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.

…. says the MW - probably.

I had a water birth with gas and air that resulted in a second degree tear and I was surprised at how well I coped with the pain of childbirth because I'm normally a bit of a wimp about pain. My birth plan said I wanted those things for pain relief, but if they didn't work out I wanted to go for an epidural too. The worst bit pain wise for me was definitely getting the stitches done afterwards. I tell you this not to boast, but to illustrate the point that I think our experience of pain can be much worse if we feel stressed out and not listened to or supported fully. I expect your friends experience of labour was worse because she didn't get what she said she needed.

This wasn't me experience either OP. It was all about options, considering your birth plan, choosing what I thought was best.

As with anything related to pregnancy and birth you have to weigh up the pros and cons / risks and benefits. Epidurals do come with benefits of course, but they also come with risks.

However, it should be the woman's right to choose whilst being in possession of all the facts.

Your midwife should have said to you - ok I hear that you want an epidural and the benefit to one is X - however, I have to point out they are not risk free and here are some of the risks with having an epidural and here are the statistics.

The stats are important - you can't say they are riskier without giving context, e.g they should say 1 in 1000 women may experience xyz - which is still very much low risk.

I had to choose between an induction or c section. I was given a massive document with all the information and the consultant took me through all of the stats line by line. The main risk for me based on what was happening to me at the time, was that c sections have a higher incidence of secondary infertility compared to inductions. But the incidents of inductions resulting in a c section are much higher.

Secondary infertility was not a primary concern for me because I'd already decided I'd be happy with just one baby, so for me personally a controlled planned c section carried a more reduced risk vs an induction with a much higher risk for an emergency c section. For another woman that might not be the same.

That's why all care should be mother centric. What's important in my decision making may not be important for another woman.

If you have an epidural it is harder to push and more likely to result in an assisted delivery with a need for episiotomy. I had a long slow labour and had to have an epidural in the end. Had forceps delivery, tore very badly as baby's shoulder got stuck them haemorrhage everywhere. It was horrible and probably couldn't have been prevented due to large back to back baby coming out sideways. It did require a lot more staff and resources than my second labour, just me a midwife and some gas and air and I imagine the stretched NHS do need to try and preserve anaesthetists and theatre staff for real emergencies. I'm not saying it's right and it's not the midwives fault, just the state of things these days I think. Of course you could go private but it would cost thousands.

Really sorry to hear your decisions weren't respected OP, shocking this is happening in maternity care given the number of scandals rooted in women not being listened to.
I was also discouraged from having an epidural but pushed for one. The evidence that it leads to more interventions is actually out of date. It is the most effective pain relief and means you can be conscious if an emergency c section is needed and still experience the birth of your baby.
It seems bizarre and sexist that society puts the pain of childbirth on a pedestal and there is so much push for natural birth. All pain is natural - but we don't have to put up with it for no reason we have medicine!!
That said I fully support people who choose no pain relief, everyone should be able to pick what's best for them. But there shouldn't be propaganda and judgement pressuring that decision!!
It's not the same in other countries - the US has a much higher rate of epidurals.

Every single person you know has had back pain afterwards, really? That's very strange.
I had a spinal block last year (EMCS) and I've never had any. I'm friends with quite a few women who've had epidurals/spinal blocks and none of them have had lingering issues either.

There's an awful lot of misinformation on this thread. I can't give medical advice online and so won't get involved but a lot of this information is just downright incorrect- please speak to your midwives/anaesthetists/obstetricians for appropriate correct clinical advice - not this thread

(Doi obstetric anaesthetist)

If you have another one I can heartily recommend an elective section. Apart from the first time I stood up the next day (which wasn't fun) it was mostly painless.

I said it was speculation if you see my original post. In my experience, the split between people with back pain and those without is a split between those who have had spinals and who haven't. I also said that epidurals have other risks such as failing, one side failing and spinal fluid leaks. All medical procedures come with risks, including unmedicated labour and delivery.

I'm 100% for women having their own choice but I dislike how many think it's no big deal or some magical fix all for a pain free birth. It's a needle in your spine and can have an effect on how your delivery progresses and your recovery. I don't blame medical staff for suggesting exploring non-invasive options first but should respect mums choice. In this case the staff behaved inappropriately.

I agree. Probably worth hiding the thread, I've never seen this level of medical misinformation on a MN thread before and it's really surprised me given the usual predisposition of MNers towards C-sections. How do people think the pain relief for an ELCS is done?

FWIW to balance out some of the overly-negative comments on this thread:

DC1: I had a spinal with my EMCS, had a dural headache afterwards. It cleared up by itself in 10 days with no intervention.

DC2: I had an epidural with my VBAC at the point where I'd been in agonising stalled back-to-back labour for 16 hours and was being put on syntocin. My midwives were very supportive and insisted on getting the anaesthetist in before the syntocin drip went in. I went from 4cm to 10cm in 2 hours and pushed my baby out with minimal problems. I still felt the contractions but I didn't feel the "ring of fire" or any of that. I had no complications from the epidural and I'd have one again if I ever had a third child.

Less likely to tear badly or need interventions because you're able to move naturally. Your coccyx can move out for a reason and so the ideal position to give birth is upright, leaning forward, so your pelvis can open.

But no one should be made to feel bad for having an epidural if that's what was right for you. Are you perhaps just being a bit sensitive about it?

I had the same experience. Overdue, waters broken at 5 pm by the midwife, drip put up at six. I asked about the epidural and was fobbed off until I was in agony at 8pm. Blood test taken at 11pm by a furious phlebotomist who asked the midwife "why do you always wait until they're in this state to call me? How can I get blood from someone writhing in agony?". Eventually got the epidural at 1 am, and my partner had to prompt them to top up the cylinder as it was running out the next day.

I think the NHS maternity works like it's stuck on opposite day. If you ask for something, they want to give you the exact opposite thing.

I found the same too. Epidural was in my birth plan but I was refused one. They said they wouldn't be able to get hold of an anaesthetist, but didn't even appear to be trying. Was on a week day, office hours too.

I can definitely see why midwives would discourage an epidural if no induction as they do definitely slow labour down. You can’t move around as much/at all and you can’t feel what your body is doing. However I am VERY surprised they would discourage an epidural if you are being induced with a drip. When I was given the choice, once I knew I was being induced, as soon as I elected for epidural, everyone in the room nodded their head like I’d given the right answer. I have never heard of a midwife actively discouraging an epidural in the case of a drip induction as labour is known to be much more painful.

if this is genuinely your experience, along with with comment to student, I would complain to PALS.

I had an epidural after delivery.
Even with a drug free birth, I had a 4th degree tear. So bad things happen even in a drug free environment.

Had to be stitched up afterwards in theatre and the epidural hurt much less than the pain of child birth. I was made to stay for 4 days after the birth, suggesting that there was more to it. I have had flashbacks, PTSD and made a complaint to the hospital about the consultant who waved the massive forceps at me. Their response was that she didn't work there any more. For context, I am 5ft 2 & the baby was 4kgs with huge shoulders.

So there are many sides to this but you should be listened to. And it does eventually fade, but it took years

There's also plain old mysoginy at play. No one would dream deny men adequate pain relief during such a medical event. But women must suffer and do it quietly. Appalling...

That sounds terrifying.

I wish I’d had an epidural. 39 hours of active labour, determined to have a water birth (which I think actually slowed things down) 3 hours of agonising pushing with a back to back baby. Finally an emergency epidural and one chance with forceps. Conversely I was put off having an epidural due to this ‘cascade of intervention’ chat you get rammed down your throat at NCT. All north’s a different there’s not a one size fits all strategy.

If I’d had an epidural I could have relaxed rather than wore myself out trying to have an active birth.

I wonder what the stats are in France (wonderful place to give birth). If epidurals lead to this ‘cascade of interventions’ then what happens over there? More forceps? More c-sections? (I doubt it but happy to be proved wrong). Less exhausted, traumatised women no doubt.

Weirdly I was encouraged to have one when I had my daughter in April as even through the pain at 7cm I couldn’t keep my eyes open after a 4 day induction process due to emergency admissions. It was a bloody nightmare tbh and only numbed my right leg. Great.

I'm always a bit mmmm about this.

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 had a similar experience with my second.. they kept putting me off putting me off etc. then it was too late. Found out when back on ward there was no available anethatist. The four on my ward all had same .

I tried to get one with my third child and honest to God you would’ve thought the money for the Epidural was coming out of the midwives own pocket.

they discovered upon her arriving that she was actually completely the wrong way round her poor little forehead was black and blue and actually she’s been my first child she should’ve been a Caesarean.

i’d already had to drug free births by this point so I knew that this was not right and all the Hypnobirthing breathing shit in the world was not gonna cut it this time.

It massively affected my bonding with the baby and I think probably ended my marriage too because he didn’t stand up for me when I was at my most vulnerable.

Had epidural, first one didn't totally work, so a different anaesthetist did a second, which was blissful. I got loads of sleep which set me up for the pushing stage. They lightened it then so I could feel the urge to push but it wasn't painful. No headache afterwards, and no back pain.

Information antenatally was very unbalanced. I did find they were very hot on the 'risks' of pain relief, nothing about the benefits, no mention that you could ask for a CS. Loads of benefits given for home birth and the MLU, neither of which I wanted! I don't see how women can make informed choices if they don't get balanced information.

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

then why are women also routinely expected to undergo hysterecopies and IUD insertion without pain relief?

What a horrible experience and how unprofessional of them to be laughing at you💐. I ended up being induced after everything stopped and asked for an epidural straight away due to being worried it could end up too late/ no one available to administer. The consultant was in the room and just said that it was a good idea and it was sorted straight away.