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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

328 replies

stripyspider · 16/11/2022 17:20

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.

OP posts:
RedHelenB · 16/11/2022 18:07

There are many reasons, if the aneathist gets called into an emergency c section, the possibility of the epidural not taking, the fact ot is harder to push as you don't feel the urge
I had 2 epidurals but my completely natural birth was by far the least painful, quickest and most straightforward.

Zanatdy · 16/11/2022 18:10

I think as it can lead to an assisted delivery more so than not having one. I had one first baby, and had forceps and then didn’t for 2nd and 3rd and no assistance needed. I couldn’t feel the contractions at all due to a top up before the birth so pushing was hard. Without the epidural I could listen to my body, which made me pull back a bit when midwife encouraging me to push harder. I think that helped me not to tear as I had a slight graze but no stitches. I was amazed at how my body knew what to do, I didn’t feel any of that with the epidural. Just my experience

Twizbe · 16/11/2022 18:10

@Somuchgoo the pain of crowning was like doing an almighty poo.

I expected terrible pain but it wasn't pain. It wasn't pleasant but not horrific pain.

MaybeMaybeNotJ · 16/11/2022 18:12

The side affects can be awful. My friend had a spinal leak and suffered awful headaches and couldn't stand for days.
There are risks to any intervention that's why they try to dissuade you I would assume.

Overthehill123 · 16/11/2022 18:12

Midwife here, I feel your title is rather unfair, you've managed to make two experiences account for 'all midwives' collectively it feels.

I personally couldn't care less what pain relief a woman in labour wants, I have no judgement or preference as long as they are informed in their choice. It feels like these days, we really can't win, we are either witches not allowing pain relief or we are too pushy and make people feel like a failures! Your friend was not in active labour at 2cm, therefore it would not be advised to have an epidural, at 2cm the contractions may have ceased and all ground to a halt, then you can imagine the complaint that goes along with that one... not actually in labour, given a epidural and then the cascade of intervention begins as we then are committed to delivering a baby that may not have actually been ready to be born. I agree you should never have been discussed in the corridor in that way and the wording to the junior doctor was clumsy, but it just feels like we are dammed if we do and dammed if we don't these days!

Skyedart · 16/11/2022 18:13

I think this must be your hospital/trust. For me I absolutely didn’t want an epidural as I was terrified of the needle and not being in full control. My midwives both times were trying to get me to have one and I remember one saying ‘there’s no medals you know!’. I didn’t have one in the end (did end up asking but was too late both times!) but there was more encouragement towards it than not. This was two separate hospitals and trusts as well as we had moved and I was induced with the drip both times.

babyjellyfish · 16/11/2022 18:14

YANBU.

Your choice was perfectly valid and should have been respected from the start.

In France it's the other way round. No one can understand why you wouldn't want to have an epidural as soon as possible.

Itisbetter · 16/11/2022 18:15

@Overthehill123 not actually in labour, given a epidural and then the cascade of intervention begins as we then are committed to delivering a baby that may not have actually been ready to be born. why are you committed to delivering the baby? (I’m genuinely interested).

SerenadeOfTheSchoolRun · 16/11/2022 18:17

I used to be a midwife and worked somewhere where epidurals were discouraged. It is because they make forceps/ventouse and caesareans more likely and some midwives are almost ideological about normal birth. However, I think it should be up to the woman and so many people went from too soon to too late without getting one. I remember one woman begging me for an epidural and I went to the shift leader to say so and she told me to jolly her along. It's not right.

bakewellbride · 16/11/2022 18:19

Sorry for your experience but you can't generalise - you say 'they stop you from having one' but that's not true. I was going offered one but said no. A Google of the disadvantages of an epidural will give you my reasons and I disliked the risk of lasting damage in my back. I'd never judge anyone for having one, I don't really care.

knitnerd90 · 16/11/2022 18:19

It's not simply availability. the RCM had to scrap it but for a decade they had their "Campaign for Normal Birth" - i.e. no epidural, no episiotomy, no forceps/ventouse, and no managed third stage. Many midwives sincerely believe getting an epidural is bad for you or the baby. The RCM had to drop that campaign in 2017, but it doesn't mean all midwives lost their bias.

There's research challenging the received wisdom that epidural increases the risks of Caesarean or assisted delivery and that the correlation may not be causative: it may reflect that women with difficult labours have more pain.

SummerHouse · 16/11/2022 18:20

I had a third degree tear then a second degree tear. Third on gas and air, second on two paracetamol. I didn't feel the tears at all. I had an epidural after the third degree tear for stitching and it was bloody wonderful. But I still wouldn't change a thing about my births. It was painful but the natural high was like nothing else. I could actually feel it rushing in after each contraction. It was kind of addictive and a fascinating experience. It was what I wanted though and that should be the right of every woman in labour. I think it helps to read up, whatever you feel you want. I was obsessed with understanding what the pain actually was.

No way on god's green earth would I go on the drip without an epidural. I would not wait, I would not "see how I got on" - same for back to back.

MsBubbles85 · 16/11/2022 18:20

Something similar happened to me. During all my appointments with the midwife,I mentioned I wanted an epidural and she kept saying that better to see how I was going. At the end, I arrived to the hospital when I was 2-3 cm dilated and they just told me to wait and gave me pethidine to keep with the contractions. Next time they checked (2 hours later) I was 5 cm dilated and they sent me to the labour ward as I was literally screaming for the epidural but they took too long to have the room ready, the wheelchair ready and then I arrived to the labour room I was already 10 cm dilated and they couldn't give it to me, so I gave birth without any pain relief.

PurBal · 16/11/2022 18:21

Not my midwife. She encouraged me to have one ASAP to ensure I had all the benefits and don’t spend more of my labour in pain than I wanted to.

fairgame84 · 16/11/2022 18:21

It must depend on hospital or midwife. I was encouraged to have one but initially declined. Once I got to 5cm I wanted one but by the time the anesthetist arrived 20 minutes later I was 10cm and pushing so I didn't get one which in hindsight I'm pleased about.

Kazzyhoward · 16/11/2022 18:22

Surely it's the risks to the spinal cord. I know two people who suffered severe problems when it was injected into the spinal cord.

Subbaxeo · 16/11/2022 18:23

I’m appalled at your experience. Sadly the NHS is full of old boots who criticise anyone finding procedures difficult or painful, call patients wimps and mock them. For some of the staff, it’s kind of like you’re morally superior if you ‘don’t make a fuss.’ It’s like you’re not allowed to let them know you’re in pain. Fuck that. Your experience was particularly horrid though and I’d make a complaint. When I had my babies, I wanted an epidural after trying gas and air and got one. I wasn’t made to feel like a nuisance or a wimp-and my view is that if pain relief is available and you want it, whoever not? The issue that was explained to me was that the sensation to push is barely there with an epidural-although with my second, they limited the drug so I could feel the contractions. But the upside was that I was very relaxed giving birth. I’m sorry you had to go through that.

pinkpotatoez · 16/11/2022 18:24

Probably because of the possible side effects. I've also heard that the pain is motivation to push, no idea how true that is?

Orangepolentacake · 16/11/2022 18:25

onmywayamarillo · 16/11/2022 17:27

I think it's because your labour and giving birth is better and less complicated without one

“Better”? Says who?

Orangepolentacake · 16/11/2022 18:25

I’s guess is because it’s difficult to get the anaesthetist to come round

Ocampa · 16/11/2022 18:26

I hate it when people say that epidurals don't always work. It's such bullshit that thst's a problem. My first epidural didn't work so they inserted another one. They can't do this endlessly but 1 epidural not working isn't a problem, they can do another one.

faffadoodledo · 16/11/2022 18:26

25 years ago the perceived wisdom was try to avoid an epidural. It makes your birth less active and can increase the chances of other interventions.
I have no idea if that is still the case or whether epidurals have improved somehow/
It certainly put me off and I'm glad it did. Childbirth was painful (of course!) but in no way traumatising for me.

Proamble · 16/11/2022 18:27

Usernamen · 16/11/2022 17:32

The point about costs not being a factor in any way in the NHS. I would love this to be the case btw, as I won’t be able to afford giving birth privately when the time comes. Can I request to have a c-section for preference, for example (I presume this is costly due to consultant care)?

Yes you can definitely request a section.

Chaiandchocolate · 16/11/2022 18:28

I’m sorry this was your experience and you can request a debrief meeting from the hospital to discuss your birth.

Your experience was not mine at all. I was induced for medical reasons, offered pethidine and then they recommended an epidural because they said labour is a lot more painful when induced. No one sneered at me and when the Obstetrician brought six medical students in to observe when I was pushing there was no comments made at all other than this woman is at X part of labour etc.

The epidural only worked for a few hours before wearing off and the anaesthetist was called back but there was nothing more they could do after topping it up, so I experienced the full force of pain. It is a myth that epidurals are 100% safe and always work. They also increase the risk of further interventions.

I think you would benefit from having a debrief and if necessary counselling so that you can move forward and concentrate on your baby.

Stunningscreamer · 16/11/2022 18:28

I had an epidural after eleven hours of full on, painful labour. They tried to dissuade me but I was very, very assertive (unlike me). Make sure your birth partner is briefed to advocate for you. I waited for quite a while so it didn't make much difference to the length of labour and I had a mobile epidural so could move around. I wanted to kiss the anaesthetist it was such a relief.

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