Anyone else 'tricked' out of epidural?

[liznay]

I went over my birth notes today at the 'Birth Reflections' service at my local hospital. (In order to get closure and prepare for No 2!)
To cut a long story short, My previous labour was 27 hours from start to finish although I was only admitted for the last 7 hours.

I asked for an epidural no less than 6 times during this period and was given the excuse that I needed to be 4 cm before I could get one.
Suprise, Suprise, no one would examine me to check how dilated I was and so then it became 'too late' to give me once I had reached 10 cm.
Despite Nice guidelines saying that no woman should be refused an epidural (even in the latent first stage!) apparently the hospital have their own policy.
I am SO ANGRY about this and feel that I was ignored and treated like a small child. Incidentally, the hospital are unapologetic about this and refused to say sorry about the care I received. The most that they would conceed was that they had 'somehow failed me'.
Why is this still happening to us in the 21st century? Anyone else had a similar experience? What can we do about it, and how can we prevent it happening for subsequent births? It's time that midwives stopped deciding for us how much pain relief we need and consult with us regarding how to make our births more comfortable. Not saying that all midwives are like this, but mine was a particular dragon....
I don't want this to turn into a debate on the pro's/cons of epidurals as this has been done to death elsewhere...

I'm 35 weeks and this is my deepest fear about giving birth. I'm no shrinking violet normally but when in the throws of contractions it is just too much to think I'm going to have to get into an argument and try and persuade the midwife to give me medicine that is my basic right to have. I've been trying to pep up my husband (who is generally regarded as the nice one) to become demanding and be my advocate but it will be almost too much of a change of his underlying personality although he will do his best

I do feel that because this is purely a female procedure it doesn't get focused on and these types of issues go on without any changes. And yes, I'm a bit of a feminist.

Rhian82, my god.......

It's not really as bad as it sounds - I mean, the principle is bad that they don't give pain relief when asked for, and I'm ready to shout and make noise about how awful that is. But my personal experience wasn't hugely traumatic - the memory of the pain faded quickly, and both DS and I were fine afterwards.

I don't want to scare pregnant women, I'm sorry!

The question is though, what can we do about this??? If we all keep quiet and accept that this is our fate, nothing will change.
We are intelligent women, if we want an epidural and accept that this may bring further intervention, what right does some bloody midwife have to withhold it?

Who can we lobby over this? I'm standing up for women everywhere who are treated in the most barbaric, prehistoric way - all in the name of childbirth.

Oh, and BTW, the midwife yesterday would not accept that anyone purposely witheld the epidural. Even though, I know that this routinely happens to thousands of women across the country. It is Scandalous!

"Fucking midwives, however, like to keep you away from them because then they'll actually have to work and not fob people off.

"

Thats not really true. As a midwife I'd say its a lot less work looking after a woman with an epidural. I love it if a woman wants one.

Then why keep fobbing someone off who continually asks for one?

But that's been the experience of nearly everyone on this thread, many of whom got pain-relief free deliveries they did not want, some, like Starlight, with major emotional problems afterwards.

The only time I tell someone that they can't have one is if the ward is busy and the co-ordinator in charge of the ward won't allow it for safety reasons.

Or if the woman is 3cm or less and the co-ordinator won't allow it as ita against hospital policy. Now I've always been told that if you have it prior to 4cm your body could stop labouring, etc. Am off to have a look at the NICE guidelines though as haven't seen a bit about women in the latent phase should be allowed them. If it does say that I'm going to bring it up with the l/w manager and see if policy can be changed. That link doesn't work though, am off to google.

But that has not been the case for many of us here, Viva.

And also, what the gist of the thread has been is why should anyone be turned down for one ever?

Found it;

Recommendation on timing of epidural analgesia
Women in labour who desire regional analgesia should not be denied it, including women in
severe pain in the latent first stage of labour.

That is very interesting. I'm definetly going to bring that up at work. I know what they're going to say though - they'd be worried about people in the latent phase of labour "bed clocking for days". We have 10 rooms on l/w, most of which are full. We have to prioritise. If we end up with a couple of women at 2cm with epidurals we're going to end up not having room for people coming through the door at 6cm, or even 10cm and pushing.

I have to say I agree with this and I'm a water birth/hypno birthing breath through it type but when DD3 was back to back and we'd reached the 24th hour of labour and I asked for an epidermal only to be told it won't be long, the anesthetist's is busy with somebody having REAL problems you do feel close to thumping somebody.
My advice is if you know you want one, demand one before you get into the whole gown, patient on the bed scenario much easier to be assertive stood upright and fully clothed as a member of the public.

Expat - thats what I'm saying. Its not right that people are turned down for epidurals but its not always the individual midwife. I suspect a lot of the time it will come down to space and staffing constrictions. I was looking after 2 labourers last week, both of who were begging for epidurals and neither could have them as I couldn't give one to one care. Its not safe to give someone an epidural and then not be with them.

I am offended a little by the attitude towards midwives recently on MN in general (OBEM thread and particularly at the language used here and also the generalisations which I feel have been made.

I don't think the 'fob off and actually have to do some work' comment is accurate or fair. Like Vivalebeaver it is actually easier to look after a lady with an epidural.

Pain relief in labour should be women centred, however, it should also be safe. It is not the fault of the midwife if the anaesthetist is busy. They do not only do epidurals in labour; they are often also covering gynae and are involved in the emergency care of poorly high risk women too. I frequently have to run a high risk delivery suite and a midwife led birthing unit attached ( that is 15 beds and 2 theatres) often with only 5 midwives. It is not down to me (or any other mw personally) that midwives go off sick and that we are under resourced but it is down to me and my colleagues that care is provided safely. As you know
epidurals demand one to one care: you can do the
maths, as they say, with the numbers I have
presented.

The timing of epidural administration is contentious.
Whilst I am aware of the NICE guidelines (needed to
refresh myself on the wording re latent phase) I do not
believe it is always appropriate to administer one when
labour is not established because of the cascade of
intervention. Also labour is unpredictable and can
progress very quickly. The siting of an epidural can be
dangerous if certain positions cannot be adopted due
to advancing labour. An epidural can take up to a
couple if hours to be prepared for (Ivs sorted,
equipment obtained etc) sited and to be effective. This has to be considered along with if delivery is likely.

God I feel very upset that I have to defend our practise when we are truly doing our best within the rubbish resources we have. I appreciate that individual women are involved here but I find the generalised verbal abuse and swearing towards us inappropriate. The individuals who have suffered as described should justifiably take their cases forward but the suggested conspiracy (just reading the title of the thread) is un
called for. The fact is the NHS often can't provide - the pot isn't a bottomless one. Women need to be aware of what happens in their unit but there is always the option of The Portland.

Women need to be aware of what happens in their unit but there is always the option of The Portland.

And yet the argument against private schools is that if they didn't exist state schools would improve - does that not apply to the NHS which we all contribute towards then ?
The fact is we have too many people, too many women giving birth and the NHS can't cope, but that's not actually our problem is it, there are enough bloody managers they need to find solutions, perhaps they could call a meeting about it ?

This is not, and was never intended to be a 'midwife bashing' thread. However, in any profession, a number of individuals may not be operating in accordance with the protocol laid down. Please, Please try not to take this personally, as it's not a reflection of you, the individual

It's just a place where we can vent about our experiences and hopefully bring about change.

Unfortunatley, the point you have highlighted is the very one that I'm concerned about. If you personally believe the NICE guidelines are wrong/contentious, then you/your unit are not going to follow them and therein lies the problem.

Shouldn't women be told the exact reasons for witholding pain relief, rather than be fobbed off/told lies?
I.e. in my case, they could have just said, we'r short of midwives tonight, we can't give you one to one care. Yes I would have felt a bit let down, but I wouldn't have felt tricked.

I know the NHS resources are rubbish, however there are a number of ways in which clear, open and honest communication between intelligent women and the caregivers can make things a whole lot beter.

Have you thought about taking them to court - since they've breeched NICE guidelines and obviously distressed you, maybe you could get someone to take the case on.
They'll probably change their "policy" if they have a judgement against them

The problem then is that you are just taking more money out of the NHS where it is so desperately needed. Court cases cost thousands and I don't see how this would help.
I'm not seeking to blame any individual for the care I received, I just don't want this standard of care to be 'the norm'

Liznay, yes that is exactly what should happen and it is unacceptable that it doesn't. Really interesting point about the NICE guidelines: I am not sure that we are bound to them: they are a best practice guide, not a policy. Will look into that.

I had this experience with DS2 "It's too soon. It's too soon. Oh no. It's too late."

I was cross but never took it up with them. They'd cover their arses somehow.

And if that's midwife bashing, then I feel somewhat entitled, as there are two midwives in my extended family, and I get the impression that they both despise labouring women who can't pop out their babies quietly and with minimum pain relief.

Because I didn't suffer any of the complications some of you have had; I can honestly, hand on heart thank my m/w for 'tricking' me out of my epidural.

It turned out to be the most eurphroic feeling that I would have missed otherwise.

Isn't that what midwives strive for? Go on girl you can do it, you have it in you to get this job done etc.

I feel so for those who were blatently ignored. Such a tricky one for me to fathom!

Starlight, the mws that do the classes don't tend to work on a delivery suite!

I'm in Australia & had a similar experience with the public health system here. 48hrs stop-start labour then put on syntocinon with promise of epidural - one ob even said "you seem to have a low pain threshold"!!! Surely number 1 on the list of things NOT to say to a labouring woman!! Took 3hrs of back-to-back contractions to dilate from 3cm to fully dilated & when I thought they were finally getting the stuff ready for the epidural, it was the baby tray. But then another hour of pushing after that.

DP had to beg on my behalf for even gas & air as I couldn't draw breath between contractions to talk. I was given it but not shown how to work it so only ended up using it to bite down on - had very sore jaws the next day! Honestly, if men had to go through it there wouldn't be stories like these.

Isn't that what midwives strive for? Go on girl you can do it, you have it in you to get this job done etc.

Having had three births without any more than gas and air I can conclude that yes you probably can do it, but if you don't want to you shouldn't have to.

I asked for epidural and was fobbed off with pethidine, midwife saying that there wasn't a consultant available, then it was all too late and was finally given a spinal block in order to do a forceps delivery.

But if the anaesthetist was unavailable, they are unavailable. Like I previously posted, pain relief falls down the priority list compared to emergencies. I would put an epidural in myself if I could but I think I have taken over quite enough medical tasks without the pay!