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?

[janey68]

We're all free to post where we like. I have not said anything remotely offensive or judgemental- if you believe I've done so, feel free to report my posts. That would look a bit daft though, because you know very well I haven't! As I say, I think it's terrible that some midwives are contributing to women feeling bad about using epidural.
Luckily (ooh I've used that word!) I don't feel bad about my births; I am just pointing out that its equally judgemental to assume that women who have natural births somehow have it 'easy' or less painful.

Anyway, thurlow: one thing which interests me is that I know quite a few women who had epidural for their first birth but for subsequent births were very keen to go without, and a number of them (not all, but a significant number) have said that although it was more painful the for subsequent births, they felt happier with the experience. I guess this shows that for some women, it is important to experience birth without epidural. I don't think these women felt pressurised into it by midwives or other women.. From what they told me, it was their own decision.

[Thurlow]

Well, honestly brdgrl, I'm happier to go with 'luckier' because the sudden complication meant I got a CS without going anywhere near pushing and that was absolutely fine and dandy by me

Yes, janey, I did start this thread. But I'm more interested to know why there seems to be this opinion among some women rather than rehash the conversation, as I am aware that it is sensitive for many women, both those who had epidurals and those who had pain-free births. A few posters on here have actually proved my point.

If I'd had a choice I would have had an epidural as soon as it all started. I don't think that women should have to experience the pain and decide as it's happening whether it is too much or not, as long as they have made an informed decision.

[Thurlow]

X-post. I also know a lot of women who had significantly less pain-relief during their second birth. I suspect this also has something to do with not having the fear of the unknown which you have in your first birth, and possibly also knowing that early labour should be quicker.

As a personal example, while I am very committed to fighting for an ELCS for any future births due to other complications, I now know what contractions feel like and with hindsight I now feel that without the 36 hour early labour, I'd probably be able to cope if I had to have a VBAC. I'm less scared by it all because I understand it more now, having experienced it.

I think when you have experienced something once it can be easier to think about experiencing it again in a potentially worse way.

[janey68]

Is there such a thing as a 'pain free birth' ? I assume you meant pain- relief free!! (Although I have come across very very rare cases of women who genuinely don't experience pain with contractions- now they may well describe themselves as lucky, but it's a very rare phenomenon)

Thurlow- if you wanted an epidural from the get go then that's what you should have had, providing there were no medical contra indications. What you are saying simply reinforces what I am saying: all women are different. Some want an epidural from the outset, some want to see how far they can go without pain Relief. Some women have epidural first time but are really keen to experience labour without the next time , and some go without first time and then opt for epidural the next time. And some women have medical situations which take the choice out of their hands. Where there is choice though (and you started this thread in the context of where there is choice) it should of course be the individual woman's choice- not the midwife dictating. That's truly shocking- and let's put the blame squarely where it belongs.

[Thurlow]

Yes, pain-relief free

Sadly, you can't have an epidural from the get go. I full understand why not, as they don't have the time or the resources to give an epidural from the beginning, but annoyingly for a lot of women it's the time taking to get to the magical 4cm which is long, agonising and exhausting beyond words. Personally I do think there is an argument to change the guidelines slightly that if a woman has been having regular (i.e. 3 in 10) contractions for two days and still isn't 4cm then maybe they are eligible for some help, but I kind of understand why not.

Situations like that are where, I believe, some women (myself included sometimes) will use the word "luck" towards women who have had pain-relief free births. Several day early labour feels very unlucky and leave you with little reserves to face active labour; I imagine a lot of women feel that if they had gone from starting contractions to significantly dilated within half a day, they might have considered an epidural free birth. FWIW I think the speed at which your body dilates and the regularity of contractions during that period is really kind of luck of the draw, but can have a huge effect on the active labour.

[GoshAnneGorilla]

Just so you're aware, Minifingers is on all these sorts of threads clanging her chimes of doom.

She's equally charming when talking about breastfeeding.

[janey68]

Yes thurlow, it may well be the case that the guidelines need reviewing. Any medical procedure is a case of weighing up costs, resources and pros /cons (and that's a plain fact, not a judgement) but of course things should be reviewed and if significant numbers of women are saying they want an epidural before 4cm dilation then that needs to be listened to and factored into the decisions of those who hold the purse strings and allocate resources.
From what you are saying, it does reinforce that any negativity is coming from the medical profession though, not lay people

[TheSporkforeatingkyriarchy]

I think it comes from a mix of places in the systems from the media representations of births to individual medical professionals.

I was made to feel unnormal in two of my births for not having an epidural, even when I couldn't have one for medical reasons (spinal anesthetics contradict another medical condition I had). In my first I had a midwife go on about it over 45 minutes straight (I was watching the clock, she only stopped when I said I'd consider pethidine) and in my third, when I had to have my placenta manually removal (after one midwife yanked on it too hard and a chunk came out with the cord...), another midwife was brought in to help and she was gleefully saying over and over that I'd have to have an epidural that I'd avoided and be like other mums (I was actually quite smug when the anesthesiologist came in and showed her that I could not have one - her shutting up was a fine moment, the OR staff were far nicer).

Amusingly, my partner had an epidural when he went for the snip. Neither of are really sure why as he has mechanical damage in his spine but the anesthesiologist convinced him it was the best choice and was very eager about it. DH called it excruciating, and he spent longer recovering from the epidural damage than he did from the operation itself. Never an easy option he says We obviously need better pain relief for us odd body types and everyone else.

[janey68]

Thurlow- actually as well as some midwives being at fault, I also have a hunch that some NCT groups are not as transparent as they should be about their agenda, as I know some women feel they don't get what they should out of the classes, and that they are misled to an extent.

My own NCT group was excellent: the teacher was completely upfront about the fact that their focus was on breathing techniques, relaxation etc, but she made it clear she would be led by the group and if we wanted input on csection, epidural Etc she would provide it. If I had ended up not having a natural birth, it would have been very unfair of me to blame the NCT because its not compulsory to attend, and at its best, they work extremely well for many women. But I have no doubt there is some variation in quality and I've heard women say they really Weren't clear about what they were signing up for, and so I guess that may be a contributing factor to some of the issues you describe

[TarkaTheOtter]

I agree about NCT. Our teacher was very flexible and let us lead te direction. So whilst we did breathing exercises and active labour, we also learned about epidural, the practicalities of getting one (ie if you know you want it get the request in early) and bottle feeding as well as breastfeeding. It probably helped that we ha an experienced tutor who was also a former midwife.

I was offered an epidural from pretty much the outset but that may have been because I was an early induction. Once I did request it they got it arranged very quickly, so I do feel "luckier" than most of my friends who requested one and were denied because the anaesthetist was busy. Particularly the friend who then had one post birth anyway to remove the placenta.

[brdgrl]

I have not said anything remotely offensive or judgemental- if you believe I've done so, feel free to report my posts. That would look a bit daft though, because you know very well I haven't!
No, it would look a bit daft, because MN guidelines don't say people cannot be offensive or judgmental.

[brdgrl]

It is also the case that at least sometimes, the very reason some women go with less pain relief on a second or subsequent birth is because of these exact social pressures and attitudes. If one had an epidural with the first birth and then was made to feel that one had 'missed out' on feeling like a 'real woman' or 'being empowered' or somehow failed - then one might feel considerable pressure to 'correct' that the second tiem around.

[janey68]

Yes that's a possibility, but like I said, a significant number of the women I know who chose that route were happy that they had given birth subsequent times without epidural. They didn't feel coerced into it and they didn't regret the level of pain they felt compared to their first birth.

Equally, some of my friends were so pleased with their epidural first time that they wouldn't contemplate giving birth without next time.

[janey68]

In other words: what I have said all along. There is just as much possibility that a woman who wants a drug- free birth could be made to feel that she's weird, or stupid or masochistic by comments such as 'why on earth would you do that? You wouldn't have a tooth out... Blah blah blah'
Or even worse, encounter a midwife like the one described above who berated a woman for not having one, and then seemed almost pleased that following the birth, it looked like the woman might need one for a retained placenta.

It cuts both ways: don't judge people for having pain relief and don't judge them for not having it.