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.

I’ve given birth four times. Two with epidural and two without. I would choose an epidural every time and in fact did. As @GinIronic says many MW are the gatekeepers of pain relief. In my case, the gate was firmly locked and someone had lost the key.. In two of my births the treatment was appauling.

My experience was very much the opposite, especially with number 2 who was pre-term, so I was on the main labour ward being fully monitored.

I felt like I was being heavily pushed into having more pain relief, despite a significantly higher chance of complications. I'm not sure they were used to women not wanting anything and very grumpy ones too.

Then again they didn't believe I was in labour either.

Just to qualify my experience. None of my situations were gatekeeping. All were due to the timing / decisions made by other teams. In my second pregnancy I had every drug thrown at me and happily took it, the csection was emergency as I had maxed out all epidural and all hormonal drip options and could not birth an 11lb baby at 9cms after 3 days and was no longer progressing.

the pain relief itself was given when I asked. I do feel like if you say no to pethidine they’ll think you aren’t really in pain tho. I’d have said yes to anything

Risks associated with epidurals, inmobility and higher risks of complications/ interventions I would expect.

That said those things should all be weighed against the experience of the mother and the benefits of an epidural.

I had one for my first, but not for my second. It absolutely had it's place in the first and calmed the whole thing down from really being quite fraught. It gave me some rest too. I did have interventions (but was being induced, so assume that was the cause more so than the epidural) and I was super glad I was numb for those too. My second I was just asking for one when I gave birth, had it not happened then I would absolutely have had one as I was at my limit with the pain. Taht said, I much preferred being able to feel the contractions and be able to move untill that point.

Pros and cons, but the mother should have the choice and should not have to argue about it. m

It's because Labour can be so much quicker and easier if you are mobile rather than being on your back. And while there are epidurals where you have some mobility it's not as simple as if you hadn't had one.
I spent most of 4 of my labours wandering up and down the corridor (or in the case of my last up and down my hall) Hanging on to whatever when I got a contraction and those labours were so much easier (and quicker) than the two where I was on a bed attached to a machine. (One preemie and one that had passed meconium)

I was the opposite. I really really didn't want one and I was told early on that I should have one and to get one as soon as possible
I didn't

A debrief and making a complaint via pals may help you process your experience.

It should be patient choice, no one expects us to undergo any other excruciating procedure without pain relief.

I had an epidural with my eldest, i
was in agony and would have happily died rather than continue in the pain I was experiencing and the epidural did bring relief which I will never regret. I did however end up having forceps delivery and have since had 20 years of gynae problems. I’ve got major prolapse issues which are ongoing. Recovery took a good while as well with several years of dull pelvic pain.

I had pethidine with ds2 who was a huge baby. It did bugger all for the pain but I did appreciate being able to feel when to push and recovery was much quicker.

It always should be women’s choice though.

Please please please send in a PALS (complaint), otherwise their attitude will never change in that unit.

I’m sorry this has happened to you, I would be equally as upset.

I had the opposite experience! They tried to push me into having one but I wanted to scale up pain methods first.

In the end I had an EMCS so I’m really glad I didn’t have one.

From my experience, I had an epidural (which I was trying to avoid) because I was shaking and vomiting with the pain - brought on by the overnight nurse practitioner giving me a very high dose of Pitocin to 'speed things up' but that's another story.

I was trying to avoid the epidural because I'd read that in some cases it can slow down labour and lead to more likely C-section.

It stopped the pain that was causing me to vomit which was a bonus and I actually managed to sleep for a few hours.

But the downside was it was so strong - that there was no chance of walking around or moving into a different position to push so had to be lying on my back.

And I pushed so hard that there was a lot of tearing which I don't think would have happened if I hadn't been so numb.

Midwife here - it's absolutely nothing to do with cost. All the midwives I work with would never not get an epidural arranged to save money.

We have an anaesthetist for labour ward, and majority of people who opt for one get one as soon as they ask. However if that anaesthetist is in theatre with an emergency case, there may be a wait as other anaesthetists on are usually in other areas of the hospital and unable to come to labour ward.

I see lots of people who document in their birth plan that they absolutely do not want an epidural and it then can be tricky as they ask partners to also say this, but when labour establishes they ask for one and so sometimes we may try to get them to consider other methods of pain relief like gas and air, pool to keep in with their birth plan. If someone has a wish for an early epidural and they are in established labour then I don't see a point of dragging the process out, but if it's an induction my trust tends to provide epidurals prior to established labour as we know the whole process can be more painful.

I'm sorry OP you had such a terrible experience - please reflect this back to PALS. I can assure you that this isn't the morn. And actually someone with an epidural can be easier to look after that someone without. Overall though if someone asked would I recommend an epidural I probably would say wait and see how they cope, because it can then lead to a cascade of interventions.

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

This was my experience as well. I did call for an epidural at 9cm my midwife quite rightly laughed me out of the park. I am so glad I didn't have one. I was up and dressed after 6 hours, which was wonderful.

My sister had an epidural and had complications and needed intervention (forceps). I didn’t have an epidural and screamed my head off, but basically walked back to the ward after.
I would agree with the wait and see brigade. I managed with gas and air, walking about , bouncing on a ball and screaming.

I begged for an epidural at 5 cm and was told it was too late and I couldn't have one . I think the midwife just couldn't be bothered with the paperwork. I didn't bond with my child straight away as I found the birth experience Traumatic. I think it would have been so much better with an epidural.

I begged for an epidural with my first and wasn't given one. Labour was 36 hours and I remember screaming, vomiting and clawing my face with the pain. I had second degree tears but no interventions.

With my second, I got the epidural and rested, feeling nothing, until a midwife told me I was fully dilated. I didn't feel any pain but I couldn't push so I ended up with an episiotomy and ventouse delivery.

There are ups and downs to both choices but it's the mother's choice and no one should try and force anything.

From someone who has had a birth with an epidural, and one without, I would personally recommend going without to anyone who can. No judgement of anyone who has one obviously. Yes, it hurt more without BUT the birthing part was so much better - I could feel when I needed to push and as a result DD graced us with her presence in a couple of pushes. A first birth would have been harder I know but I just couldn't push hard enough with the epidural in when having DS - I needed a vontuse delivery after 1.5 hours of pushing with my son. Mostly though I just remember the hours following. With DS (epidural delivery) I was stuck to a bed for a couple of hours at least and felt faint etc getting up. Getting cleaned up was hard. DS had been taken to neo-natal and I wasn't able to go with him. With DD on the other hand I felt fantastic straight after. I went for a shower on my own and felt almost normal. I think I could have walked home from the hospital that night and been absolutely fine.
This was my experience with and without an epidural and I appreciate not everyone has the same. I don't think it's unreasonable for the midwives to encourage you to go without if you can, but the shame you were made to feel isn't ok.

I eventually had an epidural after hours of pain so great I would've taken a bullet if they'd been willing. That was in the UK. Then had an episiotomy ( better than an uncontrolled tear) and ventouse. Second one was born in France, epidural offered as standard. I read the paper for a bit, pushed a bit when I was told to, and there she was. Glorious. They should ask you beforehand what you want, and go with that.

They should not have behaved like this at all. It is your choice after they make you aware of the risks.

But in your OP you say that it doesn't affect baby, it does affect you. Every single person I know that had an epidural or spinal block has had back pain for life afterwards. Not debilitating but it wasn't there before pregnancy. Maybe it can't be officially linked and doctors will argue its from the pregnancy but its certainly more than a coincidence, no one who didn't have one seems to have the same issue...

Many think the epidural is a magical thing that will block all pain with no side effects but it isn't. Sometimes it doesn't work, or only on one side, you can get leakage of spinal fluid. They're sticking a giant needle into your spine and should not be done lightly.

You are in immense pain and have the right to decide 100%, but when there are so many non-invasive options available for mum you can see why it would be preferred that you try them first.

With DD on the other hand I felt fantastic straight after. I went for a shower on my own and felt almost normal. I think I could have walked home from the hospital that night and been absolutely fine.

I guess this is the trade off. I did go home after 3 hours with DD (DC2), walked to the GPs the next day for the baby check. I was high for weeks.

Epidurals make pushing more difficult I think, and can cause low blood pressure.
I don't like pain much either, but got through 2 labours on gas and air, so I personally was glad I'd taken the midwives advice and gone as far as possible without an epidural. I tore badly anyway, I can't imagine how bad the tears would have been with an epidural.

OP, you're not a wimp or a failure by any means. Those midwives were nasty and completely unprofessional. In what other line of work could people gossip about the 'client' right in front of them?! I'd suggest getting a copy of your medical notes just so you can get it all straight in your mind - I was glad I did even though they're littered with pretty judgmental comments.

I'd a very similar experience with my first DD - 12 days overdue, induced, baby was back to back (nobody told me). I was well aware of the risks but I'd already decided that I wanted an epidural and had already met with a good degree of judginess - eg at my NCT class when I said I'd like to have one and the woman running the class tried to hush me as if my attitude was contagious - while promoting gas and air (what's natural about that?). 'To be given epidural on request when possible' was the only thing on my birth-plan.

And yet still the midwives persisted for more than 20 hours in telling me I should 'woman up' and 'be brave'. The gas and air made me vomit and I was in agony - and knackered as my waters had broken a day earlier, the oxytocin was like riding a bucking bronco and I'd been up for three days already with pre-labour and labour. I'd also just been through a car crash and my arm was in plaster, there was a trace on me and an oxytocin drip so I wasn't exactly mobile.

Finally, after 28 hours a consultant came into the room and I pleaded with him and he sorted out the epidural to much tut-tutting from the midwives. The relief was amazing.

I had my DS in Ireland and my god the difference! I started becoming paranoid that I wouldn't get an epidural and my midwife there wrote write across the top of my notes 'to be given epidural if requested.' Sure enough, when I went into labour (induced again) the midwife arranged for an anaesthetist to come straight to the room and I was given one with no judgement or quibbling. Same with baby number 3.

I didn't have PND but I was definitely in a far worse mental state after the birth of my DD than if the midwives had made me feel they were listening to me and gave a damn. I know the NHS is free and a wonder but I don't know any other setting where a 'client' would be spoken to the way those midwives (and many others, my sister and SIL had similar experiences) spoke to me - and to the OP.

I hope all is well with you and your baby OP.

This isn't true about back pain. I had an epidural and no back pain, same with my 3 sisters and 2 sisters in law. Don't spread misinformation like this please.

I’m so sorry you had to go through that. 💐
It’s disgraceful how you were treated and almost gaslighted. Epidural doesn’t not equal a bad mum. Some midwives should wind their neck in, women should give birth however they want. When I have mind I’m having every drug known to man to get through the birth!

I had an epidural at 9cm.Im sorry your friend went through there

I’m so sorry this was your experience OP. This makes me so cross. It’s fine for midwives/doctors to advise, but they need to do so in a way that is framed around giving women the ability to make an informed decision about their care and NOT in a way that belittles, patronises and dismisses women’s choices. Even if as many have pointed out there are valid reasons to wait for an epidural to be administered, these should be clearly explained to the woman with the pros and cons and she should then be able to make a decision that is followed without comment or judgement. It seems that it is more often than not that women’s wishes are dismissed by medical professionals, and at worst mocked and derided. Women are so often infantilised when they have a baby inside them. It makes me want to scream.