Fobbed off with no epidural, how do I guarantee one next time?

[Riva27]

My labour was classed as 'quick' with apparently 2.5 hours of active labour. The thing was that I was examined and told I was only 2cm dilated and could be in this latent phase for 24 maybe 48 hours. I told them all the women in my family go from 2- fully dilated very quickly and that I was in a lot of pain. I was found my best to talk calmly, after (excuse me) emptying myself from both ends completely! And getting short gaps between contractions to be able to talk. I felt like I was a fraud and that noone believed I was having the baby, and I was treated like a child who was complaining about a grazed knee. I refused to go home as I knew I couldn't make it to the car, after just over an hour on the ward (of sleeping women, I felt very guilty as I couldn't keep quiet, and had to kneel on the floor of the toilet for most of the time in tears) I begged to be reexamined and the midwife said calmly 'just breath' I felt like I was totally alone as my husband was sent home. Anyway, they examined me and suddenly realised I was 7cm or more and had had no pain relief. I was honestly in agony. I have had root canals without pain relief and thought that was nasty but that was nothing!! The gas an air that I eventually got did nothing except make the little gap between contractions ok, but that wasn't what I wanted, I wanted pain relief! I asked for an epidural so many times it felt like noone wa listening, they said I could have a birthing ball!?! Are you kidding me, I was under the impression if you asked for it in time you could have it. I even remember begging them, I said 'I am begging you please' and I am not that sort of person, I had zero dignity in saying this and I felt like no one thought it was that painful. One midwife even said 'you chose to have this baby!!!!!' how can people talk to you like that. I had quite a bad tear at the end and had post traumatic stress, I could barely talk and couldn't talk about the labour for weeks after, even now I feel like I new want to go back into hospital, even though I want more children. I felt like they thought I was being dramatic and that labour was nothing. Even though I held most of the noise in by biting through my lip so that it was brused, bleeding and swollen and I cracked my front tooth.

Please, anyone who knows how to make sure that you get an epidural, tell me! Even afterwards there was no reason given why I didn't get one. They just kept delaying it until it was too late. I felt like a child. Only women who have felt pain like that know what it's like, I try to tell my husband, I would have done anything to stop the pain and I have never felt anything close to it. How can I make sure I get proper pain relief? I don't even want to get pregnant until I know and I hate th hospital. I want to be 100% sure that I won't experience that treatment again. It scares me to think that no-one listens and you can't do anything yourself. Thank you anyone who can help or if you have had a similar experience, I feel alone in this and feel really down.

It only takes 20 minutes to put an epidural in. A consultant units should be staffed to provide an epidural within 30 minutes from request.

It is a quality marker.

Agree with QTPie, when my dad was in a general ward vomiting and crying with pain I asked a nurse to bleep a Dr to prescribe more pain relief. She tried refusing as she said the on call SHO wouldn't prescribe further analgesia due to concerns about my dad's liver function.

I let her know pretty damm quick that I have medical knowledge and that what she was telling me was a load of bollocks. For some reason she just didn't want to bleep the SHO. I told her if she didn't I would, that I worked in the hospital and knew how to bleep a Dr.

But how bad is that? Other people would have believed her.

Ushy - it isn't always about the availability of an anaesthetist either. Most hospitals will insist that a woman with an epidural needs one to one care from a midwife. If you have 11 labour rooms and only 5 midwives there will be shifts where that's impossible.

Viva but that's the same issue isn't it? NICE said all women should have one to one care. Should we compliantly and obediently accepts the unacceptable?

I just love the Mners who kick up and don't put up with it.

It doesn't even need to cost more money - midwives just need to look after women in labour and freed up from all the other rubbish they do.

Interesting fact I came across - UK has some of the best maternity statistics in the world. How much time do midwives spend doing stats and filling forms, risk assessments, staffing rotas....? Do we our midwives need to spend so much time doing data entry? Is that actually anything to be proud of?

The paperwork may be great, the care, IMO, is sometimes rubbish.

I don't think, though, it is necessarily the midwives - its the system. Systems can change but only when enough people refuse to agree to be treated like second class citizens.

Ushy, as a midwife I don't think I do anything which isn't a vital part of my job, certainly not doing rotas, etc. the ward manager will, but not the midwives on shift. The majority of paperwork I do can't be delegated, I write as I go along, contemporaneous notes and as its my record of what's happening, my defence incase anything goes wrong then I need to write it.

Currently after the woman has delivered it takes me ten minutes max to input the birth details on the computer. Soon however were all getting tablets computers in the rooms so all notes will be electronic, so we will save those ten minutes afterwards.

Nice, did say one to one care in labour and it hasn't happened. But idont see women kicking up a fuss and refusing to accept it? Do you mean kicking up a fuss when they come in in labour? Because that won't make a difference, if the midwives aren't there then they're not there. I don't see the campaigns, etc and the hounding of politicians over the issue.

Viva, reading what you say about midwives needing to write up notes gave me a flash back to lying on a bed hooked up to an epidural (waited 3 hrs to get it BTW, emergency prevented me getting one earlier, an awful experience). Finally after 12 hours I was ready to push. Midwife needed to tell me when to push due to epidural, but spent her time typing up my paper notes from previous midwives (wasn't moved to correct ward for ages... long story) and left me guessing and asking, should I push now??? now??? Bloody notes. When I read through them after they weren't even right in places. ('Mum coping well...' um...)

Not meant to be personal to you obviously, your post just made me think of that experience and it makes me wonder whether so much note taking really is essential or should be done in that way.

Bit shaken up thinking of it all actually.

Oh, ended up with c-section!

We're told to write so much it's untrue. Obstetrics is the main area in medicine for complaints and litigation. If it isn't written down it didn't happen. We have to write when we offer someone a coffee because someone complained once she wasn't offered one for the whole of her labour!

I could be in court in 24 years time defending myself against allegations from a birth this year. I won't be able to remember it, so all I will have will be my notes.

And stuff like "mum is coping well" isn't good enough. A lawyer will pull that apart, you have to write why you think she's coping, or that she's said she's coping. It is a pita, but defensive practice is here to stay. And yes, sometimes I feel I'm spending more time writing notes than supporting the woman. It's shit.

Our notes are checked by managers frequently and you can be disciplined if your notes aren't detailed enough even if nothing has gone wrong.

That sounds awful! Especially as the more complex the situation I imagine the more complex the notes, and the more the woman will need you with her. A big legal document was shoved under my nose just before I went in for my c-section. Something about risk of serious harm/ death. Very poor timing when I was terrified and confused anyway.

Terrible how litigation can end up obstructing best practice.

Sorry OP for diverting original thread! I don't know how to guarantee an epidural, but if I am pregnant again I will try to get the same midwife I trust and discuss my worries in the first appointment, and try to get a c-section probably.

I think there should be more anesthetists available, or something! Because I would have done anything to reduce the pain, I didn't feel any pain when (sorry to be graphic) my vagina ripped, which I am sure everyone would agree, had the other pain not been so unbearable, in normal everyday life I am pretty sure I would have noticed, I could not describe the pain to someone who had not felt it, or something similar, I was in a state of desperation that comes back to me when I fall asleep at night. I hadn't lived a pain-free sheltered life before, expecting an easy ride, women arnt wimps, which is what I was treated like. I am just about to go to sleep, for the hundredth+ time after my labour dreading the thought of it happening again, scared, if giving birth is so common, why isn't it the thing we make sure we can make bearable?

I've never had an epidural but all I will say is that it doesn't hurt half as much the second time round, or at least that was my experience and I appreciate everyone is different.

What I'm trying to say is just because you felt like you needed one last time you might not feel you need one this time, every birth is different so try to just be open minded.

But maybe this time explain that you laboured very quickly and that there wasn't time for an epidural when you felt that you needed one so ask that they get the aneathasist ready just in case.