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?

None of that proves anything more than correlation. This is the problem we're always going to have when it comes to epidurals: do they cause further complications, or is it having a labour that's likely to be more complicated what leads women to want epidurals?

Neurodiversitydoctor

Why would you want afuckoff enormousneedle put into your spine and need a catheter (yuck) to avoid a few hours of pain ?
Good job we are all different eh ?

Why wouldn't you want a needle in your spine (takes like a minute) to avoid hours and hours of pain? Works both ways doesn't it.

Yes it does that's my point really.

We are all shaped by our experience, I had a colleague who lost the skin off the back of her legs and her lower back because her epidural was too deep and her labour was prolonged (25 years ago now), didn't like the sound of that at all. Also really hated the idea of a catheter, wanted to be able to get out of bed and get my baby and quite fancied a 6 hour discharge. Those reasons are no less valid (and to be fair all about my comfort rather than the baby's welfare) than those wanting to minimise the pain.

It does go into your spine absolutely they make sure they are in the right place by seeing the cerebro-spinal fluid, that surrounds the spinal column and the brain. It's like a lumbar puncture.

Like this

www.nhs.uk/conditions/epidural/side-effects/

Misinformation ?

@Neurodiversitydoctor

It does go into your spine absolutely they make sure they are in the right place by seeing the cerebro-spinal fluid, that surrounds the spinal column and the brain. It's like a lumbar puncture.

@Neurodiversitydoctor you’re confusing spinal anaesthesia (which is a lumbar puncture essentially) and epidural anaesthesia.

Spinal needles are tiny and go in the csf below the level of the termination of the cord. Epidural needles are big but end up in the epidural space (again below the level of the termination of the cord in lumbar epidurals) and should not produce csf. Accidental dural punctures happen in approx 1:100 epidurals (and that’s why we discuss the risk of aural puncture headaches). The image you’ve linked is anatomically appalling!

It doesn’t actually go ‘into your spine’ ffs. Some labours are far more than ‘a few hours of pain’ - they are long and traumatic. And a catheter isn’t a given either. So much misinformation
Of course it goes into the spine, where do you think it goes? And while a urinary catheter might not be "a given", it is not unusual to be given one with an epidural and some people don't like the idea of that.

I think you are right and I have mostly seen spinals for c-section done (So that would be a spinal?) And assumed an epidural would be similar. Still too close for comfort for me.

OP, I was so scared of medical staff trying to withhold an epidural (have heard the horror stories) that I insisted from Day 1 on an elective C Section. Best. Decision. Ever.
Don’t let anyone talk you out of an epidural if it’s what you want. Doubt very much you’d go in for a root canal and the dentist would try and dissuade you from pain relief.
Read Give Birth Like A Feminist by Milli Hill.

The pain of contractions are natural

Lol, one might argue the pain of passing a kidney stone is also natural. The fact that it's natural doesn't make it any less traumatic

I am not minimising anyones experience, just giving my view, by the time I gave birth I had probrably attended 200 deliveries- all complicated-they don't call the peads for straight forword births. I was expecting the pain to be unbearable, to have an epidural and a cascade of intervention, the only thing I was really clear about in my birth plan was no trial of forceps. In other words to some extent I expected to be traumatised. I was pleasantly surprised that gas and air works for bog standard labour pains, that is was bearable and that the baby was born without perineal or psychological trauma.

I’m a retired anaesthetist, and I wish I had a pound for every exhausted and traumatised woman I’ve epiduralled, who should have requested their epidural hours earlier. They had all believed the natural childbirth woo, and struggled on in agony unnecessarily for hours.
Modern women are having first babies much older, they are on average more obese and less physically active and fit than previous generations- so there is a higher incidence of complications, and more interventions such as induction, forceps and sections needed.
OP, if you want an epidural, get it written on your notes, and stand firm.

Let's all take a step back here.

I'm assume the majority of the women on this thread live in the UK, one of the safest countries in the world to give birth in. Advances in medicine and the advent of the NHS have greatly reduced maternal and infant mortality. We have got to (or will do shortly) give birth in clean, safe, hospitals, attended by trained professionals. Add to that, we walk out without a potentially bankrupting bill to pay.

Some of us posting here would be dead if we gave birth anywhere else or at another time in history. I'd have lost several friends if they'd given birth 50,60,70 years ago. A good chunk of us would have given birth attended just by female relatives or untrained, unlicensed 'midwives'

So - my point.

Epidurals and c sections are wonders of modern medicine and have saved lives. However, a lot of women have always been capable of giving birth without them, as have lots of other female mammals. If we weren't our species would have died out.

Sadly, until you're giving birth you have little to no idea whether you're in the 'easy natural birth' group or the 'going to need help group'. For the first group, adding in interventions that aren't needed can push them into the second group.

Using myself only as an example. My second birth was a beautiful calm water birth with just gas and air. It was quick and tbh with some of the contractions all I felt was tightening. I gave birth was able to get myself out the pool minutes after, walked to the bed. No stitches, first feed 45 mins later and home 6 hours later (would have been sooner had I been able to do a big enough wee) an epidural would have resulted in an entirely different birth. A c section would have been way more painful with a longer recovery. Great I saved the NHS a few quid, but even without that, I fail to see how an epidural or c section would have given me a better birth. That's ok though, my experience was my experience and that doesn't devalue anyone else's choices.

There's nothing wrong with telling women about non traumatic births. There's nothing wrong with telling women about the pros and cons of interventions. There's nothing wrong with saying 'see how you go'.

There's a lot wrong with saying 'epidurals are a must' or that c sections are the 'only safe way to give birth' or anything that makes a woman feel like she has to have interventions she might not need. And to be totally clear, I'm not talking about situations where the medical evidence has already shown that interventions will be required.

@Babdoc

I’m a retired anaesthetist, and I wish I had a pound for every exhausted and traumatised woman I’ve epiduralled, who should have requested their epidural hours earlier. They had all believed the natural childbirth woo, and struggled on in agony unnecessarily for hours. Modern women are having first babies much older, they are on average more obese and less physically active and fit than previous generations- so there is a higher incidence of complications, and more interventions such as induction, forceps and sections needed. OP, if you want an epidural, get it written on your notes, and stand firm.

Really? All of them?

Not one who requested it but was told it's too early/late or that you weren't available or whatever delaying tactic ?

The biggest difference about my need to have an epidural and not was my attitude/how relaxed I was.

The one when I was screaming "epidural now" - I no longer have a stuff how long induction took, that it would be big, that I wasn't getting my home birth etc I just didn't want one like my 3rd that screamed and didn't sleep for 6 months due to undiagnosed silent reflux.

Problem is if you aren't relaxed/fearful/sure you want an epidural there isn't much you can do about it!!

Birth plans can also give false expectations. It can be incredibly hard physical and mental and emotional work.

Try and be open minded, if you aren't coping ask for pain relief sooner rather than later because it's rarely instant/quick.

My other top tip, having a drip for induction - ask for the epidural to be sited beforehand!!

Good for you but you are scaring other women with erroneous claptrap when they could benefit from the bliss that is labour with epidural

And calling birth "traumatic" and "horrendous" isn't ?. Both with an epidural isn't always blissful, things can go wrong (It's rare but 1/100 isn't that rare for what is an elective procedure). Even when things go well it's inconvienent afterwards. As I say I was fully expecting not to cope and am pleased that I was persuaded (not just the midwife) to try without. Of course women should be listened to and I think induction/ intervention without analgesia is inappropriate but straight forward labour- give it a go.

Having recently given birth four days ago, the failed epidural that took three attempts to go in and never actually worked ended up causing me more harm than the good it done

The gas and air surprised me an awful lot as to how much it helped!

Glad you had a reasonable experience. I think gas and air is underrated ( think you have to breathe it properly or something...)

I have shared a diagram and quoted the NHS website. Also shared my experience as have many others, where is the clap trap ?

Gas and air got me through the 55 hour labour and up to 8cm and I think it was a case of pure exhaustion and hoping to relax to get further that made me say yes to the epidural in all honesty!
I got to 10cm after but as I said it actually failed so did nothing for me for pain relief and I still relied on the gas and air, up until I ended up with a c section - I have requested a birth debrief as I'm still unsure why I had the section in the first place when I was 10cm and never given chance to push. I'm sure there's a reason.

Covid shortages really kicked my ass with labour. I was delayed so much after waters breaking because there was no space on labour ward for me and end up 48 hours PROM before arrive labour

Do you think they thought c-section was likely so encouraged an epidural at that stage ?

Absolutely push for the debrief I hope both you and LO are doing well.