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 had an epidural and have a history of back pain- if anything my back has been more stable since that pregnancy. But perceptions like “everyone I know who’s had one has back pain”, had me worrying and googling on like Day3 post birth thinking I’d done myself over. My frantic Google search revealed there’s no correlation between epidurals and the likelihood of postnatal back pain- otherwise half of France’s female population would would have back problems. I mean I could say with complete honesty “In my experience if you vomit with pain on a midwife you’ll get an epidural within half an hour”, but it would be irresponsible of me to do that in earnest.

There’s a lot of discussion about the cascade of intervention here, and the added risk of tears and so on. I don’t know if that’s true (my googling did not encompass this point) but we’re completely ignoring the mental aspect and potential for psychological injury to women by not listening to them when they’re in extreme pain and in a highly stressful situation. I did 16hrs on the max hormone drip with a back to back baby, I couldn’t move due to the pain I was in and it ended in an EMCS due to failure to progress. Anyone who thinks without an epidural I would’ve been up bouncing on a yoga ball is off their head- at least I felt I was respected and listened to instead of being left to scream and get on with it because someone else felt they knew better.

@ancientgran is was! I couldn't even feel myself breathing so thought I wasn't, they put me on oxygen to keep me calm

I’m horrified by your experience. What awful people you encountered. I got a late epidural after begging for hours for one and was left with ptsd as I ended up with a forceps delivery and birth injuries. Had I not have had an epidural I cannot imagine the extra suffering I would have endured. I believe I was going to end up with a forceps birth regardless of the epidural as the baby had significant decelerations from early on and really a c section probably would have been more sensible but they left things go without one and that was were it ended up. I also had a health condition that my consultant requested an early epidural and similar to you I experienced arrogant midwives who in my case thought they knew better than the consultant but were equally as judgemental about me wanting one. My second baby it was on my notes to get one straight away due to said. Health condition which I did and the birth was lovely for the most part and the Labour with no interventions. I don’t think the epidural did anything to slow my Labour in fact it just made it a fond memory for me. I am so sorry Again you had that experience and you should complain, I did and it meant my next birth I got better care. If I do have another baby I hope to get an early epidural again. I have no interest in doing it without one and I think the choice should be yours. One midwife said to me the second time with or without you get a baby but no medal for the pain without and she was so right 😂please don’t feel badly about yourself for getting one it’s well known inductions are worse pain wise but even if you were without an induction it wouldn’t matter! I have friends that got no epidural and managed the pain, personally I can’t seem to and it was absolute hell for me till I got one🤷🏼‍♀️

I had quite the opposite experience with midwife encouraging me to go for it when I wasn't quite sure. She was right, it was for the best. So I'm unsure why your experience was like that

It is totally my experience. Or the best one ‘the anesthetist is busy right now’. Always busy at Calderdale Royal Hospital.

I felt like the anaesthetist who did my epidural saved my life. He didn’t, but I felt like I was being torn in two, I was induced and went from starting contractions to half an hour later having nearly non stop agonising contractions, no more than 30 seconds between them, I dilated from 2-9cm in under an hour. He was also the first calm, friendly face I saw on the labour ward, the midwives were not very nice at all and the doctors all looked worried. I did need an emergency section but I’m pretty sure the epidural had nothing to do with it as there were problems before that (hence the worried doctors) I think the issues stemmed from the induction slamming DD and I into a too fast and furious labour that neither of us could cope with.

After the epidural I actually thought for the first time since the contractions had ramped up “ok I can do this now”. And I’d read all the positive birth stuff but it doesn’t help when you’re not getting any break between really agonising contractions!

Thankfully post birth we were both fine, and I’m one and done so never have to go through anything like that again.

OP the comment made to the student doctor about you was disgusting and honestly I think you should complain. Whether people are for or against epidurals personally (and I was very against before I realised I needed one) what is so important is recognising that women have autonomy, we are able to assess the risks and make our own medical decisions. Sometimes the positive birth movement can be great but sometimes it’s a bit toxic when it’s used to shame women for valid choices they have a right to make about their own bodies.

You did the right thing!

With my first birth I was induced with Propess (not even the drip) with a back to back baby. I was in agony and refused any pain relief (I only requested gas and air). The trauma from this ruined my maternity leave and almost destroyed my marriage. I barely avoided a complete mental breakdown. There was zero help available on the nhs to help me recover. I complained to the hospital and received an apology for their sub standard care refusing me pain relief for no reason.

I almost didn’t try to conceive DS due to the trauma of my first birth. I spent the whole of my second pregnancy petrified that the same would happen again and would have a complete mental breakdown. I had a planned home birth and was able to have the pain relief I wanted. It was a completely different experience to my first birth.

if I did have DC3 I would not consent to an induction and insist on C section. If for some freak reason I did consent to an induction I would insist on a epidural before I let them start the induction!

The attitude of the midwives who looked after you is quite frankly shocking. It is however highly unusual to place an epidural before someone has dilated to 4cm as it is associated with slowing down labour and therefore requiring more intervention to get labour going again so this is why your friend was discouraged from having one when 2cm and why you were not encouraged to have one before starting on the drip.

It is entirely a personal choice however epidurals are linked to higher risks of interventions and complications in birth as you cannot be mobile and upright, it can drop your blood pressure which then affects blood flow to your uterus and baby and can cause them to get distressed then needing an emergency c section in severe cases. It is also linked to more severe tears as you cannot feel how to push and higher rates of instrumental delivery.

It seems midwives like to encourage women to get as far as they can in labour without one due to the 'cascade of intervention' that can follow an epidural.

I am not by any means bashing epidurals or anyone's reason for wanting one but they are not a risk free intervention.

Well done you for standing up for yourself. I wish I’d had an epidural with both mine. My first I was 5cm when I arrived at hospital having been fobbed off by midwives telling me not to come in. I then dilated within 20 mins to 10 cm so had nothing not even gas and air. You’re regarded as lucky if this happens to you. It was very painful
and shocking but NOTHING compared to being induced on the hormone drip with my second. Holy hell do I wish I’d insisted on an epidural before they even went near me. It was absolutely horrendous and I dilated too fast to get any pain relief. Baby was born very quickly again but I didn’t know it was possible to be in that much pain and remain conscious. After she was born I was literally a Jibbering wreck. Again well done for advocating for yourself! It’s hard to do

Thanks typing on phone predictive can be a pain! Was just supposed to say spinal!

I had an epidural and ventouse (sp?) delivery and I definately didn't feel I'd failed, and you definately didn't either.

Being in pain does not make you a better mother - we're not purified by suffering!

I had my baby in Ireland and there was no push back from midwives. A friend who had 2 babies in the UK and one in Ireland found that the UK midwives were very anti-epidural. She felt that they wanted her to labour as quickly as possible and refused her an epidural even though she wanted one both times, telling her that it was too late each time, though she had a lot of labouring to do.

It's not a spinal either....

I had to beg to have any sort of pain relief.

I was crying my eyes out begging for something stronger as the gas and air was making me vomit but they kept saying just see how you go.

I was a teenager and I was induced and had a drip in my hand, which I was told would cause more pain than a regular labour and it was likely that I would want an epidural so I had to sign a form agreeing to have one if I chose to during labour.

They eventually called the anaesthetist and she came in and said to see how I got on.
Then she kept coming in every hour saying she was trying to find the equipment or other excuses.

I never got any stronger pain relief.

I only had gas and air for the first 30 minutes, so I spent hours in absolute agony with no pain relief and I had PTSD from such a traumatic birth and I believe it’s what caused my PND.

I definitely felt that the midwives and anaesthetist purposely didn’t give me any pain relief but I have no idea why.

Cynical answer. .....Why.... because some midwives are fucking bastards hooked up to the 'natural birth' agenda, which doesn't fit with epidurals or c sections.
Less cynical answer... epidurals do end in more interventions (such as forceps) than natural childbirth, they don't protect against tears or cutting, or long term damage, you can't move around to help with the descent into the birth canal.
Personally, c section every time.

@Nursemumma92 there is now conclusive proof that an Epidural does not slowdown labour.
Also there are such things as a walking Epidural which allows complete mobility, it just pisses me right off apparently you’re a nurse Mama and still utterly uneducated.

Yeah I could stand up and move and walk around (within limits of the tube attached to my back) with my epidural. I think there is a lot of misinformation about epidurals out there!

My last birth the midwife refused to acknowledge I was even in labour and tried to make me go home. His head came out while I was standing in the waiting room and a student shoved a pillow under me to catch him. Under funded and understaffed maybe. There was no way that midwife was even giving me a room let alone any pain relief.

I had the opposite, pretty much told I was having an epidural when I was trying to wait and see.

Because most people don't listen to women, even other women when put in a position of authority. Pregnant women are still considered incapable of rational thought; labouring women are hysterical. Some midwives really do think they know better than the women they are supposed to be helping, and some are absolutely responsible for women being traumatised by births. Some - like the one who spoke to the student doctor - are patronising shites.

If a woman says she wants an epidural, she should be given one. No one should be talking her out of it during labour. She is an adult who has considered the pros and cons and come to a decision that is right for her.

With my first birth I decided to 'see how it goes' and I felt they praised me a lot for that, but they did sort the epidural when I'd had enough of that shit. It was bliss and I sorely regretted wasting my time and energy for hours writhing and moaning in agony when I didn't have to. The birth was fine, had a few stitches but wonderfully pain free and I was up and about right afterwards, no side effects from the epidural.

Second birth I was very firm that I wanted one immediately. No arguments and it was the perfect labour and birth frommy point of view. I slept for a few hours, was able to get up and walk to use the toilet, then the midwife said I could have a go pushing if I wanted. 2 or 3 pushes and he was out, it was completely calm and serene, could feel him emerging but like a pressing, no pain at all. Wonderful. No side effects that time either.

Both times the epidural (finally) allowed me to relax enough to push both (back to back) babies out. One with the help of forceps but I didn’t get the epidural until the last minute so that didn’t lead to the intervention. I wish I could do it all again and have the epidural earlier.

I don’t remember any issues with the epidural- I was about and walking very quickly. If I’d have had it earlier maybe I wouldn’t have been so exhausted and traumatised! Friends who had epidurals had lovely, relaxing births. They talked about sleeping for a bit, relaxing watching TV, no pain. Rather than my agonising ‘active’ birth. All that moving about for hours and hours did F all. Still got stuck, still turned back to back…

Agree there’s a lot of misinformation about it epidurals about.

It goes into your back in the space around the spine sorry if I'm missing the correct terminology!

Could there be an argument that being in excruciating pain and exhausted isn’t conducive to pushing a baby out and being relaxed and pain free is?

I’m very late to the thread but please OP put a complaint in writing to PALs.

You needed to know the risks associated with an epidural, but once you know the risks and continue to plan for one then you should have absolutely not gone through any of that. Especially the comment made to the student doctor (also, were you asked if they could attend your birth?)

I say all this as a midwife.

I am a midwife. I only discourage an epidural if the baby will be born before it’s sited.

Please don’t assume all midwives withold epidurals. It is a very effective form of pain relief