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.

If I were in a delivery suite, offered an epidural and accepted - and someone in that room with me was 'feckin furious', I'd want them to feck right off.

well if we're not allowed to comment according to the information given, then I don't see why there is any point in us commenting at all

the OP chose to post in AIBU, which means she has chosen to lay herself open to the opinions of people who may well think she is BU

as for MW support not being what it should be- we don't know that, do we? some of us have had experiences of supportive midwives, others of unsupportive ones, you can't really generalise

I agree with ziggurat. If the OP was the birthing partner, then she should learn to respect the wishes of the labouring woman.

But I suspect she was the labouring woman. If she accepted the epidural, it's bloody unreasonable to turn round and complain after the event. There was a choice.

Yes, I agree - I also think she was the labouring woman, and regrets how the birth went and is looking to lay the blame for accepting an epi elsewhere.

As long as the baby arrived safely, isn't that the ultimate goal?

As far as the info goes, I think OP is NBU.

My own experiences obviously colour my view though - 1st labour I was offered/suggested/ subtly encouraged by m/w to have an epidural - I still regret it 5 years later, it affected the rest of the birth and I have permanent back trouble now.

What I really needed was to be supported in an upright position and I think the m/w was not prepared to support me, hence for her it was easier for me to have an epidural.

Second time round it was all very different though and I had a home waterbirth with quite possibly the most wonderful and supportive midwife in the world ever (thanks Kath!)

But none of us were there, none of us can say can we.

The information we would need to really make our minds up is the one piece of information the OP has withheld:

are you the woman or has she told you how she feels or are you trying to guess how she ought to be feeling about this labour?

if it is the second- then YABU and no need to discuss it: it is for the woman herself to say

if the first- then was there a clear birth plan and/or did you tell the midwife that you did not want an epidural? in other words, did you actually yield to any real pressure or are you just regretting a decision you made at the time?

if the second, then sympathy, but really YABU as far as the midwife goes: they have to listen to women, and we wouldn't like it if they didn't

if the first and there really was pressure, then maybe you should bring it up with the hospital/ask to go through your birth notes

I agree none of us can know what happened.

However, I still don't think midwives tend to push women towards epidurals as an 'easy way out for the hospital' - see above for my list of reasons as to why they are more costly and tricky on many levels. Also, hospitals now have to publish figures about intervention rates. It hardly looks good for hospitals to show that they have very high intervention rates.

As for different experiences first and second time around - well, I know many women who had an epidural first time and then managed without second and subsequent times, simply because generally, second and subsequent labours are shorter and less painful - your body has gone through it before. Not always, but generally that's true. I did both my vaginal births without epidural - they both hurt, but the first was by far the worst.
But sometimes after experiencing a nautral birth second time around, some women forget how bad the first one was, and feel that if they'd been better supported, they should have been able to manage the first one without epidural. they forget that at the time, they were glad of it and accepted it. I

i'm going to read the rest of the thread in a mo but FWIW, I put on my birthplan that under no circumstances was anyone to offer me pain relief (except entonox). I knew what was available and would have asked. I didn't want to be coaxed into having an epidural/pethidine when I believe in some cases them to be responsible for many assisted deliveries, use of forceps etc etc - cascade of intervention and all that. As it was, I ended up with an emcs after four days of labour (one of active labour) as DS was brow presentation.

interesting that lots of people read this and thought op was the mother.

must admit I read it and assumed it was Midwife 1 who was furious that midwife 2 had done something differently from the way she would have had the woman continue her labour.

In her second post, FeckinFurious says that she was there, but not in a position to overrule the midwife.

This surely means she can't be the mother, because she would be in a position to refuse the epidural, and she can't be midwife 1, because she was present, and midwife 1 had gone to lunch, hadn't she?

No wonder there's a shortage of MWs...

They're not supportive if they offer an epidural but uncaring if they don't set it up asap. They don't have enough time to find out what you really want but who cares because apparently you don't even know it yourself...

Although the OP doesn't give enough information to comment on this particular situation I think she's NBU because I'd like to hope that someone involved in someone else's birth would not end up fuming easily but who knows. OTOH most MWs are as professional as they can within the restrictions of particular situations... And OP does not say how/why the epidural was offered.

As others have said, if the mother was happy and baby was healthy it's all good.

ZIPZAP - I would be horrified it it turns out that the OP IS one of the midwives involved and would be seriously questioning her decision to use a public forum as a means of validating her anger/frustration/stress. and would think that veers dangerously close to confidentiality issues. I'm still inclined to think along the lines of a doula and would be interested to know if the OP has been through childbirth herself. But it seems that she/he is in no rush back to elaborate so I guess we'll remain in the dark.

" 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".

Natural or medicalised birth - it's normal practice to listen in to baby frequently during labour, so if your midwife wasn't doing this she was not giving you or your baby appropriate care.

"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 very much disagree. My understanding of the role of the midwife during a 'natural' birth is that she should be super vigilant - very focused on the mother, her behaviour, the progress of her labour, and all outward signs which might indicate how the baby is coping. I have been in situations more than once where a mother is having very medicalised care, where technology is being used to stand in for the midwife and where signs that things were going wrong were missed, because of a lack of vigilance.

Honestly I think technology can be life-saving - but it needs to be used appropriately.

"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."

I've had three difficult, complicated labours and I also would never argue that there is a 'right' way to have a baby. But there is a 'right' way to care for women in labour - and that's to support her to have the birth she wants. If a mother wants an uncomplicated birth the midwife should do everything in her power to support the mum to achieve that healthily. I just feel very strongly that this often doesn't happen.

agree with Wotmania & carmen, it's how it was offered. in both my labours, at certain points (about 8/9cm & again when exhausted from pushing) i asked for pain relief. The encouragement and understanding I got was actually all I needed. Being told i was doing so well and a particular comment "you can do it, in fact you are doing it" meant so much to me. As carmen said, any hint of worry from them or offer of pain relief I would have seen as a vote of no confidence. However, I'd expect a MW to know the difference between someone who previously said she didn't want pain relief & then just needed encouragement and someone who did want it. So it's difficult to say without knowing how it was offered.

you don't think FF is the baby do you?

Standanddeliver - I suspect that ".....it's normal practice to listen in to baby frequently during labour..." would, in the case of a'natural' birth mean using a hand-held doppler at regular intervals - at least, that's what happened to me when I was having my two 'natural' (apart from some gas and air) births at home - so the two aren't incompatible, and the monitoring does not need to be constant or intrusive.

StayingDavidTennantsGirl Wed 10-Feb-10 12:38:40
Joanne - you are talking rubbish - the midwife did NOT give the woman an epidural without her consent and against her will. FFS, the woman climbed out of the waterpool and onto the bed - if she had been dragged there, forced into the position you have to adopt and hold whilst the epidural is placed, and then injected against her will, that would be very different.

If the midwife had given an epidural despite the woman saying 'No', that would be an assault, and that is not what the op describes.

What happened here, from the OP's account, is that the midwife offered an epidural, and the woman decided to accept voluntarily.

A birth plan is never set in stone - it cannot be because labour is different every time for every woman, and you cannot know in advance what is going to happen and how you are going to feel about it - and you might change your mind!! If a woman writes 'No caesarian section' on her birth plan, and the baby gets stuck and is in distress, and a cs is the only way to deliver the baby alive, should the woman be forced to stick to her birthplan? Of course she shouldn't!!

I don't know the details of your labour, but on the information you have given, I would say that the midwife was totally in the wrong when she pulled you onto the bed to deliver your child, and wouldnt' let you give birth squatting. If there was some actual reason why she thought squatting would be dangerous for you or the baby, she should have done a better job of explaining it, at the very least, so you could make an informed choice. If she wasn't experienced enough to deliver you that way, she should have said so ahead of time, and ensured you were delivered by someone who was. You have every right to be furious about what happened to you.

DER !! hence me saying ' IF IT WAS ME ! '

WAKE UP !

I remember being in transition, stuck in the doorway of the loo and labour room... asking my husband to 'knock me out ' ' punch me ' I said.... It doesnt mean I ACTUALLY wanted him to do it....

OP, YANBU.

I opted for a homebirth for my first (and currently pregnant with #2, also hoping for a homebirth) so could only have gas & air anyway, but put on my birth plan "in case of transfer to hospital, I don't want to be offered any pain relief - I know what the options are and will ask for it if I need it".

I started contractions on Wednesday evening, and didn't get to 4cm until Saturday afternoon - I hadn't slept in all that time and was starting to doubt my ability to do this at home. I started to say to DH "I want to go to hospital as I can't do this any more"... and he knew I really wanted my homebirth and didn't want interventions or a medicalised birth, so gently encouraged me to keep going at home... in the end the MW turned up at 11pm on the Saturday night, examined me and found me to be 5cm, and gave me gas and air. I then gave birth to DD at 6am the next morning, no tear, no problems at all (but was absolutely exhausted and in a lot of pain for the last 24 hours of the whole labour)...

I'm so glad I wasn't in hospital (and that DH knew to encourage me to stay at home and not just get in the car when I said I wanted to go)... as I know I would have accepted an epidural had I been offered one at the hospital as I was pretty beaten by that point. And then I would probably have ended up with an assisted delivery, episiotomy, overnight stay in hospital etc, when in actual fact I had no damage at all, got straight into bed with DD and DH at home 30 mins after the birth, breast feeding straight away and so on.

Just my experience, but I'm bloody glad I wasn't encouraged to go to hospital (even when I was thinking I couldn't do it on my own anymore!) and would have been upset, retrospectively, if I had been offered an epidural at the hospital had I transfered, when my birth plan said please don't offer me one (as I know I would have grabbed it! and probably changed the course of my birth unrecognisably).

And, FWIW, I think people can labour beautifully! Doesn't have to be all tree hugging to qualify as beautiful...

Boobz - I understand completely what you're saying about the birth you wanted, but I think the fact that you acknowledge that if you'd been offered an epidural you'd have jumped at it, shows the difficult position many midwives must find themselves in - damned if they do, damned if they don't!

I felt similarly to you - though I booked into a MLU rather than a home birth, but I was adamant I didn't want an epidural with its attendant risks. However, if I'd subsequently transferred to hospital, and been offered and accepted an epidural, I hope I wouldn't have blamed the midwife! There is still a choice. I had my last baby in hospital (not allowed to deliver at MLU - I had a CS with dc2). However, in a hugely medicalised environment where epidurals were available, I didn't have one because once again, I didn't want the associated risks.

I am more and more convinced that the OP is the woman she describes labouring. I think she accepted the epidural and now feels unhappy about her choice and wishes to shift the responsibility. That's not fair. She needs to come to terms with her birth choices, not try to make it out to be anyone's fault.

well said boobz. exactly.

I'm with MW1...BUT...I'd want a chat with MW2 to know what happened whilst I was out the room. Many MWs are scared of waterbirth and prefer their clients on dry land, tethered and under control.

However, I'm intrigued to hear the outcome - synto isn't started just cos an epidural goes up, it's put up to augment a labour, i.e. contractions gone off.

I wonder if synto was prescribed first with epidural then offered (as is usually done).

Am so not getting involved with politics of epidurals in normal labour tho...

"you don't think FF is the baby do you? " LOL at StealthPolarBear

"However, I'm intrigued to hear the outcome - synto isn't started just cos an epidural goes up, it's put up to augment a labour, i.e. contractions gone off."

Depends on your hospital, I once worked at a hospital where synto was prescribed for any primip with an epidural.