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.

Isn't it a bit of a damned if you do and damned if you don't though, swedes?

If you talk about horrendous the pain is, you get accused of scaring people; if you play it down, people blame you for not being honest!

I have to say, the best bit of advice I was given while pg with my first, was from a friend who didn't go into all the gory details, but who told me very honestly that I would feel pain like I'd never felt before, and that I couldn't begin to imagine! It meant I went into it realistically, knowing it would hurt like hell, but also knowing that hundreds of thousands of other women had been there and done that and lived to tell the tale!

Violet- that was more or less what my Mum said, and also that although the bit you see on fillums does happen, the swearing and sweating and biting on the bedpost bit, it's not like that for the whole labour. Which of course it isn't, I reckon I was in labour from mid-day on the Wednesday, but didn't tell dp (he would have fallen apart) till 4 am on the Thursday.....

I just wish it was like in the movies where you grip the bedposts, scream and swear but it's all over in 5 minutes! Mine went on far too bloody long for my liking!

Or on Holby where people have the first twinge, which coincides with a bucket of water slopping down their tights, they huff and puff a bit, a nearby handsome doctor has a feel (they're invariably stuck in the lift) and out shoots a perfectly clean baby! In a scene lasting about 3 minutes.....
Next time I'll order a birth like that please!
(sometimes they manage it without taking their tights off)

Bucharest - I clearly needed a very frank friend like that.
Violet - I agree. It is very difficult. In real life I wouldn't dream of saying to a pregnant friend having her first baby: "You know it hurts like shit, don't you? And your waterbirth plans are making me laugh up my sleeve." Not least because she might be one of those nauseating people who say labour was a bit like period pain.

I liked the birth scene in Dallas, the one where she didn't even take off her knickers.

But violet... surely if the MLU's are only taking low risk ladies then their record of unpleasant incidents are likely to be lower than those of a hospital who are presumably taking all the higher risk. Not meant to be antagonistic by the way, just a comment.
I would imagine the lower risk labours that remain just that go on to give birth on the MLU and then are dischatged. Those that develop into higher risk are transfered. Hence, when stats come in, the MLU appears to be more exemplary.

dischatged is meant to read discharged!!!

Barnsley - if you read my post, you'll see that I am acknowledged the exact same truth as you! You can't make a simple judgement just based on some of the deaths/bad outcomes, precisely because some of those will be due entirely to complications which meant the mother would never have been allowed in a MLU! For example, a woman may have a baby who has been diagnosed with a fatal syndrome meaning it will be born dead or live only a few hours. Such a baby would be born in hospital under specialist care. It's death would then show up on that hospital's records, but in no way means the hospital has been negligent.

I was making a distinction between this type of event, and those that hit the headlines precisely because they were avoidable - eg the babies who had severe injuries and brain damage through mismanaged high tech deliveries etc.

When you are comparing like with like (ie low risk mothers) a MLU/birthing centre is at LEAST as safe if not safer. Plus comparing like with like low risk mothers, mothers in a large hospitals statistically use more pain relief and have more interventions than those in MLUs/birthing units.

violet but wouldn't you agree that it would be better if birthing centres were situated on hospital grounds, so that women weren't put off using them because of worries about transfer?

Does anyone know why they are built friggin miles away from the hospitals? Surely it is obvious that that will put off all but the most super-confident, yet if they are the best place to give birth apart from home why not give every encouragement for women to use them?

I really don't get it.

Re the pain etc, surely most women realise it's going to hurt like hell? Or at least that's what I thought until I went to my ante-natal classes and learned that there would only be some "discomfort"

I would also have liked to have been told about possibilities of things like episiotomies and tears and degrees of tears, I honestly think that a lot of women genuinely have no idea that these things can happen and people certainly don't tend to bring them up when talking to pg women!

Maybe there should be 2 ante-natal classes - one for people who want to know all the possibilities and one for those who'd rather not.

"mothers in a large hospitals statistically use more pain relief and have more interventions than those in MLUs/birthing units"

Would that be because hospitals allow women to have pain relief and MLUs try to ration it?

Serious question - I have referred before to dire experience at MLU where the midwives wouldn't even let me have gas and air.

Quattro good point. Plus of course epidurals aren't actually available in birthing centres so naturally their stats for these will be low!

Plus my earlier comment about these centres usually being used by women who have given birth before with no complications etc and who know they didn't need an epidural etc last time - and second and subsequent births are often easier - so pain relief and intervention rates likely to be low.

Plus the slightest sign of any problems whatsoever and the women are shipped off to doctors PDQ.

"Maybe there should be 2 ante-natal classes - one for people who want to know all the possibilities and one for those who'd rather not."

i think that is a great idea.
you should know all the risks if you want to.

Depends how you look at it though Quattro... if you are very pro-pain relief, you might view it as 'not being allowed'. If you are very pro-natural birth, you might view it as 'being supported through birth naturally'.

Like I said, I think there are two basic camps, women who are quite happy to make birth as pain free as possible and will happily take drugs to get through, and women who prefer to put up with the pain for the sake of a natural birth. Obviously that's simplifying it a little, but I do think that if you're in one camp, you find it difficult to understand the other.

Incidentally, I had the g and a taken off me for the whole of second stage with my first baby in a MLU - not because the midwife was barbaric, and enjoyed watching me in pain, but because she knew I would focus better on pushing the baby out. Good midwifery I'd say.

violet I just don't believe that.

Most women want a natural birth, that is uncomplicated and easy.

Many women find that when it actually happens, they want and need pain relief.

I don't think that many women set out saying "I definitely want an epidural asap". I think many women like to keep it as an option should they require it. And that is fair enough.

Your idea of 'good midwifery' is another woman's idea of sadistic torture ...

Freely admit I am now VERY jaundiced about this sort of behaviour from midwives. My body, my say.

I wouldn't mind if they told you upfront. And perhaps wore Gestapo uniforms. Then I'd have known what the deal was.

quattro similar experience for me.

Was induced and offered no pain relief at all. I was just going to go over and knock myself unconscious against the wall (yes it was that bad, and no I'm not joking) when they came in to prep me for a section.

The midwife was useless, just stood there looking terrified. Told me I had a low pain threshold. Didn't even see if I wanted any G&A or anything, despite the fact I was a wreck.

The anaesthetist and medical people were all wonderful, calm, professional, expert. The spinal block and CS were wonderful. BF in recovery room and easy recovery.

That was my experience. I would rather try and give birth at home by myself than have to do it with a bitch like that midwife there. Absolutely no bloody use whatsoever.

And that is why I feel that women should be given the option of birth in hospital & pain relief on demand. Forcing women to give birth in conditons they are not comfortable with cannot be a good idea. Some women are comfortable in home from home environment with no epidurals CS etc available. Some people are comfortable knowing that all those things are just a shout away.

Which is why we need to keep the choices there for every woman. We are not a homogenous mass, we are all different, and as such we should be able to make our own decisions.

I think you are misreading me, lovelytinofspam!

Ok, I'm not suggesting that women go into birth wanting to have all sorts of interventions.

But I still think there are some women who are very much in favour of natural birth, and anti-intervention, and avoid it unless it's medically necessary, while others are willing to accept a higher level of intervention. That's just stating a fact.

If all women are the same, then why do some women go for home birth or MLU birth where pain relief is minimal, while others opt for a different choice? Horses for courses.

" women who are quite happy to make birth as pain free as possible and will happily take drugs to get through, and women who prefer to put up with the pain for the sake of a natural birth. "

I'm sorry but that's not just simplistic it's BOLLOCKS. Haven't you read some of the stories on here, some people, however much they might want the perfect natural birth just can't cope with the pain their body is putting them thru. I am firmly in the hippy dippy, music and oils, no pain relief except for G&A and some deep breathing camp but at least i acknowledge this just isn't possible for some women as much as they might like it.

What I have written does not contradict what you are saying Libra.

Read the words, don't put two and two together and make 5.

Yes, I agree, some women plan for a natural birth, but can't cope with the pain and then choose drugs, as you say. Fine.

Some women never contemplate natural birth, they just don't feel strongly that they want to do it, and happily go into labour wanting drugs.

And some women are very anti-intervention, and go without the drugs despite the pain because they feel very strongly that they don't want a high tech birth.

That covers all the scenarios I mentioned and you mentioned. They are absolutely not mutually exclusive.

I'm with Quattro - I would regard any midwife withholding pain relief after I'd begged for it as a sadistic bitch, not a natural birth enabler!

Stories like that are why I spent the first half of my pregnancy in abject terror, until I got to know my community mw and she promised me she'd come to the hospital for my delivery, and would never decide she knew better than me WRT pain relief.

Puts me off having a second, TBH.

I agree with Libra, lots of women expect/plan for a natural birth and keep pain relief as their last resort. The fact is that no one knows how they and their bodies will cope with the experience, no matter how much time has been spent on getting ready for birth.

Yes, I also agree that lots of women do that franca. I don't think anyone has said they don't.

I was just making the valid point that many women also choose not to accept pain relief.

I have met very very few woman who didn't contemplate a natural birth violet, at least first time. Most women try for natural and go with the flow pain/drugs-wise.

People who have already given birth may well fall into your two camps, depending on their previous experience.

FWIW 3 women I work with only have one child due to their experiences with "natural" birth.

And as I had a choice this time of VBAC or ELCS, I asked around, and the vast majority of women who have had natural births said "oh you are lucky, have a CS, I wish I could've".

Obviously this isn't a very large sample of women! But it does show that aside from the physical trauma, there is psychological trauma which many women have and I don't believe that is worked into the equation with the "natural is best" stats.

But LovelyTin - you're bringing in several different arguments here!

I haven't said 'natural is best'! You are the person using that phrase. I said that what is 'best' varies for individual women.
I have also had a Csection, and yes, in terms of levels of pain, it was much easier than natural vaginal birth. But that didn't make it a 'better' experience for me overall, because 'better' can mean, for some women, experiencing a natural drug free birth.

If the people you know were traumatised by natural birth, then it suggests that it was the wrong thing for them, or that they were badly supported, or whatever. And TBH, that can happen with a natural or a medicalised birth. There are also plenty of stories from women who had epidurals/forceps/ the whole works and feel traumatised!