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.

I don’t think midwifes are sadists but definitely in labour I was quiet and controlled. They agreed I was in established labour but no dr for epidural. Gas and air made me feel really sick but I kept hold of the handle because they kept handing it to me. Like so many other they agreed to check when I said I could feel the head to reassure me, and like so many others she caught the baby. It was fine, I genuinely believed I was superwoman and they had no way of knowing that I was so far along (hormones). Had to see a paediatrician a week later who flipped her shit that I’d not had a c section, I was so confused but apparently dh had gone though the birth canal way too fast and from look at whatever ever report she had it was clear that was happening. I had no idea that you were supposed to pause till the baby turns so pushed him out in one. If I’d got the dr for the epidural they would have checked and either I would have been talked through labour properly or had a section. But I was quiet and contained.

This is really shocking to me.

I gave birth in the Liverpool women's hospital but was consultant led due to pre eclampsia.

I was induced (with a pessary) and refused the syntocin drip until I had an epidural. Maybe that's why the anaesthetist was there within ten minutes?

My midwife turned mine off just before the pushing stage too (at my request, I could feel the urge but not push hard enough, she asked if I wanted it turned off so I could push harder and I said yes, he was born an hour later with no instruments.)

The idea that women are genuinely being denied safe effective pain relief in labour is utterly sickening.

I'm all for midwives making sure their charges really do want an epidural if they've written in their birth plan that they don't, but that needs to be done by giving women as accurate as possible information on what is going on. If they're likely to labour for another few hours or just one or two, then the decision left up to the woman and followed through in a timely manner.

But brow beating women in to drug free labour, withholding pain relief, generally not listening to their patients is dreadful.

for everyone this has happened to. I hope this report causes some serious waves and that changes are made.

Deliberately withholding pain relief without a valid clinical reason (ie, baby is crowning) should be a sackable offence.

I would be so traumatised and furious. That shit hurts but it doesn't have to hurt as much as it might.

Thumbwitches, why were you glad in the end you hadn't had one?

Mine was really good, DS was 6 weeks early my waters had spontaneously broken but I wasn't 'ready' for labour he was back to back and had a large head and I had to be induced by drip. She gave me all my options and I said epidural please and she said, yes good I think that's for the best. She was a star

Deliberately withholding pain relief without a valid clinical reason (ie, baby is crowning) should be a sackable offence.

I agree, it's a form of abuse.

@MVDorset I'm in Dorset, I gave birth to both of my children here.

First labour: I was told by a trainee midwife "I will feel like I have personally failed if you have an epidural." I will never, ever forget her words. Eight hours later I had an epidural. Total labour was 22 hours. I had to have an instrumental delivery and an episiotomy - NOT because the epidural slowed things down but because the baby was back to back and stuck with the cord around his neck. Apparently it was touch and go for both of us, and there was a consultant, a registrar and two midwives in the room when DS was delivered, but we both recovered fine.

Second labour: didn't get an epidural, apparently the labour ward was too busy and there was a queue for emergency C-sections so no anaesthetist available. I gave birth on gas and air after, again, exactly 22 hours of labour. Baby delivered very quickly in the end, my DH had to run and find a midwife as they were just so "busy" that nobody was in the room and they didn't believe that the baby was actually coming. Midwife literally ran in, caught the baby, handed her back to me and buggered off to the next patient (apparently). When I dragged myself off the bed an hour or so later, having been left lying in the afterbirth, I found FOUR midwives gathered around the desk reading a newspaper and drinking fecking tea. I had nightmares and flashbacks about the pain of that delivery for months afterwards.

Uncaring fuckers.

I didn't experience that with an epidural. I wanted to just have gas and air which was in my notes and the midwife kept double checking if I changed my mind. However after the first puff of gas and air I suddenly felt very sick and said I was going to be sick, another midwife kept telling me I was fine and to just breath and it'll pass, I insisted that I was going to be sick, she kept insisting i wasn't. The other midwife listened to me and got one of the cardboard tubs just in time for me to throw up. The midwife that told me I wasn't going to be sick then said "you were right, you did feel sick" not quite that same as being refused an epidural but still I knew how I felt

I think it's unfair to demonise midwives and lay blame squarely on them.

The NHS is crippled by staff shortages; there simply wouldn't be an anaesthetist on hand for all epidurals requested, the department is under pressure to keep to a budget so a midwife would be slammed for ordering epidurals for all her patients.

It would be unusual for a midwife to refuse an epidural out of spite or some sort of notion that "women must suffer".

Staff shortages also mean that midwives are often dealing with two or more labouring women at once, with time pressures. Epidurals can slow labour significantly simply because the woman is immobile.

The Guardian article is too simplistic and it's inflammatory and short sighted to blame midwives.

When my mother was having me and my siblings, she was told in relation to the pain she was experiencing to "offer it up"! Feckin' church getting involved in medical care. The hospital in question still had nuns running the wards. Awful!

Have you been refused one @SmileyClare

Staff shortages also mean that midwives are often dealing with two or more labouring women at once, with time pressures. Epidurals can slow labour significantly simply because the woman is immobile

Being to exhausted to push can slow things down too.

There are countless stories on here of women who have been sent home, or refused pain relief having not even been.exanimed and in fact completely disbelieve they are in labour at all because they arent rolling around screaming.

What is that then if it's not a case of completely ignorant judgement based on a staff members personal idea of what things should be like?

I was denied that as well. I was induced in the evening and the doc checked and said I wasn't dilated enough. Then at 11pm, I was in pain and blood appeared. I was half asleep and only woke up when one of the midwives said, "Alison, I'm not helping you next time; the baby is not breathing!" He came out at about 1am. It was horrendous. Why did they induced us in the evening was beyond me! If we had been induced in the morning, we wouldn't have been fallen asleep.

Epidural? What epidural? The worst thing is that my midwife told me she would be on holiday when the baby was due. I was totally ignorant. I had no idea that the blood was a sign of water breaking.

What has been bugging me has been that a nurse removed my baby and I didn't even have the chance to breastfeed him. I wonder if these gatekeepers were getting commission for feeding a new baby formula milk. This idea has been bugging for 25 years. Son was sent immediately to a baby monitor unit and he was reported as OK.

And of course, I used the same formula milk after I stopped breastfeeding my baby!

@MrsSpenserGregson I am so sorry. Stories like this is why I do my job. It’s just not okay.

Women not being believed that they are in labour is feedback that maternity voices reps hear so often, it’s something we are trying to address.

If you’re happy to do so, could you let me know which hospital this was and the year they happened? I’d like to bring this up. Feel free to PM me if you prefer (or if you’re not comfortable that’s totally fine, I just know it’s the first thing they will ask!)

I was denied an epidural. I remembered begging for one as was in so much pain from a long back to back labour. I think they tried to say the baby was coming soon but it was another 3/4 hours until she was born. Annoying I had a third degree tear so ended up having a spinal after.

I had the opposite experience. I have suffered from crippling migraines and when I saw someone who was laid flat in agony after an epidural I decided it wasn't for me so I said no to epidurals. My labour wasn't going well, it was a bank holiday and staff shortages so when midwives called for assistance the senior registrar took a while to arrive. The anaesthetist arrived and could obviously see where things were going and he and the midwives were trying to persuade me to have the epidural but presumably couldn't tell me I was going to need an EMCS. I was almost out of it by this stage and I can remember him saying, "Do you want an epidural, it would be a good idea etc etc." and me starting to cry and saying, "I want my baby, that's what I want."

So doctor arrives, says we need to do EMCS now, no time for epidural it has to be a GA and they grab the bed and run. I don't know if I could have been awake for the birth if I'd let them do the epidural, I don't know if it would have caused headaches.

I complained to my Trust as I was denied pain relief (even gas and air) during an induction with a back to back baby. At one point I told the midwife repeatedly I was going to die as I was I so much pain

This is so concerning. I had an epidural with both of my labours with no problem accessing one, but that was 30 years and 27 years ago. It seems things have changed since then. Some of your experiences are barbaric!

My 30 year old DD is expecting her first and this thread has made me so worried for her, so much so I've been looking up private care at Portland St., which is about 9k midwife lead, or 8k for elective C section. I think we'll be offering to pay.

@1forsorrow I had a similar experience in that I needed an emcs and they didn’t tell me that was likely until a minute before I was wheeled to theatre. I wasn’t in labour though. In hindsight I should have realised but they went out of their way to explain away what they were doing so I wasn’t “tipped off”.

I think it’s really wrong, especially in your case. I appreciate that they don’t want women to panic but they could quite easily have said that they felt there was an increased likelihood that they would need to perform an emcs, and if you have an epidural now that would avoid the need for a GA. It seems very paternalistic to withhold this information from women “for their own good” and prevent them from having the opportunity to make an informed choice.

This thread has so many sad stories of horrific care (or lack thereof).

It bears repeating that women’s rights are human rights.

I don't know if anyone is in the mood for a crazy story but back when I had my first, 40 years ago, I was horrified as I was lying in the labour ward, all alone and barely 18 and I heard a commotion and a woman screaming and a man saying, "Save my wife not the baby." All calmed down and I heard a midwife saying, "She wasn't even in labour." A little later it all started again.

The next day I was on the ward happily clutching my new baby when a woman started telling everyone about how she had been sent home the night before as they said she wasn't in labour and that she had gone home on the back of her husband's motorbike. They got home and had to go straight back to the hospital where she was in labour and baby soon born. I always wondered was she in labour in the first place, was she crazy getting on the back of a motorbike if she was 9 months pregnant and thought she was in labour, did the motorbike ride start her labour.

It was all very bizarre.

SinkGirl I just assumed it wasn't protocol for the midwives/anaesthetist not to say it but on the other hand I might have been so out of it, and I was tired and in agony (not what I would call normal labour pain and I have 3 others) so maybe he tried to explain and I was so busy telling him I just wanted my baby I didn't hear him. I have to say I did have wonderful care and even in the state I was in I was thinking how impressive the NHS is in an emergency.

I mean I thought it wasn't protocol for them to tell me before the registrar got there.

Yes IrishMama I asked for an epidural but was gently persuaded to not have one. There wasn't an anaesthetist available and I was delivering a large baby so was told that staying mobile and using gravity would help. The midwife offered me a bloody hot water bottle and entonox.

However I coped. Unfortunately for the cash strapped nhs, the priority is mother and baby's safety and an epidural is regarded as a last resort form of pain relief necessary when a lengthy labour has rendered an exhausted mother incapable of coping. An anaesthetist called to administer one would immediately cancel if he was needed in surgery.

I just think it's a bit narrow sighted to blame midwives for the lack of epidurals, that's not the whole picture. Fault lies with staff shortages, no time to complete paperwork, tight budgets and tired pressurised staff. That doesn't make a dramatic headline though

What makes me angry about this situation is the obvious vulnerability of women in labour. You’re in pain, you’re exhausted, you’re scared, and it’s not as if you can turn around and say ‘No epidurals? Fine, I’ll come back later when one is available’. The baby is coming no matter what. You are at the mercy of the HCPs and you have no bargaining position whatsoever.

I’m an assertive person, the epidural was on the first line of my birth plan, and yet I didn’t get one. But I’ve also seen how midwives on the yard talked to women of other backgrounds who didn’t speak much English. These women are even more vulnerable than most of us here. I wonder how many of them get fobbed off with substandard care.

Midwife tried to convince me to give birth without an epidural, because "you're doing so well!".
I fixed her with the steeliest of steely glares, and said "I don't think you're listening to me. I want a fing epidural, and I want it right fing now!"
Anaesthetist arrived pretty sharpish after that. I'm still a bit mortified about saying that - but it worked!