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?

Is this your first baby? If so you don't yet know how you will respond and manage so "wait and see" can be the best advice. There is also the reality that epidural may not be available on the day, it depends on availability of an anaesthetist.

Anecdata is no use to you - for some women the longer lasting effects or experience are bad, others find epidurals massively helpful. Look at stats and discuss how they relate to your pregnancy and body. There are some well documented pros and cons in different situations, you need to map those onto your own body and pregnancy. They also dont work for everyone.

However if its your first baby I'm not surprised that the advice is "see how you progress" rather than assume it will be needed and also available.

I didn’t have any pain relief in my first birth which was incredibly fast and was determined with DC2 I did want something.

I didn’t get an epidural but asked for diamorphine straight away and long story short it lengthened the whole Labour by 12 horrific hours. The midwife warned me that any form of drug or epidural could do that but it ended in my baby becoming distressed from the length of time it took.

Given the choice again I would choose the fast one without pain relief.

@Avarua

This thread: why is my midwife trying to talk me out of epidural One brave, informed poster: reasons, rational reasons Everyone else: you're entitled to have what you want, choose what your instincts tell you

Which poster gave rational reasons to leaving a woman in excruciating pain?

Also it’s not being “entitled to what you want” but being entitled to be listened to. Not heard - LISTENED to

I was so convinced they'd try to do me out of an epidural that I asked for an ELCS instead.

The consultant said "Why don't you just have an early epidural? I'll put it in your notes."

It was still a battle on the day - had to wait till contractions were X mins apart, cervix dilated Y cm - but I still had it early on. Midwife said "You're setting yourself up to fail". And yet, labour progressed normally while I lay back and did the crossword.

I do remember some older women relatives acting like it was a shame I'd "had" to have an epidural, as apparently they weren't pleasant back in the 80s. I'm assuming they have improved, as mine was a dream.

By the way, gas and air I found useless, and I didn't even consider the other stuff. I wanted a clear head and no pain, that's all. Epidural is not a drug, it's analgesia, and it just gets the job done without having to go through a pharmacist's cupboard's worth of mind-altering potions.

It is of course up to you OP, but do try the gas and air, I found it really good (couldn't feel the contractions whilst breathing it) and then only had an hour of pain for 2nd stage (pushing) with DS 20 mins with Dd (DC2). Being able to get up off the bed afterwards, take myself to the toilet have a bath was wonderful. I don't think they will give you an epidural before a certain stage anyway (might be wrong on that).

@MollieLarksabout an epidural is morphine, just injected directly into your spine. It very definitely stops you having a clear head

You would be mad to have an epidural from the off. Wait and see how it goes. I expected to ask for one quite early on, but I didn’t find Labour that painful, so I didn’t need it.

It would have been inappropriate to be given an epidural in my position.

Labour is a live process- you see how it goes. You don’t decide your options beforehand. You wait to see what you need and when.

[quote TrenchArse]@MollieLarksabout an epidural is morphine, just injected directly into your spine. It very definitely stops you having a clear head[/quote]
Oh, really? I did have a clear head though. At least, I thought I did!

Epidural are fab. It's absolutely not true that they ALWAYS lead to more intervention. I had them with both my babies, and both very straightforward, instrument free deliveries. Even with my first, who turned out to be back to back. Good luck with your labour!

I had one, no interventions, they are bloody marvellous!

So many posters on this thread who have failed to grasp the fact that others don’t share their preferences, and that experiences vary wildly. AND THAT EACH PATIENT HAS THE RIGHT TO AUTONOMY.

Nobody can decide whether somebody else ‘needs’ an epidural! That is down to personal preference. If a women decides she wants an epidural as early as possible so as not to take the chance of being in unbearable pain orto avoid being told there’s no-one available to do it later in labour, then that’s an absolutely valid choice she can make.

Not everyone wants to ‘wait and see’ even if you think that’s sensible for you.

Epidurals where I live are automatically offered at government hospitals. Its only the UK that seems to tie itself into knots about it. Something like 80% of french women have them

The studies into this are often shite, I remember looking for info about c-sections (years ago so hopefully this has improved) and I struggled to find anything that looked at elective vs emergency c-sections. Clearly these are very different so outcomes for mothers and babies would most likely be different too, yet they were smushed together in the figures. Also i found most studies conveniently had a very low bar for what “good” liked like in terms of post natal health. As long as you don’t die its good regardless of birth injuries. I had the dreaded c-section with a spinal block. Don’t regret it for an instant.

I imagine its similar for epidurals, anecdotes are just anecdotes. I would look for some up to date research papers. But tbh if you want an epi you should be getting one.

She isn’t telling you not to have an epidural!!! She’s telling you to say yes to it but to wait and see during the birth whether you still want it. All UK midwives tell you to wait and see. That way you have all the pain relief options available to you and so you can decide to refuse anything at the time. For example my sister had a back to back labour, tearing, but her labour progressed so slowly she actually didn’t need anything except gas and air to keep going & refused all the other pain relief they offered. Meanwhile I went from 0-4cm in an hour, DS’ heart was going wonky, and so the midwives recommended I accept the walking epidural I had already arranged to slow things down. The assisted labour that followed (me pushing while forceps were used to help pull DS out) probably saved my son’s life because it gave him time.

So say yes to everything but on your birth plan make it clear you will say yes / no as and when you need to.

I should point out that there is significant evidence to suggest the use of planned epidurals result in less birth trauma because surgeons and doctors can plan interventions in advance. It is unplanned ‘out of the blue’ interventions that cause the most physical and psychological damage as you don’t get the medical support you need when you want it - which is why midwives do support you to write a birth plan so you can make informed choices about things like pain relief. For example if you have an epidural you don’t need to go under GA for an emergency C-Section which means if you do want to breastfeed from birth you can do - which is why Asian and European countries where epidural use is high often also have higher bf rates.

It’s not that clear though if the epidural is causing the need for additional intervention or whether something is already problematic before the mother chooses to then have an epidural.

I had the drip and have always said I wouldn’t ever consent to it again without an epidural being put in. The pain was unbearable before I had the epidural. I needed a ton of intervention but things were already going wrong before I had the epidural so in my case, I don’t believe the epidural caused the need for interventions.

My second the pain was intense but no pain relief other than gas and air. It was a much easier and straight forward birth. I had no idea how far along I was until I hit transition at home and realised I should already have been at hospital.

They don't like doing them and it can slow the process and recovery. techzpod.com/ get-mobdrovip.com

Recovery is much quicker and less side effects with a natural birth

@MissM2912

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.

Sure but considering we can’t go into an alternate reality where the exact same women did not receive an epidural we also have no idea whether they would have needed those interventions anyway. It’s not like significant birth injuries and deaths weren’t a thing prior to epidurals. Perhaps those women would always have experienced this tears/injuries outcomes. It’s impossible to know.

your baby was distressed because of the oxytocin you needed as your contractions dwindled after your early epidural; your baby had a terrifying prolonged deceleration and you needed an emergency cesarean because the epidural drugs cut off its blood supply; you needed forceps because your body didn't know how to push your baby out, I could see your vaginal muscles doing fuck all while you exhausted yourself pushing the wrong way. No, it would not have happened without an epidural.

How lovely to see HCPs blaming women for this be going wrong with their care. What a refreshing change

Your "instinct" may well be to avoid pain, but in order to choose how you do need to know the statistics first.

And the ones given here by professionals are spot on.

Any data is not facts and even so women are humans not statistics

Remember, we are the ones who work with them all the time, and we literally see all these "rare" side effects all the time.

I had a natural pain free birth but had a huge blood loss due to retained placenta - not anyones fault, these things happen, but they aren’t exclusive to people who take the expensive stronger options

Having had the pleasure of fighting for a maternal request ELCS, I am now extremely wary of medical experts that blatantly have an agenda towards disempowering women at one of the most vulnerable and important times of our lives.

Totally agree with this I actually find it scary how some HCPs want to actively discourage comfort and happiness of their patients

I also think that we just blindly accept hospital care is gonna be so shit that “a long stay in hospital” is considered a bad thing. It should be a good thing! In an ideal world - rest, Round the clock support, being where the experts are. It’s so sad that postnatal care is so universally terrible that people want to avoid this

You must go into your delivery with YOUR plan. Leave room for error. Shit happens. But trust that it won't and that your body will do what it's meant to do. Breathe. But definitely make sure it's your plan, OP (and yours sounds totally reasonable!).
I've had 3 epidurals and not one issue. The first one I had was almost 20 years ago. The last one I had was 7 years ago.
I love an epidural, me.
What you DO NOT want is pethidine. That is just awful. That slows things down to a halt AND you feel sick AND it doesn't help with the pain. It just turns you into a vegetable in pain. Horrible stuff.