Who had an epidural and could you have gone on without it?

[JeuxDEnfants]

On the back of news that epodurals are being rationed... I was in last star labour for 4 hours when contractions stalled and I needed oxytocin. Without an epidural... I think I would have experienced torture. I had to beg for one. What do you think? Aibu?

They do cause cs, because they slow down labour. Ds heart rate became non responsive. I couldn't feel the contractions to push etc and the.birth was not progressing. It slowed down with epidural.

They don't cause cs - it's in the NICE guideline. They slow labour down by 15 minutes roughly but there is no increase in caesareans.

I had an epidural early on , on midwife advice as I had severe SPD. I was induced, back to back baby, on drip.

It was great until the epidural stopped working. They kept topping it up but nothing worked. i was in agony and if they had handed me a gun I would have quite happily shot myself, thats how much pain I was in.

I went from feeling nothing to feeling full on everything and it was agonising. When I got to 9cm dilated I was hysterical with pain and the midwife just shouted at me for being so upset. She said I had an hour to go , that my cervix was stuck and babys head was stuck and there was nothing they could do to help me. A few minutes later I needed to push and they didnt believe me.

20 minutes later my DD was born, back to back and she turned as she came out. I was hysterical, shaking like a leaf, out of it completely and couldnt have cared less about my baby.

It was not a wonderful moment. I did not have any more children because of my experience

SkY That's awful Why didn't they call the anaesthetist back?

They did, they bunged paracetamol into it, but nothing worked. They just said that they had tried everything and there was nothing else they could do.

I dont know if it had anything to do with it, but there was a little thing taped to my shoulder and when I was moved, an HCA knocked it off my shoulder. I always wondered if this affected the epidural working, although they said that it didnt.

Ushy you werent there, I don't care what nice guidelines say, I had a birth with epidural and it was awful and was told that the epidural was responsible for the slow labour and the need to get Ds out quick.

Bruffin No I wasn't there but whoever told you epidurals cause caesareans was wrong to say that - it is a popular thing for the anti pain relief advocates to come out with but it isn't true. NICE bases its recommendations on research and there is masses of research on this.

Epidurals do slow labour down but only by about 15 minutes - not enough to cause a caesarean. It is very common for labour to progress slowly with or without epidural.

I hope I don't sound hard - I don't mean to be. It is just that there is an awful lot of misinformation out there that stops women getting the pain relief they need and 'caesareans are caused by epidurals' is one of the commonest bits of rubbish women are fed.

Epidurals do occasionally cause a caesarean.

They can cause a massive drop in blood pressure making the babies heart rate drop and stay low making a crash section necessary.
I've know 2 women have a 'complete spinal block' after an epidural, one who stopped breathing and was ventilated on ITU for four hours and one who's heart failed and under went a 'post mortem' section. Luckily both mothers and babies survived.

Ushy it wasn't 15 minutes it was hours. I was told at the time the problems were being caused by the epidural.

bruffin - I am sorry for your bad experience.

I'm not clear though - are you saying epidurals should be restricted, and not given to women who beg for them, because you personally had a bad experience?

(Ushy btw is right about the NICE guidelines on epidurals/slow labour. No one is saying epidurals are risk free, btw - we know they are not, and the risks should be discussed with a woman as part of ante-natal info on pain relief in general. But there is such a lot of misguided and misleading misinformation out there about pain relief, it's just ridiculous. You STILL see women talking about epidurals interfering with hormonal processes - but they are quite happy to have pethidine injected into them, creating a dissociative mental state and allowing an opiate to enter their baby's body via the placenta.... Seriously.....)

I think the length of labour & likelihood of intervention are dependent on many factors eg position of baby. If the baby is back to back, it'd take a while to get the baby out / may require forceps / ventouse / csection regardless of whether epidural is used as pain relief. I was very lucky that my baby turned from OP to OA while I was sleeping on my left when I was resting (because the epidural blocked the pain) the baby was out within 20 minutes of pushing! No forceps no ventouse no csection! Without the epidural I don't think I can rest as much and might not have as much energy to push and might not be able to get the baby out so quickly!

Wow, this is a contentious thread! Personally, my epidural saved me as my baby was back to back and I just couldn't cope with the pain. I had no problems and was perfectly mobile afterwards.
My only problem was that I had to wait 3 hours after asking for the epidural. The midwives kept telling me the anaesthetist was busy with 'a number of emergencies' but Ruth hindsight I wonder if there was an element of trying to put me off.
In addition, they let the epidural wear off when it came to pushing and refused to top it up, saying that 'it wouldn't work, as the baby's head presses on a different nerve at this point'. I now know this is a blatant lie. They probably wanted me to feel the urge to push but didn't tell me that.
It didn't work anyway as after another 3 hours of agony they got the docs in who did the ventouse.
Oh and after all that the thing that monitors the baby's heartbeat had apparently not been working all along.
I'm 36 weeks with my second now- going to a different hospital this time so hoping I'll have a better experience. I'm keeping an open mind but think I'll most likely request an epidural again.

Well personally my answer is that I could not have gone without it, and that isn't just in terms of pain relief!

Pre-epidural I laboured for 28 hours and only got to 2-3 cm dilated (the last 8 hours I progressed from 2 to 2-3 cm). I wasn't allowed pethidine because his heartrate was dropping below the acceptable level with the contractions. He was back-to-back and I couldn't lie on my side to turn him because this was THE most painful position for me. Then they started the induction drugs and that was me finished! In fact, when I finally enquired about the epidural the midwife basically told me to have it! I was very lucky - it worked perfectly and they gave me a boost button.

Anyway my established labour was 9 hours with induction drugs, but given how slowly I had progressed before the epidural I don't think it made much difference. However it allowed me to lie on my side and hence he turned to OA just before he was born.

Also I did need forceps but again this had nothing to do with the epidural - after 30 minutes of pushing (I could feel the contractions above the navel) his heart-rate got worse so they had to whip him out urgently. They prepped me for a c-section but because he had turned, he came out first trial of the forceps thank goodness - anyway this means that I would had to have had a spinal in the end anyway as I was totally prepped in theatre.

Before labour I was quite against having an epidural - but the reality of labour made it my best friend

Without one i don't know how my baby would have arrived tbh. Contractions were very painful but irregular for two solid days and by the time i arrived to be induced i was exhausted and seriously struggling. I was tensing so much from the pain that i was stopping anything happening too. They had to ramp the drip right up to max and i had lost it before they even started. Twelve hours on the drip then two pushing. I was told i was pushing fine btw so don't see how it stops that. It let me relax so the contractions could work and gave me back my mind. One lady down the hallway couldn't get one later on as he was needed in theatre. Her screams were horrific.

There seems to be a pattern if back to back babies emerging here. The stories make me feel better as I was in agony and my midwife was a total bitch to me because I was hysterical with pain.

She said I was a drama queen because I said I wanted to shoot myself, that's how bad the pain was :(

None of them admitted that it would be more painful due to back to back AND being induced on a drip!

Just to add - I had forceps, but again nothing to do with the epidural. He had his arm up by his face and that was blocking him coming out - he kept sliding back every time I got him close enough to the exit. I COULD feel to push, and was told the pushes were good, strong and should have worked if he hadn't been slightly awkward with that arm!

skybluesapphire it is awful that they wouldn't admit that it would be more painful when back-to-back and induced! I can confirm that when the induction drugs went in it was significantly more painful. Well actually I can't confirm that because my memory fails me at that point, but DH tells me they totally lost me once the induction drugs hit my system (before the epidural that is). As far as back-to-back is concerned, my mother had one back labour and one normal labour and she said that the back labour was significantly more painful - she had pethidine for that one, but just gas and air for the normal labour. Honestly, I can't believe anybody ever tries to compare 2 different labours in terms of levels of pain...

I've only just seen this and I'm FURIOUS BEYOND BELIEF.

If the RCOG have to put out a statement and contact MN about the document and say they aren't changing anything there is a major problem.

Loads of people INCLUDING professionals were angry with the content of the document and the language it used and what it suggested.

The trouble is, in not changing anything in the document it will be abused and misinterpreted by just about every fuckwitted idiot out there for their own means and ideology - it WILL be used to set a target and if the RCOG can't work that out they need shooting.

The document itself needs changing to include any clarification they are sticking out in a statement and to get rid of ideas about 'influencing' patients. Its sickening.

It is some time back since I had my girls, I had an induced labour with my 1st and yes, us poor mums don't know what to expect nor are we truly prepared for the pain, after trying gas which was useless and practically calling my husband the devil incarnate I opted for an epidural. There is no shame in having one, & no harm to the child (going by my case at any rate). It's purely an individuals decision, some women are more pain tolerant than others, therefore you may need..or may not, but I'm glad I did.

"Bruffin No I wasn't there but whoever told you epidurals cause caesareans was wrong to say that - it is a popular thing for the anti pain relief advocates to come out with but it isn't true. NICE bases its recommendations on research and there is masses of research on this."

I'm really up for looking through the research and seeing if the impact of 1 to 1 care throughout labour was 'controlled for' in the studies looking at epidural outcomes. We know that 1 to 1 continuous care is associated with lower rates of c/s, but in many hospitals it is only women with epidurals who seem to be guaranteed this.

It's also the case that most studies only compare outcomes for epidural with outcomes for women using pethidine. I have only ever seen one study which compares outcomes for epidural with outcomes for women who are not using opioids (which are associated with an increase in rates of non-reassuring fetal heart patterns in labour).

So basically almost all the studies are comparing women who have had regional pain relief which hampers mobility and usually results in a supine birth, with women giving birth under sedation who are usually not very mobile, and usually have a supine birth.

And even then, according to the Cochrane index, although the total number of c/s wasn't higher, more c/s were done for reasons of fetal distress among the epidural cohort.

All that said - I'm not anti-epidural. I think it's a necessary response to the highly interventionist care that is the norm now for most women. You can't create conditions that make labour and birth difficult and then whip away the one thing that makes it bearable for many.

Shag You definitely don't have to be supine if you have an epidural - I gave birth squatting - epidurals are badly managed in uk and you are told to lie flat by some staff but you don't need to. (In fact, being flat on your back is riskier).

Birth can be unbelievably painful - traumatically painful. I don't buy that it is all to do with 'interventionist culture'. If you read the threads where women have had really awful experiences, they usually have had long traumatic labours, poor pain relief and THEN emergency sections.

I know that is contrary to the ' birth is a natural physiological process woo' but I just think that is a societal construct based on nothing other than 'natural' birth being cheap.

I am not criticising anyone who chooses natural birth I just object to it being sold to everyone else who doesn't believe in it.

I don't believe all the complications that 21st century women suffer are a result of the obstetric care. It is because we are having babies later, babies are bigger, more women are having IVF and probably fewer women who have obstetric problems are dying. No part of our modern lives is natural. Nothing. Not one jot. Yet when it comes to childbirth - suddenly natural is de rigueur.

It is so...unnatural

"You definitely don't have to be supine if you have an epidural"

No - I agree. But women usually are! Not necessarily completely supine all the time, but sitting on their tail bone.

And Ushy - it's not 'woo' to say that birth is a natural physiological process. It is. It doesn't always complete successfully, but it is a natural physiological process. Fact!

"I don't believe all the complications that 21st century women suffer are a result of the obstetric care"

No - you are right. Luckily nobody is saying that this is the case, so there's not really an argument here.

However, there is pretty good evidence that for healthy women at least, choosing to give birth in obstetric led units is linked to very much higher levels of intervention, with no improvements in outcome for mum and baby.

"No part of our modern lives is natural. Nothing. Not one jot. Yet when it comes to childbirth - suddenly natural is de rigueur."

What an odd comment. If a birth can be completed successfully without the use of drugs and instruments, leaving a happy, healthy mum and baby then is this not the best result all round?

What other benefits are there to a birth involving a high level of intervention if it doesn't result in better psychological and physical outcomes?

"What makes me laugh most is the idea that epidurals will lengthen labour. Well yes, by about 15 minutes and with an epidural who cares?"

Well, the baby will care if the delay is happening in the second stage of labour and the baby is experiencing fetal distress (as is so common), hence necessitating a hasty assisted delivery.

"The 'cascade of intervention' is rubbish"

It's not. It's a fact.

Epidurals are a godsend for difficult labours, and a reasonable choice for any woman, even if she isn't having a difficult labour.

But there are risks as well as benefits to any intervention which disrupts the normal physiological process of labour. As an epidural most assuredly does.

Re: posterior babies,long labours and syntocinon drips - I have had this in two of my three labours.

First labour involved me being cared for by a succession of midwives, some good, some bad. My mobility was restricted (CEFM), I was encouraged to take pethidine (which made me weak and ill), and I eventually had an epidural. I needed it.

Second labour involved me being cared for by one midwife I knew and trusted (a friend). Mostly at home. Also needed augmentation and CEFM but this time mobility not restricted as friend kept me upright and moving. No pethidine. No need this time for epidural. Despite labour which was as long and painful as the first.

We know the things which help women cope with long, difficult labours: epidural, one to one care from a midwife you know, access to water to labour in. Being cared for at home.

How many women on this thread had access to one to one care from a midwife they knew and trusted in labour?

Why isn't everyone shouting for greater access to case loading care for labouring women, even though they know that this type of care makes difficult labours easier to manage and less traumatic?

And is linked to better psychological and physical outcomes for women and babies?

Why this overwhelming focus on epidurals as the answer to everything that is hard about labour?

Do we really want to end up with a situation where 90% of women are labouring with an epidural, like in other countries?

I suspect there are many people who think this would be a really good goal to have.

Hear, hear Shagmund!!! Well said.

Shag A couple of really awesome posts there