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?

If you want an epidural have one. In France 80% of women do and it doesn't appear to be an issue.

Seriously she probably did it without and thinks everyone else shld. Well ignore her and put it on ur birth plan. I was surprised that the midwives did actually read it when I was in labour! Ok it was very short but I did say I thought I wanted an epidural.

It was amazing! Honestly like flicking a switch with the pain. It started to wear off down one side and was topped up but wore off again but honestly it was magical. The gas was alright too but it didn't take the pain away only made it slightly more bearable.

I have a few friends who had one and didn't next time. One where baby was just very fast and no time. She said it was awful absolute agony but recovery was great. Another friend kept being robbed off and that it was too late baby was coming now and hours later she was still in pain and she didn't get it in the end. She said though it was painful but she was glad she didn't have it in the end.

Then there's my sister who never had anything not even the gas said that did nothing for her. She used to tell me not to have epidural and it can cause back problems yada, yada, yada.

I cldnt recommend it more. I was induced on the drip with a back to back baby and I was just glued to the gas unable to talk or anything and the pain literally disappeared, amazing!

Entirely up to you. Is worth thinking how you’d cope if it’s delayed etc. I wanted an epidural with my son (DC2), an anaesthetist wandered in to talk me through it quite far in in labour and finally came to do it as I pushed out my son. This was in a large teaching hospital with more than one anaesthetist around.

I’m not sorry I didn’t have one, gas and air worked very well for me and I subsequently had DD2 with just gas and air although for both I insisted on it at about 2cm. Both were straightforward and quick labours and both we went out for dinner on hospital discharge but if they had been more difficult/gas and air hadn’t worked so well I’d have liked a better plan to manage because when an epidural happens is entirely under someone else’s control and they may not be in a rush.

I had one and it was great. Recovery fine.
Stick with what you want. Plus you can always change your mind and say you don't want one on the day if not needed.

I was 'against' an epidural after I had my antenatal classes because they said it was more likely to need medical intervention (forceps etc...). But reality was, baby was back-to-back, I was in loads of pain and vomiting with each contraction. My midwife made it obvious that she didn't think I should get an epidural and so I felt super pressured not to. In the end, I endured over 14 hours of horrible pain and sickness before begging for one. The relief when I had it was huge, sadly I was so tired that when it came to pushing I was very weak and so I did need intervention (episiotomy and forceps). Second time around I was induced and opted for an epidural early on and it was brilliant! I felt so energised and baby came after 20 minutes pushing with no intervention. For me (not saying this is the case for everyone), I believe my first birth was more difficult because I was exhausted. If I'd had the epidural earlier, I think I could have had a more peaceful birth. You need to push for what you want. It's your body and your baby!

@Hospedia I agree with the no medals for being a martyr!

@DivaRainbow @Joolsin thankyou that is reassuring! I know loads of people the same that have said they were fab.

@CallmeHendricks this is my fear that I dont make it clear and end up without it! I've heard alot of that.

@SheWolfOFFrancee I agree. I have an appointment this week and I'm going to make sure my birth plan states its what I want and if not then hopefully the midwives are supportive when I'm there on the day.

@MissM2912 just curious are you a midwife when you say you work in this field? When you say its more likely to lead to a section so they not use it to give people a section?

I have three kids. One labour I had an epidural, the other two I was too late for it (quick births) but screamed blue murder for it any way.

Tbf to the statistic my birth with an epidural was by fair the worst. Basically everything went wrong and cascade feels like the right word to describe it (ventouse, back to back, episiotomy, haemorrhage, baby had to be resuscitated, infections, transfusions). The labour itself was amazing, relaxed and painfree until the baby crowned. But it took me a good six months to feel anywhere near normal.

My two without were painful and obviously I'd rather not be in pain but the recovery was a million times better, there was no interventions snd my babies were alert straight away. My son with the epidural didn't open his eyes for about a week. We also had a lot of trouble gaining weight and establishing breastfeeding. And I don't know if it was the ventouse, the traumatic birth (both could have been because of the epidural) or the epidural but he screamed for the first 3 months of his life non stop.

A lot of friends that had epidurals suffer back problems (luckily I don't), not all but a lot.

This is obviously all antidotal but to me my experience does ring through with why midwives and people say against epidurals.

just curious are you a midwife when you say you work in this field? When you say its more likely to lead to a section so they not use it to give people a section?

Based on a quick AS, I'd take any professional/work in the field claims with a huge pinch of salt.

Op, If this is your first baby she might just be thinking see how it goes as if you do have an epidural you can't move around etc which can slow down the birth. I've had two baby's and both were completely different so you never know how it's going to go.
Hope it goes smoothly for you though and definitely take what you need if you feel you need it. As long as you and baby are ok that's all that matters.

@Joolsin

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!

Midwives couldn't care less about the cost of a medication.

I had an epidural which was removed as the doctors needed me to feel my contractions, work with my body as otherwise I’d have been heading for emergency C-Section (baby was becoming distressed.) It seemed cruel as the time, as it bloody hurt, but it did help me focus & get the job done as it was the only way to stop the pain.

Still couldn’t avoid an episiotomy which was unfortunate and my body never sprung back but we safely delivered our bundle of joy.

NTC classes said just when you think you cannot take the pain any longer; that’s when the baby’s ready to be delivered.

First delivery, I was given the alternative of pethidine which just sent me sky high - I am utterly convinced, to this day, I delivered the baby in a store cupboard. I even got my camera out as if I was a visiting tourist on the event; bonkers. Baby was given an antidote to pethidine as it was in both of our systems. The obstetrician wasn’t not impressed with my lack of focus. Still couldn’t avoid an episiotomy then too, asked how many stitches and they answered one long stitch (took 30 minutes,) down there has never been the same since, neither had hair or waistline 😭 (worth the sacrifice but women give a lot of themselves up on the delivery table.)

I met a friend after my first. She had had her first child in a small country hospital where the only anaesthestist who did obstetric epidurals only worked M-W 9-5, hence to cut down on requests for elective inductions on those days, the expectant mothers were told that all epidurals gave you migraines for life. She was horrified when I told her I'd had one and it was great and I had no headaches or any other after effects. I was horrified that she had been blatantly lied to.

[quote Melvin2021]@Hospedia I agree with the no medals for being a martyr!

@DivaRainbow @Joolsin thankyou that is reassuring! I know loads of people the same that have said they were fab.

@CallmeHendricks this is my fear that I dont make it clear and end up without it! I've heard alot of that.

@SheWolfOFFrancee I agree. I have an appointment this week and I'm going to make sure my birth plan states its what I want and if not then hopefully the midwives are supportive when I'm there on the day.

@MissM2912 just curious are you a midwife when you say you work in this field? When you say its more likely to lead to a section so they not use it to give people a section?[/quote]
In the kindest and least patronising way, try not to worry.

Most people don't even have a birth plan. Your community midwife is probably just saying 'see how you go!' conversationally.

When you go into labour and get to the hospital, you can just say 'I'd like an epidural at x point' and the midwife will arrange it. It's as simple as that. It's your choice and your midwife will support that.

Midwives aren't in this business of withholding analgesia, not at my Trust anyway.

I am not a midwife- I have said I work in management and as part of that have access to the birthing statistics for every month of the year for a major UK hospital and some months it hits as high as 50% of women needing a section, and even higher figures for those needing forceps or ventouse.
Statistically you are MORE likely to end up in this position- which is a worse outcome for the mother- if you have had an epidural than if you have not.
I don’t understand what exactly is controversial with stating this!!
The women reporting the most birth satisfaction are those that have had a natural unassisted vaginal delivery. I absolutely appreciate that this is not viable for the majority of women but as stated above- I agree with the midwifes recommendation to initially try to avoid an epidural.

I have had 3 kids, one with epidural and 2 without - the epidural was with my first and was after a good 24 hours of labour, I was just exhausted and had nothing left and was on the drip so was really intense. The epidural came quite quickly and was amazing for pain relief, but it was a horrendous birth - took 2 hours of pushing, baby got stressed, needed an episiotomy, which lead to a heamorrhage and later required a blood transfusion. I felt absolutely butchered for weeks and weeks, and had a completely numb patch on my thigh for over 2 years.
Subsequent 2 births were super straight forward - both times had no tearing, not even a graze, and baby just pushed its own way out - I didn’t have to actually actively push at all, and the crowning part was just pressure and not painful (though the contractions were obviously agony ). Maybe it’s just that the first one was my first and my body knew what to do after that, but personally I would not have an epidural unless it was a last resort.

I wanted one with my 2nd as had one with my 1st, with 2nd I was induced and was intense once on the drop thing. Unfortunately there was no anesthesist (however u spell it) available for 3 hours. As a couple of more important emergencies By then it was too late. Dd was born as he came into the room.
. With my 3rd there wasn't time.

Nobody is any better a mum for not having an epidural!

Of course there are potential side effects, but these are pretty rare.

My epidural was magical, I slept through active labour, not a single contraction was felt. My baby was born perfectly healthy with only a first degree tear, there's been no latter side effects.

Don't let anybody make the choice for you, if you want an epidural then push for one!

OP I had an epidural and intervention when I had my first. I was induced and the pain was awful, so I asked for an epidural. Ended up having an emergency delivery with forceps, so would likely have ended up with anaesthesia anyway, but what I hated afterwards was that they wouldn't discharge me until they had 'proof' that I was urinating sufficiently! 24 hour chart of liquid in and liquid out. All I wanted to do was go home as the ward was so noisy, I was on my own overnight and finding it hard. The second time around I really wanted to avoid an epidural so I didn't have to stay in. I went in to labour following a sweep and gave birth on gas and air. The pain was much more manageable than when I was induced and I was glad to be able to leave the hospital as soon as possible! I also appreciated being able to move around the second time instead of stuck on my back. My advice would be to say immediately you think you'll want an epidural, don't be talked down, but also see how it goes. Best of luck OP.

Why don’t you just see how you get on?

This is your first baby and you might progress well and have a straightforward labour that’s manageable for you.

You might not

Every birth is unique as much as the woman involved. I’ve had three babies and there wasn’t time for an epidural for two of them but I found being mobile helped enormously with the one where it had been possible to the point where I was able to move and respond in a way that helped her be born my having declined one.

Not sure why there is any sort of competitiveness around this it doesn’t make you better or inferior whatever choices you make. The end goal is a healthy baby and a mother who feels that she has been supported and empowered wherever clinically possible for the delivery she wanted.

Op you are entitled to ask. I have had 5 births, the first two I had an epidural for the majority of both labours ( I asked early on ) this is over 20 years ago now.

My 3rd birth I was left until it was too late and was severely traumatised by it.

My 4th and 5th I asked for c sections because of the trauma from birth number 3 eleven years before.

My final birth 9 years ago was via c section as I said. I wouldn't have had c sections for the last two births had my birth plan on number 3 been adhered to.

You know your body, you know what you want. In my experience ( and I do have a bit of it having had 5 children over 22 years ) yes epidurals can lead to more Intervention but my first two births were amazing. Hardly any pain at all and super easy to recover from. Epidurals worked brilliantly for me.

The epidural wore off and I was up and about in no time.

It's been some time since my last epidural 23 years ago and I bet they have come on in leaps and bounds. I wish you the happiest healthiest pregnancy and a wonderful birth - I hope you are able to get the birth that you want.

It’s not about ‘being a better mum!’- it’s about optimising your chance of having a positive birth experience. The impact of having a negative birth experience can be huge- both physically and emotionally.
Yes- you can have an epidural and have a fantastic birth- but many women, as seen in previous comments, do not have such a good time and the reality is you won’t know until you are in the throes of Labour how it will work out.

Would you have a tooth extracted without an anaesthetic?

Exactly.

I think you have to be very careful interpreting the causality of those epidural statistics - both outcomes and satisfaction.
Women are much less likely to ask for and have an epidural if they are having a quick, straightforward labour.

It is nothing like getting a tooth out.
The issue with an epidural is the impact it has on the rest of the birth and the mother needing further help to deliver the baby.
It isn’t without risk and it should be balanced against if the pain is genuinely unmanageable against the increased risk of needing an emergency section to get the baby out quickly!

@MissM2912

I am not a midwife- I have said I work in management and as part of that have access to the birthing statistics for every month of the year for a major UK hospital and some months it hits as high as 50% of women needing a section, and even higher figures for those needing forceps or ventouse. Statistically you are MORE likely to end up in this position- which is a worse outcome for the mother- if you have had an epidural than if you have not. I don’t understand what exactly is controversial with stating this!! The women reporting the most birth satisfaction are those that have had a natural unassisted vaginal delivery. I absolutely appreciate that this is not viable for the majority of women but as stated above- I agree with the midwifes recommendation to initially try to avoid an epidural.

It is up to the patient to decide what is the best outcome for her, what risks she prefers to take and which she prefers to mitigate and what treatment she consents to. Not the midwife. And certainly not hospital management.

The ‘risk’ of further intervention is just one consideration a woman may have. For some, the prospect of being in unbearable pain for hours is not something they want or feel they can cope with. Some do not want a vaginal birth. And the psychological impact of feeling out of control and/or bearing pain for hours can be very considerable, to the point it results in post natal anxiety, depression or PTSD.

You are wrong and out of date where you state that women report greater satisfaction from natural childbirth. This is an ideologica viewpoint based on old ideas and old and flawed research. In fact, the more recent research shows that women experience greatest satisfaction when they get the birth they want and are treated with respect and listened to, no mater the mode of birth, eg where a women wants ELCS and gets it, she is far more likely to be satisfied than a women who wants an ELCS but is denied autonomy and forced into birthing vaginally.

You seem to feel very very sure that you know it all and are right. But the reality is far more nuanced than you are aware. A little knowledge can be a dangerous thing.

OP to answer your questions, midwifery is a branch of medicine that is prone to follow a certain ideology and there has been a culture of infantilising women during childbirth. Of course there re some wonderful midwifes around - but also those with fixed ideas who think they know better than the women they treat, about what that woman should want. Do your research and think carefully about what you would prefer and then be very clear and firm.