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?

I would rather be in agony for a few hours than months of healing from a forceps delivery and worrying about incontinence but that’s just me!
And before anyone says ‘but that might not happen’- I know that but it is more likely and not a risk I would be keen to take if I could avoid it.

Excellent post @DropYourSword

I used to work for the NHS and sadly I found that so many staff in management are brainwashed to tow the party line of whatever crap the head honchos want to spout when what they mean is “we want to save money”

However I’m a bit agog that someone in management thinks a once size fits all - or rather, a ‘everyone will be happy with X experience’ - WRT childbirth. As DropYourSword said, women want to feel listened to, they aren’t idiots who don’t know what’s good for them, they know what they want.

I can’t believe in 2022 I have to say this - but would it really be so very hard if for once, women were listened to and trusted?

And yes I have given birth- one heavily medicalised and traumatic and took months of recovery and one which was a water birth with a trainee midwife.

Again @MissM2912 - have you actually had a baby?

You seem to be forgetting you can be at risk of all the things you’ve mentioned even without having an epidural. Yet you’re talking about them all as if they’re absolute givens if you have an epidural, and absolutely no risk of them if you don’t.

@MissM2912

I would rather be in agony for a few hours than months of healing from a forceps delivery and worrying about incontinence but that’s just me! And before anyone says ‘but that might not happen’- I know that but it is more likely and not a risk I would be keen to take if I could avoid it.

I had no pain relief with a vaginal delivery and it was a year before I stopped pissing myself.

Why do you think it’s either or? Don’t get too hung up on statistics - women are humans, not statistics.

And you would prefer that, and therefore you should be listened to if you give birth. The same way a woman with an opposing view should be listened to.

Again my experience of the NHS was scary as decisions did seem to be based on “Well if I was a patient I wouldn’t like X Y Z” from people who NEVER had the experience of said patients - in my whole time there, men were chosen as key decision makers for maternity, the highest member of staff for the department was never a woman - rather than listening to other humans who went through the services.

I am not disputing that women should be listened to- if you want an epidural have one, what I initially said was that the midwife had good reason to say to see how it goes without. She won’t have said this to suppress the OPs rights or infantilise or make the OP feel shit, but because she probably has delivered hundreds of babies and in her professional opinion it is preferable to avoid an epidural!
I mean would you argue with a solicitor like this? Or an accountant?? Is it just midwifes who aren’t worth listening to?

But missM
Not getting the epidural on my birth plan -- no reason given may have been because it was nighttime?
Led to
1 me not wanting to hold the baby
2 crying after at home as i hadnt been listened to
3 i had a tear anyway and that was worse than the episiotomy with dc1.
4 possibly depression due to the lack of pain relief/trust in medical people
5 i was so close to making a complaint as i know the hospital is bad for pain relief from when i had dc1.
6 i 100% wouldnt have a baby in a english hospital again.

My birth plan had been removed from my notes.
I did have interventions with dc 1 after epi - but dc was b2b and took days to come out with both ventuose and forceps..
I think more have epi with child 1 so follows that leads to more intervention. And people that pop babies out easi

I’m sorry that you had a traumatic birth experience @MissM2912 but I think you’re projecting your own fears and experience and using your “job knowledge” as cover and an excuse for that.

Your posts have the tone and implication that an epidural will equal a traumatic birth, medical intervention or damage (or tearing etc) and that a natural birth will almost likely come without all of that.

I had no pain relief and enjoyed giving birth, I didn’t feel any real pain and was 9cm when I walked into the hospital after 4 hours of labour, laying on my bed in the dark.

Every birth is different - no pain relief doesn't mean you will experience horrible pain.

Fwiw, it’s your birth and not your mw’s, you’re entitled to pain relief.

I also know women who’ve EMCS and spring back into normal life 2 days later with little more than a small scar as a side effect.

I’ve known women have infections after ELCS and EMCS

I know women who had ‘interventions’ such as ventouse and were absolutely fine.

I know women who had epidurals and no side effects.

I know women who had no pain relief and had to then have their baby removed with forceps

I know women who had an epidural that did need intervention.

There are SO many variables as wether the birth is vaginal, c-section, doped up to your eyeballs or happening naturally in a field surrounding by patchouli and singing children - it’s a risky procedure. Risks can be mitigated, and they should be, but to attempt remove the chance of risk entirely is
A. Impossible
B. Seems to be done with a litigious mindset rather than at the concern of mum and baby
C. Should not be done at the expense of women’s choices and voices

No I clearly said that many women have an epidural with NO issues. I am not in anyway disputing that. But the fact remains that there are significant risks with them and many women who have had them have a poorer birth outcome. THEREFORE- to reduce this risk, it would be worthwhile attempting to manage with lower risk pain relief where possible.

@MissM2912

I am not disputing that women should be listened to- if you want an epidural have one, what I initially said was that the midwife had good reason to say to see how it goes without. She won’t have said this to suppress the OPs rights or infantilise or make the OP feel shit, but because she probably has delivered hundreds of babies and in her professional opinion it is preferable to avoid an epidural! I mean would you argue with a solicitor like this? Or an accountant?? Is it just midwifes who aren’t worth listening to?

She should have said “Yes let’s explore that, I’ll go through benefits and risks” rather than dismissing it entirely. That is NOT listening to the OP.

And yes I’d argue with a solicitor if she said “I know you want to plead not guilty because you didn’t do it but statistically stats show that those who plead guilty have a more positive experience”

As previous posters have pointed out, what about the correlation ≠ causation aspect?

As far as "ask and ye shall receive"...hmm start asking good and early is all I can say. I had 2 syntocin inductions, no epidurals but both times it took a hell of a lot longer to get my finger on the remifentanil clicker than I would have liked. The second time (VBAC) I went into the delivery room saying gas+air wasn't enough last time and the pain escalated quickly , please can I get an IV line placed for the remi now and whizz through all the consent stuff so we can press go when the time comes...nope got fobbed off with "see how you go" then after a few hours when the pain suddenly ramped up massively quickly like before "oh dear no anaesthetist available to ok it, um just try to breathe and she'll be here within half an hour, hopefully". Bit hard to gently breathe away the pain when you're on your knees vomiting with it and your hands are shaking too hard to hold the gas and air thing.

Is it just midwifes who aren’t worth listening to?

It is the patient who should be listened to, the midwife should not be the decision maker

@MissM2912

No I clearly said that many women have an epidural with NO issues. I am not in anyway disputing that. But the fact remains that there are significant risks with them and many women who have had them have a poorer birth outcome. THEREFORE- to reduce this risk, it would be worthwhile attempting to manage with lower risk pain relief where possible.

Would it be so bad to treat women like humans rather than parrot statistics of women who are not them?

There are significant risks with ALL types of birth. That can’t be avoided and it can’t be predicted. So the best thing is surely to listen to women, prepare for anything as let her decide what a positive birth outcome is?

I think a lot of midwives are just being realistic- unless you have an urgent medical need for one at the moment you are incredibly unlikely get one. I wish my midwife had been honest with me and told me this in advance as I knew I wanted one, was led to believe that I would get one and ended up with one midwife running between three rooms all with a woman in active labour and no one else available to help her.

@TrenchArse

I think a lot of midwives are just being realistic- unless you have an urgent medical need for one at the moment you are incredibly unlikely get one. I wish my midwife had been honest with me and told me this in advance as I knew I wanted one, was led to believe that I would get one and ended up with one midwife running between three rooms all with a woman in active labour and no one else available to help her.

It that’s (really) bad management rather than hospital policy. The fact that lots of other people are being admitted shouldn’t reduce your quality of care.

It doesn’t really matter what your community mid wife says, she won’t be there when you have your baby and therefore has no gravitas over whether you choose (or need or can indeed have one).

There are valid reasons for having one and valid reasons for not.

If you have a midwife who is suggesting that you just see how it goes then she’s probably doing her job ok. Leaving the door open to all possibilities.

A birth plan is a plan, not a strict protocol.
A community midwife might help you consider the pros and cons of everything birth related but ultimately it’s not her decision nor will she be there on the day.

I don’t know one woman who hasn’t been offered pain relief during labour. They won’t withhold it if you want it or need it.

How do you know you won't cope if its your first child you have no idea how you will feel or cope.

@Ohisitreally

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!

Unnecessary pain erm birthing your child is not Unnecessary. Pretty sure having an epidural is medical intervention erm you no to stop the Unnecessary pain of that thing called labour 🤔 . I enjoyed giving birth twice with no medical Intervention and I know how the pain feels it ain't that bad 😊

I'm in my 50's and I still regularly deeply regret having an epidural with my first child. I have had 30 years of back problems because of it including long periods of sciatica and lots and lot of acute back pain. It's been awful.
I had the next three babies with gas and air (and quite a lot of screaming TBF 😅)

Just tell them when you go in that youve discussed and put in your birthplan that you want epidural ready for when you feel you need it.
I had all the drugs inc epidural for birth 1 and then completely natural ones for the others through choice.
Its so important to have this option. Its an anxious enough time anyway. There are pros and cons to epidural, but if the woman is that terrified of the pain of labour and childbirth then thats quite a big one. Its a significant event in a womans life.

@Cherrytart23 well whoppee doo for you, do you want a medal?

You must realise you’re in the very very tiny minority who think labour isn’t painful? Why do you think every other woman should do what you did?

And yes pain that can be prevented is unnecessary. Duh

Do what you feel is best for you. Don’t ne put off by people saying epidurals are bad- they are very widely used and beneficial to many. It’s absolutely your choice.

My midwife and birthing centre are the opposite and very pro epidural. I’m going to have one and over 80% of mothers who birth there do. I have read quite a lot around the topic and also have several people who have praised epidural pain relief and said they enjoyed their births.

It’s absolutely your choice to make. Your midwife should be giving you accurate information and not her personal feelings- by that I mean statistics for and against. It is true they can lead to deliveries requiring more interventions, but this is not every birth. At my birth centre they give a dosage and you can top up yourself using a pump system. Ask for facts and not judgement. Good luck! You aren’t obliged to take on the anti medical hypno narrative or the full medical intervention narrative either- do what’s right for you Xx

@AsYouWishButtercup it’s due to huge lack of staffing rather than bad management. The NHS is in utter crisis at the moment. Essential cancer treatment is being indefinitely delayed, a woman would be incredibly lucky to be given an epidural without genuine medical need at the moment. It’s not right and it’s terrible for both patients and staff but it is reality.

I trained as a nurse and I did one module of midwifery. I always remember our lecturer asking us why women are expected to endure pain when there’s an option not to. This was over 20 years ago now so possibly not so much information around on possible extra intervention but it stuck with me and I was adamant I’d have it when I gave birth. Midwife was all “see how you feel when you get there” but never mentioned once that it simply wouldn’t be an option. The whole experience was traumatising (whole other thread) but feeling like I’d been lied to by my midwife and being completely unprepared to Labour in such pain was horrible and scary.