To ask why midwives try to prevent / discourage you having an epidural ?

[stripyspider]

I recently had my daughter, ( six weeks old). I knew from the outset of the pregnancy I wanted an epidural, (I don't cope with pain well). Everyone I knew who had one, (including a midwife friend), spoke excellently of them, and had no side effects. Also, what was an important factor was, unlike pethidine, epidural does not cross the placenta and effect the baby.

However, at any antenatal appointment I had, (including the birth planning appointment), my midwife kept telling me I should see how I do, and kept saying, " but you might Suprise yourself and cope so well with gas and air you won't need an epidural," "be so much better if you didn't have one." She then kept telling me I should try and wait as long as possible before having one.....the implication being, that I was being a bit of a wimp for wanting/ being set on an epidural.

I just couldn't work out why it would be better for me to exhaust myself by going through hours of agony unnecessarily, ( which could potentially lead to PTSD/ birth trauma), when the hospital have epidurals that are proven to work, and don't have any ill effect on the baby ?

My anxiety was peeked by the fact a friend of mine had her first baby at the same hospital a few weeks before I had my daughter. She was also clear from the outset she wanted an epidural, and faced the same attitude of "well you are being a bit of a wimp," by midwives, ( she had such bad tokophobia she was referred to the mental health midwife, and the mental health midwife tried to persuade her against having an epidural when making a mental health birth plan !) In the end, this friend went to hospital , was found to be 2cm dilated and was sent home even though she was crying in agony and begging for pain relief. She returned a few hours later and had dilated to 9cm really quickly, so was then told it was too late for an epidural and she had to give birth with nothing. She is very traumatised and upset by this.

I tried to explain to my midwife I was worried about similar happening to me, and she just dismissed it and said, "but your friend is lucky she managed the majority of her labour at home and had an intervention free birth, that is a good thing. Don't worry yourself stripyspider, don't let your friend scare you, she actually had a good experience, and some people like to moan for nothing, she sounds like one of those people"

Anyway, in the end I went 13 days overdue so needed to be induced via drip. Even the NHS website states that induction via drip is likely to be a lot more painful than natural labour, and you may want to request an epidural at the start. I thought if this was standard NHS advice, it would be pretty mainstream.

The midwives kept trying to dissuade me from having an epidural before the drip ,saying it was an "unusual choice," and why would I not want to wait a while to see how it goes ? They also stated that an epidural at the beginning would prevent me from having an active birth and be able to move around.

I pointed out I was hardly likely to be bouncing on birth balls up the corridor given I was canulated, attatched via wires to a massive drip and several monitors, ( and therefore waterbirth would be out regardless). They said I should start the induction and try pethidine first, I pointed out I didn't see why it would be better to try pethidine when I have a family history of reacting extremely badly to opiate medication, the anaesthetists had already told me pethidine didn't really do anything to relieve labour pain and , unlike an epidural, could transfer via the placenta to the baby. In the end , they did agree to allow me to have an epidural before the induction drip started, but I was really upset to hear them laughing about how I was "demanding an epidural," in the corridor. When the shift changed, the next midwife said to me she would have likely had an epidural as she's not good with pain, but would have waited until 4/5 cm dilated. When I asked what the benefit of waiting was, she just shrugged her shoulders.

When I was actually giving birth , they invited a student doctor in to watch, ( he was on placement), and even said to him, ( in front of me ), "sorry you don't get to see a more normal/ natural birth."

I feel like i've been made to feel like a failure and not a "real," mother/ women for wanting an epidural, even though there appears to be nothing to suggest an epidural is damaging to baby at all.

Why are they so, so , so keen to stop you having one, ( to the extent of telling my tokkophobic friend she didn't need one). The only reason I can think of is it costs the NHS more as you have to stay in hospital longer with an epidural , but is there more to it ?

The being made to feel pathetic has really knocked my confidence as a mum tbh.

That’s my point. That it should be decided case by case, depending on the situation. So it would have been a mistake for me to have had epidurals and I followed my experienced midwives advice. Tbf they were all really nice.

Before I had my first vaginal birth I was terrified about the pain and was pretty convinced I would have an epidural. After giving birth, I realised that epidurals are great if you need them but gas and air and breathing are very effective if the birth is straightforward.

And it isn’t about getting a medal. I wouldn’t have an operation without anaesthetic and win some sort of medal and if I require pain relief I take it. It’s just that if you don’t need complete numbing, then the process is easier on the mother’s body.

Think there's two things here: if you have any intervention in a natural birth, this increases the risks of further interventions. So if have epidural, more likely fail to progress in labour amd require forceps or c section.

However, if you're already having IV oxytocin to induce labour I would 100% want an epidural!!!!! As could be more painful than natural onset and already having iv drugs as you say.

Hope you're enjoying your baby despite your birth experience.

I had this.
Already had two births on the drip and needed to have an epidural in both instances.
I was induced for my third - I requested to have the epidural before the drip started, but the midwife pushed me into "giving it a go with gas and air". "Some women just panic. You might be calmer this time".

Sure enough, once she turned the drip up past a certain level I was screaming in terror and agony, had to wait 50 minutes for the Dr to arrive to put it in.

I'm more traumatised by my third labour than the first two - because I was not listened to and had to endure the horrific pain of the drip for what felt like forever.

(Not to mention the fact that my baby was stuck in my pelvis due to the drip going up too fast - ended up with an emergency section)

So last year I had some dental implants. To have the implants I needed anaesthetic. To have the position checked, the healing abutments needed taken out and then screwed back in. On one side it killed as the gum immediately goes over a bit of where the screw is so getting the healing abutment screwed back in means gradually pushing the gum out of the way. the dentist numbed one side as there was more gum but on the other side it was more bearable, so didn’t numb it.

So why not numb both sides? Because I didn’t want to not feel my mouth for the following 2 hours.

Nothing brave and if painful and necessary I will take the anaesthetic but if unnecessary, a bit of bearable pain is better than no feeling.

Like I said I had 3 vaginal births. I didn’t know what to expect with my first one and I was terrified. My midwife said that if I had coped with the level of pain already then I wouldn’t need anything else. And she was right. With the following 2 births, I knew the score and I was more relaxed. But happy to know that if I needed it, pain relief stronger than gas and air was available.

But @Musti the issue is who decides at what point the pain is unbearable and anaesthetic is necessary. Why is a midwife allowed to deny you when you are screaming and begging for one in the middle of labour? Why I'd she allowed to deny if you've done your research, understand the risks but still want one from the get go?

The decision should be yours alone.
Just as it was in the dental work example you gave.

Our body, our choice.

Well that depends both my labours were complicated anyway ,i wss induced with both my boys ,first labour was really long with all kinds of intervemtion ,ds 1 waa finally born with his cord wrapped tightly round his neck and not breathing ( thankfully hes now a healthy nearly 16 yr old) and ds2 was also complicated and eventually born via ventouse ,
But back to the op im sorry you went through that ,that wasent my experoence ,i asked for and was given an epudural in both my labours

I completely agree with you and I have had lovely midwives (I have 4 kids and have given birth at different hospitals). I would just be wary of people who haven’t experienced birth deciding beforehand they need an epidural.

It is comforting and more relaxing knowing that if you need it, pain relief is there.

And I also know that despite childbirth being natural, it would also cause a lot of deaths if left to nature, so we do absolutely need medical intervention. If I hadn’t had a C-section with my first, we would both have died - no question about it.

You think I’m a midwife?! Ha.

Sounds awful, op - I’m sorry you had such a bad experience. As others have said, a debrief might be helpful. I was induced overdue and got the epidural at 6cm. The only resistance I had was an initial ‘are you sure?’ and a rundown of the risks, which is the way it should be. I loved my epidural - went to sleep until 10cm dilated then could feel the contractions enough to know when to push without them causing pain. However, like all pain relief it has different effects on different women and it sounds like I was one of the luckier ones. As long as you know the risks all women are entitled to their decision.

If a woman knows she doesn't want to suffer any pain, why does she need to wait and see how it goes? It's her right to decide to opt out of pain, there's a treatment right there that can do that for her in most cases. The midwife shouldn't be able to override the decision of the mother, whether she agrees with it or not.

This has nothing to do with anything, you just fancied boasting about your experience. Other women’s experiences don’t match yours, do you think it’s because they ‘didn’t try hard enough’? Get out.

I would just be wary of people who haven’t experienced birth deciding beforehand they need an epidural.

But then if you don't insist on one from the start you run a very considerable risk of being fobbed off when you do ask for it late on, under the excuses of "it's too late"/"but you're doing so great without"/"no anesthesiologist on hand". As evidenced by a gazillion stories on this thread alone.

Also, what is worse - an epidural you could have done without or a traumatising birth in agony that leaves you with PTSD because someone gaslighted you into going without?

@Herejustforthisone well said, just what I was trying hard not to say to her in fear or being too rude...

I had an epidural for both mine-1st at 7 cm and very tiring Labour, 2nd as they were considering inducing-in the end didn’t need it. My 2nd came after 10 minutes of pushing and I was up and home the same day-yes with an epidural. What I’m saying is that you can’t extrapolate information from your individual experience and use it to tell other women what they should be doing. If you wanted minimal pain relief, it’s only right your wishes are respected-but if someone wants the whole she ang, they shouldn’t have to beg for it because natural is ‘better’.

speaking as an ex healthcare professional, it's a clinical procedure which confers potential extra risks for both you and the baby so staff are duty bound to get you to consider other options. I likewise did a job where patients sometimes couldn't avoid experiencing pain and had to encourage them through that in a supportive,compassionate way....people don't know what they can cope with until they are in the midst of the experience so epidurals on request are not clinically sound. What they don't have ANY right to do is gossip about you, make unfair digs or treat you with any less respect because of the type of birth you have or the requests you make. Likewise I still hurt many years later because of disgusting comments I overheard staff making in regards to my failed attempts to breastfeed...I still wish i had made a formal complaint, not least because its a breach of patient privacy to hear them giving handovers about all the patients in the bay within earshot! There have been baby death scandals on maternity units solely because staff have been wedded to an absolutism about natural birth which overrides their responsibility to assess every woman on an individual basis.

...people don't know what they can cope with until they are in the midst of the experience so epidurals on request are not clinically sound.

Can you share the official guidelines or research that supports that assertion?

@2022again imma call bullshit on that, because a quick search of NICE guidelines directly contradicts you:

You should be able to have an epidural at any point if you want one, including during the early stage of labour.

www.nice.org.uk/guidance/cg190/ifp/chapter/pain-relief

@Herejustforthisone did I ever say anyone didn't try hard enough? No! Don't project your feelings onto me.

In another comment I have said that epidurals and c sections are wonderful things. They have saved lives and are a reasons we have low maternal and infant mortality in this country.

HOWEVER, not every birth needs to have epidurals or c sections. That is a fact. Some women give birth without them and aren't traumatised by the experience.

Women who have the births they wanted aren't allowed to talk about them apparently for fear of 'boasting'

My point was that I didn't need those and wouldn't have liked to be forced into them.

indeed. Some people do know what they want to ‘cope’ with in advance (want not always can), particularly if they are otherwise in pain, are going to be induced etc. it’s fine to specify an epidural in advance and turn it down on the day and it’s also fine to plan to have one and for that plan to be respected and put into action.

My point was that I didn't need those and wouldn't have liked to be forced into them.

But you seem to be arguing that sometimes it's ok for women to be forced OUT of them...

Nobody is ever forced into an epidural, plenty of people are forced to have a delayed one or to not have one at all.

Generally speaking epidurals increase the risk of other, more serious interventions. I think people often view epidurals really casually, as not a big deal, but they actually are and that's why there's the pushback to try without.

My nephew nearly died thanks to an epidural - it slowed the labour right down (which had been progressing normally until the epidural), mum couldn't feel anything in order to push, baby got stuck and became distressed, but was too far into the birth canal for an emergency C-section. Cue ventouse with the Dr literally bracing his feet against the bed and pulling as hard as he could because it had become a life and death situation. They got him out in time thank God, but he has permanent vision and jaw problems due to the ventouse, some of which may require surgery later on.

My guess is Drs and midwives will have witnessed births like the above, and would prefer to avoid those situations if at all possible.

No that's not my point.

My point was;

1. before going into labour you have no idea what will happen. Being wedded to ANY birth plan can lead to disappointment if it doesn't happen that way. That's whether you want all the drugs or none at all

2. midwives and health care professionals should get women to think about all options for pain relief before birth so they can make informed decisions during birth.

3. over medicalisation of birth can be just as bad for women as under medicalising it. It's a super fine line though between the two and very individual.

4. other countries have very different approaches to birth but different isn't always better. Having only epidural for pain relief isn't great. Having only planned sections isn't great. It's a balance again.

5. some women have good births (I'm sorry but they do) they should be allowed to talk about them without fear of people saying they're boasting or insinuating that other's didn't try hard enough.

6. informed choice is important.

My labour was awful but the midwives encouraged me to have an epidural, so did the doctor. Maybe because I was induced & on the drip? Anyway, it only worked on one half of me, probably because I have scoliosis. So yeah, that was shit!

If there's a known shortage of anaesthetists at your chosen hospital, the midwives may be trying to manage expectations.