Epidural questions - Why the stigma attached

[horseshoe]

I had one with DD1, G&A with DD2, desperately trying for a home birth for DC3.

I have said to the MW that if I end up going to hospital I am just gonna ask for epidural if I feel I want one to which she replied "Oh you dont want one of those".

With DD1 I did have vontouse delivery but I had epi after 18 hours of labour when I was 8cm dialated and before they realised that baby was back to back and getting stuck in birth canal.

Everyone I speak to especially "angellic "i've had 3 natural no drugs birth sis" appears to look down their noses at this decision.

So can anyone tell me why they are so wrong and what is the best time to have one - nearer birth or early labour. I seem to remeber that they wait until at least 4cm dialated.

Oh goodness - Am relieved to hear there's no such thing as a Gas & air cs!

Maybe i will have that third baby after all

that is lovely news waynetta

for those for whom epidural has worked and it has not made labour longer or more complicated, that is great. but that does not mean that for those for whom it did not work, that they are wrong !

re why does not everyone have them?

they do have side effects!

they do take your birth into a far more medicalised route.

but chacun a son gout, i enjoyed feeling the senstaions of labour and birth with DD

Expat - epidural have worked for you. That does not mean they always work.

Anagram - you say it is "nonsense" that epidurals do not work. It is not nonsense - it is fact.

Do you think I am making up the fact that mine did not? Why would I?

The anaesthetists could not fix it. They tried several times but could not.

I would have liked my epidural to have worked and I chose it as my preferred form of pain relief but if you chose one you need to be aware that it does not guarantee a pain-free experience.

I had been warned beforehand that they did not always work (as I was when told about them pre-chidbirth) but of course I chose to block that bit out in the hope of a blissful pain-free three days. I ended up with injected morphine which took hours to kick in and made me vomit.

Pollyparanoia is quite right, difficult labours=more likely to need epidurals=interventions more likely to be necessary in any case
Anna, this "researched" area was done with old-style epidurals, new-style ones are much less "heavy" and can still allow movement and have far, far fewer side effects. It's always going to be a what-if situation with any kind of pain relief, you'll never know what would have been different if you'd taken another option but it imo would be crazy to refuse an epidural if you're in that much pain for fear of possible interventions you might end up needing anyway! And of course then it might not work etc (though you'd be very unlucky - poor you thingone). Though far more likely anaesthetist won't be available when you holler
rofl at g&a misunderstanding, how horrible would that be!

In fact, someone from the royal college of obstetricians told me that it was unknowable whether epidurals really did prolong labour. And as Zoe Williams once wrote, if it prolongs it by 20 mins but that 20 minutes is painless then you're not likely to care are you?
Nobody should feel stigmatised however they give birth. There is nothing wrong with eschewing an epidural or having one and I don't think anyone would really judge either way.

anagram how refreshing

thingone if the morphine took hours to kick in something was wrong

having done the natural thing 4 times i got epidural 5th time

the mocked me when i was so grateful for the spinal which took the edge off the pain before the full epidural was set up

an epidural half working it better than pethidine diamorphine and the hideous gas and air rolled into one

give me a failed epidural over natural delivery any day

thingone if the morphine took hours to kick in something was wrong

having done the natural thing 4 times i got epidural 5th time

the mocked me when i was so grateful for the spinal which took the edge off the pain before the full epidural was set up

an epidural half working it better than pethidine diamorphine and the hideous gas and air rolled into one

give me a failed epidural over natural delivery any day

Horseshoe, that's sad that you feel there's a stigma. You should definitely be able to express an opinion of what you'd like in labour without feeling judged. Having said that, I'm personally somewhat wary of them because my mother and a good friend both had bad reactions to being given an epidural. I guess there is some risk with any medical "procedure".

Re stigma - it can work the other way - in some quarters you are viewed as some kind of weird Luddite/cavewoman if you don't want one (the "you wouldn't have a tooth out" school). If you want one have one! A friend of mine just had a great second birth with an epidural from 3cm, she could feel when to push and everything.

mrshackleton - I agree that the new 'mobile' epidurals are in many ways a great advance on the old style epidurals that gave such a profound motor block.

However - as they still turn your pelvic floor to mush, thereby hampering proper fetal rotation and descent, they're still more likely to result in a higher rate of instrumental births than non-epidural pain relief.

The new low dose epidurals also often include an opoid in the pain relief cocktail that's injected into the epidural space - usually fentanyl - unlike the old style epidurals.

There's been a fair amount of research recently showing that babies born to mums who have had epidurals are more likely to have problems breastfeeding - which is believed to be down to the fact that they've been exposed to opoids during labour.

On a personal note I had an epidural with my first. I didn't know then what I know now about how epidurals disrupt the normal hormonal mechanisms of birth. Once I understood this didn't want to have another one - I don't want to expose my babies to opiates if possible.

But that's my choice. I do understand why other women choose to have an epidural.

after a fast and furious birth with no pain relief my baby was slow to develop

he did not feed well in the first week and had to go back to hospital for blood tests and the like

he then failed to meet a few milestones

my birth record was requested and the baby was sent for brain scan to look for bleeds

baby was then under care of paedatrician till 18 months when he was discharged.

i went through hell that year blaming myself for forcing my baby out so quickly

the next time i had a baby i had epidural

calm controlled pushing - no catheter no loss of leg feeling

the anaesthetist told my husband ' no doctors in this hospital give birth without one'

perfect calm and happy baby .....

i dont buy this 'opiodes cross to baby'

what about pethedine/diamorphine?

Doctors, anaesthetists especially, are well known for opting for epidurals. Of course they do. Their levels of anxiety about labour are often much higher than in the general population because they've been disproportionately exposed to trauma and problematic births. I'm sure I remember seeing research from South Africa showing that medics also tend to have higher rates of both elective and emergency c-section. I should imagine that anaesthetists are constantly exposed to labouring women in states of severe distress. What does that do to their own confidence in their ability to cope with labour? Where ever you get doctors involved in normal births overall you tend to get higher rates of intervention. That's why I'd always choose midwifery care for myself and why in the USA they have a c-section rate that's rapidly approaching 30% of all births...

Anyway - how much importance and value you attach to all these things is down to the individual. I had one long labour with an epidural that resulted in a forceps birth/problems breastfeeding/postnatal infection. I had another long labour without an epidural and felt that both my baby and I had benefited from me NOT having spinal anaesthesia. Other people, like you ButterflyMcQueen, have different experiences that lead them to really value their epidurals.

I think though when it comes to deciding for yourself as a first timer, the more information you have the better. You need to know about the way epidurals disrupt the hormonal mechanisms of birth and about the possible side effects for you and your baby. You also need to know that most women who have epidurals are very satisfied with them and that they usually provide brilliant pain relief.

they also cost a lot

the midwife said to me ' you have been cheap thus far'

In a nutshell?

An epidural or medicalised birth carries a greater risk to the baby than an active, unmedicated birth. The increase in risk is tiny.

The very British stigma comes from people reading the first sentence and not the second. Stiff upper lip and all that ;)

Really, I wouldn't worry about it. No one is going through your birth but you and your baby. You'll make the decisions best for both of you. No-one else's business what informed decision you choose.

Hello! I have a low pain threshold, so when I was pregnant with ds 1, I asked my MW if it could be planned that I have an epidural when I needed one. MW said yes, at anytime of the day/night and at any stage during labour.

Anywho, coz my ds had his arms over his head (no-one was aware of this at the time) I had a really long latent stage of labour. This was like really bad period pain, I could cope but it made me feel knackered as I didnt sleep well during the night. So as soon as I got into established labour I got my epidural (I was prob 1cm dilated). It was ace, i felt relaxed and carried on dilating nicely. About 6 hours later they could tell that ds had his arms up and his hands in his hair - and i was whisked to have a c - section! But this was'nt coz I'd had an epidural. I thought the epidural was good.

There is a stigma attatched in certain circles, because they are a medical intervention.

I dont criticise anyone who has one, but i would never again have one it was the most horrific experience of my life. The whole birth just got more panicked and scary as we slipped from one disaster to another, I realised immediatly there was something wrong, after 6 attempts by 5 anaesthatists they gave me a spinal block, I suffered a dural tap, had to have a blood patch done 3 days later and suffered blinding headaches for my whole stay in hospital, I wasnt able to stand up on my own, I couldnt even lift dd1 out of her crib, I would have to call a MW to help. I couldnt go to the toilet all because I took the epidural, I was put in a quieter room with the other mums who had suffered complications 6 of us on the ward all with side affects from epidural.

"Just interested why women in labour more or less seem happy to have epis (or whatever pain relief is going), while MWs seem to want to avoid them"

Because MW is not the one in excruciating pain?

I had to have an epidural and, although I was angry when I was told that, by God I was pleased when the time came!
And if I have more kids I want another one too.

When I had my epidural I was really relieved and happy too. I felt so much more relaxed and in control. The MWs who looked after me didnt say anything against them, while I was planning to have one, or when I was in actual labour.

Good God, I can't say I've ever heard so many stories of what appear to be very incompetent anaesthetists.

cherrylips - i was told you could only have epidural at 4 cm?

i would love your experience i literally live in panic sheer panic of being told 'no'

There was a similar thread recently where I likened the question about whether to have an epidural to running a marathon. To those people who say 'Would you have a tooth out without anaesthetic?' I'd simply say 'Would you run a marathon?' After all, there's no need to do it. The look on a long distance runner's face as they approach to final mile is agony! So why do it? I guess it's partly something to do with wanting the experience of pushing your body further than you've pushed it before. There is something enormously empowering about experiencing natural childbirth, and I don't see why women shouldnt be allowed to say so. I think it's up to the individual whether they want a painfree medicalised birth or whether they want a more natural experience. For me, the feeling of giving birth naturally was like nothing on earth - I felt a strength I never knew I had in me. In contrast, my csection with an epi was pain free but I felt as though I had a procedure done to me rather than as if I'd given birth IYSWIM. But that was my experience. Some people think epis are wonderful. Each to their own, as long as you are aware of the risks.

"In a nutshell?

An epidural or medicalised birth carries a greater risk to the baby than an active, unmedicated birth. The increase in risk is tiny."

Sorry - I appreciate that most women are delighted with their epidural and I was certainly happy myself to see the anaesthetist when I had mine during my first horrible labour, but the I would argue that it's actually quite hard for us to quantify the more subtle negative effects of epidural anaesthesia on babies.

What about those babies who end up with bruising after a forceps birth (which is twice as likely with an epidural than without one for a first time mum?).

Or those babies who end up having lumber punctures and antibiotics because of suspected infections after a mum has become pyrexial during labour with an epidural (how many women realise that running a temperature during labour is more common with an epidural and that this might make investigations on your baby more likely?)

And if epidurals impact on breastfeeding then I don't think it's right to describe that as unimportant. You only have to lurk on the bf board here for an hour to realise how many disappointed and sad mums there are out there who've had horrible experiences with breastfeeding which have taken something very special away from their first few weeks with their babies. Someone I know has just had a dural tap with an epidural which made her first week with her baby completely traumatic and has had long term consequences for her breastfeeding. How might that affect her baby in the long or short term?

This is one of the most ill-informed, misdirected comments I have seen on MN. The list of good research on epidurals and their risks is extensive.

Here's one to start you
www.healing-arts.org/mehl-madrona/mmepidural.htm

I agree that it is definately a choice for women and their should be no stigma attached to any choices a women makes about her birth.

That doesn't mean its ok to spout unsupported, incorrect information.