Hospital putting me in midwife led unit so no epi available-worried!

[Manc451]

Hi, I found out this week that I'm low risk so going into the midwife led unit rather than the consultant led bit. They slipped in that that unit doesn't offer an epidural, which I was determined to have (my sister had a horrendous time and I'm terrified!). I'd at least like the option? They said that if I said so on the day they could then move me to the consultancy led bit and try to get me one then. But what if a bed isn't available at that late stage, or they try to convince me to leave it? Maybe im being a fuss and it will be easier than i think? What do people think?

There are pros and cons to epidurals. Yes it may reduce your pain (though for some unfortunate women an epidural can't be correctly sited) but it may also prolong your labour.
I've had three epidural-less deliveries. It can be done and gas and air, tens and other means of pain relief that will be available to you aren't half bad tbh.
It sounds like you're feeling quite scared at the moment and fear and pain are very closely linked. Rather than worrying about a bed etc etc in your shoes I would try and make a positive decision to explore how you can do without an epidural. Why not start another thread asking for POSITIVE stories of non-epidural pain relief. Here's mine for a start - i found that if I got dh to count me through the contraction I could focus much better and I knew at which point the pain would be worse and when it would start to ease off. I also focused on the fact that every contraction completed was one I never, ever had to do again and bought me closer to seeing my baby.

Thank you, that's such a good tip :) and it gives him a job to do too.

If you know you're going to want an epidural, don't be frightened to make a fuss until you get that as a definite option. It's all very well them saying they will sort it on the day but in my experience, they don't.

I've had both an epidural birth and a none epidural birth. The epidural makes a massive difference to the pain level suffered

Try not to worry about it and try not to let your sister's experience cloud your own expectations - its really sad she had such a bad time but it doesn't mean you are going to. Have you spoken to them about your worries - I would think you can be a bit more forceful about going to the consultant led unit if you really want to. If you do go to the MLU and need and want an epidural there is just as much chance as you getting a bed at that time as there is when you first go in (I think most people with a choice will be fighting to get into the MLU, not the other way round). Both my labours were too quick to have an epidural so it wasn't even an option for me. Do bear in mind that once you have medical intervention you are also more likely to need more - and don't under estimate that the effects of that (episiotomy, stitches, major surgery etc.) might be far more "horrendous" than not having an epidural. My first child did get stuck and was delivered by ventouse after an episiotomy - the stitches and the after effect of them are what I most remember as unpleasant, rather than the pain of labour.

Whatever you decide you will get through it -it would be a shame if you spent your pregnancy worrying about the pain of labour rather than enjoying it as much as you can. Good luck!

Sorry but no one has any idea how things are going to go for you and no amount of mental preparation would have got me through the level of pain I experienced along with the length of time it went on for. I am not a mentally weak person, I do not have a low pain threshold.
I would find that completely uncceptable. Do you have an alternative hospital? If not, I would refuse to accept being sent to the MLU.

That is good advice. But why not investigate that approach and still insist on a consultant led ward place?

That way you can use the gas and air and tens route, but if your pain does become too great (which it might not) you are there on site for full support with an epidural.

Tell your midwife/consultant that you are very scared due to your sisters experience, and definitely want the option of an epidural.

The last thing you want is to have to be transported during labour from the midwife led unit to the consultant led one, when you really need greater pain relief.

Don't mean to scare monger - lots of women get by fine on gas and air. I have a friend who had a couple of paracetamol with each of her births and no more.

But there is no harm in having the option of an epidural if you should need it. If that's what you want then that is fine. There's a lot of pressure for women to avoid stronger pain relief. It's up to you and there is no right or wrong way, so don't be pressurised.

Have you thought about looking into Hypnobirthing? I have just had my second baby (first was emergency c-section) and I had a lovely home birth using Hypnobirthing breathing and relaxation techniques. I would not describe my experience as especially painful - hard work and an effort, sure, but not agony or anything close to it.

Every woman is different and every birth is different, your birth will not be the same as your sister's. If you are keen to ensure that you have the option of an epidural then speak to your midwife and ask how long it would take to be transferred and what the likelihood is that you could get one on request. You may feel more confident just knowing that the option is there, even if on the day you decide that you don't want one.

I also had a positive epidural-free labour. It was my second, after a not so great first one where epidural really didn't do much - so putting all one's eggs in that basket can really backfire!

I found Birth Skills by JuJu Sundin a very good book for helping me deal with the pain in a positive way, mentally and physically. I'd really recommend it.

Also, considering after each contraction -am I ok? Yes, keep going, helped me too.

Good luck!

I'm all for drug free births, I had a tens machine and nothing else for mine, but I think it's prett disgusting that the hospital are forcing you to give birth somewhere you're not comfortable with, if you want an epidural you should be able to have one. Kick up a fuss now, rather than leaving it until you're vulnerable and in pain.

I had an epidural after 15 hours of horrendous labour, it was the greatest thing ever. I think it's great if women can get by without one but it's appalling that someone may be forced to do so. Everyone should at least have the option.

That said, it is usually far nicer to give birth on the MLU unit, so I would be tempted to stick with that plan, given that you may not need an epidural.

I think it will reduce your anxiety if you make sure your DH understands that he needs to advocate for you -- if you are in that much pain you will need someone to really push for you get to proper pain relief. Also do not be afraid to be really pushy if needed, ask to speak to senior staff, etc.

Having had one birth with an epidural, and one without, I know that I would do everything to avoid one in the future, as it was awful. That said, if you want it as an option, then put your foot down!

I would try to do without it if possible, rather than have it as my first choice, but that's just me, and my experience!

You can't predict how you will cope, and therefore you shouldn't worry about it until it actually happens. For all you know you might need to be moved to the consultant led unit part way through labour anyway (like myself, DS1 had meconium) and they found me a bed pretty quickly!

Suffice to say I managed without an epidural, and DS2 was born on the midwife unit without an epidural too. I found the best way to cope (for super organised me) was to say, when it gets to half past whatever,I'll ring the hospital, when it gets to quarter past whatever I'll think about having gas and air, so by the time I allowed myself to ask for the epidural with DS 1 was actually fully dilated.

Mind over matter, good luck!

No epidural doesn't equal no pain relief - lots of people (me included) opt for pethidine/ similar synthetic opiate, which isn't without side effects but which can be very effective. DC2 is due any day now and I plan to use tens, gas and air plus pethidine in combination if I feel the need to.

FWIW I had DS on a consultant led unit and as there was no anaesthetist available I couldn't have an epidural, but to be honest afterwards I was pleased I didn't as I managed fine without it.

this shouldn't be about you "managing", or about NHS budgets. a pain free labour may be longer but it's also going to allay a lot of your anxiety and you should be entitled to it; keep asking, and on the day, turn up at the consultant led unit. You don't wan tto be anxious in the run up, and the level of risk you are has b*gger all to do with your pain relief choices. Just because a migraine is low risk doesn't mean I'm going to battle through without a handful of paracetamol.
Get practising your lioness mode now, and require rather than ask.
good luck

You have a right to give birth in a consultant led unit. I suggest you contact the supervisor of midwives and tell her that you want an epidural early on. Make it clear in your birth plan that it is what you want. No one should be bullied into giving birth on a midwifery led unit.

Its ironic that some hospitals allow c-sections on demand for tokicophia, but you are not being allowed a consultant led unit.

I had an epidural with my first and it was glorious. Bare in mind that the probablity of having forceps or an emergency c-section or tearing is higher if you have the epidural.

Its OK to not want a natural birth. (I say this as someone who had a lovely homebirth with no painrelief whatsoever.) Every place of birth has its advantages and disadvantages. As a patient you have a right to choice.

your body your choice, surely?

All the other people in the world saying that they had no epidural doesn't matter a jot and is actually even a little bit undermining of your feelings. This post is not about us and our labours - it's about you and yours.

You want the option of an epidural - you should insist on being somehwere that that is an option.

Agree with ReallyTired - this is meant to be about your choice - you should be able to go where you are most comfortable (mentally and/or physically)

Thanks, that's all good advice. The more I hear the more I think I'd like to give it a go without, because it won't necessarily be the same, but it would put my mind at rest to at least know I've got the option. Think I'll have another word!

I think the thing to remember is that an epidural does not guarantee a pain free labour. It works for some, but not for others, and you could end up like me with unpleasant side effects. The best bet is to be open minded about pain relief, and let your body tell you what it needs. If that is an epidural on the day, than you should have the opportunity to have one. But when the time comes, you may find that you don't feel the need.

Good luck!

I have not yet given birth (31 weeks and counting) and totally understand your anxiety about a late change to your plan, especially given your sister's experience.

But I thought I would offer a contrary view - many people would feel lucky to have their risk 'downgraded' to MLU level. MLUs offer a gentler environment than consultant-led wards, women are supported in a more holistic way and there are options that in some cases do not exist on a CLU, eg water pools etc as a form of pain relief.

You're also statistically less likely to have any interventions (partly because you're low risk and partly because, as I understand it, women are often given more time before interventions are encouraged) and you may have better access to breastfeeding support and also better visiting hours.

If the MLU is attached to the hospital you are in a win-win situation, a lot of excellent opportunities to have these options, with full back-up and more medical pain relief available nearby if you need it.

Some people will never have that opportunity - due to complications or BMI or the fact that there simply is not a MLU facility available (like in my area - I have CLU or homebirth options only as they recently closed the FMU).

Why not ask someone how long it would take to be transferred and have an epidural sited? However, if you really really want to close the door on the MLU option, then you should be able to request it.

If you WANT to have the option of an epidural, go to the labour ward, not a MLU. Midwives will know you mean business if, as a low risk/no complications patient, you opt for the labour ward - it usually indicates a desire for epidural. That's what I did.

If you WANT to have an epidural-free birth, ie, that is your aim, go to the MLU as they will encourage you hard not to have one. (You will not be left screaming if you really need the epidural but they will assume you want to persuaded/coaxed through it naturally).

I think that it's important to have an open mind when going into hospital to have your baby. I think it's also important to recognise that some midwives will use the "bait and switch" tactic on women ie promise an epidural without any intention of organising one for you, keep promising the anaesthetist is coming until you are at 10cm and "its too late now dear".

ginder you said "I think that it's important to have an open mind when going into hospital to have your baby. I think it's also important to recognise that some midwives will use the "bait and switch" tactic on women ie promise an epidural without any intention of organising one for you, keep promising the anaesthetist is coming until you are at 10cm and "its too late now dear".

But that is totally out of order and is disgraceful

Completely agree with queenofknickers and Quangle

Your body, your choice and your right to choose where you want to give birth. Is the midwife unit under threat of closure due to low uptake? Tell the midwives you will be writing a letter of complaint to the Chair of the Trust and see if they change their tune.

Ushy - I'm sorry that you don't like my comment. I am basing this on my experience and experiences of friends and colleagues.

I wonder how many women on Mumsnet have had the same treatment?