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Childbirth

Share experiences and get support around labour, birth and recovery.

Anyone else 'tricked' out of epidural?

1003 replies

liznay · 10/02/2011 17:25

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....Grin
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...

OP posts:
Ushy · 18/02/2011 20:41

Liznay Just read your post about the journalist.

I say go for it - the credit goes to you for raising this. Look how much anger it has provoked. You could be responsible for getting something done about this ...good for you!!!!

Keep us postedSmile

gloyw · 18/02/2011 20:44

muckypupster, what an awful story. I'm sorry you had such a shocking experience, it really beggars belief.

liznay, just to respond to your post about journalistic interest - is the need for a photo a deal breaker? I'm sure they would prefer one, but papers do run stories about sensitive issues and protect their contributors identities sometimes.

Ushy · 18/02/2011 20:45

muckypupster Just read your post - that is just barbaric.

What century are we in?

Hope you aren't suffering any psychological after effects from such cruel treatment. Sad

muckypupster · 18/02/2011 20:49

Ushy and gloyw thank you.

I had an ELCS with my second and it was a brilliant experience. I know plenty of people are critical for that but I just couldn't go for another natural delivery. The trust was gone for me Sad

MamaMary · 18/02/2011 21:04

Reading this is so shocking. I had a difficult birth, but I got an epidural -twice in fact as first time it only worked down one side- almost as soon as I asked for it. Both times the anesthetist was by my side before I knew it. But this was a very big and busy hospital and I think maybe I was very lucky.

mathanxiety · 18/02/2011 21:05

The infant mortality rate in the US compared to the infant mortality rate in the EU as a whole is 6.8 per 1000 live births to 6 per 1000.

Behind the figures is the fact that the US registers as live births many babies that some countries do not. All foetuses born with any sign of life are registered as live births in the US. By contrast, Japan counts only infants who breathe at birth. Perinatal death rates are correspondingly higher in some countries as a result. 40% of infant deaths occur in the first day of life in the US -- many of these babies have extremely low birthweight and very short gestational age and would not be counted as live births elsewhere.

France, Czech Republic, Ireland, Netherlands, and Poland do not report all live births of babies under 500 g and/or 22 weeks of gestation.

The main reason for the US figures is the sheer volume of preterm babies - 1 in 8 babies born is premature, (and are reported as live births if they show any sign of life as noted above)

There are tables here showing both causes of infant death in the US and variations according to state. Washington DC has a very high rate (14.1) while Minnesota has the lowest (4.78), both per 1,000 live births as defined above.

mathanxiety · 18/02/2011 21:07

Sorry link here.

Cleofartra · 18/02/2011 21:21

mathanxiety - what are your thoughts on "The Business of Being Born?" Have you seen it?

Would also really recommend Jessica Mitford's 'The American Way of Birth' - bit out of date now but such a good read. Very entertaining.

Blurb:

"The American Way of Birth brilliantly describes the ways in which childbirth is conducted in the contemporary United States. It shows how the "conduct of birth" in the hospital, the home, and the free-standing birth center impacts both the medical outcome of birth and the birthing woman's psyche. Whether birth is a highly "medicalized" and surgical event or a "spiritual event" without medical intervention, childbirth is inevitably "socially constructed." This book provides a provocative historical account as to how and why things came to be as they are in the birth room. It elucidates the nature of the doctor-female relationship, issues of race and class, the reasons for the increase in the Cesarean birth rate, and the impact of the malpractice insurance industry on childbirth practices. Several studies of out-of-hospital birth are presented. In addition, practices of nurse and "lay" midwives are explored, both inside the hospital and out. With contributions from the most highly knowledgeable scholars of our timePamela Eakins, Ann Oakley, Nancy Shrom Dye, Diana Scully, Janet Carlisle Bogdan, Barbara Katz Rothman, Sandra K. Danziger, Margaret K. Nelson, Pamela S. Summey, Wenda Brewster O'Reilly, Myra Gerson Gilfix, Gary A, Richwald, Regi L. Teasley, Linda Janet Holmes, Deborah Leveen and Dorothy Wertzthis book is required reading for anyone interested in the history of childbirth, childbirth practices, and childbirth reform. As Ann Oakley writes in the Foreword, "It is only through a careful examination of the past and an analytical look at the present that we can begin to construct a future in which the pain of birthing, in all senses, is understood, acted on, and diminished."

Cleofartra · 18/02/2011 21:35

gloyw - well I don't think anyone enjoys having catheters inserted or removed, having multiple vaginal examinations or having a drip inserted, all things which you tend to get with an epidural. Doesn't change the fact that I was profoundly grateful for and in need of my epidural at the time that I had it, and that I got very good pain relief from it.

"I think the basic fact here is that some of us feel that women have a RIGHT to pain relief including epidurals in labour - and others don't. They see it as an optional extra, not a priority"

I agree that there are women who need an epidural to feel that they can bear the experience of labour. There are other women that need to have freedom of movement, or one to one care from a midwife they know and trust, or a homebirth, or access to a birth pool to get through labour without being traumatised.

Should we campaign to have all these things made available to all women all the time? No matter what the cost to the NHS, the impact on staffing and consequently on the safety of mothers and babies on antenatal and postnatal wards, and those labouring without epidurals, birth pools or one to one care.

I do sympathise with women who want an epidural and don't get it. I was terrified of going into hospital to have my second and I wasn't given the option of a homebirth on the NHS because I was high risk. I ended up remortgaging my house to pay for a private midwife. Point being - I do know what it's like to feel like your wishes and needs aren't respected and your fears aren't taken seriously. It's crap. But at the moment, realistically I can't see a way around it. We just don't have enough midwives and anaesthetists to make guaranteed epidurals, one to one care, waterbirth and homebirths available. I'd love for the government to put a squillion quid into maternity services so put all these things right, but I can't see it happening. Can you?

Ushy · 18/02/2011 21:48

Mamamary which hospital waa it? Can we all go on the waiting list? Smile

Cleo You wrote "I'd love for the government to put a squillion quid into maternity services to put all these things right, but I can't see it happening. Can you?"

I am not sure I agree, Cleo. If the hospital like the one that Mamamary went to can provide decent care and epidurals when people ask for them, why are there so many APPALLING BARBARIC stories on this thread? There are people talking about being operated on without anaesthesia - it is medieval.

If some hospitals can provide good care why not all? Isn't it that hospitals are just making choices and some hospitals just think women in labour are bottom of the pile.

Unless people kick up a fuss rather than accepting the status quo, things will never change.

Cleofartra · 18/02/2011 21:59

But it's not JUST about providing epidurals is it?

Different women need different things to make labour bearable.

I needed to be looked after by a midwife I knew and trusted. I also needed to have my baby at home. Other women will pay for a birth pool and have a homebirth to guarantee access to water in labour - they know this is what they need to have a birth they can cope with.

We can argue for 'epidurals for all', but it's just as important to argue for 'one to one care for all' and for 'birthpools for all'. Smile

Ushy · 18/02/2011 22:10

Cleo We TOTALLY agree with you. No-one is saying that one to one care isn't also important and should be provided.

This thread, though, is about the particular issue of epidurals being denied - sometimes for no reason other than the midwife not liking them.

The pain from a long traumatic labour without adequate pain relief can make people mentally ill. Please read some of these posts - they are hordrifying. Where else are people left in that kind of pain in the NHS?

That is not acceptable and THAT is what we are talking about.

Ushy · 18/02/2011 22:12

Oops..whats hordrifying ..Hope you know what I meant Smile

mathanxiety · 18/02/2011 22:36

I read Jessica Mitford's book some time in the 90s, after the birth of DD1 and DS (it was recommended to me by my OB/GYN at the time weirdly enough as we chatted once during a prenatal visit about US healthcare in general vs. Irish and European). Though she had some good points in general, especially relating to the history of doctors' takeover of childbirth from midwives and the demonising of midwives (with the corresponding deification of doctors), I actually found I couldn't identify with some of her observations, having gone through the process of childbirth twice, and having mc'd three times, with one D&C, as well as having another operation (gallbladder) by that stage. It was well-written, though horrifying too, although some of it wasn't really new to me as I had studied history in college.

My feeling by that stage (after DD1 and DS) was that it was individual nurses, doctors and other staff that make or break a hospital experience of birth, even given the generally poorer management of maternity units compared to other areas of the hospital that I had observed up to then (all my experiences took place in the same hospital). The next three births that I experienced reinforced to me the difference priorities make to a hospital experience, not just individuals.

Throughout the whole 5 deliveries the experiences that made me feel like a slab of meat were the treatment I received from the nurse who pretended not to speak English (twice) and the realisation that the anesthesiologist wasn't going to get to me in time, plus treatment after a D&C by a nurse who was clearly just phoning it in. My pain was important to me even if it wasn't high on the priority list of others.

I haven't seen The Business of Being Born. I do take issue with Jessica Mitford's general idea that something like the NHS is the panacea for the poor outcome of maternal health in the US and if that was a premise of The Business of Being Born, I think it's not a given.

Cleofartra · 18/02/2011 23:07

The Business of Being born is more focused on the issue of the availability of homebirth and of midwifery care in the US.

I really enjoyed it.

Cleofartra · 18/02/2011 23:10

"The pain from a long traumatic labour without adequate pain relief can make people mentally ill. Please read some of these posts - they are hordrifying. Where else are people left in that kind of pain in the NHS?

That is not acceptable and THAT is what we are talking about."

Actually the real issue here is women being patronised and treated with disregard during labour, full stop. Sometimes it manifests itself as a refusal to supply adequate pain relief, as we see in some of the stories here. But it's a much broader issue than just about the availability of epidurals.

As far as I'm concerned the failure to provide one to one care in labour to women who need it is just as serious and as damaging as the failure to provide adequate pain relief. Both result in trauma and distress.

Ushy · 18/02/2011 23:38

Cleo Totally agree it is both issues but to be honest it is not just one to one care by ANY midwife.

There are some midwives who have posted on this site whose attitude to women, as other posters have said, is so appalling it leaves you speechless.

It is not just having 1 to 1 midwifery, it is having midwives who do not patronise and disregard women's wishes - exactly what you said.

However, IF we had good midwives who genuinely advocated for women, they would be applying pressure to get the pain relief women want.

They wouldn't be campaigning AGAINST epidurals, saying epiduruals are unnecessary or, as that incredibly infuriating male midwife said last year, saying that 'pain is a rite of passage and women won't bond with their baby if they don't suffer it.'

Do they sell ball snippers on Mumsnet?Grin..was so tempted.

Who in the world would want 1 to 1 care by him?

So actually, one to one care by DECENTLY trained midwives who respected women's choices would help.

Can I say before anyone jumps down my throat that I know there are tons of brilliant midwives out there who are incredibly kind and supportive. It is a real shame that some of the olleagues who let your profession down don't take tips from you.

Ushy · 18/02/2011 23:40

Oh bu!*!+r colleagues not olleagues Confused

mathanxiety · 19/02/2011 00:08

Cleo -- I think the pain issue is central to the trauma. It is one thing to be left alone while pain is moderate but another thing altogether when it is not. Not having your terrible pain taken into account adds vastly to the trauma. You are lying there helpless, whether with a MW or nurse or no-one, and your experience counts for nothing, your wishes go unacknowledged whether you are attended or not.

The idea that you could lie there (or walk around or whatever you do) and tell people how bad your pain was and ask or even beg for relief and not get that relief makes you feel you are not being believed or that your experience is somehow unimportant, and that is where the trauma comes in. The question of being listened to when it comes to your own pain and your own endurance is central to the trauma; it is actually worse imo when you have someone at your side who seems to be blowing you off. At least if you were on your own you would know you were talking to the wall.

Cleofartra · 19/02/2011 07:25

"The question of being listened to when it comes to your own pain and your own endurance is central to the trauma; it is actually worse imo when you have someone at your side who seems to be blowing you off. At least if you were on your own you would know you were talking to the wall."

Yes - I have mentioned about 5 times on this thread THE IMPORTANCE OF BEING LISTENED TO.

"They wouldn't be campaigning AGAINST epidurals, saying epiduruals are unnecessary or, as that incredibly infuriating male midwife said last year, saying that 'pain is a rite of passage and women won't bond with their baby if they don't suffer it.'"

Who's 'campaigning' against epidurals?

Or saying they are 'unnecessary?'

Re: Denis Walsh - some women DO see the pain of childbirth as a 'rite of passage'. Denis Walsh was acknowledging this as a valid response. There is also a mass of research which has looked at the way using drugs in labour impacts on early interaction between mother and baby. This is what he was referring to in his article. He's a professor of midwifery and has produced some fantastic work. I think it's very unfair to dismiss his views based on one very poorly reported article, and based on the fact that he's a man and his views make you uncomfortable.

"However, IF we had good midwives who genuinely advocated for women, they would be applying pressure to get the pain relief women want. "

Midwives have a primary aim which is to help all women have the safest and best possible experience of childbirth. As a body the RCM really does care about good practice. Nobody would deny that there are unkind midwives. But they're not representative of the profession.

Ushy · 19/02/2011 09:17

Cleo "Who's 'campaigning' against epidurals?

Or saying they are 'unnecessary?'

The lunatic fringe of the bloody midwifery profession

Look at these press links - it was also on the radio so it is not the press making it up - I remember it as clear as a anything because I had just had the baby and I could have spat!

www.dailymail.co.uk/health/article-378638/Safeguard-free-epidurals-say-Mail-online-readers.html

This is from the Guardian about the women need to suffer idiot (who I have just read is a PROFESSOR of midwivery - what the...)
www.guardian.co.uk/lifeandstyle/2009/jul/12/pregnancy-pain-natural-birth-yoga

What planet are they on?

Personally I would rather have one to one care from a nightclub bouncer.

Again - sorry to all those lovely midwives - this isn't aimed at you.

mathanxiety · 19/02/2011 15:46

Listened to and importantly, having your (reasonable) requests put into action. To be listened to and not to see any effect to your request for pain relief is maddening.

A wall can give the impression of listening -- you're speaking, the wall isn't going anywhere; it's a one to one wall. But you're still in pain and the pain is getting more and more difficult to endure, because the wall is doing nothing for your pain and neither are some MWs apparently.

gloyw · 19/02/2011 19:11

I agree that better maternity care all round would be ideal. However, I think the issue of being in agony, and having people supposed to be providing care for you refuse or fail to provide pain relief that should be available is something unique in a traumatic birth. I think mathanxiety describes this well.

I think it's an issue that goes beyond 'let's have one to one MW care'. And I think the argument of 'if you give epidurals on demand, then surely you have to concede to every maternal request as if they were all equal' is rather misleading. It would have been lovely to have CD music of my choice playing during my DS's birth. It wasn't possible. I have not been left traumatised by this.

cleofartra, you argued on another thread that you thought mothers should only be asked to pay for homebirths [which I'm not advocating at all] IF mothers in hospitals were asked to pay for epidurals which were medically unnecessary.

Can you explain what you mean by epidurals which aren't medically necessary? Are there any circumstances were a labouring mother said she was in a lot of pain, and requested an epidural, where you would feel it was legitimate to deny her?

Chynah · 19/02/2011 20:41

I find it amazing that after 29 pages we are still discussing if pain relief (by epidural) should be available when requested.

I would have thought that in this day and age (in a civilised (?) country) a person in hospital and in pain would get pain relief when they wanted it (oh yeah, they do don't they .... just not if they happen to be in labour!)

muckypupster · 19/02/2011 20:42
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