Epidural being refused?

[Cel982]

Does this happen commonly? Where you ask for an epidural (once in established labour, obviously) and aren't given one? I'd never considered it a possibility, but was reading another thread here where women mentioned their request being denied.

Am 35 weeks in my second pregnancy and, while I'd like to get through labour without an epidural, I also want to know that I'll be given one if I request it. I had my first baby in another country and, while they didn't push the epidural on me, I was given it as soon as I asked.

To play a bit of devil's advocate, short of them having an anaesthetist on standby for every room there will always be situations where women have to wait and then they progress too fast to have one.

Oh sure, absolutely this can happen and I do understand the staffing issues that can arise, especially in smaller hospitals. It just seemed in some of the posts that it was more a case of midwives refusing to put through the request even when the patient asked for it.

Mine was refused in a major Birmingham hospital.

It's frankly shocking.

Now somebody will comment that pain relief during labor is not essential and therefore we shouldn't expect it to be covered under the NHS. Which is struggling as at is and therefore we shouldn't complain.

I was refused one as I was told I was too close to delivery. When it became apparent I wasn't I was told it would slow things down. Then again told I was too close to delivery. They were wrong on all counts- my labour stopped even though I had no pain relief and it was 3 hours after they said I was too close, that baby was delivered.

Bastards.

Orlando until I gave birth, I agreed with you. Now I realise they do what's best for them. Totally fucked me over.

I gave birth in the John Radcliffe in Oxford, is that a teaching hospital? I don't even know...

anyway, I was adamant from the get-go that I would have an epidural. I had to wait a short while and a particularly huffy midwife got a bit sulky about my dismissal of her fucking hypno nonsense, but they came good with the drugs in the end

I was refused during both labours. Both times because I was too close to delivery. First time I was 10cm on examination (that was the first examination I got) and second time I was 8cmon examination but DS did arrive 15 minutes later.

I'm glad to be honest, it turned out that was able to cope with the pain both times and the recovery was quicker. I do labour quickly though so I think that makes a difference.

I was refused one as it wasnt in my birth plan. Could have been more to it but glad after i didnt get it.

There is some excellent information provided here in the mumsnet q&a with a consultant anaesthetist David Bogod: www.mumsnet.com/onlinechats/david-bogod

There are really very few circumstances where you should be refused an epidural but unfortunately it seems to be happening. Key pieces of info:

The default position should be to proceed to an epidural unless 10cm dilated and actively pushing. We often insert epidurals at full dilatation during the early part of the second stage before pushing starts. Some midwives do have a tendency to try to artificially limit the range of cervical dilatation over which an epidural can be done (as an extreme example, some might say that before 4cm you're not in active labour and after 7cm you're in transition). This is not evidence-based, and goes against NICE guidelines.

There is a national standard relating to response times for epidural requests, which speaks of 30 minutes as the norm and more than one hour only in exceptional circumstances.

The midwife advised us that you have a bigger 'window' of dilatation range with your first labour for getting an epidural. For second and sequence labours, the epidural has to be given before you are dilated past a certain point. If you are writing a birthplace (preference of conditions list) you could mention it to mw when you arrive so they can be prepared. I agree with saying it early. If you do have an epidural, rotate between which side you lie on so it takes effect all over the area and there's less chance of it failing.

I was told I could have one prior to the induction drip being sited or at any point after. When I said I wanted to discuss one after nine hours of drip, I was told I could only have it once 4cm dilated.

I later found out during my birth debrief this isn't actually true, but it was a factor in terms of going for EMCS rather than trying drip for another seven hours when failing to progress.

Maternity care, in my experience, is one of the areas of medicine where you're most subject to the personal whims of the healthcare professional rather than there being a set of guidelines to be followed. Things like whether you're allowed to be mobile or not on the induction drip depending on the midwife in question. I think it's totally unacceptable that there should be such variations in situations where neither the mother nor baby is at risk.

I couldn't have one in either of my labours. The first was because they thought I was progressing too fast and wouldn't have time (in the end DD got stuck so I would have had time) and the second because I didn't have time (DD2 born in less than an hour).

I was sick after gas and air in my first labour and really reluctant to try it again but was fine with it in my second labour so it may be worth considering. Good luck!

Thanks all (especially mimi for that interesting interview). I'll certainly be quoting NICE guidelines if it comes down to it Although it shouldn't be the case, the fact that DH and I are both medical often does make a difference when it comes to this type of situation. But I agree with comments above that the whims of the particular midwife on duty should never come into it.

But I'll definitely give gas and air another go - glad to hear you had a better experience with it the second time around, Smiling. It would be nice to have more control over the second stage than an epidural allows.

I asked for one as soon as I arrived in the labour ward as I was so scared they'd say the anaesthetists were too busy etc. As it happened I only had to wait about 10 mins. Haha. It was lovely. I have to have a planned section this time otherwise I'd do the same.

I had an epidural for my first labour and it slowed it down so much I had none with my second and it was by far a much quicker and much better experience, Im hoping to try for a third so who knows with that one but I would hope to not have an epi on my third but never say never.

Definitely give gas and air a go, even if it makes you feel sick initially, if you stick with it it can be really helpful. I had both my babies with just gas and air and I'm by no means a person with a high pain threshold.

I was refused an epidural during a drip induction: they had ramped up the drip to the full dosage to no effect whatsoever before realising maybe I was right that not ALL my waters had gone when they "broke" 48 hours prior. So, leaving the drip on full dose, they broke my forewaters sending my uterus into a hyper-stimulated state with agonising CONSTANT pain. Who knew gas and air doesn't work on everybody?? The consultants came and patronised the fuck out of me, telling me "women who really need them are being seen to right now, it's not all about you, we'll get to you if we get the chance later" whilst refusing to reduce the drip, despite my midwife (borrowed from another hospital due to short staffing) told them in no uncertain terms it wasn't fair what they were doing to me. So they reduced the drip - eventually - and it turns out all I needed was the lowest possible dose.

I did eventually get an epidural, although by that time I was no longer in much pain, and all it did was put me off attempting the pushing stage at all with no sensation. BUT it came in bloody handy when, after my baby's heart rate crashed repeatedly and I'd lost any confidence in the medical team around me (nice midwife now gone) I insisted on a c section. Not that I got that straight away - they told me I could well die on the operating table and future pregnancies would end in stillbirth TWICE after telling them I'd made an informed decision on separate occasions - but after refusing consent to continue the drip and a change of the doctors on shift we got their in the end.

Massive essay - sorry - but yeah, epidural refused.

Well it depends on the situation - if a medical professional has refused me an epidural then I would think it was because it wasn't in the best interest of me or the baby to have one. They don't refuse out of spite and I am not qualified to make medical decisions

Spite isn't the word I'd use, but if you think the decision to try and prevent a woman from having one is always based on solid clinical reasons, you've been very fortunate and/or not heard many birth stories.

OP there are always going to be situations where women labour too fast for one, or when there happen to be three times the normal number of emergencies so there's nobody available. There's not much to be done about that. However, not all of the ocasions where women don't get the epidural they want fall into either of these categories, and unfortunately in the UK, despite NICE guidance, I don't think you can trust that you will be given one if you ask for it. I did trust, and it turned out that was a mistake.

I would also say that as a second timer with a previous VB, and someone who is at least giving thought to doing it without one, you're a pretty prime candidate for a midwife deciding to save you from yourself if you change your mind. Sorry. If you do think you might want one, I'd be making it extremely clear, extremely early on.

I made sure they knew I wanted one right away.

Mine was refused as the blood they had recently taken had a high white count suggesting I had an infection. Was on the drip and in much pain like a previous poster, I really think epidural should be given with that bastard drip! Ended in c section anyway and they had no problem giving it then!

I was refused an epidural. Twice.

DC1 delivery left me with severe anxiety and PTSD.

DC2 pregnancy I was under the mental health team due to the anxiety. Despite meetings and discussions (where I was talked out of a CS in favour of agreeing to epidural from the start) the team that was in charge when I had DC2 refused the epidural as they felt the previous issues with DC1 were unlikely to be repeated, they were.

There wont be DC3. I was pleased when the maternity unit closed last year.

I waited forever with first and was only given it to prep me as they feared emergency section after baby in distress.

With second they outright refused. Had an excuse each time that I wasn't in labour, even at 6cm. I was only ever allowed co codimol and when examined at 9cm told too late for anything. Never did understand why they did this but was cruel

I will be ringing the labour ward at the first sign of a contraction to tell them to get the big needle ready. Why everybody is so obsessed with doing labour without pain relief is beyond me.

Just gave birth to dc3 and epidural was given pretty quickly in my idea but dh said it was not fast enough. Pure heaven once I had it in but dd was back to back I could not push her out and we had emcs.
Honestly after having that epidural I don't know how I did it the first 2 times with pretty much nothing.

I am so worried about this happening to me - it's causing me severe anxiety. Besides asking for it as soon as I'm admitted to the hospital and writing it in my birth plan is there anything else I can do to ensure I am not denied an epidural?