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

[OldRichandGrateful]

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.

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?

They don't discharge without established feeding

Pretty sure they do. I was home within 4 hours, baby was alseep that whole time.

They didn't want my sister to leave before feeding was established, they made her feel really bad for wanting to go home before. It probably depends where you are and what the mw are like.

This thread has got me thinking about the subject (again).

As a midwife I think I'm considered "epidural happy" at my unit. If a woman asks me for one I ask her (after the contraction) if she's sure and quickly run through any pros and cons then get it sorted if staffign and Dr availability allows.

I do think I have this attitude due to MN, afetr previous similar threads. The attitude amongst (some) midwives seem to be that woman don't always need one/mean it, especially if outwardly them seem to be coping.

I looked after a lady the other week who asked for one and it was her mother who was "oh you don't need one, etc, etc". I said yes straight away and I'm sure her mother was disapproving....probably thinking I should be trying to encourage her more, etc. The lady seemed delighted when the epidural was working though.

Then the other day I went into a room where a more junior midwife was caring for a woman. The woman was getting loads of support from her midwife but was asking for an epidural. I was quite uncomfortable in the room as the woman seemed distressed and was sobbing and telling me "I've been begging for hours for an epidural". I had to trust the other midwife's judgment that for whatever reason this woman wasn't meaning it. But I dwelled on it for some days after, wondering if I should have interfered, etc.

Then I answered a phone call a few days later from that lady saying she wanted to leave a message of thanks for the other midwife for making her birth such a pleasant experience.

It is so hard sometimes. I always go on "if they ask for an epidural they get one and if they regret that decision later than its down to them" approach. Informed choice, etc. Other midwives seem to think if a woman is asking they don't always mean it.

Viva La VivaLaBeaver! More MWs like you please

VivaLaBeaver you sound awesome. Not practising at a famous East Anglian teaching hospital by any chance?

Merlini, no I don't. Sorry.

I think I was similar to you as a midwife viva, I was equally happy if a woman DIDN'T want one either...I always felt it was down to the woman. I did wonder if I always got it right..one or two women said to me afterwards they had issues about having taken an epidural and I did wonder if I should have explored the issues more with them at the time. It is very hard if you just meet a woman for the first time in labour...in that case if she says "I want an epidural", I always got it sorted.

The NHS operates in such a way as to get the best health outcomes for the most people for the least money. Research shows that over all increasing access to epidurals doesn't improve health outcomes or (in statistical terms) women's satisfaction with the birth experience. In fact, for those having low risk births the highest rates of satisfaction are found among women having their babies in settings where epidurals are not immediately available (ie birth centres or at home). Go figure.

OP - your sister was lucky to have you with her. I appreciate that you felt helpless in the face of her pain but you know what - your presence made a big difference to her.

Viva - IMO epidurals are the logical response to lack of continuity of care, hospital birth, high rates of induction, monitoring, general intervention etc. I'm amazed more women don't need them given how obstructive to normal birth some hospital labour wards are. In my personal experience though, there's very little in labour that can't be tolerated when you have the care and support of a midwife with whom you've established a strong relationship of trust over several months.

Week asked for an epiduralbut I had spoken to the midwife and said other when I do ask for one please try to encourage me to do without, esp as by the time I ask for one it means I am near the end (ime). But if people had overheard the situation they may have thought the midwife was being mean but she was actually following my request. In fact with dd the anaesthiatist was nearby and heard me and popped his head round the door to ask if he was needed but the midwife said no all was fine.

But obviously that was part of my birth plan and the midwife was following my wishes and it was generally only at the peak of a contraction when I was like 'give mdthe fucking epidural' once they had subsided and I was calm etc I was fine. But I needed encourage and support to get through it. My midwives were brilliant tbh.

But yes if a wants pain relief they should get it, vivas approach of checking when the contraction has ended makes sense.

Week asked?!! I asked

YANBU. She should have been given one.

I'm definitely in the minority I think.

I screamed for an epidural when in labour with DS1. The MW kept putting me off and saying 'we'll see how you get on' She kept squeezing my knee and saying things like 'you're doing great without one, you don't need it'

I had a very long, tiring labour but I'm bloody pleased I didn't have that epidural. I'm petrified of needles and the thought of an epidural scares the living day lights out of me. I didn't care in the throes of labour obviously, but I'd have looked back on it and been sick that I'd had it.

My second labour was quicker but 10 times more painful (back to back big baby) and I felt a sense of relief knowing that I could do it without an epidural.

The MW did me a huge favour ignoring my hysterical cries.

Of course I understand that that's just my experience and everyone is different and should have all pain relief options available as much as possible.

Out of interest how many women have had epidurals and ended up regretting it?

Yanbu about lack of support. Even if an anaesthetist isn't available, she should have had other options available.

Chunderella - I'm not an anaesthetist but there are more reasons than 'who's in more pain'. How on earth do you expect a person could stay still during surgery without anaesthetic? Not even counting the pain their condition is also causing - I had surgery for an undiagnosed ectopic pregnancy, the tube had ruptured, I was bleeding internally... I couldn't have stayed still if I tried never mind still enough for them to perform such a fiddly operation.

I'm sure some women do regret it but at least they're regretting their own decision if you know what I mean. Whereas I think it would be worse to regret not been given an epidural if you'd begged for one and then found the whole labour and birth really traumatic. I've heard about women having PTSD, etc after not getting epidurals.

Viva's point of women being able to own their own decision is a really good one as well. It is surely better for us to regret something we have done consciously rather than something that has been done, or not done, to us. That powerlessness in labour is one of the most difficult things to deal with in the aftermath. And although there may well be better outcomes for labouring women who develop a good relationship with a mw the NHS is unable to provide that for most of us. I've given birth twice "out of hours", once on New Year's Day and once at 3.45am after arriving at the hospital about 10pm. There was a skeleton staff available, I didn't see a mw for hours either time and by the time anyone showed any interest in me things were already starting to go wrong. They didn't believe me, dismissed my pain and worry and told me I was making a fuss. My experience is not unusual.

I've always considered myself someone with a "high pain threshold" and have spent many months on end in hospital having various hideously painful operations with undignified recoveries. I've had minor skin and orthopaedic (x fix removal) procedures done with no anaesthetic and been totally unconcerned. I thought I was a brave person. During my two awful labours the MWs made it entirely clear to me that I was a feeble failure instead. How bloody dare they do that to me or anybody else?

We are not stupid children. Apart from in the most extreme cases we are considered to have mental capacity during labour. We should have confidence that when we ask for pain relief we will be treated as any other adult in pain and taken seriously. Any regrets are then ours to own and deal with.

I'm due to give birth for the third time in 9 days and trying very hard to stay positive. Really wondering why I thought a third baby was a good idea.

Well, the buck should ALWAYS stop with the mother herself. In relation to epidurals and all other medical input into labour.

I'd like to see more truly informed consent being sought and respected in the NHS.

Agree 100% with owning your own decisions and not being treated like a 'hysterical woman' who needs ignoring

Re op pain vs childbirth

I had to be repaired after my first child. How often do they stitch torn lacerations without anaesthesia? My experience after childbirth was exactly that. The LA didn't take because of massive bruising and swelling. I couldn't physically lie still despite their orders to and at one point they asked my husband to hold my pelvis down to stop me moving (ankles held in stirrups). How can that be considered acceptable? I guess if you expect someone to endure 8 hours of agony then a further 30 minutes is also reasonable? It would be daft to set up epidural for stitching if you have refused it for 8 hours labour really wouldn't it?

I tried to write this last night but couldn't because the memory was still so distressing. She's 21 years old I'm sure someone will be along to tell me that I'm a hysterical weak woman for feeling this however...

I remember the name of that midwife and the name of that Dr to this day. I've never forgiven them