AIBU to have found childbirth unbearably agonising?

[Caff2]

Just that. I had an elective section with ds2 because of it. And yet I have friends and read on here of people who "did it naturally" or "just had a bit of gas and air at the end".

Why was childbirth so awfully painful for me?

Homebirth is no more risky for your baby and it's less risky for you if it is your second or subsequent birth.

I was deemed low risk (I guess) for my first pregnancy, since the midwife was all for 'trying for a home birth'. I wasn't keen - as it turned out I went more than 14 days overdue and was induced anyway. Just as well I didn't have the home birth though, as I would have had to be transferred due to complications (umbilical cord related, not hospital related), and as things went pear-shaped very quickly I'm not sure that the outcome would have been good. I know my experience is only my own individual one, but nothing would persuade me to have a home birth now.

Yes - cheaper too. They have a set amount of money to spend. I'd rather that money was used to provide life saving care to women with complicated labours needing medical input. Ideally there would be enough money for everyone to have everything they need for a happy labour, doulas, case loading care, birth pools for everyone who requests one, guaranteed epidurals within 5 minutes of request, free hypnobirthing training, ELCS on demand for low risk women, excellent postnatal care... All of it. But this is the NHS we're talking about and they need to ensure the highest numbers of healthy mums and babies for the money they've got, which is not very much. Simple measures like not admitting mums routinely in early labour save money and theatre space by reducing the number of emergency c/s, so leaving obstetric services free to deal with women with complicated births caused by ill health rather than by institutional practices.

Purple - maybe you would have made up one of the 'would have been better off in hospital' homebirth statistics. Maybe not. But you would be balanced out by a poor outcome for a mum in hospital which would have had a better result at home or in a birth centre.

Because that's the bottom line - statistically, you aren't safer in an OU, not as a low risk mum (although the minute you start the induction process you stop bring categorised as 'low risk' incidentally).

It is cheaper and yes, the money does need to be focused on many other things to but - and this is of course just my experience - I was so beyond exhausted with a long and painful latent phase that should I have needed to push, I would hardly have been able to do so. I hadn't eaten in two days, let alone drank; I hadn't sat down in two days, let alone rested. I believe that if other complications hadn't meant an emcs, I would have had no reserves left in my to manage active labour and pushing - ergo, a higher chance of intervention being needed.

That, to me, is what gets missed sometimes in these discussions about pain relief and intervention in early labour.

Simple measures like not admitting mums routinely in early labour save money and theatre space by reducing the number of emergency c/s,

I don't understand how sending a distressed woman home in early labour is contributing to a better outcome? Surely stress arising from of lack of care in the early stages must have a huge hormonal effect, making interventions as likely as being admitted in the first place?

They have a set amount of money to spend. I'd rather that money was used to provide life saving care to women with complicated labours needing medical input.

I've seen it said several times on these boards that the cheapest option of all would be for all women to have ELCS. (If anyone wants to jump in with a reference for these stats I'd be very grateful.)

That would avoid all of those women needing life saving care due to complicated labours AND save money - win win right?

I assume that that isn't something you would want to see Lemis. But in the same way, I don't want to see options for effective and safe pain relief withdrawn from "low risk" women. I think the latest NICE guidelines run the risk of being interpreted in ways which result in exactly that.

That's why I think invoking cost as a reason for justifying interference in women's decisions during pregnancy and birth is so dangerous and unhelpful.

It hurts. I've had two drug-free homebirths, but both 8 hours or less. I'd have begged for every drug had I had a 24 hour job like some friends.
I'm pretty hardcore with pain, managed ok with the births. But last week, I cried and thought I might vomit just getting my eyebrows threaded.
Who knows, pain's a mystery to me.

Thurlow, in the bad old days a long latent stage would be managed by keeping the mother warm and rested, and tipping chicken soup down her as well as gin . I can't imagine women would have been so left alone, unsupported and emotionally neglected as they are now, to grow demoralised and knackered.

Yes - ELCS for all would be as cheap, as long as your comparison group were women trying to labour in OU's. And they only wanted one baby.

But most women want more than one child and ELCS comes out as much poorer value in health and financial terms if the comparison groups are women labouring in low tech settings,

ELCS is clearly the cheapest option if you consider the long term costs of a birth with serious complications. A child born brain damaged from oxygen deprivation will require a staggering amount of money purely for supportive health care for life. Given medical advances the life expectancy of such babies can be significant (in terms of costs) so if ELCSs for all women reduced the number of VBs with serious complications like oxygen deprivation and neurological problems, they are the cheapest option.

It's similar to the smoking argument: on the surface it looks like smokers cost the NHS more by requiring treatment for smoking related conditions, but they actually cost less by dying young, rather than living longer and incurring old age health and social welfare costs anyway.

I would flat out refuse a home birth or mid wife unit. And i think it should be mums choice completely.
I believe more babies will die. As they cant always know the chord will be wrapped round or the baby wont breath when born or a PPH etc.
I suddenly had high temp and they needed to immediately give iv antibiotics (but couldnt get vein)
So possibly nearly had EMCS.
No way after ivf i wanted to lose my only baby.
Anyway its your house maybe you dont want ruined carpet/bed etc. what to do with your other kids.

I personally wouldnt have different pain in whatever setting (kind of find that a bit loopy) i was in agony in all locations.
I was refused epidural as not far enough along. 2cm.
I dont believe pain depends on how dilated you are.
In fact i wouldnt be surprised its more painful if your cervix is trying to dilate and its not working

Not sure about that Booboo. Dm is nearly 70 but has ill from about 50. Had heart attack and lung issues. Those 20 yrs of care. Not to mention 2 DDs with asthma so i estimate the cost is pretty high. And that is only what we know about
I suppose that is now we have medicine to keep people alive (in whatever state) and that is expensive.

I wonder if it would be better to have free choice for ELCS.
But my DSis had a ELCS now for Dc2 has placenta previa and they are worried about it growing into the scar which could be very dangerous. So i guess there are consequences from anything. But other than that i think i have much more issues from my VB, piles and tear, weak PF muscles

"If someone is begging for pain relief then they should be admitted and treated for the pain they are suffering, however far along in their labour they are.

Yes, this is the humane response.

But what happens if it becomes the norm - that women are told that they'll be admitted in early labour if this is what they want? Labour wards would end up having to turn away women in active labour. Some hospitals in London are closing their doors to new admittances many times a year already - a 1000 times last year apparently, because there are so many babies being born. NHS hospitals don't have the capacity to offer care to women in early labour on the basis of current funding. If they were offered much more funding it'd be difficult for them to argue that this is how it should be spent, when there is a severe crisis in postnatal care (that's just one area where maternity care is really struggling to meet even the most basic needs).

"ELCS is clearly the cheapest option if you consider the long term costs of a birth with serious complications"

I'm not sure you are right on this, but I can't find the document from the RCOG which backs up my view. Pregnancies following a c/s are more likely to result in placental implantation problems and uterine rupture - both things with high rates of fetal compromise and death.

"I assume that that isn't something you would want to see Lemis. But in the same way, I don't want to see options for effective and safe pain relief withdrawn from "low risk" women."

Happily, there are no plans to do this.

Plans are afoot, and underway though, to close birth centres and cancel homebirth services to save money.

"But my DSis had a ELCS now for Dc2 has placenta previa and they are worried about it growing into the scar which could be very dangerous. So i guess there are consequences from anything."

According to RCOG stillbirth rate and unplanned hysterectomy rate are both significantly higher in pregnancies following first or second c/s.

"I would flat out refuse a home birth or mid wife unit. And i think it should be mums choice completely."

It is at present, and there are no plans to make it any different.

"I believe more babies will die. As they cant always know the cord will be wrapped round or the baby wont breath when born or a PPH etc."

And yet, when they look at the outcomes from 1000's and 1000's and 1000's of home births, and compare them to the births of similarly low risk women birthing in hospital, no more babies die or are damaged. And fewer women end up ill. Go figure! NICE wouldn't be recommending home birth as an option if there wasn't evidence of its safety.

I have had 4 VBs and a CS (breech). Only in one of those labours did I get an urge to push. The other 3 were just unbearable pain (& screaming) from start to finish. I only ever had G&A because I was terrified of an epidural and the only other offer was pethidene which I didn't fancy. Diamorphine would have been a better prospect.

I have watched OBEM and been amazed at the quiet women who just seem to tune into themselves and out pops a baby. But for every one of those you see 3 or 4 screaming the place down.

If I'd known how calm and painfree the CS was going to be I'd have had 5 of them

I have had 2 babies.

I didn't find either labour painful, I didn't realise I was in labour with DD2 just felt. 'A bit crampy' until I got an unmistakable urge to push & out she popped....

& I howled with pain with tooth ache, I am definitely not known for my high pain threshold!

Utterly. Unspeakable.

I was LIVID with all the claptrap the NCT and silly pregnancy magazines had peddled about sodding labour 'music tapes' and TENS machines/massage etc.

I was truly broken with it. Couldn't believe that level of pain was normal. Actually I think the sniffy attitude that some have about epidurals is offensive and illogical. Who would opt to go to the dentist for a filling and tell them to 'hold the anaesthetic'? No one. Just bonkers.

Chunderella - midwives in many areas STRONGLY encourage women to use the birth centre in the hospital. In fact in some areas women are asked if they'd prefer not to have an epidural and if they say 'no' they're steered towards the birth centre as the most appropriate choice.

You are right of course that most women who choose homebirths strongly advocate for and prefer this type of birth setting.

Merce - nobody chooses tooth surgery without analgesia, but lots of women don't want and choose not to have epidurals and they have very good reasons for doing so. No need for you to be angry.

Chunderella - should high risk women be encouraged to give birth on the labour ward because research suggests it's a birth setting associated with the best clinical outcomes for them? Yes?

So why shouldn't low risk women be encouraged to have MLU births if research has suggested this birth setting is linked to better clinical outcomes (it has) for them?

Really - the amount of frothing about the promotion of midwife led birth on this thread - given the current 95% dominance of OU settings for birth, a record high level of epidurals and c-sections... I mean, where's the sense of proportion?

In fact in some areas women are asked if they'd prefer not to have an epidural and if they say 'no' they're steered towards the birth centre as the most appropriate choice.

I would guess that a significant number of women - pre-labour, having been exposed to the anti-epidural stuff that's peddled - will say 'oh no, I don't want a nasty needle in my back that's going to compromise my lovely whale-music birthing experience'.

Many women reconsider this in the throes of labour, by which time it's too late, especially if they are in a birth centre where no epidurals are available. Even if they are in a hospital they may well be 'discouraged' from having an epidural.

The question of 'choice' is a false one, given that no-one really knows what their birth experience is going to be like until it happens.

Purply - in my experience women can be quickly reassured re: how an epidural is administered. It's when they find out about the higher rates of fetal distress, running a temperature, urinary catheter, and association with forceps deliveries that they tend to reconsider whether it's something they want. Obviously these things go to the wind when they are really struggling in labour.

Nevertheless - it perfectly rational not to want an epidural. I had one and would never have had another. There are other people here who feel the same.