midwife refused pain relief

[liznay]

Please help as I'm seriously getting myself in a stew about this...
I'm due to give birth for the 2nd time at my local hospital. I'm under consultant care due to previous traumatic birth. He has said that I'm fine for community care from this point on (I'm due this Friday) and can have an epidural at 3cm this time if needed. (Didn't get one last time even though I asked 6 times)

However the issue I have is that the hospital seem to be seriously run off their feet at the moment. My friend gave birth there at the weekend. They had no delivery rooms available and so she gave birth in a side room behind a curtain because the midwife refused to examine her (hospital has a strict 4 hour policy on VE's) and said it was too early for G&A as she was only 3cm last time she was examined!!!

What are my rights if they try and do this to me? I was getting panicked about doing it without an epidural (even though I managed last time) but without even G&A, I think I might actually flip out completely.
Even if there is no piped G&A for a room, surely they should have got her a cannister? BTW the birth has been recorded as a near miss as midwife didn't spot she was about to give birth, so head of midwifery is looking into it.

I'm scared

[wheelshavefallenoffthebus]

Hi OP
Is there another birth centre/hospital you would feel happy to go to? Could you discuss this with your consultant or perhaps the head of midwifery at the local hospital so that you get a chance to voice your concerns in advance?
Completely understand why you would be feeling scared!
when are you due?

[liznay]

I guess I could phone the consultant's secretary and get him to call me. I do know him quite well so I think he would speak to me.
I'm starting to feel like it's all a bit too late.... I feel like I'm preparing to go in and fight with these people just to be treated humanely rather than to meet my baby and that's really sad...

WHFOTB - I'm due Friday

[hazchem]

I think speaking to the consultant is a good idea. Also trying the head of midwifery before the birth is a good idea.

Also speak to your birth partner/helper/OH whoever else is attending the hospital with you about the things that are most important to you. they should then be the one insisting on the level of care. Eg once given the epidural you should have a midwife with you.

It is sad that you are feeling this way before the birth. It shouldn't be case and it sucks that it is. Try to focus on the first cuddle your going to have with your lovely new baby. (it's much easier said then done I know)

[wheelshavefallenoffthebus]

give them a ring OP :)
also great advice from hazchem especially making sure your birth partner is a strong 'voice' for you and your wishes.
I had a difficult experience with my ds1 (birth was fine tho) and this time didint feel properly relaxed about it all until I had a good plan formed with the consultant including pain relief options. Then it felt like a weight had been lifted.
I'm sorry you are getting this close to meeting your beautiful baby and having to think about all of this.

[addictedtofrazzles]

Not sure if this helps but I had an epidural nightmare with DS1. So for DS2 I had an independent midwife with me at the hospital and the only thing on my birth plan was 'epidural'!

It was a busy night and the anaethtist (sp) was held up but the IM and DH would not let the request for the epidural go.

When they fob you off with "it's too late", they are talking rubbish. I had my epidural at 10cm...they gave me a spinal block so I could have immediate relief and then they were able to site the epidural because I was still.

Definitely speak to your consultant and don't be bullied by the midwife.

[VivaLeBeaver]

The problem is the consultant can say what he wants but if on the day they are so busy that they can't provide you with one to one care then you are unlikely to get an epidural.

[herethereandeverywhere]

Start smashing things up. If you scream and throw yourself around and crash into stuff and generally make the biggest fuss in the unit they'll find an anaesthetist. It shouldn't have be that way but you have to look after yourself.

If I'm made to VB I'm going to be hell on earth unless I get what I want.

[mumblejumble]

Agree with make a nuisance of yourself, sadly.
My last dc, the midwife tried to restrict the G and A, I screamed and made a fuss, until I got some.
It was very difficult to do, but the pain was excruciating for me, and slot of it was genuine screaming in pain. She also wouldn,t let me go to the toilet, but she was MAD.
Anyway, I would get the consultant to write into your notes and sign off the fact that you must have an epidural. Then if refused, ask to see the doc on duty, point out your notes and that should get you an epidural.

[Cheria]

Agree with addicted them saying it's too late for an epidural is a fob off. My hospital (abroad) said it was never too late and that even if we refused first time we could ask for it at any stage before pushing.

Note they automatically offer it to everyone.

[nocake]

Can I second the advice about making your birth partner away of your needs and how important it is that they're shouting for you. He/she needs to be your advocate and make a fuss if you're not getting what you need. I found that it was worth going straight to the senior MW as soon as there was a problem. If that doesn't get results then ask to see the duty doc.

[liznay]

Thanks to everyone that has replied :)
I've kind of resigned myself to the fact that I may not get an epidural if they are busy, but no G&A??, I mean that's barbaric
I know that no-one looks forward to a birth, but I'm truly dreading it!

[mintpurple]

Sorry to hear that you're so stressed about this.

VivaLeBeaver is right though and irrespective of what is written in your notes, by the consultant or anyone else - if the anaesthetist is in theatre or doing an epidural for someone else, they will not come to you until they are finished. Shouting and getting aggressive or throwing yourself around is equally pointless and if its done by your partner or support person is likely to get them removed by security, as many hospitals (my own one included) have a zero tolerance to aggressive behaviour.

On a more productive note though, hopefully you will have no problems getting the epidural this time. And yes you can have an epidural right up until you can see the head! However a lot of midwives and doctors will try to withhold it if you are getting close to delivery as they think that you wont need it as birth is close. It can also be difficult to get the epidural working when you are close to delivery and the head is low, so often its not very effective.

One thing that will probably spur most staff into action is to rationally ask for their name and tell them that you will be putting in a formal written complaint about them if they intentionally withhold the epidural or gas, and the other thing is to ask for them to call in the anaesthetic consultant if there is going to be a significant delay in getting the epidural (due to theatre going on etc).

In an ideal world, there would be one on one midwifery support when you have an epidural, but in reality that doesn't happen in a lot of hospitals, so midwifery staffing shouldn't be taken as a valid excuse. One final thing that might get them moving is if you are screaming loudly during contractions, it may encourage them to hurry with the epidural just to keep you quiet:)

I hope you get the birth you want - good luck.

[herethereandeverywhere]

I wasn't suggesting anyone's partner get aggressive. But NOONE took my situation seriously enough and I suffered such hell it still affects me 2 years later. The consultant at my (failed) "begging for a CS" appointment said he was "sorry I had a bad experience last time". Not good enough. No way near good enough. It makes me so fking furious I could smash things. And next time I will.

OP please disregard my bad example but I'm not being the doormat patient this time. Manners get you nowhere except being ignored.

[sittinginthesun]

I was in a similar position with my second baby.

DS1 was a nightmare labour, I was desperate for an epidural, moved from midwife unit to main labour ward, as he was in distress, but no epidural as no one available to do it. Ended up with 3rd degree tear, stitched in theatre, with an epidural!!!

Was so scared second time, and told my consultant. He wrote in red ink on my notes - said first labour was "mismanaged" and I was "abandoned". He said it was code for "do as I say, or she will sue!".

Whatever it was, it worked. I coped without pain relief until 10cm, then asked for an epidural, was given one in a flash, and this enabled the midwife to deliver DS with the necessary cut etc. Loved every second of it.

Phone and say how scared you are - I am certain there are things the consultant can put in your notes.

[sittinginthesun]

Oh, I wasn't actually going to sue! I had no idea it was mismanaged, but when the consultant went over my notes with me, I was actually gobsmacked. I won't go into detail, but it was quite gruesome, and I'm lucky they could actually put me back together.

[lovingthecoast]

I simply don't understand why midwives see it as a victory to get you delivered without an epidural. Why all this, it's too late nonsense? I was told that at 8cm with my first who was back to back causing me agony.

Afterwards, I asked why she didn't get me the epidural and she smiled and said 'I was sure you could do it without' as if she'd somehow saved me from an epidural. She thought I'd be proud of having done it without. In fact, I was livid because I don't think it's her decision to 'save' me.

It's not even as if they ever say, 'no, I think you can go without so I'm going to ignore your request.' Instead, they roll out the 'too late' line which is bollocks. The quicker that myth is rubbished and all women are made aware at antenatal classes that you can have one up until crowning the better.

[lovingthecoast]

Oh and I insisted on having one with my second even though I didn't need it for pain management at all. I was almost 10cm and DD1 was born 11minutes later after pushing for 3minutes. I was still so pissed off after first time. I was probably traumatised if it was affecting me 2yrs down the line to the extent that I demanded pain relief I didn't need just through anger.

[VivaLeBeaver]

Our hospital has removed aggressive women in labour never mind their partners.

[Ushy]

"Our hospital has removed aggressive women in labour" Where exactly do they go vivabeaver? This is the 21st century and women should be entitled to pain relief when they ask for it without having to get aggressive. Unfortunately it seems in some hospitals nothing happens unless people kick up a fuss.

[gailforce1]

Wow - how do you "remove" an aggressive woman in labour and where do you "remove" her to?

[VivaLeBeaver]

Only known it happen once and woman was in early labour rather than established. She was told to find another hospital and not to darken our doorstep again.
I agree that it would be lovely if every woman could have one to one care and an epidural if they want it, it would make my job a lot, lot easier for one thing! However if it's out of my hands then I'm not going to put up with aggressive behaviour. We have a zero tolerance policy on it in our hospital whether it's on labour ward or someone in a&e on a Friday night.

[gailforce1]

Sorry but someone who has deliberately gone out and got drunk or high on drugs and ending up on A&E is completely different to a woman in labour who is panicking because she cannot cope with the pain and is frightened.

[VivaLeBeaver]

I do totally see your point but it's the end result/behaviour. If someone is seriously threatening me physical violence and not calming down no matter what I try I'm not going to take the time to distinguish why. Are you seriously suggesting that it's ok if a woman or her partner beat me up as she's in pain and scared?

. Not all labouring women are like your average mums netter.

[Lulumama]

of course everyone should be able to get an epidural, up until crowning if they wish to BUT it is not a myth that there might not be an anaesthatist available and it's not a myth that there might not be enough midwives to offer the one to one care necessary with an epidural.

[gailforce1]

Viva I certainly believe that any partner showing physical aggression should be shown the door but a woman about to give birth? What about the risk to her baby?

And as an aside, a friend of mine did her "stint" in A&E whilst nurse training and had a young woman brought in by ambulance in a drunken and abusive state. Boyfriend rings after 6 hours asking if xxx can be collected yet? My friend is amazed that this regularly occursat weekends and boyfriend will ring hourly until told that xxx is ready for collection!!