Why did they stop providing pain killers?

[ajja2021]

I'm just wondering if anyone has any insight on this, I had a ELCS in 2019. Relatively straight forward, larger incision due to larger baby and some staples instead of dissolvable due to the size of the wound.

I had pain relief on the ward and was discharged within 24 hours and told to buy Paracetamol and ibuprofen, I was refused codeine because I was breastfeeding.

This led to me being in agony, I really struggled and I genuinely believe this impacted hugely on my initial bond with DS and my breastfeeding experience. I was horrendously depressed and it was just a horrible time.

I had another ELCS less than 22 months later, I was given plenty of pain relief on the ward and was given various pain relief to take home (paracetamol, naproxen, dihydracodeine, diclafenic) and I was breastfeeding this time too.

I asked the nurse, she said the trust decided to not give any pain relief for elective section patients for a year and she didn't know why.

I know some women are great and can be up and doing the school run within days, but first time around I genuinely couldn't move for being in unbearable agony. I also didn't want to be high as a kite in my first few days of
Motherhood but the painkillers made such a difference, particularly in the first 36 hours.

I had such a positive experience second time around and I can't understand why the trust would stop giving pain relief? I've had dental surgery and been given more pain relief than after my first csection.

Has anyone been through similar?

I had no pain relief after a forceps delivery because the ward was short staffed and they couldn't do the drugs round.

I was given co-codamol to take home after all 3 c-sections (1 EMCS and 2 ELCS). All same West Midlands hospital but several years apart.

I agree that the way women are treated after childbirth is often horrific.

There are always lots of ‘it wouldn’t happen to men’ comments on these threads but an anaesthetist friend says it’s common across all departments and the reason is not to save money on drugs but because they can get you out faster on weaker pain relief. It’s the beds that they’re really after, and shortening the length of your stay. He doesn’t approve, by the way, partly due to the negative psychological impact of pain. But it’s a management decision rather than a clinical one. My DF experienced similar with major surgery recently.

Sounds like everydayNHSsexism to me. Its becoming worse with increased cost cutting.

What did they suggest you do for pain? Is there a process whereby an alternative provider prescribes it or do you just accept your "woman's lot"? I'd be interested to know which other surgical procedures are followed by denying the patient pain relief.

The trust I worked in asked women to bring in paracetamol and ibuprofen whether you were having a vaginal delivery or a section. It’s to die with cost. A dr has to write you a prescription for the paracetamol and a pharmacist has to dispense it. This all costs a huge amount of money. Where as yin can buy it a supermarket for 35p a pack maybe £1 and then administer yourself.
If you need stronger than paracetamol or ibuprofen it would be prescribed such as co-codamol. It sounds terrible but really the Keats amount of pain relief you can get by on the better.
I’ve had 1 emcs and 2 elcs, I’m a total wimp when it comes to pain but found paracetamol to be surprisingly effective.

If you needed stronger though you should have been given it but it is a case of having to have a dr or a prescriber writing it up. A midwife or nurse can’t just give medication on a ward without it being prescribed.

Reading this thread alone has prompted me to order some 500mg naproxen for after my ELCS on Tuesday. I was given diclofenac (?) after my first in 2013 and that seemed to work well. Same hospital so hopefully it will be the same 🤞🏻

Some of these sound absolutely barbaric!

My oldest is 14 and after CS I got morphine drip. Then maybe some paracetamol until discharged after about 36 hours. No drugs to take home.

So this isn't new.

You can buy codeine otc, not that you need to of course but it is available.

You do know you can purchase Paracetamol and Ibuprofen for pennies yourself right?? It costs the NHs 75p ish for each box of paracetamol vs 16p if you buy it yourself so they do not give it out.

If you have been struggling with pain and taking a third line analgesic, codeine or dihydracodeine then this can be given to you for discharge home. If you start off fine on the other two then get worse visit GP who can prescribe the third line pain relief.

Hope this clears things up so you do not think your being mistreated or neglected by your hospitals lol.

@anniee8ava I know that, I'm not stupid. I don't think I'm being unreasonable to expect a hospital to give me pain relief to take home with me following major surgery?

I don't expect paracetamol or ibuprofen from them, but I did assume I would receive a stronger pain relief to get me through the first 48 hours to say the least.

This time around, I was given naproxen and dihydracodeine, and if you read my OP this made ALL the difference for my recovery.

Also, first time around I was denied any pain relief upon leaving hospital and my GP would not prescribe anything stronger than the paracetamol and ibuprofen as I was breastfeeding with my first ELCS.

I was also breastfeeding this time and given pain killers, so I wondered why within 22 months had everything completely changed.

@anniee8ava What’s with the “lol”? These posts have not in any way made me want to laugh.

@anniee8ava

You do know you can purchase Paracetamol and Ibuprofen for pennies yourself right?? It costs the NHs 75p ish for each box of paracetamol vs 16p if you buy it yourself so they do not give it out.

If you have been struggling with pain and taking a third line analgesic, codeine or dihydracodeine then this can be given to you for discharge home. If you start off fine on the other two then get worse visit GP who can prescribe the third line pain relief.

Hope this clears things up so you do not think your being mistreated or neglected by your hospitals lol.

Read the OP.
Firstly, if the hospital wants patients to take in their own drugs they need to tell patients in advance and factor in relevant advice for self medicating. Secondly the OP is talking about pain relief after surgery, not paracetemol for afterbirth pains Thirdly whenever I've been in hospital drug issue and tracking has been strictly controlled (including regular prescription drugs) rather than encouraging patients to take random drugs and self medicating.

I'd also be interested to see the Equalities Impact Assessment on the decision to let patients sort out their own over the counter pain relief after surgery.

Because they are bastards.
Post natal care is always poor. It's only women isn't it.

My Trust still do this.
Our women sometimes give birth in a separate Trust but have their antenatal and postnatal care through us (due to where they live or preference) and I remember everyone being shocked a woman was sent home with oramorph following an EMCS. It was very uncommon for us to give that even on the postnatal ward.
Please don't straight away blame midwives, a lot of the stronger medication can only be prescribed by doctors or by us during labour but not postnatally (oramorph is an exception and I have seen it being given more on the wards now). Women are looked at like they're a PITA if they ask for more pain relief.
It's one of the many, many reasons I'm looking to leave Midwifery after just 2 years. I'm very sorry to any of you that have gone through this.

Women are looked at like they're a PITA if they ask for more pain relief

By whom? Or is this a general bit of casual misogyny in the health care system rather than one group disregarding women's needs?

After my first I was sent home with plenty of codeine to see me through. After my second (Elcs) I was sent home with two tablets! However as soon as I told my community midwife she got me a proper prescription for more! I think it's just cost cutting.

I had a few days worth of dihidrocodeine the first c section to go home with. Second c section they said they didn’t give it to take home any more. This was 2015 and 2018

Yeah after my ELCS I was discharged with nothing.
EMCS was paracetamol and ibuprofen but 1 box of each. On the ward both times I had to ask for oramorph. If I hadn’t then I’d have been given nothing more than paracetamol and ibuprofen. Fucking barbaric.

I had EMCS in 2019 and was sent home with a whopping box of tramadol, I had only had one whilst on the ward and didn't take any at home, but they were keen for me to stay on top of the pain so sent them home with me. So sounds like it really does vary as to the approach to pain relief.

Im a midwife. In regards to medication in hospital, you should be give what you need. However, for medication to take home, it costs the hospital £10 roughly per packet of paracetamol and £10 per packet of ibuprofen. You can buy both of these for 35p each in Tesco. In my hospital (a south London trust) if you were having an ELCS, you were told in your pre op appointment to buy some and keep at home when you come in. It wasn't just maternity that this was brought in, it was across the hospital (exceptions made for vulnerable people) so it wasn't an anti woman thing. It saves trust's thousands of pounds per year that can be plugged back in to other resources.

And OP, they shouldn't have given you Dihydrocodeine, it is contraindicated post ELCS and if breastfeeding.

To whoever tagged me above i am not advocating self medicating. In my trust we give out whatever they need as an inpatient. If a woman needs oramorph she stays in until she can cope on lesser medication.
Lots of women cope post op on just ibuprofen and paracetamol only.
If they needed codeine/dihydracodeine then thos can be prescribed and given to take home. But remember these are only given when NEEDED as they can be addictive and cause constipation, constipation and post surgery is not a good combination.
Also of you need more medication why not talk to your midwife or doctor?? So many people bashing health professionals but you have some responsibility to be your own advocate too.

@Willthewashingeverend just to reiterate I wasn't asking for paracetamol or ibuprofen, I was aware from my first csection and had some at home in preparation.

I was wondering why they didn't give any pain relief with my first csection, then less than 22 months later I got quite strong pain relief to go home with.

I did not at any point ask to be given paracetamol or ibuprofen, I was glad to be given stronger pain relief this time around as I really genuinely believe it helped my recovery massively.

@anniee8ava please read my OP, I did request pain relief as I was so desperate and in so much pain, I wasn't given anything my GP said they couldn't prescribe anything due to breastfeeding.

This is why I was confused this time around being given so much while I was breastfeeding again.

Not complaining this time around, had a wonderful recovery.

I also state in OP that although some women can cope on just paracetamol and ibuprofen, first time around I really couldn't. I was in so much agony.

However, for medication to take home, it costs the hospital £10 roughly per packet of paracetamol and £10 per packet of ibuprofen. You can buy both of these for 35p each in Tesco.

Wow. Talk about using the NHS’s massive buying power to full effect! Scandalous.

Ive been in hospital loads of times for different things.

I know if you need ask the nurses for anything you can be sat there still waiting a couple of hours after.
So I brought my own paracetamol and ibuprofen into hospital. It shouldn't have to be this way, but the freedom of being able to just take 2 paracetamol when you need it is great.

Also I think part of the problem with them giving people strong painkillers is- it's harder to get the patient put of hospital of they are still on the strong painkillers. Also it takes ages for the meds to come up from the pharmacy.

You can either leave straight away mid afternoon or wait up to 24 hours or longer for your meds to be dispensed.