to wonder, where the move towards 'epidurals are wimping out' ideas come from?

[Thurlow]

I very strongly believe that every woman should be encouraged and supported to have the birth that they want, whatever they want to do.

But I've noticed over the past few years - anecdotally, on places like MN - that there is this background belief from some women that other women who have an epidural are somehow 'giving up' or 'not woman enough to cope' or 'not embracing a natural pain'.

Now I really don't care how people give birth, as long as they've been supported by their healthcare professionals to achieve what they want, because all that matters is that the mum and baby are both well. I understand the cascade of intervention that an epidural may bring, and that a pain relief free vaginal birth is probably, on the balance of things, better for both the mum and the baby as long as everything is going well.

But I can't help but wonder how or where the natural birth push has morphed into some people being so anti-epidural for other women, into the sort of judgement that someone women seem to embrace at the moment?

And although I'm not in the UK, I think the feelings of inadequacy about pain relief are nurtured by some midwives and doctors unfortunately, the same as over here.

I don't know any women who feel inferior for having pain relief, nor do I feel superior for not having pain relief. But I think the media, and parts of the medical profession foster this idea that to somehow "succumb" to pain relief is like giving up. It defies belief, it really does.

I can't remember seeing threads where there was any consensus that epidurals are 'wimping out'. Ever.

Do you need to feel victimised for some reason OP?

Really - if you want an epidural in a UK hospital and you ask for one, it's generally forthcoming. In as much as you can ask for anything in an NHS hospital and expect it to be provided lickity split, especially if there aren't enough midwives or anaesthetists to go around.

I hate the "cascade of intervention" rubbish. Often quoted on here. Women having difficult births will often require intervention - they will be a having long, painful labour and that's why they want the epidural.

Difficult births lead to epidurals, not the other way round.

Quote Thurlow: ' I understand the cascade of intervention that an epidural may bring, and that a pain relief free vaginal birth is probably, on the balance of things, better for both the mum and the baby as long as everything is going well.'

Why would you say that? Are you Dutch? If men gave birth, GA would be available...seriously...why does a vaginal birth have to be pain-relief free?
There are lots of pain relief options although I favour epidural myself for vaginal births.
The Dutch seem to argue evilly that anything other than natural painful delivery interferes with bonding but obviously that is complete bollocks.

I think the media is a bit anti elective C-section because of propaganda put out by NCT and the Midwives Body but having pain relief for a vaginal delivery is a separate issue.
The real problem is that NHS hospitals cannot guarantee an anaesthetist being available to do an epidural so that may well make some women arrange ELCS instead.

BabyMamaDrama and Frieda....
It's ridiculous that you were both in Labour for between 36-40 hours before getting your epidural....if you want a comfortable labour, epidural should be in your birthplan from the start especially if you are induced.

THurlow: 'That's very much what I am failing to explain! Studies and risk assessments say that an intervention free birth is generally best for both the mum and the baby, where possible. I understand this. But if you have an epidural for whatever reason, some people see that as 'wrong'.'

This is where you are going wrong Thurlow - how can a load of traumatising pain be best for me psychologically?
When humans first started giving birth we didn't have anaesthesia - now we do and so there is no reason not to use it. Very few female obstetricians have pain-relief free deliveries - they usually go ELCS - I wonder why?
Would you have a tooth out without anaesthetic? Thought not.

All the pain relief options were set out in full detail in my NCT classes, I felt I went into labour fully clued up which make me feel more confident. Had epidural first time round, which was great. Second time round I knew it would most likely be a fairly short labour of 6 hours or less like the first, so gas and air was fine, though I did ask for pethidine as I must have been transitioning, but didn't have any in the end. With first daughter it was the uncertain length of time that made me go for the epidural. I thought there was no way I would be able to withstand the pain for what could have been 24 hours or more for all I knew, and then have the energy to push out at the end.

So instead I had a nice, fairly restful, if alert, time while the contractions ramped up and I dilated further, then only had pain at the end when I had to let it wear off to push her out...but I knew it would only be a relatively short time by that stage.

I definitely recovered quicker, had less stitching and no bruising with second non-epidural delivery, but hard to know if it was the lack of epidural or just being a second birth that made the difference. I had also listened to self-hypnosis CDs and had done yoga throughout pregnancy second time. The breathing certainly helped a good deal with contractions pain, though undoubtedly previous experience played a big part too.

Interesting debate and good to see that most of us here are in favour and believe that most women are in favour of it all being a v personal choice. I agree that subtle messages are filtered through media, nct (which we avoid) and yes there is a sense of pride in having limited interventions in childbirth , which arguably could come across as 'smug' in some. Interesting points about why nhs discourage it (in my case it was too late by the time they could get the on call anaesthetist). I think the guilting effect is only v subtle ...far worse in the breast feeding side of things and guilt at not being good enough as a mum is associated with PND . ......I'm unashamedly having an epidural /drug birth this time and really good to hear such positive accounts of it. I'll use my pregnancy yoga to labour some of it out at home first though.

The only time I experienced a sneering attitude to pain relief was from the midwives in hospital. NCT, friends and mumsnet threads (!) have in my experience been completely open to any kind of pain relief/intervention required. I have never felt judged for my labour.

The midwives, on the other hand, refused me gas and air as apparently 'you shouldn't make such a fuss, you don't need gas and air at this stage, no other woman would need it' (thus was having my waters broken after 12 hours of completely ineffective contractions) and then tutted loudly after I begged for an epidural 20 hours in and said 'yes, I thought you'd be one if those who wanted an anaesthetic'.

I do think the NCT is getting an unfair bashing here. My NCT classes were not at all hostile to births requiring interventions, in fact I felt very prepared by my classes and had a good understanding of the pain relied options available to me (well, available in theory, had the midwives not appointed themselves as judgemental gatekeepers to the drugs cupboard).

The problem with NCT seems not to be their message but the lack of consistency between teachers. I have heard on here about some awful attitudes promoted through NCT antenatal classes.

Well, I have never heard of anyone talking about how they got though their appendix operation on just gas and air......

If something hurts and you want to stop it hurting then wonderful. If you don't then meh, I don't really care what you did.

I have ways avoided swapping birth stories anyway, a)because I couldn't care a less about how another woman gave birth, it bores me and b) I see no honour in being the one to have survived the most horrific pain in this day and age.

There is nothing more irritating to me when someone is telling me about their new baby and it goes like this "she's lovely, 8lbs, and I did it all by myself with just gas and air".

But then, I speak as someone arranging my second elective section.

Fwiw, when I had my ds, I had the misfortune to overhear two midwives on the ward talking a out epidurals.

One was saying that when a woman asks for one, you should always fob them off, tell them it's comming until its too late as women don't need them. The other agreed and laughed about fobbing off distressed women with excuses.

I was shocked and upset and I hope that if they are ever in horrific pain one day that thief pain relief is held up for a long as possible. Nasty women.

"I hate the "cascade of intervention" rubbish. Often quoted on here. Women having difficult births will often require intervention - they will be a having long, painful labour and that's why they want the epidural.

Difficult births lead to epidurals, not the other way round."

Yes - difficult births lead to epidural use, so it's very hard to unpick any cause and effect relationship when you're trying to work out why such a very high percentage of first time mums with an epidural need interventions in their birth.

It is interesting though, that if you are a healthy, low risk mum and you plan to give birth in an environment where epidurals are available, you are about twice as likely to need an emergency c/s or instrumental birth as a similar mum who opts to give birth somewhere (ie at home or in a birth centre) where epidurals require transfer. In other words, there's something about labouring in a place where there are high rates of epidural use that makes healthy, low risk mums more prone to interventions.

(can I just point out before anyone says anything - the Birthplace 2011 study, where these figures come from looked at outcomes for birth based on the mothers risk status at the start of labour, and her preferred place of birth, not her actual place of birth - so women who booked a homebirth but ended up transferring in to hospital for a forceps birth would be included in the 'homebirth' section of the trial. Otherwise you'd have a figure of 0% forceps for homebirth as these aren't done outside of an obstetric unit!).

To shed some light on the 'I was refused an epidural by a midwife' scenario - in the UK 8% of women nationally answered 'no' to the question 'did you get the pain relief you wanted in labour'. In some hospitals it was as low as 2%, in one hospital it was as high as 22%. Interestingly, high rates of women saying 'I didn't get the pain relief I wanted' don't necessarily go hand in hand with low epidural rates, and vice versa. So the hospital with the highest number of women saying they didn't get the pain relief they needed (22%) had an average rate of epidural use. The hospital with the lowest rate of women saying they didn't get pain relief had also had an average number of women opting for epidurals (25%)

In Kettering hospital - where only 16% of women used epidurals, 11% of women said they didn't get the pain relief they needed.

In Epsom, where 42% of women have epidurals scarcely fewer (8%) said they didn't get the pain relief they wanted.

Point being - expectations about pain in labour are not consistent regionally. High epidural use doesn't always go hand in hand with high rates of satisfaction with pain relief in birth and low rates of epidural use don't always go hand in hand with low rates of satisfaction with pain relief in labour.

Go figure! There is far more to all this than meets the eye.

Minifingers, I have never seen a thread where the consensus is that epidurals are wimping out. I have seen plenty of threads where many individual posters feel that. What prompted me to start this thread was another one last that that included someone, anecdotally, who thought their labour was better than someone else's because it was intervention and pain relief free.

Quesidilla has it: you come across people who fetishise pain during labour.

The reason I say it is "better" is probably explaining my point in itself - I am no medical professional, my knowledge is from NCT classes and sites like this one, and I have been very much left with the impression that a drug free birth is 'better' for everyone, and by better I mean healthier.

Ukatlast, are you in the UK? Epidurals are generally only available in the UK once you reach 4cm. You can do day's worth of labouring to get to that stage.

What upset me was about a month after DS's long, epiduraled, induced, ventoused birth, a good friend had a natural birth. Her DH sent around an announcement including in it how proud he was that his wife was "hard as nails" and did it all without pain relief.

Made me feel like shit and like I had wimped out by asking for pain relief. Especially as my DH didn't include anything about being proud of me in his announcement (I know he was, he just ain't the publicly soppy type).

Was probably the hormones at the time, but I've never really been able to shake that feeling that I failed. And have never managed to say the phrase "when I gave birth to DS..." I say "when he was born..." or "when he was delivered..." As I feel like I didn't do it properly so can't make that claim.

I may have ishoos...

Oh and I'm now pregnant with dc2, and those feelings were compounded when, at my booking in appointment, the MW told me I could try harder this time around for a natural birth.

I'm now stressing out about this birth and failing again (which looks likely because the bugger is currently back to back...)

I have never understood people's negative attitude to pain relief in labour. What is it, the equivalent of an iron man competition? I chose an epidural for DS1 but was less bothered about having it for DS2, however, he was late and then I was induced and after nearly three days of labour and no sleep I was exhausted as soon as I got to 1cm I was offered an epidural which I accepted gratefully, they broke my waters as soon as it took effect and I fell into a much much needed sleep. About an hour or so later I woke to a strong pressure and DS2s head was there. That hours rest gave me the energy to give birth without any other intervention to a 10lb baby. I would bet that without that sleep I would have ended up in an emergency section as there was not an ounce of energy left in me to push that baby out.

It was a horrible birthing experience for many reasons but one of the only positives (other than my gorgeous DS) was that wonderful epidural.

Thank god for modern medicine.

In my experience its always the Alpha Mamma's who love to say they were pain relief free during labour as a medal of honor, ("oh you had XYZ, I had a natural birth because its better for baby") and then they go on to try and make other mums feel guilty about having pain relief.
My dads partner keeps reminding me that she was lucky to have gas and air back in her day and that the modern woman has it soooo easy with disposable nappies etc

That women should feel they've failed if they have an epidural makes me so sad. And the idea of women being refused pain relief makes me absolutely furious.

One thing that hasn't been raised actually is the cost - as I understand it, there is a significant price tag attached to administering epidurals, which is partly why they are 'rationed' in some hospitals...

I must admit, following my NCT classes I was absolutely convinced that I was going to hypno birth my baby and have zero pain relief - how naive that sounds in retrospect! My Spanish husband just didn't understand my attitude, as apparently you are offered an epidural as soon as you go through the hospital doors over there!

As it turned out I had a 46 hour labour and it was agony. I had every pain option going (g&a, pethadine and water) but as my heart rate went up to 190 in the pool they pretty much insisted I have an epidural to bring my heart rate down. The relief was amazing - I was texted my NCT class within minutes saying 'take the drugs!' My labour was so much quicker once it was pain free and I still pushed (so not being able to is myth!)

Next time I will be requesting drugs the minute they wheel me in!

In other words, there's something about labouring in a place where there are high rates of epidural use that makes healthy, low risk mums more prone to interventions.

I nearly had DD1 at home but wanted the option of an epidural and decided I quite liked and felt safer in the hospital. So presumably it's self-selecting. I don't count an epidural as "intervention" but as "pain-relief".

See, while posters can say they haven't seen much criticism of epidurals, there are plenty of women who can say, like fredkiller, that they feel that they failed because they had an epidural. So there must be something out there that is giving people this impression.

The epidural/cost argument makes perfect sense.

OP, if that's the attitude of some people to epidurals then think I will keep away from the parent and baby classes etc as I will no doubt be considered the lowest of the low as I am due an ELCS this week. I have gestational diabetes so consultant wants baby out before due date. Was planning an induction if favourable but with Bishops Score of 1 so far and 2 failed attempts at performing sweeps I see no point in putting myself through an induction which is likely to fail so in order to avoid increased likelihood of EMCS I am opting for ELCS (unless things have progressed when I'm assessed again on Monday).

I think this is the right decision for me but part of me can't help but think it's a cop out and I'll end up regretting not experiencing labour. I'm sure labour competitiveness from women in the first few weeks after baby arrives when I'm no doubt a hormonal wreck really won't help.

Dreaming, in my experience I haven't met anyone who has judged an ELCS for medical reasons.

I'd have had an epidural if I could. (I did ask, apparently too late.) There's nothing wonderful about a forceps delivery with no pain relief.

And then having a spinal block in theatre to be stitched back together.

I had an elective section the next time and it was flipping amazing .