Feeling traumatised by not getting the pain relief i asked for, anyone else

[Naty1]

Had dc2 friday, and been feeling upset about not getting the epidural i asked for (3hrs before delivery)
I had it clearly on birth plan.
I asked for it then said pethidine while waiting and ended up with g&a too.
Mw went off to request epi and said its a busy night theyll be there when they can.
I clearly couldnt cope with what i had and remember begging. Saying i want it now.
I just shut down and willed the contractions to stop.
Was saying the baby was stuck (as dc1 was )
But i think what has triggered my anger/ upset is reading my birth notes. My birth plan isnt there and on the computerized printout as its not a question- no mention of my requests or why it wasnt done.
It feels like they want people to be too late for pain relief.so keen to send home, refusal to check dilation.
Not caring how it feel afterwards to be ignored, patronised 'havent you done well with no pain relief.'
I did have epi with dc1 back to back, stuck at 2cm, sytocin, failed ventuose and forceps, episiotomy.
But i think the issues were more to do with being back to back.
It just annoys me the illusion of choice but if your choice isnt natural you are being judged. Made to go on a bit longer until its suddenly too late.

Oh gosh it happens all time! They have a limited number of anaesthetists and they have to prioritise. I know lots of people who did t get the epidural they wanted, not uncommon at all. Birth plans are just a wish list, it actually would be more helpful if they didn't bother with them as it raises people's expectations unrealistically. Congratulations! Book for a section next time, much easier all round!

"Book for a section next time, much easier all round". It's not easier for the NHS, it takes more time of the doctors and anaesthetits and surely therefore adds to the problems of being overstretched. It makes it even less likely that women in labour will have access to anaesthetists.

And I wonder who would care for you after your elective c-section? Look after the babies if they were poorly, support you to feed your baby, give your antibiotics when you develop an infection in your wound, help you to walk again, have a shower after you have regained the feeling in your legs? I doubt it would be your anaesthetist or your surgeon. I hope your recovering well now. Perhaps speak with your Drs for a debrief, it may answer some questions for you.

This is all nursing care, and I would prefer it to be done by someone who has qualified as a nurse, than a midwife who has not.

I am glad that some trusts are using nurses on postnatal wards now - my friend just had her second baby and since the first, the trust introduced nurses - she said the difference was like night and day.

I was also going to say the same about nurses instead on wards, having read a thread about some awful care received.
Elcs would have had little impact on the availability of anesthetist at night 10pm -5am, unless they went too soon and became emcs overnight.
If everyone opting for cs is expensive then easy solution more anasthetists on call or one for ward one for CS
I think though people need to do whats right for them, its not like anyone else is going to prioritise your needs.
I can see mw would be desensitised,
I think the limited checks would contribute to going further without pain relief than you are happy with.
I think i was checked twice, both my request 3cm and 5 , 3 hrs apart,
Not even when i was trying to push was i ever checked to see i was fully dilated, i thought they needed to to avoid injury,.
They had to wrench my legs apart as my instinct was to hold them together and being on my side, again not a choice is i assume what caused a side tear, so less pain more control would have helped. Control the pushing etc
'Actually all cs would prob be easier or all epidural because its then controllable, the unpredicatability is the problem

This thread is awful.

The key point here is that the OP felt out of control and not listened to. If her request had been properly acknowledged and reasons why she couldn't have pain relief communicated then she may not feel like this.

Way to go on being dismissive of how someone feels and supporting poor practise.

It IS a put up and shut up attitude.

If everyone opting for cs is expensive then easy solution more anasthetists on call or one for ward one for CS

For the record. In terms of expense, if everyone had an ELCS it would actually be cheaper than the status quo (source: NICE CS guidelines!!!).

And actually NICE also felt that a) cost alone should never be a justification for refusing an ELCS because the difference in cost was minimal and b) if you add in the down stream costs then the cost of an ELCS may be indeed more favourable in many cases (for example if someone has a vb and then is traumatised by the experience so then needs counselling).

Personally I don't think that more ELCS is the solution. When you analyse the reasons behind requests for ELCS, high on the list are not being listened to and wishes respected and poor communication. Something that's generally not the fault of nature and definitely the fault of poor attitudes and staffing.

OP it's terrible what happened to you. 3 hours is a terribly long time to wait for pain relief and it just shouldn't happen under any circumstances. Ideally there should be more anaesthesiologists (I have no idea how to spell that sorry) so this would never ever happen.

I do want to reassure you though that it is possible they were telling the truth. My Emcs lasted 2.5 hours and that doesn't include the epidural which took about 30 mins to do before the surgery (had to do it twice as it didn't work first time). My Emcs went on for so long as I was bleeding for 2 hours and they couldn't stop it. Had to wait for another surgeon to come and help them. So it is possible they were telling u the truth. It would only take 1 complicated Emcs to keep the anaesthesiologist busy for 3 hours. It still shouldn't ever happen though and I can completely understand why you feel upset about it

What RedToothBrush said. Some awful comments on here.

I'm sorry for your experience OP. I hope you do make a complaint or seek a debrief and get some answers.

I did get my epidural eventually but only after bring dismissed for several hours and offered nothing but paracetamol. My baby was also back to back and it was excruciating.

Sorry for your experience OP. I'm glad your baby is ok!

Ime I haven't met many midwives whom I've trusted. Most seem to have an agenda to coerce vaginal birth and minimal pain relief. With my first dc I felt very bullied by midwives, they were critical of my distress and crying due to pain, told me to get a grip, told me to eat something after I'd been sick and had no empathy whatsoever.

The doctors I met were far kinder, more empathetic and reassuring. I never expected it to be that way round! I've had the same experience with dc2, obstetricians advocated pain relief etc whilst midwives blindly dismissed it.

Based on my experiences I found midwives to be overpaid bullies, I have no time for them. I don't think I'm alone in this, based on experiences of other friends. Maybe we've all been unlucky though, there must be some compassionate midwives out there....

There was actually a blog post on here I think by a consultant anaesthetist from what I can remember their advice was absolutely the best form of pain relief is the epidural and women should insist that the midwife puts the call in to them anyway.

Ok it was a mumsnet online chat www.mumsnet.com/onlinechats/david-bogod

direct entry midwifery should be abolished - nurses first then qualify into midwifery

Thanks Essex i hadnt seen that. Interesting reading.
So it seems
there is no reason for no pain relief till 4cm medically
Epi should take up to 30-60min
Epi sounds better for baby than pethidine

Epi is useful for cases where there is a chance of EMCS.

I also read some of the thread linked to the blog

Just realised that the baby was in distress (meconium in waters)
I think the other side is with no pain relief and maybe especially with pethidine if something swrious happens you are not in control enough to understand or make decisions

I'm really surprised by this. I don't think the professional midwifes have concocted some plot to withhold pain relief!

If you are we're in so much pain, it is likely that you were not thinking or communicating clearly and would not have a clear grasp on the situation. I think many women have too fixed ideas on what birth will be and struggle to deal with any variation to their imaginings. In labour it is very easy to lose control and that in itself can be challenging to recover from.

I have experienced many midwifes and some have not been great. But none have wanted me to experience unnecessary pain or cause me harm.

Thankyou to the midwifes that have commented. There are I am sure many of us that truly appreciate the work that you do with the inadequate resources available.

Yeah, no.

I asked repeatedly for an epidural, over several hours, very clearly. My husband also communicated this request. It was denied, I was angry, and vocalised this anger. None of this was in the notes. There is not one iota of this that could be put down to me not communicating clearly what I wanted. Anyone who thinks this is coincidental, I have some seafront property in Birmingham I'd like to sell you.

And it's not about midwives deliberately wanting to cause pain. If you think that sophie, you've not really understood this discussion. It's about some of them, not all, thinking they're acting for the best in withholding pain relief. The erroneous belief that an unmedicated birth is desirable and some kind of achievement, that a woman in labour can't be trusted to make decisions for herself and instead needs to be made to have the kind of birth that someone else is best. She must have NCB inflicted on her, for her own good. It's horrifyingly pervasive. In some ways, I'd rather the honest to goodness sadists or sins of Eve brigade. You know where you are with them.

I think thats a bit patronising.
Screaming 'i want an epidural and i want it now' is very hard to misunderstand.
A birth plan with epidural underlined twice at top. Epidural asap, gas and air and perhidine dont work again very hard to misunderstand what i wanted.
Also my first request once 5cm was the epi.

The mw i saw yesterday said they do take out the written notes.
Which meant she couldnt explain anything to me.

Try reading that other thread, clearly there is/was an issue with so many comments.
And anyway, its hardly an excuse if they said i wasnt communicating well, i wonder why? By then in too much pain. A simple query at start about pain relief and the mw would have known.

Certainly your comment did give my dp a laugh though so thanks

I gave birth to my twins last week and was actually offered an epidural as the canula was being put in my hand. I decided to use gas and air instead just to cope with the contractions. Once I started pushing I had very little energy so wasn't giving it my all and one midwife took the gas and air off me to try and get me to push more. I was upset about it at the time and begging for it back but looking back now it was for the best

That blog is really interesting. What I found truly fascinating was:

"I think many anaesthetists tend to overstate the efficacy of epidurals. They probably only provide the level of pain relief which the woman wants in about 60-70% of cases. The others sometimes need stronger solutions or even the epidural resited. They are still far more effective than any other form of pain relief, however. "

So there are a lot of women out there, like me, for whom epidural didn't work properly.

For me it actually made it far, far worse as my only coping technique with a back to back baby had been to be upright, which was no longer possible after a whopping dose of epidural to try and get the pain under control.

For me, after my first labour I swore I'd never have one and the impression I had was that I was unusual. It sounds like I'm far less unusual than I realise.d.

Yes it must be awful if it doesnt work if youve pinned all your hope on it helping.
With dc1 my was perfect only a mild ache with contractions.
I wonder what different anesthetists success rates are. But also if left too late it would be hard to sit still enough.
I did have back pain for about a yr after though (not bad though)

Just to check then - midwives deliberately withhold pain relief to force labouring women to uphold the British Stiff Upper lip and stoicism.
Screaming 'I want an epidural and I want one now' is to be congratulated (because I had a good experience with one last time, and decided well in advance of my birth that I wanted one, and I must get what I want, never mind the fact that there may be emergencies that rate my 'wants' pretty low on the priority list)
And healthy babies mean nothing really, it's too low a bar. ELCS would be preferable in all cases (even though too posh to push is apparently a myth).

Righty ho.

I was in exactly the same situation 4 months ago OP. DC1 was induced, and the epidural was in place before the drip went in. The whole process was smooth, controlled and well managed. I have an existing health condition and the concern was natural labour could be very difficult for me.

For DC2, I went into spontaneous labour the day before my induction was booked. I had requested the same again and had a big sticker on my notes that I was high priority for the anaesthetist. Unfortunately there was an emergency and I spent 4 hours in labour on just gas and air. Epidural finally arrived about 3 am and from then everything went smoothly. But all I can remember is those hours of sheer panic and pain.

I felt there was a similar attitude from the midwife to those displayed here - women do this all the time, get on with it. I didn't feel at all supported, I was terrified and I think about it every day, five months on. I don't think there was a conspiracy to withhold pain relief, just that in my case I really needed someone to help me understand what I was going through, as even though I had given birth before this was all new to me and I don't feel the midwife did this. She did her job, she delivered the baby, but I am still struggling with it all. Also didn't help being told that in the final stages when I tore quite badly that it wouldn't have happened if I had been breathing properly.

Also I don't think my notes were read clearly. After the birth I just wanted to go home, but was told I couldn't until I had had a shower "to show the epidural had worn off". Midwife helped me to the shower door then left. Went in, just a normal shower. I'm a wheelchair user, I can walk short distances but not stand for any period of time so those showers are difficult at the best of times. So had to sit on the floor, then find my own way back to the delivery suite without any of my mobility aids . It is very obvious from my notes I am disabled, and my wheelchair was there in the delivery suite!

Yet with DC1 the midwives (I was kept in for a week, there were many!) were all amazing.

With PTSD and PND being so potentially damaging for both mum and baby (short and long term ), it would IMO make sense to invest in more anaesthetists and MW to prevent traumatic births, as they cause whole lot of more grief and spending down the line. If men were giving birth too, I dare say labour and post natal wards would look a lot different.

I had a confusing, painful birth experience (EMCS), and was not even told about the call button, but was in more pain and serely sleep deprived on the post natal ward for 5 days. That was much worse and most HCPs had little compassion. I was forcefully whisked to a bathroon alone to shower myself, when I was freshly stitched, could barely stand slumped or shuffle very slowly in a lot of pain, and had my my urine catheter still in. I could not believe it. I leaned on the shower wall, rested the urine bag on a stool and cried woth anger, pain and humiliatio . I had to escape the hellish, noisy ward even when the MWs recommended I stay (they could see I was developing PND).

I saw some people who had a CS actively wanting to shower as soon as it was allowed, then dress up in trousers and shirts, do their hair and make up, turn down pain relief, as if nothing much had just happened. I understand that the pain was not the same for them, or maybe they felt/processed it differently.I don't know. All I know is that I was in pain and felt desperate, helpless and alone. Week after the birth I was suggested the Mother and Baby MH hospital ward, which I managed to avoid by having my DH and DM drop everything help me 24/7 for a while. This all combined with desperate attempts and insistence on bf for too long against better judgement, and velcro reflux baby, the bonding between me and DS was affected.

Enlightened owl -

At the uni where I trained (I was the first direct entry midwife to train and qualify there 19 yrs ago) they abolished the shortened 18mth training for nurses to become midwives as it was not deemed long enough to fully prepare a nurse or midwifery practice versus the three years I did (although the 6 months of these were general nursing placements in medicine, paeds, psych, and gynae). All but one of the nurses I trained with didn't practice at the end of the programme because they felt they didn't have enough training and had struggled to complete the requirements in such a short period of time.

I had to prove myself as a direct entry and it was perceived I was lacking as I was not a nurse. This judgement is/was upsetting. Please don't generalise.

Sorry just seen others have commented about nurses being superior to midwives up thread too. Don't mean to single you out, enlightened owl!

It's not about criticising individual midwives, I think we all agree they do a hard job. IMO the very fact they're so overworked is the problem.
Sophie - in my case I honestly couldn't have communicated more clearly, it was my second DC so I knew the drill and said early on "I would like pethidine or an epidural please". This then became "am I ready for pain relief yet?", then "please can I have something - even gas & air, a paracetamol - something" and finally "WHERE'S MY FUCKING PAIN RELIEF???". DH was with me the whole time and was brilliant, repeatedly asked them clearly for some pain relief. They just kept repeating "soon...soon..." until I gave birth. It wasn't super quick or anything, a long early labour but the very painful bit was probably about four hours.