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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU to expect a Midwife not to ignore a request for an epidural?

162 replies

OldRichandGrateful · 02/05/2013 22:38

I have had an exciting day being a birth partner with my (a lot younger) DSis. Her husband is away in the forces and I was back up support. DSis had a beautiful daughter. Smile

She had a tough time and this wasn't helped by the total lack of any help from the Midwife. My Dsis was in great pain and struggling to keep calm and focused. She kept asking for an epidural and the Midwife kept fobbing her off. The Midwife didn't stay in the room for very long and just kept disappearing.

I had my DS a few years ago and my Midwife was brilliant.

AIBU to think my DSis should get an epidural if she asked for one and to expect her Midwife to support and help her?

OP posts:
Merlini · 03/05/2013 15:49

Yy to Visualise and Chunderella above. I've had two horrific traumatic labours with persisten OP babies and dreadful mw care. This "productive pain" stuff is just not the same for everyone. In both my labours I had a massively fast first stage, in the second I went from no dilation to 10cm in 40 mins, with a back to back baby who had his head on one side (there's a word for this but I can't remember it). I defy anyone to cope calmly with that level of pain and see it in a positive way. If someone had given me a gun I would have shot myself. On top of that I had to deal with a totally unsympathetic mw who shouted at me continuously that I was not trying and was being weak and feeble. DS was delivered by forceps after a grim 2 hours, just after the wonderful anaesthetist arrived and gave me some remifentanil. Have no doubt the labour was more drawn out because of the horrendous pain. Even after a birth afterthoughts meeting I am filled with rage and shame over the way I was treated by the mw in particular. Reading things like "poor maternal effort" and "ineffective pushing" all over your notes is pretty bloody hard.

I can't have epidurals because of a genetic condition but it makes me bloody furious that women are routinely denied them. There is no other area of medicine whe people in serious pain and distress are belittled, ignored and made to feel to blame for their own pain.

Would also really like to see a shift in the way pain in labour is discussed as well - instead of saying some women are more able to cope with pain than others, wouldn't it be more helpful to say that some labours are more painful than others?

JakeBullet · 03/05/2013 16:00

Well said Merlini, pain is a very ndividual thing, for some women, labour pain is manageable and for some it is not. Lots if things influence our experience and perception of pain. For some women the pain WILL be worse ....contractions from an Oxytocin drip for example tend to be more painful
Women should be able to access pain relief as and when they need/want it in labour.

slug · 03/05/2013 16:03

One of the many, many reasons I have only one child is the way my midwife treated my requests for pain relief (of any kind) I was told it was Eve's punishment for original sin. Believe me, this is not what you want to hear, especially when the end result is an episotomy and forceps delivery without benefit of any pain relief at all.

I suffered PTSD after the birth and to this day can still panic uncontrollably whenever I feel anything that even vaguely reminds me of the pain.

TheRealFellatio · 03/05/2013 16:24

Shock Was that in the UK on the NHS slug? I hope you complained bitterly and tirelessly to her superiors and anyone else who would listen. She should not be working as a midwife imho.

Merlini · 03/05/2013 16:25

Jake absolutely agree that pain and perception of it is individual and of course, there is no objective measure for it, but I think that focusing too much on women's ability to manage it is not always helpful. Can't we just say that some labours hurt more?

I've read the hypnobirthing book, for example, and am generally a big supporter of hypnosis as it has helped me with many areas of my life. There are many many useful things to take from it but I struggle a bit with the total emphasis on the fear/pain link. Undoubtedly there is a huge link but sometimes things happen in labour that are just more painful. And when women have experienced terrible pain in labour it can make them feel like they've failed by not being calm and,positive enough, or not being strong enough. It is pretty horrible to feel like that.

I think there is an unfortunate tendency among some people (MIL, I'm looking at you) to extrapolate from their own experience and apply it to everybody else, either deciding that women who have a hard time in labour are making a fuss, or that all labours must be horrendous. I don't discuss my experiences with anyone pregnant and am certain that many women have a wonderful positive experience of labour and am thrilled for them. Hopefully that will be me in twelve days time. DS2 is fortunately OA so am feeling positive!

slug · 03/05/2013 16:40

UK NHS. Inner city London.

Merlini · 03/05/2013 16:49

Slug that is absolutely awful. Have you thought about complaining?

CabbageLeaves · 03/05/2013 16:59

Some themes from this thread:
It's a natural process so shut up and get on with it
You're lucky to be having a baby so shut up....
The Drs are very busy so shut up...
The midwives are very busy so shut up...
If you struggle to deal with it or are distressed you're feeble minded
Other countries do better than us
Other countries do worse than us

Lots of reports from women distressed by their experiences....

Imagine telling a man he's lucky to be getting NHS care for his rugby injury, broken bones and open wound. Lets just stitch this without adequate anaesthesia because the Drs are busy... etc

happyscouse · 03/05/2013 17:14

Oh I had experience of this with my second child. It still annoys ne 10 years on. It wasn't the fact that i didn't get one, it was totally the attitude of the midwives not answering me straight, saying things like "lets see how you get on" and talking to me husband getting him round to their point of view "ooh her recovery will be much quicker without one" Fuck my pain! God it makes me sooo mad when i think about it, they never once said to me straight whether anyone was available to deliver one. they ended up forcing a pethedine injection on me (and I mean forced)which I absolutely hated and made what was a horrible experience even worse. At one point I let out a little whimper, I had no energy for anything more and was told to save it for when ii needed it.

I really regret not complaining once home but had so many things going on in my life quite apart from a new baby, but I really should have. They treated me like a little girl who did not know what was best for her and would not understand explanations! Gah feels better to get that out.

In summary Midwives be Honest and Open with your "mums" we are grown ups treat us as such. Thanks!

Merlini · 03/05/2013 17:27

Good post Cabbage and happyscouse sorry it has happened to you too. My kids are 6 and 3 now and can still be driven to impotent rage about the whole thing. Was hoping that might go away soon!

ivanapoo · 03/05/2013 17:28

Cabbage are you trying to claim giving birth isn't a natural process?!

Sorry to hear about those who had traumatic labours but interestingly all of you mention something which would have made it potentially loads more painful, ie less than optimal positioning. In this instance I'm very surprised you were denied epidurals or other pain relief.

PunkHedgehog · 03/05/2013 17:42

There are good reasons why an epidural may not be suitable, or may not be the best option.

There are reasons (often not really 'good' but valid) why an epidural may not be available.

There is no acceptable reason for ignoring a request without explanation.

If your sister is concerned about the care she received, or simply wants to talk through what happened during the birth, she is entitled to meet someone from the hospital for a post-birth debriefing. They will go through her notes with her, talk through what happened and why, and answer any questions she may have. If she is still unhappy after that she should contact the local PALS to ask for details about how to make a complaint.

eccentrica · 03/05/2013 18:12

Merlini Would also really like to see a shift in the way pain in labour is discussed as well - instead of saying some women are more able to cope with pain than others, wouldn't it be more helpful to say that some labours are more painful than others?

But it might be less accurate. Pain is notoriously difficult to measure subjectively, but it's true that some people (in labour and at other times) do deal with pain differently from others. Different attitudes can be seen in the fact that there are many women who are absolutely sure they want an epidural before labour has even started - that is about expectations not about immediate experience.

My labour was pretty similar to yours in many respects - I had a back-to-back baby, my waters had broken and were totally gone right at the start. Eventually she was born tangled up in the cord. By the time I got to the hospital in ambulance I was fully dilated - had gone from very little happening to full dilation, into second stage, in well under an hour, spent part of that time on my own in my (scummy, mouse-infested) flat, ringing 999 and trying to persuade operator that I did need an ambulance (didn't have a car).

When I got to birth centre, the MW said to my partner it would be exceptionally painful because all the waters had gone, and because baby was back to back and had to turn round on her way out - and it was exceptionally painful during the contractions - which were long, with not much time between. The pain was extreme and I was screaming my head off and writhing throughout each contraction, it was so bad that the midwife wasn't able to measure the baby's heartbeat at any point because there wasn't enough time between contractions. I had some gas and air but found it made me very disorientated and felt like I was tripping (not in a good way). I felt panicky and in agony.

But then I managed to get into the water tub and I couldn't believe how effective it was as pain relief. I instantly felt like myself again, felt normal and in control, and was able to give birth about 10 mins later kneeling up in the water. I had 3 midwives with me and my partner there too, all sitting round the edge of the tub while I was in it on my own.

What i'm trying to say with all this is that the same physical set-up for labour can be helped or not helped by the environment, by the way other people treat you (my midwives were pretty good), which feeds in to your subjective experience of the pain.

Epidurals are risky for anyone but not even possible in your case - if you'd had water birth available to you, maybe it could have been the turning point in your experience, as it was for me? it's not necessarily that the pain was worse but you didn't have the 'way out' that was available to me. I do think more midwives, more sympathy and more water births would help a lot of women (if not all) to have less traumatic and painful labours.

Merlini · 03/05/2013 19:28

Eccentrica you make some really good points and our experiences do sound very similar. I did get into water for a while but it didn't help. I think you are almost certainly right about being treated sympathetically though, maybe I would have coped better if someone had just spoken to me kindly or supportively instead of berating me endlessly. And the lack of options is a scary thought so I prob wasn't in the best mindset going into the whole thing. I do feel such overwhelming shame and failure.

I do think that sometimes circumstances conspire to present labouring mothers with worse pain and that sometimes pain is so bad it can't be managed with anything other than medical intervention. It would be helpful if someone could tell us that it wasn't our fault for not trying hard enough.

Just realised have hijacked the thread quite a lot. Sorry about that. OP if you're still reading then when your sister is feeling more herself she might want to discuss what happened. Or maybe have a birth afterthoughts meeting, you could go with her for support. In hindsight I wish I'd taken DH.

Yika · 03/05/2013 20:05

OP, YANBU. I think it's appalling. Regarding laGuardia's comment on the risks of epidurals, the anaesthetist at my hospital (here in Belgium, where a very very high proportion of women have epidurals) said that in his career of about 20 years he'd never seen or heard of anything major going wrong; that the risks were more or less theoretical. As for recovery times, why would it make recovery slower? Haven't heard about that.

eccentrica · 03/05/2013 20:09

Merlini sorry the water didn't work for you. I think the idea of being berated in labour is just appalling and not helpful at all. I was told to "keep it down, we can hear you in the nurses' station" but that was said in jest (and only once!)

I read an interesting thing recently about memory and pain (in a book called 'Thinking Fast and Slow') which basically says that how you feel at the end of an experience completely colours the whole experience, when looking back. So if you have two identical painful experiences, but one ends with the pain gradually improving and getting less bad, while the other one stays painful and scary to the end, the first one will all seem much more positive when you look back on it.

I think if my labour had ended in a traumatic and painful way, I might well remember the whole thing differently. As the end was by far the easiest and most enjoyable (!) bit, I have never felt traumatised by what was, in parts, a pretty terrifying and agonising experience.

OldRichandGrateful · 03/05/2013 21:25

Thanks for all your comments.

DSis is still in hospital - she lost a lot of blood and is recovering. She still feels a bit down over the birth - but to be fair she did say that everything hurts and she hasn't had much sleep because of the noisy ward.

She has tried to BF DN but with not much success - no help from any HCP.

Overall not a positive experience but on the plus side - DN is gorgeous!!

OP posts:
Pigsmummy · 03/05/2013 21:42

I begged for one, it fell on deaf ears

PunkHedgehog · 03/05/2013 22:21

There should be a specialist breastfeeding advisor - ask to see them. And ring the La Leche League or [the other one I've currently forgotten the name of] helpline - they may have someone who can pop in for a visit.

CabbageLeaves · 03/05/2013 22:35

Ivanapoo. Everything is natural. Gallstones, cancer, heart disease, arthritis and death. It's all natural. Its all part of a lifecycle from birth to death. No one says the same trite remarks about accepting the pain because its natural ... They try to relieve the pain. They give sympathy. If they don't, we'd view them as negligent. Why do we feel the need to force women to accept pain in childbirth? Really? Why?

ivanapoo · 04/05/2013 07:48

Because "unnecessary" intervention can sometimes have negative repercussions on the length of labour, the amount of further intervention required, healing and breast feeding, and administering epidurals is not without risk to mother and child, I guess...

I think wanting an epi and being denied it is dangerous, in terms of feeling like you didn't get the birth you want - as a PP said it's how you feel at the end of an event that shapes your perception.

CabbageLeaves · 04/05/2013 09:26

Which brings us back to the nub of this discussion: communication. Why don't midwives communicate a reason why they have refused an epidural? If it's on clinical grounds, tell the woman why. If it's because of staffing, tell the woman why. If it's because it' your personal belief that labour should be suffered without an epidural....be honest so that the patient can ask for a different staff member.

I understand the belief that they can cause problems, but since there isn't a NICE guideline saying they should be refused on clinical grounds it would seem they are refused for a host of other reasons, wrapped up in a smokescreen of 'knowing what is best' for a woman.

The link that was posted earlier is very good here

thistlelicker · 05/05/2013 09:18

Sorry to hear ur sis has had a poor time. Regardless of how busy nurses/midwife/support worker are! They can only do one thing at a time and make that person feel valued and make these days specials. Everybody gets support with bf in the hospital I work in! We even have specialist midwives who attend drop in groups on the ward! If the baby hasn't bf then she will or should have been supported to hand express
To help her flow and mostly her
Confidence! I very much doubt she's had no support but if u feel she hasn't then your relative is well within her right
To complain! They don't discharge without established feeding! Hopefully your relative is on the mend now! Best wishes x

RichManPoorManBeggarmanThief · 05/05/2013 11:45

Re childbirth being "natural", there's the fact that whilst labour is natural, women having their first child well into their thirties, as it common these days, is completely unnatural. In "the wild" we'd be having our first child around 14-16 years of age- almost certainly below the age of 20, when labour tends to be easier. Older, first time mothers tend to have longer, more difficult labours than their younger counterparts.

We don't live naturally, and there's no point in trying to

ProphetOfDoom · 05/05/2013 12:52

This reply has been deleted

Message withdrawn at poster's request.