How can I make sure I get an epidural without a fight?

[redheadedleague]

I'm 40+8 with my second child and my mental health is crumbling. Up until a few weeks ago I was looking at an MLU birth, or even a homebirth, and was feeling fairly calm and confident. Then I started having panic attacks and flashbacks to my first labour (a 36-hour back to back ending in forceps delivery under spinal anaesthetic). The panic attacks have become daily, and nightly. I can't sleep. I cry all the time. I can't think about anything positive. I'm terrified of the labour pain that I know is coming. I overwhelmingly feel that I cannot, cannot at all, do it again. I'm aware that this is not good and if I had the time to I would get help from the GP, but there is no time.

Today I caved and decided that the only thing that would bring me any mental peace (and possibly let me sleep and stop panicking and crying) was planning to go to the hospital and have an epidural as soon as possible into the labour. I had intended to have one last time, but was checked so infrequently it was too late. This time, I decided, I would ask for one ASAP. Because I'm not sleeping I have no reserves, either mental or physical, to ride out a 'natural' labour. I've done all the hypno and active birthing prep stuff and the fear has eaten all my good work. I'm so low.

I've just been to the hospital to check out the birthing unit - the delivery suite is adjacent but you can't tour it. The midwife asked why I was looking at changing birth place so late, and I said because of the availability of epidurals. She then gave me the standard chat about second babies being different, keeping an open mind, and asked me to understand that they would 'try other options first' if I asked for an epidural. Like aromatherapy. Fucking aromatherapy. One of my flashbacks is being in transition with DD and someone clipping a stinking strip of jasmine paper to my bra without asking, and me telling DH to GET IT OFF ME. Gas and air did nothing for me. Water slowed everything down and they had to get me out. The only positive thing I can recall from DD's birth, apart from her being given to me, was the moment 30 minutes before the end when the spinal took effect and I stopped feeling the contractions.

I am in pieces. I've been crying in the car on the way home. I just want to feel safe, and be able to look forward to the arrival of our little one. I want to feel listened to. I feel fobbed off and unsafe, like if I go into labour and go to the hospital they'll try and stop me having an epidural and then I'll have to argue with the people who are supposed to be looking after me. While I'm in labour.

How do I get anyone to understand what I need? How do I get them to take me seriously? What the hell do I need to do?

@nottakenusername

You shouldn't have to fight for a c-section in these circumstances. I had a traumatic first birth similar to the OP and knew my mental health would not withstand a second. After an additional appt with the midwife who specialised in perinatal mental health, the hospital were happy for me to have an ELCS. And it was the best decision I could have made.

Just be very firm with them. I know a lot of people who wanted one and the midwives kept saying ‘You have to wait a bit longer’ and then it was ‘Oh well it’s too late to have one now’. Which is horrific really, purposely denying them pain relief for something so painful. I’ve heard so many similar stories. Just don’t let them push you about, it’s YOUR birth experience, you want an epidural and you should be able to have one.

Op I am so sorry for you. It is disgraceful that you should be left in such a state of worry about your pain being left untreated.

Midwives often behave appallingly unprofessionally when it comes to pain. Is there any way you can ask for your care to be led by a doctor? Ask for consultant care and ask for an appointment urgently. The only role of a midwife in epidurals should be to request the anasthestist. They should not be making any judgement on "how well you are coping" or any other nonsense. Tell everyone you see from the moment you arrive that you request an epidural. Get your partner to ensure the request is properly made by the midwife and to document every request you make.

Best wishes.

An update: I had my daughter yesterday!

I used the advice here and wrote a polite but firm birth plan requesting epidural asap. I also told the hospital on the phone before we went in.

They were great. We were sent straight to triage, where I got a lovely gentle midwife who didn't question my choice at all and asked for an anaesthetist.

Unfortunately it was Easter sodding Sunday and bad weather so the hospital was crazy busy and they didn't make it in time. I had a quick labour and delivered DD2 on gas and dismorphine. It was tough, and I had another episiotomy and then a large PPH, but we are fine.

I'm really happy about my decisions even if circumstances meant I didn't get my epi. And the huge difference for me between this birth and the first was the midwife. I got lucky this time. She was with me the whole time, really cared for me and listened to me, unlike the first time when I felt quite alone.

Thanks for all the advice, it gave me the confidence to say what I wanted.

Diamorphine. And Sunday obvs day before yesterday

Huge congratulations op. Well done and so pleased your midwife was a star. It makes a huge difference.

That is just awful to talk to you like that. My midwife knew I wanted an epidural, she asked me when I was getting to the point of not being able to have one if I still wanted it then organised it.

Oops missed the update, congrats!

Once you have requested the epidural in the hospital write in your maternity notes what you asked for and what the hcp said to you - date and note the time and sign next to it. If I hadn’t made notes I doubt the poor care I received would have been recognised when I complained. It was harder for them to deny as I had made my own time dated notes which evidenced they had not followed the correct procedures. With hindsight I would have written in my hospital notes and then maybe they would have followed hospital guidelines.

Congrats! That’ll teach me not to read to the end!