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 think what most of us are agreeing on is actually that 'best' = a birth the mother feels good, or at least comfortable with. And for some women that will mean a lot of drugs and intervention and for some it will mean natural.

The problem being that that isn't what the natural birth lobby or the NHS seem to want, as per OPs link.

Yes but Violet you seem to be of the school of thought that denying women pain relief is "supporting" them to deliver naturally. Which is the sort of orthodoxy that I and many others on this thread are reacting against.

I also don't really get this "two camps" stuff, it really isn't like that for the vast majority of women.

Plus to add to quattros point, some of us feel best supported to deliver, naturally or otherwise, in the knowledge that lots of doctors and machinery and operating theatres are just a few metres away. Some of us do not feel that midwife care is enough.

A little oversimplification there Quattro!

I quoted my own experience, where the midwife explained that I would get through second stage quicker and with less risk of my baby's heart rate dipping if I went without gas and air.

That's using professional judgement.

I'm not part of any natural birth lobby - I wanted to avoid interventions myself, but other women make their own choices!

That's what hospitals are for Lovely!

I'm not saying anyone should shut down hospitals. Though there was someone saying MLUs should be shut down!

Horses for courses

But the point of the OP was that there is a crive to deny women choices.

I also don't see why birthing centres can't be based in hospital grounds. Why deny the "home from home" experience to people who are quite naturally concerned about an ambulance ride if it all goes tits up? It seems that the siting of the birth centres takes a "two camps" approach as well - that you must either be the sort of person who is super-confident that all will go well and who wants a home-style birth with only midwives, or you are the sort of person who wants to be in a hospital.

The person saying about closing MLUs, what they meant was why not have the birthing centres sited at the hospitals so that they were the MLU units, in easy distance of the docs etc.

Actually I was saying that the resources currently used in MLU should be spent bringing hospitals up to the standard of MLU care so that everyone would have the benefits of one to one midwife care and fluffy pillows. However all MLU being attached to a hospital would be a good compromise as I think more people would then take advantage of them knowing medical care was just across the corridor if necessary. I know I would have. I think the main problem is land.
However as I have already pointed out at least once it was only a suggestion on how to make things better for the majority of women on the resources we have and I don't think the gov't are going to be paying much attention to me anytime soon.

Hmmmm... Interesting thread...

I gave birth in France. I thought you might be interested to know how the French do things...

It is ROUTINE to give what we call 'mini epidurals' as they consider it to be most effective and risk free to Mother and baby. For twins and babies in difficult positions women are booked in for C-sections - no hesitation.

All new mothers stay in hospital for at least four days after the birth to rest and get to know thier baby with the support of midwives and doctors.

I have noticed that there is certainly less choice for women in France but also I have noticed that there seems to be less birth horror stories per French friend of mine than amongst my British friends.

It would certainly make good sense to build new birthing centres in hospital grounds. As far as I know, the trend now seems to be to build 'attached' MLUs.

Thing is, no one is going to knock down all the hospitals and start again are they! So we have to work with what we've got. Our regional hospital is absolutely in the centre of a large and already overcrowded city, so there's no way a MLU could be built there - it would create far more problems than it solves. So, it seems right that there is the opportunity to deliver in a cosy 8 bed unit 15 miles away if that's what you prefer. And the hospital if you want. As others pointed out, the reality of transferring during labour is not as bad as the thought of it anyway - i have yet to meet a mum who wasn't happy that she attempted a home or MLU birth even if she then transfers.

I am all for improving standards everywhere, but I would be very angry if our local MLU were to close down just to pump more money into the hospital - that;s denying women choice.

"that;s denying women choice." No it really isn't they can still have pain free natural births, just in hospital or at home. You are quite happy to deny women in hospital the comforts found in a MLU, it almost sounds like you think women in hospital don't deserve the same sort of treatment as they would get in a MLU.

mini-epidurals sounds like mobile epidurals which are apparently quite common in Aus (we got any aus mums to back that up?) but not in UK. When exploring options I asked if my hospital did mobile epis (the drug combination is different) and was told no.

Arrgh this is really frustrating Libra!!

I am not saying I would deny women in hospital what they would get in a MLU!

In fact, a quote from my last post:

'I am all for improving standards everywhere'.

Some women do not want to give birth in hospital. They want to give birth in MLU. Yes, you can have a drug free birth in a large hospital but it is not the same experience!! So Libra, YOU are denying choice by saying everyone should either a) be in hospital or b) be at home.

That was not my choice, it is not the choice of thousands of women. They want to be in a very small scale unit, preferably near home, with no doctors. Why are you trying to deny them that choice?!

I agree with that point Lenin. I don't think society is going to change - people don't remain in the same areas now, and so we need to find ways of replicating that kind of support in a way that works for the 21st century.

The thing is though violet, is that most of the consultant led units are not as "cosy" as the MLU you experienced. For the ones where an attached MLU is not feasible then why not upgrade and create a more "cosy" atmosphere here and then everyone is happy. In an ideal worls there would be room for both, but it seems the way these days is to make a beautiful MLU and leave the hospital as it is.... which is simply not fair. Surely it makes more sense to plough all the resources into one place where either a medicalised or natural midwife led birth can take place.
Why should it be that natural births get cosy, medicalised don't? Surely that's trying to force the choice??

"Some women do not want to give birth in hospital. They want to give birth in MLU. Yes, you can have a drug free birth in a large hospital but it is not the same experience!!"

It is not the same experience because the amount/quality of care is different and there are less fluffy pillows. If we hired more m/w in the hospital and spent money on fluffy pillows then the experience would be the same but FOR MORE WOMEN. This money could come by shutting down MLU.

"'I am all for improving standards everywhere'."

That's all very well but where is the money going to come from for these improvements. At least I am trying to offer a solution, albeit one that is never going to happen.

I don't understand how they would be able to draw the line between 'normal birth' and 'abnormal birth'.
I laboured with my second child in water pool and to all intents and purposes it was a normal birth but the pain was horrendous.

Much worse than my first labour.

so I asked for epidural.
at that point it would still have been classed as a normal birth but after pushing for 2 and a half hours the consultant was called and we discovered that DS was malpositioned and that was the reason for the pain being so bad.
So in my case I would have been denied an epidural because by the time they found out that there was a problem it would have been far to late for an epidural.
There would be no way that they could enforce this kind of rule, and they would leave themselves open to lawsuits from people who are denied pain relief who really needed it.
Also on the point of paying for epidurals, I would have given all my money plus my house at that point to get out of that pain.
all I cared about was making it stop.

By definition, a large scale set up with operating theatres, consultants, doctors, is not going to be as 'cosy' as a little 8 bed unit. No reason why it shouldn't be pleasant though, I agree.

We got a birth video at school age 13. Class of 30 girls sat there horror-struck with their legs crossed. Best advert for contraception ever

I had never held a baby for more than about 1 min before I had my own. Certianly never changed one or anything. One of my friends who was BF did think I was a bit odd though when I was pg and asked if I could see exactly how she did it... Looking back I realise that she wasn't getting on with it very well, but I thought it was a good idea to try and see it in "real life" for when it was my go!

A bit off topic there - but just backing up lenin's point.

interestingly my leaflet says to bring partner + 1 person who has given birth - presumably in response to the studies showing that things go better when women have another woman who they know and trust in attendance.

So basically not only do you have to be low-risk you also have to cross your fingers and hope there is going to be a bed at your cosy MLU?

Leningrad good point, we didn't have any birth videos in our NCT class, we did have several in hynobirthing but they were all of women giving birth in silence in a water pool (one of the women had her partner AND children in their with her, the children looked bored) which is hardly representative.

RCOG are shortly to produce guidance that all women having syntocinon (or equivalent) are to be offered an epidural beforehand.

Just to throw a spanner in to the works!
Don't believe everything you read in womens' magazines (or on mumsnet)

Libra - you really are talking rubbish if you think that the only difference between a MLU and hospital is that you get more fluffy pillows in a MLU!

Look, many women choose a MLU. It is NOT the same as a hospital. I know,I've done it. Why on earth should MLUs be shut down, just because you would choose a different type of birth?

Of course there will always be limited funds so priorities need to be made. But it seems short sighted and selfish in the extreme to want to get rid of entirely successful, well run MLUs just because some women don;t want to deliver there!

Violet... many women do choose an MLU, because they are there. The point is, they can still achieve a natural birth with no medical intervention supported by a midwife at the same place as someone who chooses to have a medicalised birth. Why does so much money have to spent creating a special place to do this? Home or hospital refurbished to same standard as MLU should be enough.

"Libra - you really are talking rubbish if you think that the only difference between a MLU and hospital is that you get more fluffy pillows in a MLU!"

The fluffy pillows are representative of the differences.

"Look, many women choose a MLU. It is NOT the same as a hospital. I know,I've done it. Why on earth should MLUs be shut down, just because you would choose a different type of birth? "

Agh it's not about me, it's about the fact the majority of women don't choose MLU or can't choose MLU and why should they not have the same creature comforts or even more importantly the level of support you recieve in the MLU.

"Of course there will always be limited funds so priorities need to be made. But it seems short sighted and selfish in the extreme to want to get rid of entirely successful, well run MLUs just because some women don;t want to deliver there! "

It's not because some women don't want to deliver there it's because to improve the facilities in hospital to MLU standard - which every labouring woman deserves - the money has to come from somewhere.