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.

As far as I was aware lastest studies showed that although epidurals may increase the need for syntocin, the need for CS was not increased.

I had an epidural and believe that they should be as availiable to women as a birthing pool as far as birth choice goes

If it were men that gave birth no doubt some boffin would already have found a way to have the fruit of our loins springing fully formed from them, with no actual "birthing" involved at all.

Bruffin- this thread isn't about the pluses and minuses of an epidural, but should women who want one, get one. (much like the old chestnut of should women who want a natural or homebirth be allowed one.) The answer, in both cases, is yes.

Voilethill, that is an interesting point but if you were going down that route isn't IVF an expensive medical procedure that's entirely down to a woman's choice?? Should we stop women going down that route to become parents because of the costs involved??

Thunderduck, it's only in retrospect that I think about heavy blunt objects. At the time I sobbed. Properly. With snot and tears. I had PTSD after a very traumatic labour.

Studies do show that epidurals increase chances of further intervention. This should be acknowledged and accepted by women requesting epidurals.

I don't like the medicalisation of birth really and think it's become so medicalised that appropriate care and environment increase the likelihood of medical intervention ie labouring in a foreign environment with not enough staff and the screams of other women bouncing off the walls, it's not the best start to something that is natural.

I don't think the dentists analogy works because of the inherent difference between the two situations. Giving birth is natural, dentistry is not. I stand by my assertion that epidurals should not be restricted but maternity care in general needs to be addressed.

Many other things on the NHS are performed with pain relief for the comfort of the patient, where there is no medical need.

Why should it be women giving birth who are the ones denied?

christmas - IVF isn't entirely a woman's choice though is it? Different areas have different rules about access to IVF - different age limits, different numbers of cycles that will be paid for etc. My whole point is exactly that these things are not fixed in tablets of stone! Most people would not accept that a woman should be entitled to a CSection on the NHS purely because she wants one. And the epidural issue is exactly the same argument in principle. Unless you need one for medical reasons, it could be argued that it is a more expensive and risky procedure.
Again, I'm not giving a definitive answer here - I'm sitting on the fence I think!! But it's a legitimate question.

Giving birth the way our bodies are and the size of our babies now is no longer natural.

Biologically the majority of women would need to have MUCH bigger pelvises due to us having much bigger babies.

Undergoing any procedure (which is why I used dentistry as analogy) should be an individual experience tailored to individual need.

Giving birth is now in a lot of cases a medical procedure due to having bigger babies.

It would be lovely if giving birth were solely a natural experience and I'm glad it is like that for some women. For a lot of women pain relief is needed and felt needed.

Laurie - I really can't agree that birth 'is no longer natural'!! Or that it's all about the size of the baby. My first baby was big, and I managed a natural birth. A lot of my friends who chose epidurals had smaller babies!!

I think the point is that birth generally has become very medicalised, and many women no longer view it as a natural process, or have confidence that they can achieve it naturally.

Violet, you just proved my point - it's about individuals only and individual need.

I certainly couldn't achieve birth naturally, if I had a baby I would need to have a CS as my pelvis would break.

I do not think anyone for any reason should have to have pain that they do not choose.

LaurieFairyCake - I'm intruiged by your last point 'biologically the majority of women would need to have MUCH bigger pelvises due to us having much bigger babies'.

Where does that come from? Do you have a link?

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I can't see how they could restrict epidurals in practice. What would the criteria be and how would the control it? HCPs can be bad enough at listening to mothers wishes during the labour as it is without making a judgement call on what pain relief you are 'allowed'

I held off for 40 hours in utter agony before having to resort to induction and an epidural in what was a very traumatic birth experience. I honestly couldn't have done it without it.

I didn't have an epi either time. Desperately begged for one both times though... The first time I gave brith, it was the middle of the night and they kept telling me the anaethetist was on his way, on his way, on his way, then guess what! it was too late.

the second time I was 7 cm by the time they examined me and they said to me "too late honey this baby is coming now". I have asthma and I can't take gas and air.

So I had two children with NO pain relief. LIke a woman several hundred years ago. The first time I thought I would die! The second time was quicker but the ring of fire or whatever they call it. Good lord. I got flashbacks of it.

violethill, my babies were both small and it doesn't hurt any less.

Here in Italy epidurals are restricted, in that in the majority of hospitals that offer them (and not all do, by a long shot) you have to pay for them, and decide months in advance that you want one, which involves meetings with your designated anaesthetist etc. I suppose theoretically the UK could go the same way.....

I asked for, and was given, an epidural with both my DCs. No arguments, no fuss and no hassle - how it should be. It's all down to personal choice, and most women know, or are told beforehand, that an epidural may lead to intervention. In my case, it did, with a ventouse delivery first time and forceps the second. But I knew that and still wanted the pain relief.

Every now and again a piece in a newspaper or magazine says that the NHS are going to restrict epidurals and it never actually happens. It's just to keep us all down.

Just as an aside - getting an epidural doesn't always mean you'll be pain free for the whole labour - when my DS was on his way and I was pushing, the midwife refused to top my epi up so I could push more effectively. It was agony but worth it.

I think it would be very difficult to take a backwards step now that epidurals have been invented! And as Kutner says, what criteria would you use for restricting them? People have different pain thresholds, and also different views on what they are prepared to put up with. If you are very pro- natural birth and anti- intervention, you may well be prepared to put up with a lot more pain than someone who isn't too bothered about natural birth.

I do think all these things need honest and open discussion, simply on the basis that there will always be limited funds, and it's absolutely right that there is discussion about how the funds are used. There has been a lot in the media about restrictions on certain cancer treatments too. How reasonable is it to spend thousands of pounds on drugs which will prolong life a little longer for terminally ill patients etc.

No easy answers - and of course people will be influenced by the things that affect them directly. If you are dying of cancer, you are far more likely to be in favour of spending on the drugs, than if you are fit and healthy.

"I think the point is that birth generally has become very medicalised, and many women no longer view it as a natural process, or have confidence that they can achieve it naturally."

Many cannot. Before medical advances, many did not. Syntocin, ventouse, forceps, episiotomy are not natural either - do you imagine that those are by choice? I had them all.

Psychological reasons are also valid IMO

i had an epidural with my twins, doctors insisted on it .. i didnt want it. then once it was in they forgot to tell me that id have to push a button to top it up.... so i ended up having ventouse without pain relief working.... then they left me alone (DH had to leave for other dc and told them )in the room with drip in one arm and a drip in the other attached to machine thingy( have no idea what it was) unable to reach DS4 who was screaming his head off, and dd4 was away at scubu, for 3 fooking hours! had i not had the shitty epi id have been able to pick up my son and feed him, i wouldnt have been left for sodding hours with a needle in my back and my labour would have been better imo.

Some women cannot Upwind.

Most can.

Most pregnancies are straightforward, and the woman has the potential to give birth naturally.

Out of the women I know who had epidurals, only one was given it on medical advice. The rest chose it as a form of pain relief.

Now, I'm not making a judgement on that, good or bad. Just stating a fact.

Look at it another way.

To use the dentristy analogy, let's suppose some wonderful new invention was made which meant injections were no longer needed for dental work. The whole process would be less painful than it is now. But the new process would cost 5 x as much as the injection.

It's a dilemna isn't it? In an ideal world where funding is no barrier, we'd all be given the option of the new invention. In the real world, we probably wouldn't. It would be available privately, or maybe restricted to certain people.

The issue with epidurals, is that they have become very widely available, so to work the other way round and restrict it would be very difficult.

But the principle remains the same - they are more costly, and therefore it's a legitimate question to ask.

I had a similar experience to you you OP - 31hrs of increasingly painful back-to-back contractions (making me pass out each time) and still "only 3cm". Was told I could not have strong pain relief as I was not dilated enough and maybe I could go home and have a nice warm bath .
Got an epidural only by my hubby refusing to take me home again and me insisting if you don't give me an epidural you had better phone the consultant and let me speak to him.(I am a doctor so I think this scared them) Once epidural was in, contractions sped up and son born 8 stress-free hours later with forceps and 2 pushes because the contractions had got too strong and DS was distressed.
I am sure the pain was slowing my contractions down and diamorph would not have helped as I am hypersensitive and it makes me pass out too.
I felt that the midwives were trying to withhold pain relief simply because of my dilation and not assessing the situation as a whole. There is no way I could have actively participated in a 'natural birth' in that state.

i think epis make labour longer, and so make birth harder on the baby.... but they are a good thing if needed for a section as are much better than a general.

Drlove sounds to me like you had very bad care, not a bad epidural. Can't believe they just left you

With my first labour I started off in the pool but the pain was so unbearable I ended up asking for an epidural and got one fairly quickly. It turned out that the baby was in a bad position and wasn't coming out so it ended in an emcs. After that experience I just couldn't understand how it could be possible that a woman could cope without heavy duty pain relief as I imagined all labours to be that painful.

With my second it was a completely different experience. Don't get me wrong, it bloody hurt, but it never felt unbearable. To the point where I didn't realise how far along I was and ended up fighting the urge to push in the car. I had a sniff of G&A before the baby arrived but not enough to make any difference.

So based purely on my own experience I would say the pain levels in a problem labour are going to be higher, so a request for an epidural is more likely. It's that old correlation does not equal causation chestnut. Maybe more women who have epidurals have intervention because they asled for epidurals because things weren't right?

I don't get this difference - 'on medical advice' ?

Epidurals are pain relief, how is medical advice relevant, until you get to the point where they're coming at you with a scalpel? Either you feel you can bear the pain or you can't, and I think it's impossible for people in the category of straightforward births to have any idea of what a complicated birth can be like for the woman.

Let's not forget that in undeveloped countries, giving birth is the most dangerous thing a woman can do, far more likely to kill her than disease or malnutrition. And until we got 'medicalised' many more people died here too.

And if these advances in medical science mean that some people have epidurals who could have managed without, had they had slightly stiffer upper lips....well, you know what, I'm comfortable with that. Why should they suffer so we can all feel smug that only people who really need it are allowed pain relief?

Violet - you don't know that.

In fact I was told by my consultant that I really should have an epidural, because I would probably be having an emergency c-section as my baby was not doing well. It meant there would be less time wasted in getting one in place.

I have never shared this information with anyone in real life. The whole thing was very traumatic.