How to make sure to get an epidural? C&W patient

[bluemonday2020]

Hi everyone. I am currently a patient of Chelsea and Westminster hospital through the NHS. I have heard some horrible stories in general/about other NHS hospitals that women are not being given epidurals when they request them. Has anyone had any experience with this and do you have any tips to make sure you get one? In particular at Chelsea and Westminster?
Thank you in advance!

Don't think there's any way to guarantee one, tbh. They seem to fob you off a lot so start asking as soon as you get there.

If there's time then there's no reason why they wouldn't give you an epidural if you ask for one. Most of the time when women are refused one it's because they've progressed too far for there to be time to get it all sorted before you start pushing. And if you've managed to get to 8/9/10cm without one and you're in transition already then you're nearly done anyway!

They'll tell you there is no anaesthetist available. Over and over. Until you're too late and then say, oops, too late.

Has anyone had any experience with this and do you have any tips to make sure you get one?

There is no way to make sure you get one. Depending on time and availability of staff you may just have to make the best of things.

The only way to guarantee an epidural is to go private. When I was in labour the ward was very, very busy. I laboured for about 12 hours without one and then eventually when I was on another planet with pain - finally an anaesthetist became available

There’s usually just one anaesthetist covering the labour suite and maty theatre, OP. So if she’s tied up with a run of Caesareans/retained placentas/trial of forceps etc, she can’t simultaneously insert your epidural.
Many years ago, we had a system of booking your epidural in advance, after discussing your wishes with an anaesthetist at the antenatal clinic.
This still didn’t guarantee it, but it stopped the midwives fobbing you off or playing for time - they knew it was booked and they’d get a bollocking if they tried to block it!
I’m long retired, and I don’t know the system at your hospital - I think it’s best to assume that you aren’t guaranteed.
Unless you have a medical indication for needing one - in which case, if it was vital, they might be able to pull in a second anaesthetist on call.

Had DD at University College Hospital. Assumed since it was a large hospital there would fewer staffing issues when it came to this sort of thing. Ha. Asked for an epidural and was told there was only one anaesthetist on duty and he was "on the other side of the hospital" dealing with someone else. Midwife advised gas and air (which did sweet FA). When I repeatedly asked for the epidural she told me to stop thinking negatively as that would make the pain worse

I got one at 6cm (what I was at when checked). You can ask for one past 4cm. I wasn’t denied, I just had to wait until the anaesthetist finished administering it to another woman. You’re best off telling them up front if you want one rather than waiting until it’s potentially too late. They don’t always try to put you off. Just remember you’re entitled to one and stand your ground. Barring the anaesthetist being in emergency surgery, there’s not many other reasons to put you off.

Thank you ladies, it is good to be mentally prepared. I guess I will try to go early (even with a risk to be sent home) and already talk about getting an epidural.

Have experience of C&W and they are very epidural happy @bluemonday2020 so I really wouldn’t worry! If the anaesthetist is busy you may have to wait but we try to reduce waiting times as much as possible for epidurals but obviously depends on what is going on on labour ward/the rest of the hospital as to being able to get another anaesthetist to do it if the labour ward anaesthetist is busy. There are other pain relief options in the meantime and they will talk them through but my advice is to look at www.labourpains.com/home and have a read of the info in advance! Good luck

I don't think it's just that hospital, both previous births I've been fobbed off with 'there's no one available' and then later on 'oh you're too far along now' xx

I dont want to derail the thread but so when are anaesthetists available then? Are they mostly for when their booked as such?

I had an epidural with my 3rd. It was a drip induction and I declined the epidural offer at first. When I was begging for it later it seemed like they had the person there straight away

@PrivateRentNightMare most labour wards will have a dedicated anaesthetist there 24/7 - during the day likely one or two and usually a consultant and a trainee and at night a trainee who can do obstetric anaesthesia. Have worked at one place with a very low birth rate that had an anaesthetist covering labour ward and somewhere else but that is rare in my experience.