Midwives say women should pay for epidurals

[TheDullWitch]

At least £500 a baby it says here

snafu, and army slang word, situation notmal, all fucked up.

See also FUBAR

Fucked up beyond all recognition

i am pleased to say when i first started posting on mumsnet someone mistook me for snafu
[proud]

Thank you!

All my midwives were great, I was very lucky and very grateful. It was a very busy night and I did have to wait a few hours for the epi - I think I growled something at DP about threatening them with legal action if I didn't get one soon, though I bet they get a lot of that. The only thing that did piss me off was the OB telling me to be quiet as I was pushing DS out. She apologised when she saw the size of him though. Heads up for the RVI at Newcastle!

I saw a really nice midwife at the RVI - is it something about the north east that their healthcare policy is different to the rest of the country?

My midwives were and are NorthEast and have in the most part been great. Really reassuring and informative and followed my Birthplans in the crucial moments.
I thank my lucky stars i really do!!

I can't believe how many people have been told to be quiet or to stop making so much noise when they're in labour and delivering their baby. Isn't noise supposed to be a good way to relieve pain?

I (perhaps stupidly) have told Dh that I wasn't in as much pain as it might have sounded like, but making a noise helped make me feel better. That's not to say that I wasn't in pain... but I probably did make it sound like I was having each of my fingers amputated without anaesthetic. I make no apologies for that.

I have just come across this thread and am posting without reading it in it's entirety so apologies if I repeat what someone else has said.

I am sure there are very few midwives who believe women should pay for epidurals - this motion will be aimed at generating debate which has certainly been successful as far as mumsnet is concerned. It will do the same at conference.

Women freely get epidurals when requested. Unfortunately though, in the many units you can get an epidural in, you have to hire your own pool if you want a waterbirth. Is that fair? A pool is more likely to facilitate a normal birth. Epidurals often cause a cascade of intervention, which otherwise may not have occured.

As a midwife, I have on often recommended epidurals to women who are having protracted labours or high blood pressure.

I do get frustrated when women demand epidurals on admission, prior to labour even being established. An epidural that is sited too early impacts on labour. The pain of labour is replaced by the pain of forceps deliveries or C/S. However, I would not deny a woman choice, but unfortunately very often it is not based on anything more than the belief you have a pain free labour. In my experience, often an epidural reults in shivering, vomiting, blood presure falling, baby's heart rate falling, labour slowing, drip needed to get it going again etc etc.

Epidurals can be absolutely wonderful where labour is not progressing well for whatever reason. They can be horrendous when they interfere with an otherwise normal labour. There is no getting away from the cost either way. Some would say that the presence of one-to-one midwives in labour would reduce the need for epidurals. It is a chicken and egg scenario though. As long as money is used as it is for interventions which are unecessary, there will be no spare money for midwives.

Thanks for that very informative post mears.

Beattie - I found that the noise I made in labour was more due to the sheer physical effort than the pain - I really did have to push very hard to get 9 lb 10 oz DS with his head on the 99%ile out. In my mind I likened it to the noise weightlifters make when they are lifting a big weight. With DD I was quiet as a mouse because (although the pains were still intense) it was much easier and quicker to get her out.

Mears - for all that I've sung the virtues of the north Durham PFI hospital tonight, I really, really wanted a water birth in hospital but couldn't have one because the floors of the maternity ward in this ultra-modern hospital weren't strong enough to take water baths!!

I mean, FFS!! What were the architects/planners thinking?!

well then the problem is informed choice. i certainly didnt know what mears said. i elected for an epidural with my first - the whole experience was too horrendus to go into. i was told it was recomended as weould be easier to cut me open ded quick - when i was having the twins.

thing is - i never really had the choice i thought i did - did i? becuase my choice was ill infomred.

Precisely Mears, it is a valid debate but the way its been framed has just meant the press have picked up on the sensationalist aspects. I really think press officers need to be more clued up about this; we live in a misogynous society and any opportunity to mock or denigrate essentially female processes is taken by the majority of the media. That gets people talking but what they're not arguing nuanced give and take your promoting - they're arguing to take the rights of vulnerable women away!

what do you call 'normal' though mears.

It's true that women through the ages have given birth with no pain relief whatsover and no intervention either - resulting in many mortalities - both mother and baby. Surely progress in medical science extends to labour and birth as much as disease and condition?

Why on earth would you want to see a woman in pain if that pain can be avoided safely, surely not in the name of 'natural' birth. So you gave birth with no pain relief? Wow! Good for you, but for what?

Having had a 'natural' birth, I know what that pain is - excruciating! Nothing 'natural' about it at all. Give me an epidural any day - and they did - two of em!

Why say "for what"? This is just the kind of thing that gets my back up.

I didn't have pain relief because there wasn't anything I could have that wouldn't have had side effects I didn't want and I was managing with the pain perfectly well. Had I not coped, I'd have weighed up whether the blistered back woud've been worth it and had an epidural, whether the shivering out of it puking would've been worth it with pethidine and the just plain old puking would've been worth it with gas and air.

Actually, no, I'm just a dopey old earth mother who enjoys pain. When I breastfeed DS2, I make sure I put the other nipple in a vice so I can really enjoy it. Gah.

Well if mothers on a mothers' forum can't respect one anothers' right to choose whether or not to have pain relief, without playing daft oneupmanship games about who did a better job of it, or who only did it drug-free to make a point, or who bonded with their baby better (or worse, who deserved to bond with their baby better)then we're all f*cked! Good for you, HM for knowing how you wanted to do it and doing it the right way for you. If I were you I would get very cheesed off with inverted snobbery about not using pain relief. And good for you, JT for choosing the option which suited you best and making it happen. Of course epidurals should be available to those who want or need them. There are enough obstacles to women having positive birth experiences, without us all attacking each other and making each other feel like crap.

I am now PARPing this nonsense, as I am turning into the Evil Phantom Who Haunts Any Thread Involving Midwives.

Mears - the birthing pool comparison is an interesting one. If I started a post ranting about how I wasn't able to use the birthing pool for dd2's L&D due to a shortage of midwives or because someone else was using it, I wonder if I'd gain as much sympathy as those who weren't able to have an epidural when they wanted one.

I really wish the outcome of this 'stunt' was a debate, resulting in every woman being able to labour in the way they choose with the pain relief they choose. But, like almost everyone else here, I can only see the media's interpretation ~ "women cost the NHS more money because they won't accept the pain they should take during childbirth"

You can't compare birthing pools and epidurals. But you have a point - maybe if you want to have a birthing pool at home you should be able to get them free on the NHS since they save on intervention. They are a luxury and they should not be. I spent one night of my labour in my own bath and it was fantastic so I would loved to have given birth in water but was not "allowed" to because my waters had broken and my son's heart rate was a bit erratic (hence why I "had to" go on a drip and had intervention after intervention. Hey ho).

Anyway I am still going to write to the RCM and say that if they support this motion and start lobbying health authorities they are barking mad. You may not agree with me - but then you can write to them and say the opposite.

i agree with Hunker too.
Though i did use gas and air, the side effects of the others scared me plus i was quick and the midwives were telling me that i'd be groggy after the Birth. Don't think anyone willingly thinks 'oh yes please a few hours of excruciating agony'.
Mears your post was very interesting.

What do you mean by need an epidural. During my first labour after being induced I asked for an epidural at 5cm cos I didn't want the pain anymore. I don't know if my pain was bad enough to warrant an epi but I felt I NEEDED one. The worse the pain got the quieter I got. Don't know why. A midwife would not have much to judge me by.

DOn't people react differntly to pain. I slipped a disc a couple of years ago and when I saw the consultant he said I probably had a slipped disc but probably a small one based on how I was able to walk and stand. He was shocked when he saw the MRI scan cos it was a whopper. We assumed I had a high pain threshold.

Should get what you need & want for childbirth - why should mums have to pay for a birth pool as Mears says?

For the epidural - how much does it actually cost? Has any figure been given? Can't be that much surely?

Why is it always women who have to suffer cut backs?? Thinking of the panorama prog on the fight to get a drug for breast cancer, the issue of not enough midwives & now the issue of pay for pain relief. Do the powers that be expect mums to get their cheque books out whilst giving birth??

Plus what if the epidural didn't work!! - what if it only gave relief on one side - half price!!

Also how to organise - if mums are paying they would expect better service - no wait for the epidural, no being told there was no doc to do it!!! - would cost loads to have an on call no wait doctor for this!!!

Hellywobs, why can't you compare birthing pools and epidurals?

I was wondering that

Milward ~ I'm not sure how the midwives are pricing the epidurals at £500. The one I heard on the radio said the 'cost' was to ensure enough anaesthetists were available to administer 'on demand' epidurals.

In Naomi Wolf's Misconceptions book, she states that epidurals are pushed upon American labouring women so that the hospital can recover from the medical insurance companies, the costs of having enough ready-available anaesthetists.

So, if women start to pay for epidurals to ensure there are more anaesthetists on the labour ward, the knock on effect could be that the epidural rate increases, to prevent anaesthetists sitting around doing nothing or being poached by another department.

I say 'for what?' from my own experiences and having had one 'gas and air' birth and 2 epidurals (no side effects from any birth). I can only say that the latter two were far more enjoyable (if that's the right word!) experiences than the first one and had an epidural been around when dd was born and I'd turned it down I'd have questioned my decision - 'why did I put myself through that?' - sorry it gets your back up hunker, its just my pov.

Of course its a personal choice but I certainly don't think women should be made to pay for pain relief if that's what they want.