(Trigger Warning!!!) To think labour pain is not respected by healthcare professionals?

[Goldfishshoals]

Warning: you probably don't want to read this if pregnant/about to give birth!

Three weeks ago I gave birth. I had back labour - truly agonising. The pains started on Friday, but because they were about five-six minutes apart they were arbitrarily considered 'pre-labour' rather than actual labour (despite hurting as much as 'real' labour pains). They continued like that for four days, in which time I obviously got no sleep. I called the midwife for help several times and was fobbed off with 'take paracetamol', which unsurprisingly did bugger all for the intense stabbing sensation in my back every contraction. After one call in which I cried they let me come in (30 mins car ride there and back in pain!) and have a single dose of coedine (barely took the edge off) before sending me home.

On Tuesday my waters broke so I was finally allowed in the hospital for monitoring - I pretty much immediately begged for pain relief. 'of course you can have some!' said the midwife breezily before buggering off for fifteen minutes leaving me in pain. Then she came back and said she just had to ask a few questions then 'we'd see' about getting me some pain relief... I did eventually get given some gas and air.

My contractions never became more frequent on their own and eventually I ended up being induced with epidural - which wore off just in time for me to be fully dialated. First they said they'd get me more - then they said it was too late and gave me gas and air - which they took off me again when it was time for pushing. I begged for pain relief (for anything!) and was ignored. I struggled to push but the pain was overwhelming and stopped me being able to push fully. Baby eventually delivered with forceps, and episiotomy which I could barely feel in contrast to the agony I had been in.

I had third degree tear which needed stitching, and suddenly everything changed. I had an anaesthesitist numb me fully, and keep checking my pain levels for the theatre, I had a few days in hospital with three types of pain relief thrown at me, and I was sent home with boxes of unnecessary coedine etc, for the incredibly minor soreness of the stitches.

When I compare other hospital visits (for being run over by a car as a teen, and a more recent dvt) it's a similar story. My pain was taken a lot more seriously and I was given better pain relief much more quickly, despite them not being nearly as painful as my back labour.

I realise not everyone has back labour, and some people have much less painful births (lucky cows) but surely having high levels of pain isn't that unique? So why wasn't it treated seriously? The only thing I can think of is that labour pain just isn't respected. Aibu to think this?

adagio you had 2 lovely births but...

Had 3 degree tears and got sent home within 4 hours
Had a lovely midwife but didn't see much of her until you were crowning
are now scared to have sex as a result of the whole experience/ standard of treatment received

Ok, well that's good to know, at least. Perhaps as a midwife you can shed some light on what is going wrong then, if not pressure to cut costs?

"Minifingerz" wow do you mean to say that dimmed lights would have made a substantial difference to the fact that DD was back to back? Who knew that's all it took to get her to shift? Good that you are here to tell us!"

What I said was that hospital environments are not conducive to the normal physiology of birth and the evidence of this is very much higher rates of complicated births among low risk mothers in obstetric settings than in similar low risk women in non-medicalised settings.

My first and my third were posterior.

The first was resolved with an epidural and forceps. My third was resolved by time - took me 16 hours of regular contractions to get from 7cm to fully dilated and for my baby to turn OA. I was at home with a midwife for most of that time. Had I been in hospital I would have been augmented or gone down as a 'failure to progress' c/s.

C/S rates were 2 in a 100 in the 1950's - women must also have had OP babies then, but the evidence suggests that most turned, as childbirth related deaths, although more common than now, were still rare. That suggests to me that most OP babies will turn, given enough time.

Note: I'm not saying that all OP babies will eventually turn.

Yes most will turn given time. This means a longer latent phase and labour as the contractions are rotating the baby. Speeding up a labour just because the latent phase has been long starts a chain reaction of intervention which ultimately increases risk of feral distress, pph, shoulder dystocia and c section/instrumental birth. Problem with labour pain relief is the other human involved who also gets it. But really there should be no issues with getting an epidural once established.

The NHS is about 5000 midwives short and the birth rate is rising and becoming much more complex. The NHS needs more midwives. I feel this is where it is going wrong. Of course the person who went private got amazing care - they are staffed to give that care! EVERYONE should get one to one care in labour - that's the standard. Its terrible that people are not getting that.

Yes most will turn given time. This means a longer latent phase and labour as the contractions are rotating the baby. Speeding up a labour just because the latent phase has been long starts a chain reaction of intervention which ultimately increases risk of feral distress, pph, shoulder dystocia and c section/instrumental birth

Which is why women presenting at the start of this process need to be told that it is likely to be a lengthy process and offered an ELCS. I wish I had been.

But on the topic of labours getting more complex (we are older, heavier, more likely to be on our 1st etc) literally every midwife I have ever discussed this with says that back to back is more common now than it used to be. Number of theories, one being that we're more sedentary. So in reality, we also probably didn't see as many back to back labours in the 50s as we did now. And of course, it's entirely possible to deliver a back to back baby without them having turned anyway.

So that, plus various other factors, meant minifingerz claim that it was DEFINITELY the case that a number of women who had complex labours requiring epidurals wouldn't have needed one had they not been in the hospital in the first place because 50s and because she and a self selecting group of women who choose OOH birth because of particular views on labour and pain relief have certain experiences, was completely inappropriate.

@Miaowthecat - I hear you! And am sniggering lots at 'Crotchtober'

It is 12 years last week since my first symptoms on Pelvic Girdle Pain appeared - and I still have bloody pain from it on a daily basis (albeit not as bad as during pregnancy and the 2-3 years afterwards when I was in constant agony, depressed, limping round everywhere, unable to ran after or play with my kids properly and being woken every time I moved in my sleep). What did I get? A fucking elastic strap and some paracetamol! Nothing else could be given as 'it' not tested for use in pregnancy'. If it was men that gave birth, they'd damn well prioritise testing of pain relief drugs for use in pregnancy.

After having DS I did get some codeine, which didn't touch the pain. Any other condition, GPs would be bending over backwards to find something that worked. Once they here 'pregnancy related' it's just 'oh well you'll have to put up with it, it usually resolves itself eventually'.

I have had two c-sections. After the first I was in agony due to complications. I was treated like I was drug seeking when I asked for more than paracetamol. My best friend had the most hideous labour and was only allowed gas and air, which they then took off her as they decided she'd had enough! She ended up with PTSD and got herself sterilised so she'd never have to go through that again .

Dd1 was an absolutely shocking experience. I couldn't find one midwife who had any empathy or honestly any real fucking calling to midwifery IMHO. It took me a long time to be able to try for dc2 and I did have counselling. I will always hate those fuckers deep down.

With dd2 I had a lovely Italian midwife who was so empathetic and just 'present' with me the whole time I had an amazing, but of course not painfree, birth.

Yes I know you've seen 1,000's of women give birth, and yes I know we're designed to do this not really and yes I know the NHS is stretched (yes actually said to me during labour) but honestly that is absolutely no comfort or help to me.

Should midwives consult their crystal ball when a woman first presents in labour then!?

persis

They wouldnt let my mum and dad into see me as the room looked like a murder had taken place

Dh (against the orders of a very pissed off midwive ) took ds1 out to meet my now crying dad who thought something had gone wrong and my 'where is the baby' mum

But honestly the midwives who dealt with the labour were lovely, its just stuff went wrong

Really quick labour 4 hours in call but i was 90 minutes pushing

Oh i have two midwife friends and i did consider it as a career myself

So i do know a very little about some of the pressures they face through conversations with my friends

And my children are lovely, i know the midwives didnt help with that bit really but any excuse to bring it up

Really lovely

Should midwives consult their crystal ball when a woman first presents in labour then!?

If you think it would require a crystal ball to establish whether a baby is back to back, and to know that this statistically is more likely to mean a lengthy labour, I'm rather worried for you.

I don't doubt there are some shit mws about and plenty of people have birth horror stories...but after reading lots of them on here, I do think that the outcome being based on 'not being taken seriously' is all well and good with hindsight. But like a pp said, mw's don't have crystal balls and lots of these birth experiences IMO seem to have been appropriated handled for the information available at the time.

Yes it's awful that a back to back labour resulted in 3 hours pushing and emcs...but for every woman who experiences that, there'll be just as many who have a successful, natural birth. I don't think the answer is for hospitals to give epidurals as standard or to whip all women who are dilating slowly in for a section after 4 hours.

If a woman wants an epidural who the fuck are you to say I don't think and bandy around give birth naturally??

Not your fucking choice. Well it shouldn't be because we're all for if a woman wants an abortion it's her body but if she wants to give birth someone else then gets to tell her what to do with her body??

Yes won agree and that's what I've been wordily trying to say!

Why the fuck aren't epidurals available as standard.

Adequate pain relief is the sign of a civilised health service. Epidurals not available - not civilised, not humane.

Don't worry for me. Worry for the women you think should have unnecessary major abdominal surgery who will have a longer recover, who statistically will be more likely to have a serious infection postntatally, who are exposed to the risks of an operation, who will statistically have more complex second or subsequent pregnancies. Feel for the babies who are statistically more likely to have respiratory problems after a csection.

Back to back is not a reason for a section. Really.

If a woman wants an epidural who the fuck are you to say I don't think and bandy around give birth naturally??

Calm down and learn to read.

I never mentioned a woman wanting one...I said I don't think they should be given as standard just because xyz.

By 'naturally' I mean a vaginal birth rather than a cs.

Back to back isn't necessarily, but all sorts of other reasons are.

But if a woman wants pain relief, then it is completely up to her. It doesn't matter how determined the 'care giver' is that a natural experience is 'better'.

They should be available as standard.

Of course they shouldn't be given as standard because that implies proper consent hasn't been given / sort. Which takes us back to the core reason birth services are problematic - this idea that women's bodies are things to have stuff done to them/decisions arbitrarily made about them (like many attitudes around sex) rather than bodies belonging to actual people who should have absolute say in what happens to them.

Should add that I have the choice to make of a CS or vaginal birth with #3, and it's one hell of a decision.

sought

Yes it's awful that a back to back labour resulted in 3 hours pushing and emcs...but for every woman who experiences that, there'll be just as many who have a successful, natural birth.

Interesting that you leave out the middle ground here, women who do deliver vaginally but do so via instruments and/or tear and/or experience a great deal of pain and trauma they would rather have been given an alternative to.

VB vs section won't tell you half the story here. Also, don't refer to a VB as opposed to a section as 'successful'. Like, literally, never ever do that. It isn't ok.

I don't think the answer is for hospitals to give epidurals as standard or to whip all women who are dilating slowly in for a section after 4 hours.

But then, literally not one person has suggested it is, so one wonders why you felt this was something that needed rebutting?

It's important here as well that we understand it doesn't take some kind of crystal ball to ascertain that women presenting at the start of a back to back labour, particularly with ROM early in the process, are at risk for lengthy labours. People seem to be presenting that as some kind of unknowable thing. It really, really isn't.

One of the side effects of an epidural is that it can slow a birth down. So I think the reason why it isn't standard is because of time constraints and volume of women birthing. In other words, cutbacks and money.

Don't fucking insult me Secret

Yes it's all money. And it's worrying the number of midwives who appear not to have thought critically about that and just swallowed the whole 'vaginal is best because reasons'. Instead of advocating for women, midwives who swallow that wholesale become gatekeepers.