by a complete stranger so it's no wonder this communication isn't really possible.

oops, I had both epidural and spinal tap. LOVED my anaesthetist, he was a beautiful man.

same, DH was right there with me during my labour, whih involved forceps in the theatre. Fun times.

'I think it is terrible that you have to chose between having an epidural and having your DH with you!'

Where is that? I've had an epidural and forceps delivery and DH was there for all of it.

woah - is that true?!

I think it is terrible that you have to chose between having an epidural and having your DH with you!

"If it were men who gave birth there'd be all different sorts of pain relief and/or support available."

Interesting - and I bet it's true.

I appreciate what you're saying, and I know that some women have a terrible time, and relief should be available. I just wish that this wasn't the only scenario perpetuated on the tv or by people trying to scare the crap out of first time mothers. But that's an aside, I suppose.

ONLY during labour/childbirth are people treated as if they're imagining the pain they feel and treated like second-class citizens.

Because it happens to women, of course.

If it were men who gave birth there'd be all different sorts of pain relief and/or support available.

'why do people insist that giving birth is up there with dying in terms of pain?'

Because for a good many of us, it is terrifyingly painful.

I wound up giving birth to Dd2 drug-free and I am so scarred by the level of pain I felt I still have nightmares about it.

I was in so much pain that my mind was powerful enough to actually put off the birth of DS until I got that damn epidural.

Sure, it's not like that for some women, but it does for some. It's real, they're not imagining it and all the positive stories in the world won't change their pain receptors.

Has Zoe Williams already had kids or is this the first?

But seriously, what right has a mw to decide whether you 'can manage a bit longer'? How the feck would she know.

I was told I coped very well. Text book labour that had me suffering from PTSD due to the sheer level of the pain at just 2cm.

Fuck's sake - why do people insist that giving birth is up there with dying in terms of pain? Granted, some people have a horrendous time, but lots don't. I think culturally as well if we ever heard slightly less pessimistic accounts of childbirth people might have a slightly easier time.

The problem is though when you're in transition you're likely to throw any birth plan you may have had out of the window. Some women shout "Give me an epidural and a caeserean now!" and others shout "I want to go home and I want my mum!" - the midwives have seen it all before and they can tell a desparate plea for pain relief from a mad transition-fuelled outburst. I suppose the problem is if they keep denying the request on the basis that you could manage a bit longer, then it turns into transition, it can seem a bit like a conspiracy!

No doubt, Bumper. So does mean if I expect to win the Lotto it'll happen? I strongly expect to lose 2st. Oh, wow! That was easy!

I agree Carmen. With better support the epidural/CS rate would come down, but they're trying to do the latter without having the former in place I think.

I dabbled with natal hypnotherapy with my last. I expect if I had another I wouldn't do a lot more. I quite 'liked' the pain for some reason and after each contraction I was willing on the next

I'm in the US now and epidurals are absolutely the norm, meaning that the majority of women labour in bed and are prepared for any complications - an IV in their arm and nil by mouth except ice chips from the moment they check into hospital. I think it's important that women are aware of the risks of epidurals and the effect they have on labour and the spiral of interventions. For a start being immobile and not eating is likely to lead to exhaustion and failure to progress, hence the insane caesarean rates (near 50 percent in my local hospitals).

That said, yes, women should be able to choose whether they want one. Labour really, really, really hurts.

But the pain is /more/ manageable with support, yet women are not that well supported generally in hospitals. Giving birth with a doula is shown to reduce pain and interventions. And I watched an amazing hypnobabies video recently where the woman literally closed her eyes, breathed through the contractions and smiled afterwards. I was at how calm she was, so I think there is some truth in it. I took a rather half-hearted visualisation/self-hypnosis approach to my last labour and it helped, but I'd have liked to have gone to proper classes and really worked at it, I think it can be surprisingly effective.

'I'm a strong believer that you get what you expect to get. So if you're expecting agonising, searing pain, what pain you feel will be magnified by the fact that you're expecting it to be absolutely awful - perception and expectation is everything. When I eventually have a child, I want to use hypnobirthing techniques. There are amazingly encouraging videos on Youtube - looks like a wonderful peaceful way to give birth.'

Hahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahaha!

I actually feel very sorry for Abigail. I mean I expected it to hurt but it hurt a lot more than I thought it would. So if she thinks it won't hurt then it will probably be 10 times worse!

LOL @ Abigail comment!!!!

I went in thinking the pain would be minimal and even if it wasn't, I am a tough girl who can cope.

I was in searing agony and asked for (and got straightaway) an epidural, so none of the article rings true for me, athough I'm sure it does happen elsewhere.

I think that if the pain is more than uncomfortable in second stage labour (or what I would call well before the pushing stage) then unless you are dead set against one, that's the point to request an epidural, and mean it - don't say "I think I might need one at some point". They need time to page an anaesthetist.

Sounds like a cunning plan! You're so at the whim of whoever you get on the day ISTM.

'Have you considered writing in birthing plan that you do NOT want an epidural? That would probably get you one straight away! At least that's what I discovered when I put "No Episiotomy" in my plan'

he he he

Love the comment from Abigail.
Basically saying that labour won't hurt if you use hypnotherapy, then admitting that she hasn't actually had a baby. Can't wait to see her in labour, no doubt screaming for drugs.

This is a bit tongue in cheek but I'm afraid the underlying sentiments ring true for me:

www.guardian.co.uk/lifeandstyle/2009/jul/03/anti-natal-zoe-williams