AIBU - to be really pissed off that epidurals are being restricted?

[christmasmum]

Was just reading an article in Mother and Baby magazine saying that epidurals are classed as an 'abnormal birth' and that they should be restricted in the future to avoid women having caesareans.

What is this all about? Why should women not be free to make their own decision on pain relief, while being aware of the risks involved in every form of pain relief? And is it not the case that women having diffcult births in the first place are more likely to BOTH have an epidural AND end up having a c-section anyway??

Before giving birth to my DD I bought into all the information from the NCT, books and magazines etc and was determined to go for a 'natural' birth. I ended up being induced and despite being told by every woman I have ever spoken to who has been induced, that I should have an epidural the midwife advised me that I would not need one. After 10 hours of intense contractions and finding out I was a huge 2cm dilated I decided enough was enough and had an epidural.

I was instantly relaxed and started to actually enjoy the process, 2 1/2 hours later (despite the consultant arriving to prep me for a c-section) I found out I was fully dilated and delivered my wee girl after 5 minutes of pushing to a room that was full of people laughing and singing Christmas carols.

I obviously only have my own experience to go by but I am absolutely convinced that the relaxing effect of being out pain helped me deliver my baby naturally.

What is this pressure on women to be in pain and suffering to be 'real women'. And why is that every new Dad I've spoken to with wives who did not have pain releif seem so proud of them? Is this just another example of male oppression of women? Even subliminally??

AAGGGHHHHH. Rant over.

I only had one for my first labour btw but of course it should be given if a woman wants it!

OK. Good point.

But presumably anyone who makes a decision about something which impacts on their child weighs it all up. I think you have to give people credit to be able to make their own informed choices, and not think you know best for someone else or their children.

I was glad of my epidural for my c section, that's for sure...Safer for me and my DD than a GA.

Would like to add, that as long as we have the system of maternity care that we have at the moment - lots of inductions for post dates pregnancies, lack of one to one care, high levels of intervention in birth - we'll have a very large number of women needing epidurals. Any attempt to restrict women's access to epidurals, without making the changes needed to make birth more humane in other ways would be really blood cruel, and would result in large numbers of very unhappy mums.

It is amazing that anyone would think it is acceptable to restrict pain relief during labour.

No-one would ever restrict pain relief to a mirgraine sufferer (that is the only thing I can think to compare it too), so why should women in labour have their pain relief limited.

I imagine it is because some mad person (either a man or someone who has had very easy labours) thinks it is "so natural" not too.

That previous post was to Policy Wonk.

"And I think that some (most?) midwives see a drug free natural birth as the gold standard, as do the NCT.

This riles me.

The gold standard is a safe Mum and baby, and a HAPPY Mum - however she delivers."

I work for the NCT and we DON'T see a 'drug free natural birth' as a 'gold standard'.

But like the Royal College of Midwives we acknowledge that births without intervention - when they can be achieved without risk to mum and baby - are what most women want, and result in the best health outcomes.

Ali, you do know that there are serious complications associated with epidurals, right? (This is NOT to say that there is no risk associated with drug-free birth.)

Maybe, just maybe, the desire to limit access to epis is down to an awareness of these risks, and not to wholesale sadism?

It was me, Crosseyed, who said that about the NCT and you are quite right to pull me up on it in a way, as it would be wrong to tar the entire NCT with the same brush and as I don't like generalisations I oughtn't to be indulging in them myself.

It's just that there is a judgey element within it, (perhaps at a local level rather than as a national policy), which can be a little disconcerting to say the least.

"I imagine it is because some mad person (either a man or someone who has had very easy labours) thinks it is "so natural" not too."

Or alternatively they've looked at countries like Holland, where there are very low levels of epidural use, and also very low levels of c-section compared to the UK and thought - this is a way to save the NHS money and improve health outcomes for mums and babies at the same time.

I don't agree with the policy of restricting epidurals in any way, shape or form, but I'd assume that the thinking behind it will be more about improving women's health in childbirth than about joss sticks and aromatherapy.

I notice in the Times article that all the Consultans they interviewed seemed to have a problem with the rigid target being set.

Only Belinda Philips at NCT seemed to be broadly in favour.

It is all still very raw for me and I do feel shellshocked by it and I am not a first time Mum I have had 7 labours and have 6 DC .

3 labours were awful and this was because I was not listened to and the MW's thought they knew better.

My last labour (8 days ago) I went in with a birth plan I showed them the birth plan I wrote on it I wanted an Epi it was ignored I asked for an Epi when I started feeling like I couldn't cope I was told no you will be quick . I screamed begged shouted and at one point offered to pay for an epi .But the MW knew my body better than I did and told me to wiggle my bum like I was in a nightclub .

In the end another MW agreed to me having an epi and I was then told that noone was available to give me one .

My labour was painful, humiliating and out of control and I have also ended up with a torn muscle in my calf from leaning over the bed for 3 hours as the midwife suggested trying to breath through it .

I would not hold my dd when she was born for an hour as I felt too shook up I sat and cried on the postnatal ward because I couldn't believe what I had been through .

When I had suspected kidney stones forst thing a doctor did was give me pain relief same when dp had his appendix out so all well and good to those who want to try and do childbirth without pain relief but I did'nt and was forced to when in reality there was plenty of time to give me an epi and I would have had a calmer more positive birth .

I was thinking about another thread and the holland thing the other day. My dad walked me to the hosp for an ante-natal appt and we were discussing birth options. He said "I read something recently that holland has a much higher mortality rate than other comparable countries and no-one knows why". And I thought of the thread I had been on which quoted that about 50% of births in holland were home births and it was held up as an example of how to do things well.

Hopefully my dad wasn't talking out of his arse - I will try and find some mortality rates. Will be happy to prove myself wrong!

PW there are medical risks associated with epidurals etc, but i wonder if anyone has looked at the psychological side. I know quite a few women who have been left seriously traumatised by their "natural" births, but i doubt that gets factored in anywhere.

I suspect that this is what my dad read re peri-natal mortality rates in holland.

Will go and read it now myself!

I am aware of the complications associated with epidurals but I actually don't think anyone would want a needle stuck in their back for fun and I am sure that most people don't choose to have one as a first choice. Most people I know who have had one have had quite traumatic / long labours. There are a few people I know who have been lucky to have short labours and they are generally the ones that have not had epis.

For most people childbirth does seem to be an extremely painful experience. What is the point of having pain relief if it is not used?

"It's just that there is a judgey element within it, (perhaps at a local level rather than as a national policy), which can be a little disconcerting to say the least."

If you say so.

I've been involved with the NCT for years. I've also had three complicated births with various interventions (including epidural). I've never felt judged by anyone I've come into contact with through the organisation. But then I didn't know anything about it before I started training with them (I did my antenatal classes with the NHS). I didn't go into it looking to be offended, and with a idea in my head about what other people involved in the NCT might be thinking about me or my birth and feeding choices.

There are loads of women who're involved with the NCT at a local level who are simply ordinary mums, doing things with and for other mums in their area. They have had no training by the organisation and their views don't represent the views of the NCT. There are also some crap teachers - but then there are crap teachers in any field of education.

I just get weary at people using the NCT as a target for their ire about natural childbirth. I sit there reading comments like 'The NCT are a bunch of muesli munching yogurt knitters who think everyone should give birth in a yurt', and it makes me want to cry.

The amount of viciousness and ignorant stereotyping about the NCT I've come across in the media and here on mumsnet has demoralised me so much in the past it's sometimes made me want to jack in my job, despite the fact that I (mostly) love what I do.

Have to say at my NCT classes we had an open an honest discussion about pain relief with no judgey-ness, although we definitely all had rose tinted glasses at the time. They did however put the fear of god into me about induction, which wasn't great once I got told I had to be induced.

Just before I had DD I met up with a friend who is an anethetist and she told me when she has kids she would have definitely seriously consider having an epidural.

It won't let me read it

But was interesting that holland specifically came up on one of these threads as an excellent example and literally the next day I was told they had poor a mortality record.

I don't think it always hurts like the worst pain in the world either tbh.

I would rather have another child than have rhinoplasty (after my broken nose) which was about the worst pain I have ever been through.

My second child literally popped out after about 4 contractions and was hardly painful at all tbh (didn't need any pain relief).

However, I asked for an epidural for my first child and they wouldn't give one to me (she was born too quickly for one anyway) but I do think denying women pain relief is just farking ridiculous however, do agree with policy that TEACHING women they will be in murderous pain, is not great either tbh.

I had an epidural.
As I suffer from chronic pain syndrome it was fantastic, my few hours of no pain at all in YEARS.
If I had not had an epi I would have had to have had a ceasarean due to complications with my hips.
The epi meant I could dilate naturally and push a bit while lying down.
Previous to this I had a spasmed back muscles and a dislocating hip.

The obstetrician offered me pain relief immediately, and once I decided on an epi (2 midwives and the registrar recommended it) the anethetist turned up immediately and it was done after the next contraction.

Mind you, I deliberately chose a hospital which gave epidurals on demand...it was not my local hospital, we travelled miles on purpose.

I don't think people should put up with pain because it's "natural", that means people dying of cancer just have to "stick it out"...how nice. Women used to die in large numbers of child birth which you could also say was "natural", and so is many children dying before the age of 5 if history and some parts of the world are considered "natural".

A friend who is anti medical births smoked joints through her entire home delivery to relax, now that is natural pain relief!!!!!

I would just like to stick up for the NCT, they don't have very long to cram an incredible amount of information in, they should be balanced and I think most of the classes are (there are always 1 or 2 extremists in any group) however because they have to cram so much in (and mine covered everything from drug-free to c-section) they don't have time to really concentrate on things that could help the mother such as breathing techniques, positions etc. This should be drilled into our heads so in labour it is second nature to us . (I am not saying this would help in all cases but it would be a good thing to do)

I think every women should get the birth they want whether that be drug free or elective c-section HOWEVER I think if pregnant ladies got more support during their pregnancy in regard to their labour the c-section and epi rate would come down.

oh and Kathy as I understand it there are 2 parts to surgery anathestic the part that numbs you and the part that deals with your awareness, obviously the numb bit worked but the awareness didn't.

abetadad - all female consultants (or even regs/SHO) I know want either C/S or epi from word go.

comewhinewithme huge sympathies again on your awful experience. It sounds appalling. If it is cathartic for you to talk about it, feel free to continue to do so.

Wriggle your bum like your in a nightclub FS what was she thinking?

Really for you.

crosseyed I can understand why you get upset but unfortunately people do come across people in the NCT who live up to the stereotype, and it colours their view of the whole organisation. Maybe it's something that needs to be addressed higher up?

I think I was polite and gracious, Crosseyed.

Right, well I am not going to reel off my list of anecdotes about the NCT.

I didn't go into it looking to be offended, but perhaps it's just me and a few people I know who have experienced this with the NCT. I am sure there are plenty of decent ones, and I am sure they help lots of people. But it's a bit naive to say everyone is enlightened, I just don't think they are. You sound it, CrossEyed, but they are not all like you.

Libras the doctors I know want all the drugs/CS as well.

"I read something recently that holland has a much higher mortality rate than other comparable countries and no-one knows why". And I thought of the thread I had been on which quoted that about 50% of births in holland were home births and it was held up as an example of how to do things well."

Yes - their neonatal mortality rate is higher than ours (though lower than the USA). My understanding is that it's likely that this isn't due to the high number of home births (30%, not 50%) but down to issues connected with very different practices re: neonatal screening. I wish I could link you to an article about this but I don't have one to hand.

"unfortunately people do come across people in the NCT who live up to the stereotype, and it colours their view of the whole organisation. Maybe it's something that needs to be addressed higher up?"

If a parent makes a formal complaint about their classes this will be taken up with the teacher, whose practice will be reviewed by a panel of senior teachers.

But when it comes down to the behaviour and attitudes of mums who are involved with supporting the charity at a local level - what are the NCT to do? Say 'you can't attend an NCT coffee morning or help out at a nearly new sale unless you agree not to say anything snotty about epidurals or cut your eyes at someone bottlefeeding......?

I've had to sit through NHS antenatal classes where midwives have given women a complete whitewash, really discouraging them from using pain relief, and down-playing the challenges of coping with complicated labours. I've also cringed while watching women being patronised about choosing to breastfeed ('Oh good for you dear') by midwives in antenatal appointments (I've worked as a maternity support worker in my time). Seeing these things hasn't led me to assume that midwives who do this are representative of their profession, so why is anyone involved in the NCT at any level (including volunteers and members, who vastly, vastly outnumber teachers and other lay workers who've been trained by the organisation) always assumed to be towing the NCT line on pain relief and feeding choices?