Why is my midwife trying to talk me out of epidural

[Melvin2021]

Hi I'm 38.5 weeks and I've been pretty certain from the off that I would like an epidural when in labor obviously if everything goes to plan. Mt midwife said I don't want one and to see how I get on? Has this happened to anyone else?

Because the birth outcomes for you are likely to be much worse.
An epidural often leads to what is known as the cascade of intervention- episiotomy, assisted delivery, c section, plus longer recovery time.
She is right- you don’t want one unless you really aren’t managing and it should be last resort.

Some MWs want to push their own idea of a "gold standard" delivery and will try infantilise the women they're supposed to be supporting and advocating for.

I had one MW in pregnancy who tried to tell me what I wanted (VBAC) instead of listening to what I actually wanted (ELCS). I changed MWs, had it written in my notes that she was not to be involved in my care (community MWs here are one team), and saw a MW who did respect my wishes.

If you want an epidural and you're informed in the risks vs benefits then you have one, that's your decision and it is not down to anyone else to decide that you should "just try without" or "see how you get on". You know what you want, push for it (no pun intended).

I disagree- there is very good medical reasons why an epidural should be avoided if possible- this isn’t the midwife pushing own agenda it is medical fact. There is reams and reams written on it.

@MissM2912

Because the birth outcomes for you are likely to be much worse. An epidural often leads to what is known as the cascade of intervention- episiotomy, assisted delivery, c section, plus longer recovery time. She is right- you don’t want one unless you really aren’t managing and it should be last resort.

You really shouldn’t post misinformation. Plenty of women have epidurals and have a wonderful birth experience.

They don't like doing them and it can slow the process and recovery.

"The cascade of intervention" is an old fashion nation, modern dosing and anaesthetics mean that there is not a significantly higher risk of an assisted delivery. The biggest potential risk is a drop in BP but this is easily rectified with fluids and positioning.

And even if this wasn't rhe case - it is the OPs body and it is entirely up to her. The MW should present the pros and cons in a factual manner and allow the OP to make her own decision without applying her own agenda to it. If the OP wants an epidural then she should be allowed one and should not be treated like a child with a pat on the head and the instruction to "see how you get on".

There are no medals for being a martyr.

I had an epidural 2 out of 3 times and I would definitely recommend it if needed. With my last birth I told them I wanted an epidural before I was induced and lucky my MW team were amazing. My longest and worse recovery was the birth without it and I knew I didn't want to experience what I had done previously..

@MissM2912 I won't cope thats the reason I would like one as the other methods of pain relief don't sound great.

@Hospedia thats shocking!! Glad you managed to change midwife

I wished I'd listened to my MW and not had one. I ended up with spinal tap and permanent nerve damage in my leg.

Simple answer - because it costs more. They have to push women away from the idea of an epidural with scaremongering stories. If you want one, OP, don't be dissuaded. Epidurals are fab, imo, I had two!

Of course there are women who have epidurals and are fine- but statistically a high number, something like 50% end up needing an assisted delivery or section. This is a WORSE outcome for the mother and often leads to further problems including post natal depression.
I stand by my comment that it is better to try and manage without an epidural if possible.

I had two epidurals and they were the best thing ever!! Babies fine, straightforward deliveries with no issues at all.
I was lucky in that my midwife was totally supportive in ensuring I got what I wanted. Friends of mine had different experiences and were told, as you have been, to "see how it goes." And of course, when the time came and they were pleading for one, it was, "Oh it's too late now."

I had epidurals at all 3 of my birthday. Also had very supportive midwives during those births.

Can only go on my own experience and maybe I’m just lucky but I didn’t need any assistance (like forceps) and I suffered zero tears or grazes during my births. I also recovered very quickly and was up and showered within an hour max after each birth

I assume it’s your community midwife being unsupportive however don’t forget when you’re in Labour chances are you’ll have a completely different midwife who might be much more supportive

Joolsin- I work in this field and it is nothing to do with cost.

I'm a midwife and we definitely don't have to push people away from epidurals etc because of expenses. Our job is to provide facts and yes, an epidural leads to a higher chance of intervention further down the line such as instrumental birth. However, I think they can be blooming wonderful and wouldn't hesitate to have one myself!

but statistically a high number, something like 50% end up needing an assisted delivery or section

If you're going to thrown stats around then you need to cite your sources. Where did you get this 50% figure?

The thing is, when you need one you really need one.

Ideally you wouldn't of course! But if you have a big stuck back to back baby (I had this twice) then it will feel like a bloody life saver.

@MissM2912 Do you have any professional expertise in this field? Or an affiliation to any particular standpoint? Because either way, I think you should declare any interests.

Plus the cost of ongoing treatment or a section is more than administering an epidural

Because they are obsessed with natural childbirth OP. I told my midwife if I didn't get one I'd sue them. I wanted am epidural from the start because I'm just not good with pain. We shouldn't have to fight for these things. We are adults and know what we want.
Make your intentions quite clear to them and dont take no for an answer.
The days of brutal childbirth and post childbirth PTSD are over.

Yes I work in a management role within a health trust and am involved in midwifery services. I am not a midwife or a doctor, but I work closely with them and know that there is good reason why epidurals shouldn’t be the first choice for a multitude of reasons.

The obsession with natural childbirth is because statistically the outcomes for both mother and baby are better.
It’s not about oppressing women- quite the opposite!

Pain relief is there for a reason. Interventions are evidence based. Midwives have some funny opinions. If you want pain relief then have it, don't be dissuaded like I was by my midwife... wish I'd had my epidural much sooner!

Just stick to your own instincts. I definitely was very sure I wanted an epidural..wasn't prepared to go through unnecessary pain .I had one and actually enjoyed giving birth..absolutely no medical intervention was necessary!

I had an epidural with my first birth, it was a 17 hour labour and I tore even with an episiotomy when they used forceps. I did have pelvic floor damage too and later had to have surgery. However, I still wanted another epidural with my second birth but was talked out of it, I was incredibly angry and very vocal about it whilst giving birth, the pain was horrible - but - it was over in 20 minutes and the feeling of actually giving birth, feeling my baby come out of me - was worth the pain. I didn’t tear or have any damage either.

It’s a tough call as having no pain is great, but the complications for me were pretty bad afterwards. If I gave birth again I think I’d take the pain and feel my baby actually coming into the world - it’s a feeling I’ll never forget, in a good way.