Thinking of a birth centre birth, minimal pain relief.

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I would love to know people’s experiences with giving birth in a birth centre rather than a labour ward.
I’m aware in a birth centre that epidurals are not given.
My first baby is due in 9 weeks and I’m depending and trying to tell myself I can do this without an epidural.
My reason being that I want to be mobile and feel more in control. The thought of a needle in my spine also freaks me out.
I know all births are different but would love to hear experiences of birth centres and or non epidural births.

I didn’t have a catheter for either of my epidurals and was home six hours later.

My one birth with no epidural I would not wish to repeat even though it was so quick. I’d rather have a longer pain free labour.

My advice to you, and to my dds when the time comes, will be have an early epidural (not one later into active labour - that’s where all the problems happen) - nice and relaxed, in control and pain free.

Why women break their necks to have a pain-filled birth experience when we have modern analgesics I will never know.

I've had the experience of both.
Go for the midwife led unit if it's attached to the actual obstetrics team and delivery suite. I regret not opting to do it with my first.

Yes, I should have made it clear that my sister was already at very high risk of spinal cord damage (and it did happen - which was precisely why her doctors didn’t want her to have the epidural). But when you’re pregnant with your first child, and doctors are discussing epidurals and paralysis with your sister, even if academically you understand this is nothing to do with you, emotionally it’s very different.

I certainly wouldn’t want to put anybody off an epidural. I was just trying to explain my reluctance.

Again the objections you’re quoting are from many years ago. You can have a walking epidural now where it will take away the pain but you can still stand up, even with a full epidural. I was more than capable of changing position and using my legs and they turn it down for pushing, unfortunately.
I will be strongly recommending my daughters get them as I’ve said repeatedly on these threads there is no medals for bravery
You still get a baby at the end and that’s it

I gave birth in hospital each time (no birthing centre nearby)
The first time I was shocked by the level of pain and had a epidural. Whilst it is everyone’s choice I wouldn’t have rushed to have it again as it slowed birth down and made it harder for me to push (resulting in dd having to be born via ventouse)
Knowing what to expect helped massively and next time I coped significantly better and was fine with gas and air.
Have you experienced any significant pain prior to this? Do you know how you manage pain?
prior to giving birth my only experience of pain was a broken shoulder at the age of 7 which was not that painful.

I loved my birth in the birth centre but it was next door to the Labour ward so had their been any issues I could have transferred. My births were very straightforward, gas and air in the pool with DD then nothing with DS, but I hear now that so few are straightforward. I planned the birth centre for my second but didn’t make it in time and had him outside the hospital 🤣

Have you done ECT? That helped me massively knowing what to expect with the pain, what to do etc.

Walking is still not that common even with ‘walking’ epidurals. We don’t routinely ‘turn down’ epidurals for pushing (that’s an old fashioned relic from the days of high concentration mixtures). They do still normally anticipate longer for second stage for women with epidurals even with low concentration mixes.

Epidurals are great when they work well and are really useful for making things safer for some women as well as making it less painful. There is of course a 1:8-1-10 risk that they won’t work that well though and they can cause some problems even with the low dose mixes. It is important for women to understand stand all of the benefits/risks for them when they’re making their decision.

All birth comes with risk, but it doesn’t need to come with pain.

epidurals don’t always work and sometimes aren’t even safe to attempt. It’s great if yours worked a treat, but it just isn’t always possible.

Why are some people so derisive of women, who want minimal/no pain relief when giving birth?

There ARE benefits to doing it without, and there are benefits to epidurals. Your choice is not the only right one.

They’re not, they’re saying give yourself the choice. Committing to a birth centre 20 miles from the nearest hospital, as my friend did, turned out to be a huge mistake. Nobody is going to force you to have pain relief if you don’t need it but why taken the option off the table by committing to a venue that doesn’t have it? Childbirth for me was white hot agony, and I’ve broken bones doing extreme sports etc and not cried or screamed. This was completely different, it felt like my entire torso was in an industrial crushing machine.

I had my daughter in a birthing centre, I've given birth 3 times and the birthing centre was my favourite birth. Out of all 3 first photos with my newborns, DD is the only one I'm beaming on because the birth was so so lovely and calm ( other two were at hospital and traumatising, I was crying on both my sons pictures 😭 )

It was over a decade ago I had my DD, but I was allowed gas and air and pethidine. I has to get out of the water whilst I was on the pethidine but once it wore off i was back in the water.

The water birth at the centre was absolutely my least painful / most relaxed birth, I'd always recommend it ( ours was connected to an ambulance station so if anything went wrong I'd of been taken to hospital via their ambulance )

I'm not talking about the people saying give yourself the choice.

If they weren’t safe it wouldn’t be offered

For me I don’t understand why someone would take a risk of being in pain when there is an alternative.

That's fine that you don't understand. Everyone weighs up the pros and cons and makes their own choices though.

I've had experience of both a busy labour ward and a quiet midwife led unit (guess the same as a birth centre?). Both times I just had gas and air, and used the pool, no epidural.

The main difference was in the ward post birth - first time was very busy, short staffed, loud and little help with baby. Second time was peaceful and quiet, midwife looked after baby while I had a shower, and in general a better experience in those first hours.

I had an epidural with my first son, and gas and air only with my second and third children.

It’s hard to convey just how painful children is and can be. Of course, it’s possible to do it without an epidural, but in my experience, I would prefer to have it there as an option, than to not have it as an option.

I think how much pain you are in is hugely dependent on the exact position of the baby. And perhaps being mobile and upright does help with that - I don’t know, it certainly didn’t help for me. As an aside, I also wonder if it’s correlation rather than causation. If the baby is in a good position you aren’t in that much pain and you can move about. I was in so much agony I physically couldn’t move anyway.

I’m saying that because I’ve spoken to and heard so many women who blame themselves if they do end up in huge amounts of pain. They think if only they’d moved more/ prepared/ done hypnobirthing/ gone in a pool/ done spinning babies it would have been different. When in fact it almost certainly wouldn’t have been.

Go with the flow, but above all don’t think you can control what happens and that you’re failing if you can’t!

When epidurals work they border on miraculous - you can literally go to sleep, wake up, push for maybe an hour and then you have a baby. All 100% pain free. However they are associated with a higher rate of complications. Epidural analgesia:

• increases the risk of malposition as you can’t mobilise well, and they also reduce pelvic floor tone which sounds like a good thing but it’s not - means it is harder for baby to rotate.
• increased risk of prolonged second stage of labour (the pushing bit) which can lead to pelvic floor damage and itself is a risk factor for haemorrhage.
• increases the risk of assisted delivery.
• increases the risk of significant tears involving the anal sphincter.
• epidurals also require continuous fetal monitoring which does not improve neonatal outcomes and massively increases the chance of a caesarean section.
• epidurals can cause transient hypotensive episodes in mum which can lead to baby suddenly dropping their heart rate. Not a big deal because these decelerations are usually self limiting and mum’s low blood pressure can be treated with fluids, but the midwife would have to call the crash bell, the whole team will rush in and it can be stressful for families.
• epidurals increase your temperature, which can increase baby’s heart rate. This can be mis-interpreted as infection, resulting in you getting a caesarean you didn’t really need.

Why not start in the birth centre using the pool, gas & air etc and then move to labour ward for an epidural if you need one? Having started the labour physiologically will minimise the risk of complications.

I had my first baby at 36 at a birth centre attached to a hospital. I was absolutely prepared to get an epidural if I wanted one but as it turned out I had an amazing water birth with no pain relief at all. It was lovely. The best bit was being in the water as it was so comfortable. Good luck and I think there is no harm at all planning for an epidural free birth if you are open minded to all options, and have the flexibility to adjust your birth plan.

I absolutely agree with @EarlGreywithLemon . Luck plays a huge role. The time it takes you to get to 10cm so you can push, and baby’s position is out of your hands in many ways. Good luck! It’s an exciting time.

Epidurals can cause chronic headaches/ csf leaks that can last years and back pain, not as rare as reported. My two natural births I had gas and air, pethidine with second and it was a good experience with both. You get people who are very pro epidural fair enough but people also deserve to know the risks and they shouldn't be downplayed

there isn't conclusive evidence for quite a lot of the things people have said about epidurals on this thread and some of the statements are frankly wrong. Not sure it's massively helpful to the OP to keep returning to this one thing, so will duck out after this... Epidurals can be great, but they can be a pain. Like everything in childbirth there are pros and cons. It's sensible for the women who are thinking about having one to look at objective, evidence based info like that found on the website I linked to earlier or speak to an anaesthetist, rather than listening to non-experts. (DOI before anyone takes offence: obstetric anaesthetist)

I had my first in a very small midwife unit with no epidural available. It was either that, or a huge regional hospital. I decided I wanted the small, more personal atmosphere of the unit where I knew the midwife team - my antenatal appointments were there and by full term I’d met all the midwives.

yes of course it hurt a lot but I felt comfortable in the environment, it didn’t feel clinical. It’s not about anyone expecting a medal for giving birth. For some women, giving birth feels like a very different situation from a medical thing like having a bad tooth out or surgery, where we would choose to have pain relief.