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?

But PeaceandHope the pain IS positive because it's the pain that's part of the labour feedback loop. It is in some way neccessary. We don't have to feel it (with an epi) but then the feedback loop it severed and strong contracting drugs are routinely administered....with the risks they entail.

I feel there is a lot of scaremongering around pain in childbirth - all the screaching and screaming on TV, it's seen so negatively. And then we say to ourselves 'why suffer, I'd be a fool not to have an epi'.

I'm not living in the UK at the moment, but here in France, women face the politics of 'why suffer when you can have an epi?' I like to see a more balanced debate, which is why I posted what I did when I felt the debate was becoming a bit too onesided.

Many people with autism have been found to be deficient in oxytocin. I can't help but wonder whether this deficiency is triggered at the time of birth due to too much interference and lack of the body making high quantities.

PeaceAndHope = "Unfortunately, not everyone can look at pain as positive thing simply because it involved birth. Pain is pain and is processed by the body in exactly the same way."

Pain is a perception of a stimulus (usually in itself nociception) & it can be 'processed' by the body in many ways.
e.g. being modulated downwards by 'higher' functions (like people viewing it positively/difference in expectations/previous experiences etc.) or for some people altered at an input level by things like TENS/massage/other senses (gating theory).

But yes, unforunate that some people do seem to find it more painful than others. Though it's important that people can make vaguely informed choices considering cons as well as pros... have heard of lots of people who'd like a magic-mobile-epidural where it always works first time, just takes a way nociception/small fibre inputs but they can still walk around & push effectively & there are no potential complications!

(Thankfully we didn't get to the part in our informal birth plan where DH quoted old essays on pain being a percept at me! )

Please don't tell me (or any other woman) how she is supposed to view pain.

I don't think labour pain is positive. It was the worst experience of my life and I am not alone in thinking this. And no, it had nothing to do with being too tense or not "trusting my body". It just fucking hurt and I wanted it to stop.

Pain is pain. And to leave someone in that pain when they are requesting relief is inhuman and unforgivable. In cases when it's done to women, it's also misogynistic.

Starlight

Lovely. So are you now blaming mothers who had epidurals for autism? FFS.

Of course she's not 'blaming mothers for having epidural s' you twonk.

I have an autistic child who I had after a long augmented labour (so no epidural but plenty of syntocinon which is what the question marks have been raised about). I have thought about this issue over the last couple of years and find it interesting.

Have you even read the thread Peace, or are you just on a bit of a monolguous rant?

Starlight I have read the thread, but I don't think you have. Calling labour pain "positive" and denying women pain relief is unacceptable.

OP should make sure she get's the birth she wants. That's all.

Minifingers There is no need for name-calling.

Well said Peaceandhope Quite shocked at some of these responses because the OP wants an epidural and telling her 'pain is positive' is not really much help is it?

I liked your quote:

"Pain is pain. And to leave someone in that pain when they are requesting relief is inhuman and unforgivable. In cases when it's done to women, it's also misogynistic. "

Great post and completely agree with you.

Hi, thanks for your messages. Midwife appointment next week so I'll let you know how I get on. Think, having read some of your posts that I'd like to give it a go without but not rule it out- might have to say no to the mlu to achieve that. It will be interesting whether they accept that? It is frustrating though, presumably it's just resources. Let you know what they say ...

Many units have along side birth units and all low risk women begin labour there. If they become higher risk or decide they want an epidural they can be transferred relatively easily down the corridor to the consultant led unit. Are you sure this isn't the set up at your hospital? It would mean that no matter where you are, all pain relief options are still available to you ...

If the two units are in the same building, it's still different. If they are in different buildings, then IMO that isn't safe for anyone. Transfers might take long and in an emergency every second counts.

It's fine when women make an informed choice to give birth in a MLU. But to force that choice on them is outrageous.

"If they are in different buildings, then IMO that isn't safe for anyone. Transfers might take long and in an emergency every second counts."

In the Place of Birth study 2011, midwife led units outside of hospital had outcomes for babies and for mothers which were as good as those found in hospital, despite the average transfer distance of the FMU's (free-standing midwifery led units) in the study being 17 miles.

In other words, there is no evidence that labouring in a MLU outside of a hospital is any more risky for the OP or her baby.

(sorry to hijack OP - I know you don't want to give birth in an MLU or FMU. Just couldn't let the comment about the risks of giving birth outside hospital slip by without setting PeaceAndHope straight).

"Pain is pain. And to leave someone in that pain when they are requesting relief is inhuman and unforgivable. In cases when it's done to women, it's also misogynistic. "

If I was a midwife I'd not want to withhold pain relief from anyone who'd requested it. However, there are women who've posted on this site who asked for pain relief in a moment of desperation in labour, didn't get it, gave birth and then THANKED the midwife for helping them avoid using pain relief, and were happy about it. Midwives know that women go through periods of being very low and at the end of their tether in labour - it usually happens towards the end of the first stage of labour. I have been in that situation myself and I'm really glad my midwife didn't offer me pain relief at that point as I would have taken it, and actually in retrospect it wasn't what I needed or wanted. In other words, midwives have withheld pain relief at times and may actually have been left feeling that it wasn't an inhumane thing to do, or misogynistic. That actually they were supporting the woman to get the birth they wanted. There is anecdotal evidence - plenty of it on this board - that this does sometimes happen and women are thankful for it.

" In other words, midwives have withheld pain relief at times and may actually have been left feeling that it wasn't an inhumane thing to do, or misogynistic. That actually they were supporting the woman to get the birth they wanted."

Minifingers,
whatever agenda or "good intentions" they may have it doesn't change the fact that it is still INHUMANE and MISOGYNISTIC. Full stop. If someone tried that on me, I'd have wanted to kill the b*h.

"There is anecdotal evidence - plenty of it on this board - that this does sometimes happen and women are thankful for it."

This is a very interesting psychological phenomenon, but imho it is only our psyche's way to cope with shock and trauma. Women simply try very hard to repress the feelings of helplessness and humiliation and to jump on the train of "I'm proud not to have pain relief in the end" is always there because that's the ideology of natural chilbirth that is constantly pushed on all women.

Hi, just to update - the community midwife said to discuss it with the unit when I call to go into the labour ward. She seemed to understand that I wouldn't know if I definitely wanted one in advance and also agreed there was a risk I wouldn't get it if I just went in then requested a transfer. So I guess my other half will be in charge of negotiations!

Sorry - if a midwife doesn't provide pain relief which a mother asks for in a moment of desperation, and the mother in retrospect feels empowered by the birth and is happy with the choice that the midwife made, how can it have been 'inhumane'?particularly if the midwife made the decision hoping to help the mother have a better birth.

In theory good the midwife should always act immediately on any request for pain relief, but most midwives will be able to think of times they have tried to get a mother through without if they believed that this was her true wish and she was capable of achieving a drug free birth without trauma. It's not woman hating to try to help a mum have a straightforward and drug free birth. In fact I'd say the most sadistic and inhumane thing that happened to me in labour was my midwife ignoring my wish to have a drug free labour and offering me pethidine every time I got noisy, until my confidence broke and I accepted it. It ruined my labour and breast feeding.

Mini,

I accept that if they initially agreed that the woman wants to have drug free birth even if she screams for the midwife to kill her, then yes, the midwive only acts according to their agreement.
However, there were countless situations when pain relief was denied just because the midwife "knew best" and had her own agenda. That's outright cruel and sadistic and misogynistic too, I'm afraid.

re the psychology of birth - you can argue the same thing in relation to all those women who accept induction for post date pregnancy, or an epidural, or who choose to go to a ridiculously busy OU when they have a perfectly good birth centre available as an alternative, who then end up with an agonising 30 hour labour on syntocinon followed by an emergency c/s for 'failure to progress' . I'd say you'd be hard pressed to find a midwife who doesn't believe that about half of all emergency c-sections are avoidable, and yet it's a rare woman who's willing to face up to the fact that her decisions about where and how she chose to labour may well have resulted in her having an 'unnecessarean' or a perineum ripped to shreds following an assisted delivery.

As for women being routinely pushed towards natural birth - rubbish. 95% of uk mums give birth in units where epidurals are available and most women get the pain relief they ask for in labour. epidurals are used in over half of all first births, the home birth rate is less than 3% nationally and most women still give birth lying on their backs.

The challenge isn't how to get a medicalised birth with lots of monitoring and intervention - this is common and actually the norm for most first time mums. The challenge is for women who DON'T want this type of birth, as they are the ones who are most likely to have their wishes trampled over by a system where decisions about how births are managed are driven by a fear of litigation rather than a respect for a woman's autonomy in relation to these issues.

RalucaV you're shouting about misogyny at the same time as calling the hypothetical midwife a bitch

Minifingers,

the OP is however the opposite as she wishes for epidural to be available to her and she is pushed into the MLU. This goes against what you are saying is the reality nowadays. She doesn't want to go to MLU, but her HCPs seem to push her regardless of her wishes.
This doesn't really help the natural childbirth supporting midwives at all as it only shows them in a bad light, as fanatics that go against the wishes of their patients.

kittenmittens,

yes, a woman who denies another woman pain relief because she has some funny ideas that pain is good, resulting in torture and trauma is a sadistic b*h, I insist. :)

Mini,

I forgot to add that there were many many cases of women that were denied epidurals on this forum and not so many cases when it happened the other way around. I think this is a feminist issue really. Women are still deemed to be less important and their pain less deserving of treatment it seems.

I was pulling you up on your use of misogynistic language, but you missed the point.

kittenmittens,

the language I used is derogatory and misogynistic in a way, I agree. I'm well aware that it is used too often these days. However, in these circumstance I can't find a better expression to describe that sort of a woman who can do something like that.

Minifingers

Because midwives are not clairvoyant. They have no way of knowing whether the woman will end up feeling "empowered" or traumatised. There is plenty more evidence on mumsnet (and in real life) of women who were refused pain relief and ended up with PTSD.

I think that I know what is best for me and not some midwife who is for all practical purposes a stranger to me. I would be furious if someone was patronising and presumptuous enough to make this decision on my behalf assuming that I would "thank" her later.

An epidural should be a human right. Any woman who asks for it should get it without agenda-driven, "clairvoyant" midwives trying to stop them from accessing pain relief.

And kittenmittens, when women exhibit misogynistic behaviour, they will be referred to accordingly. Being a woman doesn't exempt anyone from being called out for chauvinistic behaviour.

I will second what RalucaV said and insist that any midwife who prevents a woman from accessing an epidural and has notions of pain being "good" is a total, utter and complte b*tch.