Pain relief - why is there stigma against using it?

[CalamityJ]

39+6 so seriously beginning to think about the actual birth process (probably about time!). A few NCT friends have given birth already and have a few RL friends who have also given birth in the last few months. The general gist has been that they've made it through childbirth with as little pain relief as possible. One posted on Facebook that he was 'really proud of his wife as she'd done it all without pain relief'. And that made me feel a bit as before then I hadn't thought that people would think worse of me if I went for whatever pain relief I felt was necessary. Speaking to the midwife last week she mentioned the birth plan which has that I want to know when it's becoming too late for an epidural so I can make a decision about if I need it. She basically tried to say I should not bother with one and I should just try for gas and air. I'm not sure why I should feel the need to be a hero and go without pain relief? Would it make me a 'better' mum? Why wouldn't I want to make it as easy as possible on me?

Fair enough, Katie, nobody wants that! Though it sounds like in those cases the dose has not been calculated precisely enough - perhaps the hospital had used a one-side-fits-all dosing regimen rather than a mg/drug per kg/body weight individual approach? I don't know how it works on labour wards.

Anyway, as I said, I'm of the view that whatever you decide to do is the right decision for you. Feeling in control, however you do it, is probably the most important factor, I'd imagine.

I get the argument about drugs affecting the baby but given I've been on cyclizine since week 16 to week 40 (today!) & omeprazole since week 28 then I've had to come to terms with taking drugs which may affect my baby simply to get through my pregnancy. So I feel I've also had to come to terms with potentially needing pain relief to get through the labour.

My friend said she'd gone pain relief free to compete with her sister who had recently had number 3 with no relief. It was my friend's first & she had a 10lber over 3 days including forceps, her sister's 3rd which was an 8lber was out in 45 mins. She wished she hadn't been competitive & taken the pain relief. I am so non competitive I too hate the Momolympics as a previous poster termed it. And agree with everyone who says only you'll know what you need. Except my worry is that midwives will think they know better.

Codeine is common OTC drug for migraine and period pain, Shagmund (awesome username, by the way!) But I'm a pharmaceutical research scientist of almost 15 years now - granted I haven't read every single paper published, but opioids in carefully controlled, occasional doses are regarded as safe.

Anyway, didn't want argue or seem critical - sorry if that's how I came across.

Oh, and sorry codeine made you feel ill, shagmund. Indeed we all react differently to medications.

Go with the flow love and ignore everyone else.

Yes epidurals slow down your labour but when you've been in labour for 9 hours or more and your still only 4 cm dilated I really think it isn't relevant!

Your first baby takes 12-16 hours (approx) and your body has no idea what it is doing the first time round... natural instinct my butt crack!

Your body has to LEARN how to have a baby it's not something your body automatically knows how to do. (I'm sure there are exceptions to the rule..there usually is!)

I have 3 children all 4 years apart and we are trying for baby no 4.

My first baby I ended up with everything. Twice. I ended up with an epidural and did not have an assisted birth. (I was also induced).

My subsequent 2 children were born fairly quickly with only gas and air, that's pretty much the norm.

At the end of the day it's not a bloody competition and don't be swayed by midwives who try to get you to have this and that (or not) just because it's time consuming.

There's also no point in blathering on about risks of pain relief. There are risks in everything we do, giving birth is a risk!

You make yourself a birth plan you feel comfortable with and be prepared to be flexible.

Good luck. xx

I had no pain relief. It wasn't out of competitiveness. I didn't want the epidural because I have a fear of loosing the use of my legs. By the time I got to the hospital, I was fully dilated, so the nurse said it was too late for any pain killers anyway. I was offered gas and air, but it really didn't agree with me so I didn't bother with it.

I was always very positive about birth, was never scared of it, which may have helped. I also was so sick of being pregnant I would have gone through anything to get the bugger out. Also I am ginger and there's a rumor we have a higher pain threshold, so that may have helped

I would think it's probably quite hard to estimate the weight for accurate dosing of opioids? How much is baby, how much mum and how much is fluid is all quite tricky to calculate accurately?

I was given codeine at 27 weeks pg when I was having strong contractions and continuous monitoring. Didn't even touch the sides! I would happily have accepted an epidural then. Funnily enough when I was in established labour 3 months later it wasn't nearly as painful and she was back to back. Course I wasn't terrified I was going to deliver a 27 weeker 400 miles from home and possibly seriously ill myself when I was labouring at home.

Lol puds. I actually felt more well in labour than I had for the preceding 3 months with dc2. Each contraction was a step closer to freedom from pain and being a PreND.

Has an epidural got codeine in it then? Bugger.

I have only taken codeine once in some OTC meds and it made me sick - my first epidural also made me very sick, well I was told it was probablythat though it was a delayed reaction, took around 8 hours and then I couldn't stop.
I was scared of it this time but the dose or the drugs must have been different as though I felt quite ill after I'd given birth, that was more like the unwell you feel when you haven't eaten for hours, which I hadn't. Not the physical vomiting thing I had the first time.

No one has told me what drugs are in an epidural, I'm interested to know.

also I wonder what effect it has on babies, as though ds3 woud have had less than ds1, they were both unsettled and worried looking babies while ds2 (home birth, no pain relief) was very very chilled from day 1.

I don't actually know what's in an epidural, Rooney! Just gave codeine as an example opioid that most of us have taken. Some people don't like it, but (pop fact) most over-the-counter doses are standardised to the average adult male body weight, so if you are a small woman, a lot of "recommended doses" can be a bit strong.

Sorry for thread hijack! Will leave the discussion to people who've actually been though labour

I would seem out all the information so that you know the facts, including risks, then you can make up your own mind OP. And try not to worry too much about what other people are saying; this may be something that they are really proud of, but it has no bearing on you, or at least it shouldn't.

Personally, I think that women should feel empowered way before the labour part by providing clear, concise, accurate, non judgemental information on pain management and other coping strategies. Empowerment comes through choice and that being acted upon, and obviously with such dire figures in women receiving the pain relief they wanted, there is a breakdown somewhere. Don't get me wrong, sometimes there won't be an anaesthetist available or some other situation may arise out of your control, but surely with such stark figures this points to a real problem?

I felt very empowered after giving birth via an EMCS for DS1 and an ELCS for DS2 and I think this came about from being listened to during labour with my first and also in the care leading up to my second child, as well as knowing all the options available to me. For me, a natural and normal birth wasn't vital because I considered labour as a means to an end, and pain relief was something to help me get to that end. As an aside, I have fibromyalgia, so pain management is something that i was particularly interested in as i am in pain every single day - immediately after my ELCS was glorious what with the voltarol and spinal taking all my pain away .

Overall, I felt at my choices were respected (although that meant little to me in the grand scheme of things) and the one person who has actually commented that I am weak for having an ELCS as I'm "taking the pain free easy option" doesn't matter at all - in the end it's about you and whether you had a positive, empowering experience not someone else's judgement on you.

*i would find, not seem

"Except my worry is that midwives will think they know better" yes I worried about this too. It's awful not having the confidence that you will definitely be listened to and respected throughout your labour - the set up we have, where we have no idea who is going to actually care for us on the day, is to blame. It's only now, having had my birth experiences, that I would be able to challenge a midwife or doctor if I felt it necessary. Shame I won't be having anymore!

Is there really such a stigma? Not come across it myself (39 weeks so also thinking about these things). The general consensus seems to be labour can't be predicted so go with with flow and be flexible when you are writing a birth plan. In fact every single person I have spoken to has said something along the lines of 'of course everyone wants a natural birth, with only gas and air, whale music and a water bath.... but in the REAL world.... etc'.

I think a lot of the stigma that is spoken of is from within. Women judge themselves and think other people are judging them, when they are not. Not true in every case of course.

"and obviously with such dire figures in women receiving the pain relief they wanted, there is a breakdown somewhere."

But nationally fewer than one in ten women says categorically that she didn't get the pain relief she wanted in labour.

And in a large number of hospitals that figure goes down to 1 in 20 or fewer.

"Is there really such a stigma? Not come across it myself"

IME women generally fall over themselves to extol the wonders of their epidurals. No matter what they think in private, generally nobody wants to be thought of as a 'natural birth nazi' (whatever that is) and so most women will say whatever it is they think will make them seem most sympathetic, non-competitive and understanding in the company of other women.

I'm not bothered about being popular, so I say what I think.

Wanted to add - yes, it's good to be well informed.

And one of the most important things any pregnant first time mother can know (other than the importance of seeing labour as an adventure where anything can happen, and where a positive and optimistic mind set is a massive advantage) is that if she goes into an environment where epidurals are very frequently used, she's very likely to end up having one herself, whatever her plans prior to labour.

Shag "But nationally fewer than one in ten women says categorically that she didn't get the pain relief she wanted in labour."

Partly true but only about two thirds said they actually got the pain relief they requested - just under a third either didn't get it or they got it 'partially' - hours after they asked for it or had it turned down right at the end etc etc.

Well - given - nearly 700,000 women have babies in UK - that's over 200,00 women who are disgruntled or slightly disgruntled about respect for pain relief wishes.

That's quite a lot of annoyed women.

"IME women generally fall over themselves to extol the wonders of their epidurals. No matter what they think in private, generally nobody wants to be thought of as a 'natural birth nazi' (whatever that is) and so most women will say whatever it is they think will make them seem most sympathetic, non-competitive and understanding in the company of other women."

What Utter Utter Tosh.

Deluded nonsense!

I've not heard of an epidural being used to resolve fetal distress. Epidurals are more likely to cause fetal distress than resolve it AFAIK.

Well, I was given one in order to slow my labour down as it was happening too fast and baby's heartrate was all over the place. Once labour slowed, her heartrate became regular again.

And, yes luck DOES plays a part in labour. You can be very unlucky and suffer complications that make your labour harder to manage such as baby not turning, pre-eclampsia, and even more serious situations which result in tragic consequences which are nobody's fault.

I was encouraged to have an epidural as I had pre eclampsia and it lowers BP. It brought mine down nicely, thank goodness for modern medicine!

YES

I have gone through labour Shag.

I don't think there is a stigma against it, but pumping your body full of chemicals is never ideal, especially not when pregnant. We've become so reliant on pain relief that we don't seem to be educated about natural birthing techniques, and even just positioning that can help with labour. How many people automatically give birth on their backs, when that is the absolute worst position to be in?!

The risks are epidurals especially are not explained. Three years on I am still having terrible issues with my back from when it was inserted, despite the fact it didn't even have time to kick in as they fucked up. The pain I was in on the post natal ward was horrific, the back pain was actually worse than labour. It also stressed my DS out.

Home water birth with hypnobirthing preparation for me next time.

I hate the emphasis given to birth full stop. Mums are amazing, we have grown human beings in our bodies and all that that entails for 9 months. We should be proud of that as well as giving birth (no matter what pain relief we had or didn't have).

Personally I'd take giving birth over being pregnant again, I hated most of it. I had a low dose epidural so could still feel contractions and when I needed to push but it was pain free and my ds was born to the sound of laughter and a very happy, smiling mum.

Sorry to hear about the back issues, Siraboob. I was more freaked out at the thought of a needle going in my spine than labour itself, and wanted to avoid it if I could.
My main reasons for aiming for a birth without drugs were the effects of those drugs on my baby, especially as I'd read about it potentially impacting successful breastfeeding. So, that's why I wanted as natural a labour as possible, not so I could brag or because I was a masochist.
I had a homebirth with a TENS machine, which worked brilliantly for me, especially as he was back to back, it just took the edge off. I had some gas and air (again marvellous for me) and I'd done the hypnobirthing book and CD. And I used a birthing pool. Not smug, and if he'd not come out, I'd have gone for whatever was necessary to get my baby out, but I am glad he didn't have drugs in his system, and I was totally with it as soon as he popped out.