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.

Can you think of any other hospital setting where a patient actively has to request pain relief when they are obviously experiencing pain

Quite. For some reason women are supposed to put up with all sorts when giving birth. Whoever wrote the book of Genesis originally deserves a lifetime of giving birth when he wrote that God said to Eve he would increase her pain in giving birth! all these centuries later we are still being told to suck it up.

I realise sometimes people need pain relief and don't get it but that's a failing of an understaffed NHS. If you went to the dentist and had a tooth out there's no way they'd just tell you to suck up the pain!

It's just so surprising that most (I have never seen a male midwife, I know there are some) midwives are women, and yet they can't possibly put themselves in someone of the same gender's shoes. I don't think this is just a midwife issue, I think it's health care in general not listening to women. But given in these circumstances that the primary care is almost always given by midwives, they're in the spotlight.

@spiderysummer that is exactly how I have felt reading this article, at the time I believed some of the things I was told but now I just think I was being forced into attempting a natural birth even though I was quite clear after 24 hours of agony I no longer wanted one. For a long time after I felt very bitter towards one midwife in particular (who kept forgetting the G&A) and I really wish I had raised a complaint. She was quite old at the time (this is 8 years ago) so I doubt she is still working.

I experienced something similar after my 2nd DC (ELCS) where the midwife came to my home and told me on DAY 3 I could no longer take any pain relief (not even paracetamol) as I was BF. I cried and called my GP who of course told me that was untrue and prescribed it immediately. I raised a complaint against her. It was so very difficult to deal with 3 days after a birth when she was in sitting in my bedroom 'advising' me.

I had an epidural the first time round my midwife was fine with it I got one when I asked but I found although it stopped the pain it slowed my labour right down and recovery was much slower. The midwife I saw through my 2nd pregnancy was not a fan of epidurals she didn't try and talk me out of it but said try other ways to manage the pain. I didn't have another epidural after that I just had gas and air the next two times and for me it was a much better experience. Its your choice though and you should never be denied pain relief.

I had a weird experience with last pg

We had MW insist we do a birth plan - despite previous one never being looked at. She went on for few minutes about how there might not be an anaesthetist available for epidural, they didn't like giving pethidine and in her experience many women didn’t do well with gas and air.

We then got a word in and pointed out we should be down for a HB.

Oh but you won’t have access to pain relief.

DH pointed that I’d managed previous labours with no pain relief – it was ordered to late with first HB and hospital I’d only been given gas and air for about 10 minutes then it was taken away for no given reason and I was told to do without it and despite birth plan nothing else was on offer. MW insisted I coudn't have and she'd been checking up on that information.

MW sent tus o a consultant who really wanted me to have a c-section and would book me in immediately for an elective – for no medical reason - I've been lucky my labours have been straight forward and quick.

Met a neighbour who gave birth within days of me who’d been fighting for an elective after a terrible first labour ended in emergency c-section. Despite fact she’d be induced they said no she wasn’t allowed one ended up with second emergency c-section after things went south very quickly.

Wasn’t just same department was same MW.

What must be taken into account though, is that we are giving birth within the NHS. There simply aren't the resources for everyone to have what they want, when they want it

Oh why is this always used as an excuse? Women giving birth are doing something useful (views on population and climate change excluded). The NHS deals with drunk people on a Friday evening clogging up A&E, it treats people with ski-ing accidents, it treats people with obesity-related conditions. It can damn well afford to give women pain relief and c-sections and I see no reason whatsoever for pregnant women to bear the brunt of any limits on resources.

I was completely against epidurals because I suffer from bad headaches but was offered one with each of my births. I had it in my birth plan as well.
Maybe I just got lucky.
It's horrific to hear that women are genuinely being refused one though.

This is good news and hopefully it will give more women the voice to challenge it.

I’d also like to see better pain relief after birth too.

Too many times I’ve seen women in tears on the word and fobbed of with paracetamol.

A lady at the side of me was crying in pain after a normal birth and could barely walk. She kept asking for help and eventually they brought a doctor in who found she had a massive blood blister the size of a fist half in and out of her vagina. She was took back in to surgery.

It doesn’t matter if there are staff shortages or low funds for drugs - we need to look after women better post labour too.

I really do think review of what happened during labour should be made standard and people can opt out if they want. I had a traumatic birth with dd1 which led to an EC, I was poorly after and suffered with PND. It was only at my appointment with a consultant for dd2 birth I realised how bad it was. Dd was back to back, I was on base line for having a blood transfusion and I’d had a panic attack on the operating table as the epidural made me feel like my throat was closing up and was given a general anaesthetic my dh was booted out of the room. I have no memory of it and no one discussed it with me after.

We really do not do enough women in labour or after it

Tbh yes, my father was in hospital a couple of years ago and we had to fight to get him pain meds during the night. In the end we had to get his surgeon to specifically tell the nursing staff to give him as much as he wanted within the correct dose and even then it was a fight.

That’s not standard practice though, is it? Poor nursing, sure, but not a practice that is considered acceptable. Although, worth noting the group who come in second to pregnant women when it comes to not being taken seriously are elderly patients!

No, but then some women don't want the pain relief, and you can't just force it on them so of course they have to ask. It's all about your preferences (or supposed to be!)

Who said forced? Midwife sees woman in pain, midwife offers pain relief, patient chooses. Should be standard practice.

Some patients don’t want morphine. They don’t leave it up to patients to ask for it because others might not want it.

If they had tried to take the gas and air away from me though I wouldn't have coped!! Also you know your own body and they don't. I had three people at the end of my bed one was a consultant the other two I'm not sure think they may have been shadowing (bit hazy) telling me it's not time to push yet my baby was born 5 minutes later they can be very dismissive no one is a text book they seem to forget that!!

I did a back to back labour and forceps delivery with episiotomy and a tear on 2 paracetamol (which I'd taken at home before leaving) because my MW wouldn't give me anything. I asked, begged actually, but she suggested a warm bath would be better and by the time she got back from running it (took over an hour!) I was fully dilated, needing to push and DD was in distress so I was rushed to delivery. They gave me a spinal afterwards to stitch me up but fuck all when I really needed it which has never made any sense to me

Who said forced? Midwife sees woman in pain, midwife offers pain relief, patient chooses

I see what you mean. Sorry.

That’s not standard practice though, is it? Poor nursing, sure, but not a practice that is considered acceptable

I don't think withholding pain meds from birthing women is acceptable either.

To give a personal experience behind believing that it’s never too late...
I asked for an epidural as I was induced because my water had broken 24 hours before.
They couldn’t administer it straight away as there wasn’t a delivery room free and there was another woman going for an EMCS so she took priority. I finally had one about 2 contractions before I started to push and I don’t think I could have gotten through the rest of my labour without it.

What must be taken into account though, is that we are giving birth within the NHS. There simply aren't the resources for everyone to have what they want, when they want it

Worth mentioning here that if I were giving birth in Australia, I wouldn't get an epidural unless I paid for one. So I was surprised to hear they do them free (when you can convince someone to do one). If it was an option to pay and avoid the argument, I think I would do it!

But @pedanticstyleguide, I agree, the NHS does dish out treatment to a lot of people who wouldn't need it if they weren't drunk, on drugs, fighting etc, and also the NHS wouldn't hesitate to dish out pain relief to someone having an operation, they wouldn't be told, "oh it's not that bad", or to " breathe through it" or "nature knows best". Let's not forget thanks to modern obstetrics and medical advancement that more babies and mothers survive child birth than they ever have.

Oh why is this always used as an excuse? Women giving birth are doing something useful (views on population and climate change excluded). The NHS deals with drunk people on a Friday evening clogging up A&E, it treats people with ski-ing accidents, it treats people with obesity-related conditions. It can damn well afford to give women pain relief and c-sections and I see no reason whatsoever for pregnant women to bear the brunt of any limits on resources

Well said!

Worth mentioning here that if I were giving birth in Australia, I wouldn't get an epidural unless I paid for one

That’s not true.

@DropYourSword It was at RPA, well sat least that's what the midwife told me. They said if I wanted an epidural it's an extra cost of about $1000. Maybe it was going to her holiday fund! :D

Is RPA a private hospital?

I had a CS so never an issue for me. It was a lovely experience, very relaxed and I was well aware of what was going on the whole time. They lowered the screen so we could see our baby being born and I held her straight away.

There's no way I would go VBAC if I had another.

I've never understood this thing some women have about wanting it all 'natural'. You wouldn't opt not to have the drugs if you were having a tooth out so why is childbirth any different? I'm not being provocative, I just generally don't understand what the benefit is.

No Royal Prince Alfred is public, and I was planning to give birth in the public system until we ended up relocating to London. I would understand paying on private, so I assumed that the cost was because it wasn't something the government was prepared to pay for. Obviously I was wrong, that's the first time I have ever been wrong. 😁😁😁

**wasn't not was

This is a relief to see...especially as I'm due my second soon...I asked for an epidural with my first and they just kept fobbing me off well see how it goes and with it being my first and not bring with it I just didn't stand up for myself...this time around I will be firm if i get to a point I feel I need it which I'm sure I will I shall be a lot firmer!

In that article, the professional body for anaesthesiologists is on record as saying that there are enough anaesthesiologists available to obstetric units to do this. Midwives say there aren’t. What’s the truth here? How can that be true at all times? I mean if you have a labour ward for 20 women what happens if they all say they want an epidural at the same time? You'd need 20 anaesthesiologists available 24/7. Or even if 1 woman is asking for it and 2 need EMCS and you only have two anaesthesiologists, surely the EMCS comes first? Obviously I am sure they could cater for an average or typical situation but I can't see that it is always possible.

If women want it and the staff are available they should be able to have it without argument but I don't think it should be prioritised over women/babies who are in a life threatening situation.

That’s really strange @auslass!
The public hospital I’ve worked in doesn’t charge for epidurals. The private one does, but obviously they charge for everything in a private hospital so that’s expected. Not sure why a public one would charge - but if you ever felt like returning at least you now know!!