Can I have an epidural if I’m low risk?

[Lulette]

Hi all, due my first child in a couple of months and had been planning to have an epidural. However I’m lucky enough to be low risk and midwife led (but in a unit attached to a hospital). My sister in law just told me that when she gave birth she couldn’t have an epidural because this would mean she would need a consultant led bed and they couldn’t spare any. I had no idea about this and it has scared me as I’m terrified of giving birth.

Does anyone low risk have any experience of this? Were you able to get epidurals if you wanted them?

[Jenala]

In my hospital you can't have an epidural on the midwifery led unit. You have to be on delivery suite - as that's where the doctors and therefore the anaesthetists are.

You don't have to be consultant led to be on the delivery suite in my area though. You can choose where to give birth.

I was consultant led so midwifery led wasn't an option for me but I believe if you go that route and end up having complications/desperately want an epidural or other stronger pain relief then they move you across to delivery. That's what they say, anyway. However my hospital delivery suite is always rammed so I think that might not always work in practice.

[Notlostjustexploring]

I was of your frame of mind also. Luckily(?) I went overdue and was induced so I got one without a problem.
As far as I remember from looking into it before :

I don't think they can make you give birth anywhere you don't want.
If you start off at the mlu, you can be transferred at any time to the consultant unit, including if you want an epidural. A request for pain relief I believe is sufficient clinical reason.
At one of my later appointments with my midwife, we discussed birth locations, where she would sign off on mlu. I would suggest you speak to your midwife, and keep speaking to her until you are sufficiently reassured.

Not the longest answer in the world, but I remember this really stressing me out too so didn't want to read and run.
Good luck!

[Misspilly88]

Same as pp, where I am you have to be on delivery suite. But it's a choice, you don't have to go to the midwife led unit. I had one baby in mlu and one in ds and they were both great.

[Lulette]

Thank you all for replying. I’ll speak to the midwife at my next appointment and see what they say. It may be wherever I am I just have to hope baby comes when they’re not too busy!

[mindutopia]

You can have an epidural if low risk (it's nothing to do with risk, only how much pain relief), but you have to choose to birth in a setting that offers them first. Usually many MLU don't. Personally, I would stick with the MLU and plan for other comfort measures, like being mobile, birth pool, massage, hypnotherapy, TENS, gas and air. If you exhaust those and really want an epidural, if the MLU is attached, they can transfer your care and you can have an epidural. Obviously, if the ward is closed because they are at capacity, they can't, but they wouldn't be able to anyway even if you booked in for consultant care from the start. Wards closing because they are full is relatively rare though, so I wouldn't panic.

I would talk to the midwife about your options, but I wouldn't plan your whole birth around wanting an epidural. With my first, I never even needed the gas and air and managed just fine with hypnotherapy and TENS and walking around lots and was truly comfortable. I never even though to ask for the gas and air. I had a friend who just had a baby who was dead set that she was having an elective c-section, did not even want to labour at all. She ended up having a lovely 3 hour labour and birthed naturally and was thrilled that it was much easier than she expected. You may just be surprised that you do just fine.

[UnitedKungdom]

You cannot have an epidural unless you are in the hospital part of the hospital. If your midwife led unit is in the hospital, you can easily transfer internally if you decide you want an epidural. Being low risk won't make any difference but your location will.

[UnitedKungdom]

I don't think any MLUs possibly can offer epidurals! The whole point is that there's only midwives there. They don't just ship in Anaesthetists when you change your mind. You need to go to the hospital part for that.

[Lulette]

Thank you all - I will definitely keep an open mind about if I need one or not! I just hadn’t appreciated that I might want one but find that the delivery suite might not be able to accommodate me as they are too busy. I will discuss going straight to delivery suite at my next appointment.

@zzzzz was that pressure from midwives telling you you didn’t need one? I think you said you were already in delivery suite so why would they care? I can sort of understand them not wanting someone to switch and take up a delivery suite bed but if someone is already there I don’t get it!

[arbrighton]

It's usual to have to go to labour ward for epidural as midwives can't do it and it requires more monitoring.

Epidural was the thing that terrified me most to be honest. A friend had a bad time afterwards and I didn't want to be stuck not feeling things and not moving (as it was monitoring and drip put paid to that idea)

I was going to try water birth on midwife led but DS decided that propess wasn't enough incentive to make an appearance so I went off to labour ward for water breaking etc. Managed, even with hormone drip on gas and air and two half doses of diamorphine.

[sycamore54321]

You are entitled to full hospital care and an epidural if you'd like one. If I were you, I would ask for that to be on your records from right now. Based on what I've read of present NHS care, I'd also request an epidural as soon as I arrived at the hospital, even if I didn't feel I needed it right then. Far easier to request it and then decline when the anaesthetist arrives, than to be writhing in agony with unsatisfactory water/gas/Tens needing to negotiate your way out of an MLU at a point when you are by definition in more pain than you can handle.

I adored my epidural both times and had zero complications. My friend developed the side-effect headache after hers and needed the repeat epidural blood patch to fix it (I think the risk is approx 1 in 100) and even she say that she would make exactly the same choice again as it was balancing the possible risk of side effects with the absolute certainty of labour pain.

[UnitedKungdom]

They won't give you an epidural till you're in established labour, that's 4cm I think, no matter how much you demand one.

Midwives are not necessarily against epidurals but they do instantly ncrease your odds of further intervention which I'm sure many midwives would like to spare you from if possible. Mine led to forceps and I wish I could go back and not get one but I made the best choice I could at the time. The other funny thing about epidurals in my experience is that usually the moment you start begging for one is the transition period when everything is really beginning to happen and if you can hold it together, you'll have a baby in your arms shortly. Another thing is that by the time they can secure the anaesthesist for you, it's too late and you would have been better not getting one.

The logistics of an epidural and the timing of it can be tricky. If it works well and you get it in plenty of time then I think it's a wonderful thing. Just the risk of further intervention is too high for me after the damage I suffered in my first labour from forceps.

[happymummy12345]

You won't be able to have an epidural in a midwife led birth centre, you would need to be in the delivery suite.
I'm not 100% sure how it works, but I'm sure I had the option of birth centre or delivery suite to give birth (the birth centre was down the corridor from the delivery suite, so would have been an easy transfer if one was necessary).

[UnitedKungdom]

Zzzz, let me find you some stats but epidurals stop you feeling properly. I couldn't figure out how to push with mine in. Baby got tired and they had to intervene to pull him out. My 2 non epidural labours were incredibly different as my body roared what to do next.

[Capelin]

United, my experience was the opposite. I had been stuck at 8cm for hours, baby just didn’t want to come out, and as soon as I had the epidural things started moving. I realise that your experience may be more common than mine though.

OP, I started my labour in a midwife led unit, but eventually transferred over to the delivery ward when I wanted an epidural. This wasn’t a problem.

[tiptopteepe]

You dont need to be consultant led but you do need to be in the actual hospital not the midwife led unit so ask about giving birth in the hospital if you are sure you want one! I was low risk and I had one and it was great. I still delivered naturally and had some level of movement in my legs.. could feel enough to push but not feel pain.

[UnitedKungdom]

It's just stats really. So there will always be anomalies. But it's recognised that epidurals can lead to a 'cascade of intervention'. And it makes sense as it cuts off feeling and has some effect on hormones.

[Lulette]

Thank you everyone, it’s so helpful to hear women’s experiences and the pros and cons. The MLU I am booked in at is attached to a hospital. I guess I just need to be open minded as I don’t know what kind of labour I’ll have and what the medical advice will be at the time. I’ll see what midwife says about if I’m better to start on MLU on basis I can transfer or try to go straight to delivery suite.

[bananahoney]

I'm really interested in this topic as I feel exactly the same as OP. Please keep us updated. I'd love an epidural but also terrified I won't get one! I'm 31 weeks so need to start making some decisions.

[twotired]

You can't have an epidural on a MLU, only in a delivery suite. You may have a short wait as you will need an anaesthetist, who is usually on call and may be seeing other patients.

MWs and obstetricians try to discourage epidurals where possible because of the increased risk of intervention. There is a higher rate of instrumental deliveries, there is more chance of episiotomy/tearing and an increased risk of sections for various reasons. You may also need a synthetic hormone drip if it slows your labor. If you wanted to research further you can look up the statistics with a quick internet search.

That said, they are amazing for pain relief and I know many people who have said that they really enjoyed their experience without the pain.

Wishing you a lovey birth and hope you get an epidural if you choose to have one.