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 may well be the case. But I was responding to the poster who said epidurals on demand was not clinically sound. Which is simply bullshit.

I’m not projecting my feelings. You’re randomly telling everyone about your births, which have nothing to do with anything and smack of you being utterly smug. And you’ve let your own agenda slip out with careless phrasing such as ‘overmedicalising birth’.

You might think you’re a hero for your drug free births, but don’t assume your experience means you know better and that other woman shouldn’t be able to ask for an epidural and be given one.

Think this is your hospital.

My hospital said if I was to have the drip they'd give an epidural at the same time.

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.

Can you not read? No one is saying women should or must have any intervention such as pin relief. All we’re saying is women should not be denied anything because they ask for it.

What’s wrong with you? Why do you keep going on about how you’re not traumatised? Your babies might have fallen out inside three hours with nothing except whale music and a pool, but other women haven’t had that. They’ve been writhing in agony for hours and we’re denied an effective and safe form of pain relief. If you want to talk about your experience and your agenda of ‘not overmedicalising childbirth’, start your own thread. You can bang on about it to your heart’s content, then.

I’m sure she’ll figure it out but that was aimed at @Twizbe.

Well said @Herejustforthisone

All births are different. Some women get lucky. Some women are in agony with babies stuck in the wrong position for hours. Nothing to do with pain threshold or trying hard. Just the luck of the draw.

If I’d have felt able to ask for an epidural earlier, rather than persisting with my active birth nonsense I’m sure I’d have had a far better experience. But the NCT really do a number on you.

Do we have any stats on France? Where epidurals are the norm? Does this lead to more interventions. I’d love to see actual figures.

I had a baby in march and also faced severe opposition from the midwives in giving me an epidural despite being v v clear in my notes I wanted one and having discussed with my gp midwife before having a cesars as I was so scared of being denied an epidural I was having panic attacks (I have had some bad surgery experiences before and know I don't cope with pain). I eventually succeeded in getting one and it was marvellous - I literally couldn't feel anything and just read the papers. I ended up needing an episiotomy, ventouse and forceps but couldn't give a monkeys as I couldn't feel anything anyway.

I found out afterwards the reason for them delaying it/trying to force me out of it was the midwife shortage - when you have one a midwife is meant to then stay with you. They had 4 midwives on duty for 11 of us giving birth that night so my demands were genuinely difficult to meet.

I am now delaying having another child as I want to save up so I can go private next time. The midwife shortage is genuinely terrifying.

I thought epidurals tended to slow things down and also increase risk of tearing etc because you can't feel when pushing etc. Once you go down the route of having one generally you are more likely to require interventions which increase risk.

So sorry you went through this OP, the comments by the midwives were unacceptable! It’s still a normal/natural birth? Just because you had pain relief doesn’t make it less so!

I also had the drip and it’s fucking horrible so I feel your pain completely, I was lucky that they actioned my epidural as soon as it was clear I wasn’t coping with the contractions, it was the best thing ever and I will be having another with my second baby.

I had my epidural at midnight and tbh I could move my legs and get up from about 9am so although it’s a long time it’s really not in the post delivery haze? I could still pick my baby up etc. everyone feels pain differently and there’s no way I would have not been traumatised if I hadn’t had an epidural. Please don’t feel like a failure. You brought another human into the world and that is heroic. However you do it!

What bollocks. I didn't have an epidural with my first until after the birth (had to get her out with a ventouse because the pain was too much) due to a retained placenta. I'd begged for one for hours but was denied. I then was taken screaming to theatre to have the placenta removed.

2nd birth, had an epidural from when I was 2cm. The head midwife had agreed 3cm but a lovely midwife ignored her 😁 got the baby out with 2 pushes no bother. Left hospital the next day.

'Pain is a very broad feeling. It's purpose is communication between body and brain. Pain during an operation or from an injury is about the body telling the brain it needs to stop everything else and focus on fixing this issue.

Pain in labour is telling you to stop everything else and focus on what your body is telling you. It's too easy for us to ignore pleasure sensations so it has to be a pain sensation.

Giving birth is like no other painful situation so you cannot say pain relief is denied just because we're women.'

I think this is a useful post but perhaps not in the way you intended. I do think this idea about childbirth and pain permeates a lot of midwifery and care - that it is somehow a useful, noble, special kind of pain. I think it's one step removed from essentially saying women SHOULD be in pain during childbirth, it's natural normal and capital-G Good. Tbh, the only thing my labour pain was telling me was to get pain relief as quickly as possible lol. Something which the midwives refused to do for over 14 hours.

(I don't want to pile on this user specifically cos I can see they're going back and forth with a couple of others users on the thread and I don't want to add to that)

Most of the stories I hear on here and in real life from those who have had epidurals are positive.

Abso fucking lutely.

It takes a certain type of person to come onto a thread of a woman who was traumatised by childbirth and explain in detail about how great her own births were as if that's evidence for why the midwife was right to try to refuse the op's request for pain relief.

Here are some.

www.lemonde.fr/societe/article/2021/06/16/taux-d-episiotomies-de-cesariennes-de-peridurales-l-ars-d-ile-de-france-publie-les-donnees-sur-les-actes-obstetricaux-hopital-par-hopital_6084397_3224.html

Here's an article - in French obviously but hopefully Google Translate will work - covering the greater Paris area. It has an interactive map with stats for different hospitals and clinics, both public and private.

Necker, which is the best children's hospital in Paris, has the following:

Spontaneous vaginal births: 52.4%
Assisted vaginal births: 17%
C-sections: 30.6%
Epidurals: 90.2%
Episiotomies: 2.7%

The clinic where I gave birth has the following:

Spontaneous vaginal births: 48%
Assisted vaginal births: 28.1%
C-sections: 23.9%
Epidurals: 96.5%
Episiotomies: 3.3%

Les Bleuets, which is supposed to be more "natural", has the following:

Spontaneous vaginal births: 56.1%
Assisted vaginal births: 29.2%
C-sections: 14.7%
Epidurals: 82%
Episiotomies: 2.4%

Thanks @babyjellyfish so even in their more ‘natural’ hospital over 80% still have an epidural. I wonder how it compares with hospitals over here. I

Thanks @babyjellyfish!

Unsurprisingly, the data for the UK is really not far off, so where's the evidence for the cascade of interventions?

I'm pretty sure the epidural rate in UK is way way less than 80%. So why is the unassisted/spontaneous vaginal delivery rate effectively the same as in France? Shouldn't we see a significantly greater rate of "success" in all those "natural" births forced upon women in the UK?

Hmmm it's almost like the cascade of intervention caused by epidurals is not a thing...

So to break it down into actual numbers, the clinic where I gave birth sees about 1200 births a year.

Of those,

Yep. I don’t think the ‘cascade of intervention’ bollocks is true. Where’s all the evidence? It needs to be strong if we are encouraging women to go without decent pain relief because of it. And scaremongering them in to trying with a bit of gas and air..

I blame myself for just taking this as a given and buying in to the NCT brainwashing. I was a lost hope - I even read that Inya May book where women were having having orgasms giving birth. I was determined to not even lie down and rest for a second. For all the good it did me.. 39 hours later, forceps and an episiotomy…

Oops, something went wrong there.

So of about 1200 women who give birth there, about 575 of them will have an unassisted vaginal birth and around 550 of those will have had an epidural.

The stats for the public hospital in Neuilly are interesting.

Spontaneous vaginal births: 72.7%
Assisted vaginal births: 10.9%
C-sections: 18.9%
Epidurals: 89%
Episiotomies: 2.2%

I'd love to know what their secret is.

The cascade of interventions isn’t necessarily about mode of delivery. It’s about increased risk of haemorrhage, increased risk of baby admission to the neonatal unit, increased risk of shoulder dystocia, increased risk of 3rd or 4th degree tears. All that data shows is that France do a lot more instrumental deliveries, where instead we do CS, and that most women have epidurals.

You’d be better to look at figures where epidurals aren’t available and compare their outcomes.

Thanks for all the stats @babyjellyfish this is fascinating.

I wonder if French women feel less panicked/stressed as they know an epidural is likely? They don’t have to fight for it. Or wait to ‘see how it goes’ and then be begging in agony once 8cms dilated. I don’t doubt the hospitals are better and the care is better. Maybe that contributes.

There should be more research and openness about this.

Well @Delatron on the upside you’ve made me feel a lot better- I blamed myself for a good while thinking my EMCS due to failure to progress was my own fault for not forcing myself to get up and walk or bounce about. It was when the midwife tried to get me on my feet for that purpose pre-epidural (which failed) that i vommed on her.

Honestly I think most people who say “see how you get on” have no idea how painful induction via drip is, especially with a baby in a sub optimum position. My blood pressure was through the roof- when I look back on it, the pain and it’s actual physical effect on me must have been part of the reason they recommended a section at that relatively early (hahahaha 16hrs post insertion of drip) stage. I’m pregnant with no. 2 and they’ve put me on aspirin due to the fact I had high BP in labour- it was just the bloody pain!!! I had low BP right up until the last twelve hours of that pregnancy.

This.

Birth is proven to progress faster when you move around. You can do this with a drip.