(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?

Glad the second birth was better for you here

I really wasn't claiming anything. Only talking generally. Like generally back to back is longer. Obviously everyone's experiences are unique and circumstances differ greatly. Everyone should remember their baby's birth for the right reasons, not for the reasons discussed in this thread. It's heartbreaking.

Sorry: in direct response to the OP I completely agree with you. Being told I was allowed paracetamol at a point where I'd been having 7 in 10 contractions throughout the night - so no sleep - with a back to back (horrific pain with absolutely no gaps in between) which was due to hyper stimulation caused by the induction gel, was inhuman.

In response I screamed the place down "no, no, no!" and repeatedly beat myself on the head in an attempt to knock myself unconscious until they grudgingly agreed to arrange an epidural (which then took 4 hours to get right and actually work...).

I have no even vaguely pleasant memories of DD1's VB. None.

Bloody hell here

here that's awful

Is there a correlation between awful birth experience and being induced? Just from looking at these stories. Does it make it more painful? Or just longer?

You certainly were claiming that a woman having a CS would have a longer recovery, along with several other things thatsnot. You said:

Worry for the women you think should have unnecessary major abdominal surgery who will have a longer recover

You made a claim there. With nothing to back it up, no less.

I appreciate that you feel you're advocating for women, but frankly if you are a midwife you need to reflect on some of your responses in this thread. Your presentation of the risks of section but nothing about VB and your conflation of VB generally with back to back VB are both really worrying.

Persis, my induction wasn't even longer - 3 hours 15mins from first contraction to baby :)

I did all the "right" things, lots of prep, practicing alternative pain management tactics, went to a mlc, all set for waterbirth. Hell I even managed to use damn bubble wrap popping to get me through 6+ hours of active labour.

But although I had thoroughly swallowed the bullshit of labour being "good" pain, it really wasn't. Birth hurts because your body is doing something unbelievably exhausting and difficult.

So when I broke down in the bath crying hysterically because I was certain something was wrong and I was definitely going to die and the pain had broken me, I was doubly screwed up as I knew I had failed. I also stupidly thought the transfer to hospital would be quick and I'd have pain relief when I got there.

It took hours for the ambulance to get ready to take me, then it was rush hour and I was not seen as emergency so we crawled through traffic while I screamed in unbelievable agony. The midwife sat and glared at me and told me off for using the g+a.

At hospital the midwives were wonderful. I was quickly told I wasn't using the g+a properly (the previous two midwives at the mlc had happily watched me use it ineffectively for oh, over 7 hours) and it finally started to work a bit.

I still desperately wanted an epidural and it was given to me a couple of hours later- but it didn't work. The midwives were great and kept getting the anethesist back but she didn't believe it wasn't working so just added a bit more and turned me over. then over the following 6 hours or so just added more and more stronger stuff which only numbed one side slightly while filling my body with unnecessary drugs. Eventually they re did the whole thing, by which point I was dilated and it was clear that my continued screaming that something was wrong was absolutely correct. I was finally in no pain, it was amazing.

By this point I was barely conscious, I'm not really sure what happened except there were a lot of people around and they were saying they would need to do forceps and possibly then emcs. I guess I was lucky they decided not to try forceps (I asked emcs but I don't know if that made a difference) as I would have had even more damage. I had emcs with a longer than usual incision as part of my uterus had clamped shut and meant my dd could never been born vaginally. If I had stayed in the birth centre I would have hemoraged as my uterus was trying to turn itself inside out and both of us would have died.

As it was, I still thought I was dying. My epidural wore off on the operating table and I was screaming/ vomiting uncontrollably so that the surgeon was shouting at me to hold still so they could get my insides back in again. No one had told me that cs could be felt so I was totally unprepared and couldn't deal with it at all even though by then it was less pain than I had been enduring. They wanted my DH to go help wash the baby but I wouldn't let him leave my side as I was pretty sure those were my last moments as the world was going fuzzy and fading and all I could still see/feel was the stitching and my husbands hand holding me.

I then had sepsis and a horrific csec recovery. I spent a week in hospital and I wept every few hours because the wait for the pain killers was unbearable.

However the midwives were wonderful and got me the drugs straight away when they saw I wasn't ok. But it was still unbearably painful from start to finish and I don't know if I will ever mentally recover.

So please don't dish out crap about birth centres as though it's the answer to everything and they magically make pain bearable. It didn't for me and actually meant I had an unnecessary and distressing ambulance trip. Plus a feeling of failure that noone deserves.

If I ever have another child (it was vaguely suggested post op I might not be able to) then I will be asking for a elcs as even if it is awful, it will be less awful than going through all the horrors of labour and then still having to have a section.

persis

I wasnt induced, labour was 4 hours from first contraction to baby

scent

Ah sorry that was longer than I expected. Couldn't stop once I started typing!

Oh scent I'm sorry.

Not induction then. I was sort of hoping I had cracked the whole thing

My first labour was horrific, long, agonising and I ended up on the drip to induce me as repeated gel pessaries hadn't worked enough. I declined anything more than gas and air because no-one had warned me how awful it would be. But about five hours later I was drifting in and out of consciousness and I begged for an epiduraland I did get it (and eventually ended up with an emcs). But worse than the pain was the fact that the midwife ignored me. She spent 12 hours in that labour ward with me and most of it was spent hunched over my notes writing, and studying the print out on the monitor. She had her back to me most of the time. I've never felt so alone.

My second birth was so much better BUT it also ended in an emcs and the pain afterwards was indescribable, and I just couldn't get prescribed stronger pain relief, it was a couple of paracetamol and a couple of ibuprofen and when I begged for something stronger I was given peppermint capsules (I wasn't breastfeeding, so it was nothing to do with that). Yet when I had keyhole surgery for something non childbirth related, I got a morohine drip

My one sister also has fast labours - hers quicker than mine. Her first was 3 hours and second (induced) closer to 2!! Her DH got there from parking the car literally at the final push

Other sister has a much more normal body that does slower labour. I think her labour was probably as long as all four of ours put together

"So please don't dish out crap about birth centres as though it's the answer to everything"

I'm sorry you had such a hideous experience and poor care, but really nobody is saying that birth centres are 'the answer to everything'.

Women who use birth centres as a group have much higher levels of normal birth than similar women who choose an obstetric unit for birth, and they are more likely to express satisfaction with their births.

That's not the same as saying they are right for everyone or that care is always good there.

But you have to be so low risk to go to the birth centre in the first place it's not surprising there are better outcomes. Do the studies account for this?

I had first birth in a consultant led unit and second in midwife led but within same hospital. Second was a vastly better experience as it was comfortable, less medical looking, the birthing pool filled in less than half an hour and the midwives let me listen to my body and push (well, breathe into contractions) rather than first telling me not to push the telling me to push but that i wasn't doing it hard enough

But one thing i do think is why does one have to be in a midwife led unit to be listened to and have a comfortable room to give birth in. Why can't you have that and access to doctors if you need them? (Money i guess!)

I think you should get what you need.
I really wanted to feel the process of labour as I'd had a disconnect with my first, having a csection. (Never felt I'd had anything to do with the birth or baby )
I was glad to feel the pains as it made me more connected with the process.

I should add the pains in subsequent births.

YANBU. My labour progressed extremely quickly and the midwife didn't believe me when I described the pain and the gap between contractions. I begged her for drugs and I got a smirk telling me this early stage would probably last for up to 12 hours. I persisted and I finally got diamorphine only for my daughter to arrive a couple of hours later. So yeah, my pain was underestimated and it led to complications. (All fine now tho!)
Huge congratulations to you too x

"But you have to be so low risk to go to the birth centre in the first place it's not surprising there are better outcomes. Do the studies account for this?"

Yes they do. I did say 'compared to similar low risk women who choose labour ward'

NICE

In the figures on that link, out of every 1000 low risk first time mums who choose a free standing birth centre for labour:
69 will have an emergency cs
118 will have forceps
8 will have a blood transfusion

The figures for similar low risk women who choose an OU for labour:
121 will have an emergency cs
191 will have forceps
16 will have a blood transfusion

But that makes the assumption that no intervention = good and intervention = bad. I know that having an epidural is probably why I needed an intervention (forceps). But, for me the benefit of the pain relief vastly outweighed the downside of having to have forceps. I accept that's one example but I don't think it's as straightforward as you are suggesting.

I feel like women who successfully give birth in birth centres are often ideologically opposed to pain relief/ intervention. That's great for them but for those of us who don't want to have to experience excruciating pain the only option is a hospital.

"That's great for them but for those of us who don't want to have to experience excruciating pain the only option is a hospital."

If reducing pain in labour is more important to you than reducing the risk of surgery and instruments then it makes sense to choose to labour in a CLU.

As for 'ideologically opposed to pain relief' I'd point out that most women in birth centres use it, and if there was something they could use in that setting which didn't involve needles, doctors, continuous monitoring, drips, catheterisation and the loss of sensation but that was as effective as an epidural then lots of women would use it. Women who use birth centres tend to be those who want to avoid the medicalisation of their births, rather than being solely focused on pain.

I suppose what I was trying to say (badly and also getting sidetracked, sorry I find it v difficult to write about) is that I was told I would be better able to cope with the pain at a birthing centre. There have been posts like this here too. It is implied, even if you don't mean it to be when you say that it leads to fewer interventions.

I actually think I had great care, I was just really unlucky. But being at the mlc did not help with the pain. It is the same dismissive attitude to birth pain that the op experienced that leads to birth centres being made and promoted as places women give birth without effective pain relief. The idea seems to be that if women can just handle the pain they'll be able to have the gold standard low intervention birth there.

I was trying to show how that doesn't actually work as simply as it sounds.
1- do your figures include people like me who move to a hospital halfway through?
2- having to move to hospital was glossed over before birth as something a few women do if they need pain relief (i.e. They can't handle it on their own) Apparently quite a lot of women do transfer and have the extra crap that just transferring entails. (Midwives at the hospital said this, sorry I don't know where to find stats.)

I think my complications would have happened wherever I was, but they may well have been aggregated by the transfer etc. It was more damaging for me to go to the mlc and transfer than if I had gone straight to hospital. The exact woman centred approach the birth centre prides itself on and claimed to be why it had low interventions was immediately lost once I asked to be transferred. I can't think of anything less women centred than that ambulance ride.

The subtext reads to me as though women like me who can't handle the pain deserve the interventions if we leave the birth centre.

From all the research I did it seems that choosing pain relief such as an epidural will increase the chances of a forceps or CS.
You may not mind that. But those on average have longer recovery and on average lead to more problems in subsequent pregnancies.
It doesnt mean that they will. Just are more likely to.

I also think we should as a society be having an honest conversation that having children later leads, on average, to more difficult births.