To feel vindicated by the D of H report, which confirms midwives are withholding epidurals?

[RevolutionofourTime]

www.theguardian.com/lifeandstyle/2020/mar/03/women-in-labour-being-refused-epidurals-official-inquiry-finds

I was denied pain relief during my first labour for no reason whatsoever. When I complained to the head of midwifery, she encouraged me to try a home birth next time. 🤨 I have also witnessed other women in maternity ward being denied pain relief.

Despite this, I have seen it argued here time and again that midwives are not acting as gatekeepers or withholding proper pain relief in labour.

This report confirms what many of us know.

I will be curious to see if this will lead to changes- more specifically, to adherence to the Nice guidelines that it’s never too early and never too late for an epidural in labour.

Never mind epidurals, I was denied g+a during my last labour!! She finally let me have it 45mins before dd was born. I was quite traumatised after that and that was my 5th birth, 3rd waterbirth. Silly moo kept on about sending me home only an hour before she arrived(and we live 50 mins from hospital!)

I wasn't denied pain relief but when a midwife switch came, my gas and air was taken off me. Apparently, I didn't need it anymore. I was like that for an hour in agony. The worst part was the contractions were the relief for me. I needed the gas and air between the contractions, which was really odd. Nobody would believe me for so long until a doctor came in. But they had to find the doctor.

When they finally found a doctor to get the forceps in, she couldn't do it because my DD was at an unusual angle and I was rushed for an emergency c-section for both our healths and nearly lost my life. The third midwife I had was livid at the second for taking the gas and air off me and was the only reason I survived. my DH says she literally dragged a second doctor to me at one point because they were struggle to close me up.

Horrible experience. My second DD was an elective c-section under consultant care because of the problems during labour with the first.

So when someone says a midwife denied pain relief or did something against a mother's wishes, I don't doubt them. Women lose autonomy over their bodies during pregnancy and labour. Like we don't know when something isn't right.

@Strandiv

No, not all the blood tests are necessarily done. I said it takes usually 20 minutes for an easy epidural siting - that's from the minute the staff are in the room. I didn't say it couldn't be done. I do say it's not always safe or wise depending on the situation. As I keep saying, my circumstances may be different from others because I work on an MLU so there are no doctors around.

Re your last comment, it depends on where you work. At one trust I could easily get an anaesthetist, at my last trust it wasn't easy at all.

I think Oscaree gave those statements regarding it taking 20 minutes, not it being possible at all.

@wondering7777 I did wonder about worry pregnant women, definitely not my intention. This was a while ago and there are midwives who will explain better and more accurately but basically the baby starts off facing your back (usually) and my the time the head is born they should be facing up. That part should be controlled and measured, the panting bit on tv. I don’t know why or how and you don’t need to do anything except take it easier than the last bit.

But honestly I didn’t realise I was the end point until it was because it was much less painful than I expected. By which I mean I thought there’s no way I can take any more pain and they are telling me I’m not even half way so I need an epidural or I’ll literally die. But I didn’t because it was as much as I could handle. Would have been so much less stressful and scary if I’d known how far along I was and or I’d had an epidural.

I was not allowed an epidural giving birth in a Sydney public hospital. Back to back baby, already been in start-stop labour for previous 72hrs. I had the drip, no option of an epidural offered, only gas and air but I was too far gone with the hideous pain to be able to speak let alone use the gas. Aus was not some kind of birth utopia for me!

Strandliv , oscaree's statement was that it takes about 20 mins if the factors mentioned were ok/normal , not that you can't have one if some factors were off but that it may take longer.

All points raised were valid and an epidural is complex, if it goes wrong, the consequences can be catastrophic.

I'm not for one minute saying women aren't being deliberately denied pain relief, but there are circumstances where epidurals don't happen and it isn't because the woman has been deliberately deprived. If you feel that you have, then please ask to see the Head of Midwifery. I totally appreciate that standards need to change in maternity.

I seem to be in the minority but I actually had the opposite experience of this - I kept saying I was fine and didn’t want pain relief and they kept pushing me to take it, my midwife eventually literally thrust the gas & air thing in my hand! Once I took it I was very grateful, she definitely made the right call!

With DS1 I asked and they refused'it was too early' except they hadn't checked and it wasn't.
With DS2 I asked for an ELC, they told me absolutely not (while pregnant)
I had an epidural, he was induced 6 weeks early. I was in and out of consciousness and his heart rate was not good.Afterwards a midwife asked the other midwife why he'd been induced and she said 'mothers anxiety'
I felt completely disempowered and demeaned in both cases & im confident that the epidural would not have been given if my DH had not been adamant about it.
Scary how common practice it is to be treated like that.

If you are scared of having another baby because of your experience you can have a c-section

Yeah right - look at all the posts on here about women wanting c-sections and being refused those, too.

What needs to happen is actually very straight-forward. Women are not just baby incubators and they have feelings and rights too. Do what they ask you to do, unless it's dangerous for them and/or the baby or they've genuinely only got 2 minutes to go to get the baby out. Is it really rocket science? But do not let your " childbirth is a natural process" and/or "this is too expensive for the NHS" views come into it.

And this is why I want an elective section

I blame the natural birthing movement..sanctimonious know alls..

I'm in 2 minds about it. They shouldn't refuse pain relief and should listen to the woman and indeed follow NICE guidelines. Or if the hospital is following different procedures (if that's even possible?) It should be made clear from the outset. It's about respect and choice.

On the other hand I saw one woman permanently disabled because of an epidural which went wrong somehow and whilst it may be a tiny risk it meant that I was always clear I didn't want an epidural ever. As it turned out I had home births anyway.
I think we need to support and empower women more. A "natural" (without pain relief) labour can be extremely rewarding and is definitely a realistic options for most. I think a lot of us discount it out of hand. We need to ensure we give options and highlight any risk properly.

It's all about empowerment and listening to a woman's choice whatever the choice is. I don't think we put enough emphasis on birth plans here, from both sides. I know I didn't it give it much thought with my first. We need to respect that more.

I've seen statistics showing some form of intervention in at least 40% of vaginal births. I doubt a natural birth is achievable for most.

I get that there is probably a degree of unnecessary intervention, but there is also a huge degree of under-intervention. I did read that midwives and obstetricians are pretty much at opposite ends of the spectrum. MW's being on the "as little intervention as possible" end, and more open to taking on risk, and at the other end, you have OBs who are all about keeping the risk to mum and baby as low as possible.

Surely there has to be a happy medium.

Surely Drs and midwives deliver entirely different sorts of patients? Drs get the high risk dangerous and midwives...the ones who don’t need a dr!

Two of my midwives were appalling but I’m ashamed to say I didn’t complain. It was a long time ago so no point now. The other two were amazing and the births much more challenging. I feel a huge sense of gratitude and respect for them and how they helped.

i had my ds young and i always felt that the midwives were prejudiced because of that and denied me any pain relief, now i know it wasn’t just me!. i was denied an epidural and gas and air was taken off me. it absolutely traumatised me

I got an epidural as soon as I asked. No idea how far along I was as I 3cm about 1w hours previous, fell asleep after epidural and was woken up by the midwife 6 hours later fully dilated. Midwife said they were just waiting for me to ask, i lay on my side for it, and was great that I managed to get a few hours sleep

12 hours after 3cm

Yes auslass, I had obsteatrivi wanted to do forceps which was my main dear from having epidural and midwife, seeing my reluctance, keeping everyone out the room and giving me a chance to push, after my episiotomy.

Fear not dear

@5zeds it's really not that clear cut. There are some very low risk patients who never go near a doctor while giving birth. There are some very high risk patients who will have doctors present nearly all the time (though often they will have elective CS rather than labour) - but even then they will have a midwife with them doing lots of the direct care. The vast majority of women will be somewhere in the middle - midwives doing most of the hands-on stuff, consulting with the doctors if there are concerns or questions. Doctors very rarely actually physically deliver the baby unless it's with instruments/via CS. The two groups should be working together for the patients - though we know there are many flaws in this model.

For example, with DS1 I saw the doctor who prescribed my induction pessary, which was put in by a midwife. Saw the doctor again at a couple of points when the midwife had concerns, but the actual birth was all done by the midwife. With DS2 a similar story, though they got the doctor to break my waters and then a different doctor (shift change) to sort things out when I bled post-delivery. Plus of course the anaesthetist who did my epidural (we're doctors too, though not everyone realises that!) I'm not completely low risk, but not especially high risk either. From my experience this is a fairly normal way for things to work.

The dr surely sees far more high risk patients and the midwife surely leads many more low risk births in this model?

I’ve only had one birth lead by a Dr and it was a gentle and empowering experience. I’ve had one midwife lead birth that was good and two that were humiliating and unpleasant. The difference in these births was almost entirely due to the midwives attitudes. I’m angry about it. I am however a better person for seeing what such unpleasantness feels like.