Why would a midwife not offer gas and air?

[12hours]

Hi, I have a 10 month old baby. Throughout the pregnancy, we had a single umbilical artery and things were a bit fraught, but it was a healthy pregnancy and I was not majorly anxious about the birth, although of course I was aware that it would hurt.
When I went into labour, we attended the hospital for the second time (was sent home the first time as contractions were too far apart) and got a room. The pain was awful (I am sure no worse than anyone else's, but it still really hurt) and I was mooing like a cow on the bed. I had a midwife who was treating me as if I was exagerating the pain and being totally dismissive. I was using a TENs machine which didnt have much effect, and due to the dismissiveness of the midwife, I think I started to panic and thought she didnt realise how much pain I was in. After an hour or so, she said "you are not coping well with the pain, you are having an epidural". I was quite happy to take the epidural at this stage (I would have taken anything to get rid of the pain!) but the whole labour slowed down and I ended up having to have ventouse, forceps, etc and the whole thing was extremely frightening because I felt so out of it. I was crying about the labour for almost 3 weeks after I gave birth (and I am not even going to go into how unhelpful the staff at the hospital were about the breastfeeding), and I cannot stop wondering why I was not offered any gas and air. this may sound minor considering the epidural, but its bothering me why an epidural seemed to be the only pain relief that was mentioned. Whilst I was writhing in pain waiting for the epidural to turn up, another midwife came into the room and I asked her if I could have gas and air. she said yes and then went to leave the room. I asked her where it was and how I should use it and she just told me that I should ask my midwife when she got back. That was the first and last mention of it and I dont understand why. Are there circumstances under which a midwife doesnt offer gas and air? Was it something I was doing that made me unsuitable for gas and air (I was not on any medication at the time). this has been upsetting me and making me angry for the last 10 months. I knew childbirth wasnt going to be a bed of roses, but something as simple as gas and air I had been lead to believe it would be almost automatic on arrival. If this wasnt bad enough, after the epidural was given, i was asking for my top-ups. I was told by the midwife that she would be "back in a minute" but she didnt come back for an hour and 20 minutes - at which point she came into the room with a cup of coffee and told me that she was "tired and needed a coffee". What do other people think? Has this happened to anyone else? I would like to put in a complaint, but I dont want to keep going over old ground, I just want to know why I wasnt started off on gas and air and the situation was escalated to an epidural?

I'm sorry to hear about your bad experience. That is not what good support in labour looks like and you should have had better support.
This is why I became a doula so that I could give women 1 to 1 unconditional suipport.
It may have been that the hospital was very busy and your midwife had a few women to care fore and was tired, but that is not an excuse to give you substandard care.
You should have been offered gas and air. My guess is that she thought thatyou were in the early stages of labour and that you would need an epidural if you were in that much pain (or that she just couldn't give you the time, and support you needed to help you have an unmeduicated birth)
I would consider make a complaint, because how will the hospital learn what is unnacceptable care if you don't tell them?
If you had had a more supportive midwife you may have been able o cope without the epidural and so possibly have avoided the forceps and subsequent rauma and you should also have been supported to breastfeed.
(((Hugs))) I hope you are starting to feel better now.
There are organisations you could talk too if the birth is still upsettting you-
www.birthtraumaassociation.org.uk/
www.sheilakitzinger.com/ArticlesBySheila/BadBirthHaunts.htm
[This article features one of my clients-
www.guardian.co.uk/lifeandstyle/2010/nov/14/scared-birth-trauma-midwives
Selina x

I'm sorry you had such a crap experience. I had virtually 1-2-1 with a fab midwife but I (well my mother on my behalf) still had to ask for gas and air for me. MW thought I was coping well without and had got it into her head I wanted a completely non medicalised birth at all costs so didn't offer.

What did your birth plan say about pain relief?

It sounds like you were were not looked after properly. It sounds like a horrible experience and I think you could ask for your birth notes and to go through it with a midwife, this might give you some answers? You do have to pay a fee to access old birth notes, but it might be worth doing. My friend did this 4 years after the birth of her baby and it helped her to finally deal with her bad experience.

hope you get some answers soon. I cant think of any reason not to offer gas and air either, but then I am not a midwife.....

That's really poor. You are supposed to have 1:1 care with an epidural for starters.
My MW didn't offer me any pain relief either, but she knew I was transferring from a home birth, so I think she was working on the principle of not offering as I had intended to go without (possibly not the wisest as I was on synto by then, but never mind). When I asked for pain relief she suggested I try G&A.
Giving the benefit of doubt I might guess she was trying not to force stuff on you, but from the rest of the story I think they might have been being a bit slack. It's not on at all, as a fair few mothers would have no idea of what pain relief was on offer, let alone the pros and cons and when to use which type.

Hmmm... doesn't sound great. I would agree that the only real explanation is that she thought that you weren't coping with the pain at a relatively early stage of labour and therefore thought you would need an epidural.
BTW, you say she told you 'You're having an epidural' : it is YOUR choice, and she shouldn't have foisted one on you if you didn't want it.

The only other time I have known a midwife take refuse g and a is at the pushing stage if its making the mother a bit spaced out and not focusing on pushing. I had a few whiffs of g and a at transition with one of my babies, and then as soon as I said I was ready to push, the midwife whisked the gas away because apparently I needed to concentrate. Ouch! But obviously this wasn't the reason in your labour as it occurred much earlier.

Hi,

Thanks so much for all of your responses. My birth plan said that I wanted to see how things went, I wasnt opposed to any of the pain relief, but just wanted to play it by ear. However, the epidural was my lesser preference, I wanted to try G&A and possibly pethidine (or whatever equivalent they had in the hospital). Funnily enough, the midwife mentioned that it was a very quiet night - she may well have been tired though and I have tried to give all concerned the benefit of the doubt because I was probably not entirely "with it" once I had the epidural. I have considered asking for a copy of my labour notes, I think I will do that as I need some closure on this - I am terrified to get pregnant again in case the situation is the same. As stupid as this sounds, I spend about 3 weeks just feeling so embarassed of myself, all the screaming and noise I was making - I was made to feel like I was exagerating (as if you would volutarily behave like that in front of people you dont know!) and I just felt so ashamed. I am over that bit now and I know that I did nothing more than the average woman in labour. I agree that the hospital need to know and I will try to put in a complaint once I have the energy to go through the whole thing again. The breastfeeding support was just non-existent. Baby was a couple of weeks early, I had not yet had the breastfeeding class and I asked everyone I saw to help me with it (baby was latching on but not staying on) and i was just told them would be back in a minute, but no-one came. 12 hours later, the baby still hadnt eaten and was jittery and I mentioned this to another midwife - she said she would get someone to see to it. No one came, again. However, 3 hours later when I was asleep, I was then woken by a neonatal doctor who wanted to take the baby for a brain scan (!) incase there was a bleed on the brain due to the ventouse (I have no problem with this, at least they checked, but I was reporting the jittering as I thought it was due to hunger?!). Once this was done and baby got the all-clear, I explained to the doctor about the baby not eating and doctor asked the midwives for some formula, thinking this might give baby a bit of energy and help him latch on. these were the same midwives who said they would be " back in a minute", but once formula was mentioned, they all looked around as if I had asked for a heroin injection! I really wanted to breastfeed, but the treatment and the whole experience in the hospital just made it impossible. I felt forced to give him formula in the end just so I could be discharged!

Aswell as the feeling of failure, I dont think the situation did the baby any good. The poor thing spent most of the first 6 months of his life crying all the time, he did have severe colic but he was constantly upset, and I blame the birthing experience for that. Obviously I would not use this hospital again if I do have another baby. There were also a few people at my work who had babies in the same hospital around the same time as me, and they all had a similar experience, so I know to some degree I was not imagining things!

Thanks again guys. XX

I would complain. Clearly this is bothering you a lot because your child is 10 months and still thinking about it, and it does sound like the care was pretty crap so hopefully if you complained it might help you get some closure from the situation? and also help to give the hosp a push to improve their service to others. You don't have anything to be embarrased or ashamed about as you have done nothing wrong.

out of interest what hospital were you in?

I really think that you should complain, if not to make yourself feel better but for other mums' to be aswell. you shouldn't of had to go through that and it sounds as if no one paid any attention to your birthplan. I also thought you would be offered Gas and air straight away as well.

It sounds like you have a really crap midwife. I used to have a staff member who worked for me, she was crap, it took me over a year to sack her and when I did a lot of the parents came and said to me they were realy glad that she had gone. It really pissed me off, if they had made complaints about her before then I would of had move evidence of her incompentance and could of sacked her earlier. Maybe this is the case with your midwife.

on another note you should not feel embarrased or ashamed in anyway

12hours - do get a copy of your notes - read them first yourself and then ask to go through them with a MW at the hospital. They should have someone there to do that with you.

Once you've got a clearer picture of your experience and how it was recorded, you can decide whether or not to complain. It does sound as though a lot of things were done poorly, and the hospital need to know when their care is substandard.

As others have said, you have NOTHING to be ashamed about in terms of how you behaved during labour and reacted to pain. Any MW who dismisses what a woman feels during birth and leaves them feeling ashamed afterwards is in the wrong job. She should be ashamed of herself.