to wonder why a midwife would offer a woman, labouring beautifully in a pool, an epidural?

[FeckinFurious]

I have namechanged as I'm not sure if this is a bit obvious and I need to ensure confidentiality.

But...

I am utterly fuming.

Scenario.

Woman. Baby no 1. Labouring spontaneously in hospital, in a birth pool.

Long and painful but baby fine. Mum tired but coping, using entonox.

Midwife 1 goes off for lunch. Midwife 2 takes over.

By the time midwife 1 comes back from lunch midwife 2 has suggested an epidural to knackered, labouring woman who accepts.

within haf an hour epidural is sited and hormone drip going.

Woman is now being monitored continuously in bed.

Please comment.

Well, she could have said no.

She didn't.

Maybe she wanted an epidural.

If, if she is upset or distressed by it THEN is the time to get 'furious'.

Talking of which would you be furious about a decision someone else has made? That's the thing..it's THEIR decision, not anybody else.

Also, surely the the person giving birth is the expert on whether or not she needs pain relief.

Not someone else who isn't going through it and has an agenda about how women 'ought' to give burth.

And by burth obv I mean birth...apologies.

Labouring beautifully ..eh whats beautiful about all that bloody pain..

"eh whats beautiful about all that bloody pain.."

What's 'beautiful' is to see a woman labouring effectively - seeing that her body is working efficiently to get her baby out.

The majority of first time mums with an epidural will have to have their baby pulled out of them by a doctor - that's why some people wish some midwives weren't so hasty to suggest them.

Not saying people shouldn't have one if they want one by the way!

"I'm not sure that in advanced labour she was capable of making a fully informed choice. I believe her wishes to avoid intervention should have been taken into account and something she did not want should not have been offered."

Perhaps it's only me but I found what I thought were my wishes before I went into labour was somewhat different from what my wishes actually turned out to be. Certainly never thought I'd be begging for an episiotomy- the idea of putting in my notes that I would want somebody slicing my private parts open! Yet when dd's head had been stuck for quite a while, that's what I did: I knew it was the only way to stop tearing- in fact, they didn't make it in time and I tore quite badly (still feel the scar in cold weather 13 years later). But certainly not something that would have occurred to me in advance.

No experience with epidural.

But unless the OP was the labouring woman, how can she know that she didn't tell the midwife she couldn't cope without pain relief and that the midwife then suggested epidural?

without knowing what the OPs role was and how the mother feels, this is all a bit futile

all i can add , further to my post lower down, is as a doula, it is not our place to be furious about a mother's birth choices or any deviation from her initial birth plan

and certainly not our place to argue with or be confrontational with the MWs

Have only read half the thread so far and noted that the vast majority were of the opinion that the OP was BU. I am actually going to say that I agree with the OP. Pretty much the same thing happened to me in labour with DS1 - was in the earlyish stages, a bit tired, frightened, didn't know what to expect, contractions painful obviously. What I needed was the midwife to talk me through the contractions, give me a proverbial kick up the backside in the nicest possible way and tell me to stick with it as I had told her initially that I didn't want an epidural.

But no, she suggested an epidural as I still had a long way to go and it would only get worse and look how tired I was.... so given that she's the midwife and knew best as far as I was concerned, I agreed.

In the end I was lucky and pushed DS1 out pretty easily without forceps or anything similar but I still have a regret that she took the easy option rather than giving me the encouragement that I needed.

"I find the whole mythology around the tree-hugging whalesong waterbirth with no analgesic or anaesthetic deeply misogynist nowadays.

There's no need to be a martyr to be a good mother"

Oh I'm a fully signed up member of the 'tree-hugging' brigade. Oddly, I found that after my 'tree-hugger' births (which involved lots of pain and more or less no analgesia), I was extremely healthy and happy, as were my babies. Much happier and healthier than after my highly medicated birth, which left me with a wrecked perineum, a very bruised and jaundiced baby, 4 weeks of breastfeeding misery and a postnatal infection that saw me back in A&E five days after the birth.

But hey - you pays your money and you takes you choice. For me better postnatal mental and physical health, and having a baby in good shape seems a reasonable 'trade off' for 24 hours or so of intermittent episodes of excruciating pain.

fwiw, I think the OP is the baby's father.

standanddeliver - that was your experience. It's perfectly possible to have no pain relief, and also all the negative effects you had with your medicated birth.

why has this turned into a tree hugger V analgeia argument

surely the whole point is that the OP is making a judgement about a woman's pain threshold. The OP says that the woman was using Entonox

Standanddeliver - your comments about "pays your money takes your choice" is quite unhelpful as are the "fact" that most 1st time mums have their baby's pulled out by a doctor. Am not saying you are but you are coming across as smug which isnt very constructive

sorry ANALGESIA

I agree with Lulu.

The only person whose opinion and feelings matter here is that of the woman who gave birth.

I would have thought that was a no-brainer, really!

Standanddeliver said:

"...But the voices which are often so loud in support of choices in childbirth when it comes to women having the freedom to choose an elective epidural are very quiet when it comes to arguing for the radical change in maternity care we need for more women to realise their choice for an epidural free birth...."

I would agree wholeheartedly that it is vital to campaign for improvements in maternity care, so that every mother has the best care possible - and for me the place to start would be more midwives on the labour wards, so that they can care for one woman at a time (two at most) - I suspect that this would be a big factor in allowing women to have epidural-free births if that is what they want.

Fedupofthis - I fully understand your anger and sadness at what happened to you:

"...I had lovely midwife all throughout my pregnancy and labour- encouraging, supportive, everything you could ask for. I was 8cms dilated and starting to panic but I trusted her when she said I could cope and that I'd soon be meeting my baby.

Well she went away and another midwife was with me, started shouting at me that I was doing it all wrong and that I must have an epidural- I was 8 centimetres dilated! Well I assumed obviously that she was right and I needed the epidural and so took it. Ended up with forceps delivery 8 hours later and regretted it ever since...."

I would suggest, though, that the main problem was the bullying from the midwife, not the offer of an epidural per se. No-one should feel bullied into a choice or intervention whilst in labour, unless the circumstances are extreme - baby in acute distress, mother refusing a forceps delivery (something I assume is pretty rare).

But if a suggestion, for example that the mother might like to consider an epidural, is offered in a way that gives the woman in labour her options and allows her to make an informed choice that is best for her, then there is surely nothing wrong with that.

Cory mentioned her episiotomy, and that reminded me of ds1's birth. Having read about episiotomies during my nurse training, I was absolutely dead set against having one. No way was anyone coming near my perineum with a pair of scissors. But as people have said here, things change when you are actually in labour - and how!

I was in labour 37.75 hours, and pushing for an hour and a half - and I was exhausted. The senior midwife had moved me to a high risk room, with an operating table rather than a bed, and in hindsight, I think she was thinking that a forceps or ventouse delivery was on the cards. At the point where ds1 was finally crowning, after 1.5 hours of pushing, she offered me an episiotomy, because, as she told me, she knew that after the episiotomy, his head would be born on the next contraction, and the rest of him on the one after that.

I accepted her offer with gratitude. I don't know if I could have pushed ds1 out on my own - but the fact that the senior midwife had moved me to the high risk room tells me that she didn't think it was very likely and she was getting ready for bigger interventions. That being the case, an episiotomy was the lesser of the evils, and I have never regretted changing my mind and having it.

The same might be true of the woman described in the OP's first post.

"i still wouldn't dream of lecturing others about how they feel about their labours/pain levels..."

Very unfair comment. Who here is 'lecturing' anyone? Someone made a point about not understanding why women go without pain relief in labour. I answered that there can be a trade off - that sometimes you have better postnatal physical and mental health and a baby born in better condition if you go without regional analgesia. It was a fair point. Midwives don't encourage women to try for epidural free births because they're sadists, but because they're trying to protect the health of mother and baby, which can be compromised by the use of this sort of pain relief.

"It's perfectly possible to have no pain relief, and also all the negative effects you had with your medicated birth"

Errr, yes. I think we all know that. But it's less likely isn't it?

"l as are the "fact" that most 1st time mums have their baby's pulled out by a doctor".

In what sense it it 'unhelpful' to mention that most first time mums who have an epidural are unable to birth their babies without medical help?

"Am not saying you are but you are coming across as smug which isnt very constructive"

Why 'smug'? And why the need to trade personal insults? Not very constructive is it?

Davidtennantsgirl - just out of interest, what else did the midwife do to help you get your baby out before she suggested an episiotomy? Did she encourage you to adopt different positions to push? Did she try to get you squatting or standing? On all fours? n your side?

In my case, I had no regional analgesia (used TENS machine for labour relief), had been encouraged to walk around through labour and still ended up with big tear and episiotomy. My only regret was that episiotomy came too late to prevent the tear. But that was possibly because the midwife didn't offer and it took me a while to collect my wits and realise there was a way to get this baby out.

Absolutely not blaming midwife, though. She went by my birth plan. It was me who changed my mind.

GlastonburyGoddess "Morloth i think your post of 17:31 is actually quite rude. Your are obviously naive about the role and responsibilities of a student midwife and the fact that you obviously know better than they do..."

Well yes I am ignorant of the role of a student midwife, hence my question. And yes I do believe I know more about my giving birth than they do, what with having done so before with no complications/interventions.

I am quite happy to have an audience, doesn't bother me at all, but I am not happy to listen to the opinions of a student as to what I should be doing. Just not on, 18 years old? hah. If it is expected that a student midwife is to give care and opinions then I don't want them around, if they are there to watch then that is just fine.

I am quite rude by nature and even more so when in labour when I have zero interest in anyone's feelings other than mine and the baby's (and possibly DH's).

I am a hypnobirthing hippy freak and still think that the midwife offering an epidural was just fine. If the Mum didn't want it she could say No.

She was offerred it and she took it. She wasn't made to have it.
Like someone else here said, it is down to the the woman in labour and nobody else!

My view is you should do whatever you want to do when you are in labour, your choice (medical conditions permitting obviously) and it really really annoys me when people talk about undermined confidence and women feeling like failure when they ask for epidural. That is what it is there for - to help with pain!

If you don't want it you don't have to have it, however if you do you should be able to.

I for one was very grateful for it after being in labour for 30 odd hours. Nearly snogged the anaesthetist who gave it to me!

Standanddeliver - the second midwife, who discussed the epidural, was also the one who examined me - the first midwife hadn't after 12 hours of labour- and discovered the baby was in this obscure presentation and started to monitor. They couldn't even attempt to deliver her by forceps/venteuse, she very quickly showed signs of distress and wasn't receovering so I had an all singing all dancing CS. And had I persevered with the first MW who was intent on telling me how well I'd coped last time and how I 'could' do it again, without monitoring the baby, THEN the outcome 'could' have been catastrophic for both of us. I think it's a very real danger that getting caught up in a whole 'natural birth' focus means that both midwives AND mums can miss some of the signs that things aren't going as well as they should. I'm actually glad I've experienced both types of birth - ironically I receovered more quickly both physically and emotionally from the second more 'traumatic' labour. I do think that having had such different labours and births has helped me be more open minded and understanding of the fact that there is no 'right' way to have a baby.