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 had an epidural with my 1st and wanted one with my 2nd but there wasn't time.

I was fully aware of the benefits/risks. I therefore made an informed choice.
Pain thresholds vary from person to person and if a person wants pain relief then they should be allowed it.

Cote, I think most women died 'in childbirth' due to puerperal fever caught immediately after the birth (or during) by poor hygiene in the vicinity. Of course there will always have been some whose babies were very badly malpositioned - and we are v lucky to live at a time when this no longer means the risk of an agonising death. But I don't think that percentage of women with very badly positioned babies has suddenly dramatically changed. Again, death in childbirth was hugely linked to overwhelming infection post-partum.

I don't know how you "think" that, given the lack of statistics on childbirth from, say, medieval times.

What about hemorraging? Without proper surgery techniques and especially blood transfusion, I suspect it would have caused a few deaths on its own, "bloody amazing" bodies or not.

I have only read the first and last page of this thread but would just like to add that i had epidurals in both my first labours and they went like a dream, my third was another induction and i knew having experienced a degree of pain in my first labour before they put one in that i wanted an epidural for the third time. I didnt get one as they were too busy which was fair enough but the pain that i was in far trancended anything i have ever felt, my DD3 was in SCBU for a week (nothing to do with having no epidural) and the experience left me not wanting another baby EVER - pain is relative and i think that its really unfair to restrict womens choices in pain relief.

Thanks to my wonderful new DH whom i married in Nov i have had a beautiful 4 month old DS now but was so terrified of my last experience 12 years ago that i wanted a C section. It wasn't agreed upon until they realised that i had diabetes and other complications so i had this method of delivery. Having had four very different experiences i would really advocate epidurals as a great form of pain relief, the C section was fine and i was lucky enough to recover very well but it makes me sad to think that any other woman (and i know plenty do not out of their own choice) would have to go through the trauma that i experienced with my DD3.

Definately different strokes for different folks and you should be able to choose your pain relief, obviously natural delivery is best as i was told many times but if you are left traumatised to the extent where you cant function properly as a parent for some time afterwards then surely an epidural isnt too much to ask for?

" I promise you women's bodies are bloody amazing and we do not need our births medicalised "

I'm sorry but many of us often do need our births medicalised in order for mum or baby to survive..

To Cote
Look, there's no need to be arsey. I wasn't. You're absolutely right, I forgot about blood loss etc. I was just responding to your question "Is that why so many women died in childbirth until recently in human history? " , and supplying what info I knew about causes of death in childbirth, and that better hygiene was a definite factor.

so kathybrown. do you think you should have had the induction without the epidural?

i don't recommend it.

or rather lack of hygiene!

Apologies if I don't respond after this - purely because I'm going out. Will check back tomorrow.

labour is ok the first time around as you don't know what to expect

second time is very different!

Me either Fishie - the pessaries combined with the drip is excruciating

Our bodies are amazing yes, but not quite so amazing when it comes to childbirth.

Walking upright has many advantages, but we also paid for those advantages by a change over time in shape and size of the pelvis and birth canal that resulted in a much more difficult birth than we'd have, had we remained on all fours.

I had an epidural with my first, pethadine made me sick and I couldn't breathe the gas and air. MW told me i would not cope without epi so I had one. It was one where my legs went numb and I could not move at all. I felt a bit pushed into it but came out of it with healthy baby.
Second time used gas and air(different mouth piece) and tens machine and had a great labour, relatively easy and very straightforward, was really pleased that I didn't have an epi.
Third time had to be induced due to diabetes, was a bit railroaded into it. got to where the pain was getting very unbearable and mw suggested an epi for the only reason, anaesthesitists sp? were on the ward and if we didn't take the chance I might not get another. Epi lasted an hour and only worked one side so I know when my contractions were coming, I could move around a bit which was better then the first time.

If i were doing it again then i would feel relieved that i could have an epi if i wanted. I don't feel it made my labours longer, and i think it only leads to cs when the mum has been in labour a long time or there is a serious problem. But any labour can lead to cs and i bet a lot do without having an epi first.
It is all about choice and individual pain thresholds, Some mums need it some don't

Just my XP, but I knew I wasn't "allowed" an epi when I went into labour with DS. It was all to do with having a mild blood-clotting disorder and the anaesthetist basically wouldn't touch me EVEN THOUGH my levels were normal, as they often are when a person affected is pregnant, because of the risk of heavy bruising possibly causing paralysis in people with low levels of factor - not me then. Suppose I should have complained.

I honestly thought I'd be fine with G&A as I was with DD, but this was something else. I had been gushing amniotic fluid for six hours before my first contraction so when they started I could feel every joint and bone of DS, no cushion at all. He was like a spiky iron ball inside me and my treacherous body was clamping down on it.

At no time was diamorphine mentioned as an option. Should it have been?

The good thing about my blood-clotting disorder was that the local hospital were determined to prove themselves, so at the pushing stage I had several people all anxious that my fanjo wouldn't tear badly on their watch, and it worked

Not sure it's about pain thresholds. It's the male equivalent of bravado -- i.e. 'are you tough enough to do labor without any pain relief...'

Funny story though when I had an epidural with DS. The anaesthetist had done all the measuring, and was all gowned up. She was about to do the needle thing, but forgot something. The midwife sat on the stool the anaesthetist was about to sit on, and it dropped about 2 feet!

I thought it was quite funny, and then everyone else laughed.

Needless to say, they got another stool for the needle into my spine!

I don't think diamorphine is offered 1st as a standard protocol? Probably just some midwives offer it to certain women under certain circumstances. A lot of hospitals don't offer it all as a labour ward drug now - they feel it's inappropriate.

Regarding OP; It's a tricky one. I think Violethill's post best sums up the issue so far. I'm an NCT antenatal teacher and we currently are trained to work on the basis of 'informed choice' - as long as Mum & her birth partner are aware of the possible implications of their choice of pain relief they should be free to choose whatever pain control their Midwife can offer.

Personally, I'm torn, (not literally) I've had a couple of lovely homebirths, a horrendous hospital birth, and a quite nice hospital birth-both of the latter with epidurals. I don't like the epidurals and I wish I hadn't had them either time. If they were restricted perhaps the word 'EPIDURAL" wouldn't have loomed in my brain with such intensity? But, who knows. They're not suggesting withdrawing them are they? Only restricting them, maybe that might be a good thing. I guess it depends what the restrictions are. Can you elaborate Christmasmum?

I was given diamorphine 1st and it was absolutely awful. I felt totally spaced out and that scared me. It did take the edge off the pain, but at least with the epidural i felt painfree and in control.

Sorry, just realised I was responding to a post on the first page -doh! A long day . . .

Also just to say, there seems to be a lot of discussion about induction & epi d's. I've never been induced, but everything I know about it would suggest that if ever there were a case for absolutely needing an epidural, being induced with a drip could be it.

Scummy - I didn't mean that the labouring woman would be less expert in her own levels of pain; I meant that she would be less expert in the risks attendant on an epidural.

Len, I hope you get one if you want one. Having become an expert during one evening of Googling , it seems to me - all else being equal - that if a woman is in relatively early stage 1 labour and asks for one, the risk-benefit analysis probably goes her way; but if she's right at the end of stage 1, or her labour is progressing very rapidly, you can see how (from the professional's point of view) the risk-benefit might be skewed the other way - ie, why take some of the (quite serious) risks associated with an epidural for half-an-hour's worth of pain relief?

Does this bear any sort of relationship to the facts?

FWIW, WRT induction, every midwife I've ever spoken to has said she'd recommend an epidural - even the quite hardcore Brighton ones who were all for eating your own placenta. I'm shocked if women who've been induced are being refused epidurals without damned good medical reasons.

pw i think it is quite common for women who are being induced to be subject to the same 'rules' as those in natural labour wrt to epidurals.

i base this on my 5 year in-depth study of mn and a gigantic bee in my bonnet.

policy... Although i wasn't induced my labour wasn't progressing so needed meds. the midwife didn't exactly advise me to have an epidural but certainly indicated i should seriously consider it. I took little convincing and in it went!

Well, based on 3 conversations with midwives and the personal experience of a few friends, I'm happy to say that that's Wrong

This risk-benefit stuff is easier than I thought

Bit if you're induced (and I've been twice) there is the possibility of hyper stimulation, so would be surprised that allowances weren't made.

I think the reason epidurals are being restricted is based on the need for almost constant monitoring. I haven't read the NICE guidelines, but a mw in the delivery suite said that a woman who has an epidural, the staffing ratio is 1:1.

Your googling research makes sense to me, pw. The midwife I saw recently to discuss possibility of vbac said something similarish, fwiw.