Panicking about birth, refusal of epidural

[liveinhope100]

Have any women ever been refused an epidural? Can you request or book it in before you go into labour?

I want to feel as in control as possible leading up to the birth but know there are women who have requested an epidural many times and been refused then it’s too late. The worry this may happen is creating huge anxiety as even though I may not go for it in the end I just want to know it will definitely be available.

Any info on this would be appreciated

The only people I know who've been refused have requested one when they're 8cm+ so too advanced and it could impact their ability to push

Best of telling them as soon as they first check how dilated you are when you first go in.

4cm is ‘active labour’ I think and you go to labour ward/midwifery unit or midwives come to you at home.

Maybe ask them to monitor your cervix dilation more frequently to check how far along you are so as to not miss the window. If it’s your first though I think average is 18 hours active labour.

Hi OP. That happened to me and it still makes me angry. Midwives kept saying to wait then when midwives agreed I should have one the anaesthetist was in a surgery when she had previously been available to do it.

My second birth was handled by a different hospital who agreed there were several failings the first time around, not just the refusal of pain relief. I was assured that I could 100% have an epidural or other pain relief when I wanted it and I requested this to be put in writing into my notes and it was.

I actually ended up with a section for the second birth but I felt confident they would have given me the pain relief I needed the second time. I wasn't forceful or assertive enough the first time and as it was a difficult birth my husband was a bit shellshocked and didn't advocate for me as much as he should have done and he had a lot of guilt about that afterwards. I would say that it definitely helps to know what you want going in.

This was in Australia not UK but similar system.

Just agreeing with previous posters- one of the issues with my first birth was they didn't check dilation and didn't believe I was as dilated as I was. It was a induced and fast labour. They thought I was making a fuss over nothing. When the midwife shift changed one examined me and was shocked to find I was about 8cm and not coping at all with the pain. I didn't realise that having the dilation checked would have made a difference but can see now that when they were saying "you've got a long way to go" there would have been an easy way for them to check that!

I asked for an epidural and was told the anaesthetist wasn’t free so couldn’t have one and they didn’t have room on the higher risk side (as opposed to the midwife led side) so they had no room to accommodate me anyway. So I just had to get on with it.

The only reasons you wouldn’t get one is if there is no anaesthetist available at the time or if you were too far along that it wouldn’t have time to work before the babies born. I asked for one right at the end but it was too late for me, I was glad I didn’t have one afterwards though.

At night and at weekends there is likely to be only one anaesthetist available so unfortunately it can be impossible to provide. I only work nights so am used to trying to keep an eye on potential emergencies on the unit and providing info/timing accordingly. There’s a medication called remifentanil which is very quick to set up and very strong pain relief which could be an option for you. Also worth knowing that epidurals don’t always work very well and sometimes not at all.

I had to wait nearly four hours for my epidural, I was induced, had my waters broken at 2cm & contractions went from zero to 100mph in the space of 20 minutes, gas & air was useless, I couldn't sit or lie down, I was screaming the place down. I asked for diamorphine but was refused, it took a lot of bad language & my mum demanding for them to put me in the queue for the epidural. If you have to be induced, refuse to let them start unless the do the epidural first.

If you ask and they refuse, ask them to record it in your notes that's what happened, and ask to speak to the most senior midwife on duty. That might make them change their answer. Instruct your birth partner to do the same (in case you're not able to do it yourself.)

I was induced but by the time I asked for an epidural the anaesthetist was busy and then I was fully dilated. I ended up having a spinal because my son was delivered with forceps but it wasn’t the hospitals fault that I didn’t get an epidural, it was because I was certain I didn’t need one until the pain really ramped up!

I wasn't allowed one as my heart rate and blood pressure was too high.

I refused an epidural with my third baby, I hadn’t had one before and didn’t like the idea. It was a quick birth anyway, but I have been told since that epidurals slow the birth. I am not sure if that is correct.

Exactly the same experience as @upthewolves With my first. I was 10 cm before they checked. They refeused to check me and by the time they did they said I was too late for even gas and air.

@upthewolves I had the same thing happen to me, going by your username I wonder if you were at New Cross too?

I wasn't refused an epidural; I did get one, but they wouldn't let me have one until I was 4cm dilated, which I think is fairly standard policy. Unfortunately, I was in a lot of pain from 1cm onwards, and it took me a long time to get to 4cm.

I'm now pregnant again and was feeling very anxious about it, but have been told by my consultant that I will be able to have an epidural before 4cm this time, and can go straight to the consultant led ward rather than the midwife led one when I arrive at the hospital, regardless of how dilated I am.

My advice would be to be prepared to advocate strongly for yourself, both before and during the birth, and make it clear what you want. Read the NICE guidelines and please be open and honest with your midwife and ask if you can be referred to speak to someone else if you need to.

You may not need an epidural at all - I know lots of people who didn't. But it's good to make sure you are fully prepared and have all the information in advance, just in case.

I gave birth in Australia actually. But it seems to be a universal issue.

My midwife offered me a hot water bottle and a sick bag and told me if I was finding it this hard now I wasn't going to cope later so had to 'find some resolve'. She said that she was going off shift now and would see me when she came back on at 5. It was about midday at that point and I was climbing the walls. DD was born at 2 and I was probably in the transition stage at that point. I still get the rage when I think of her! The midwife who took over though was absolutely amazing and saved the whole experience for me even if she couldn't get me my epidural! It does just depend who you get but I think it's important to know what you want and drill your birth partner in HOW you want them to advocate for you. My DH was just pacing and crying by the end which was no use to me at all! He has since been forgiven!

Tell your midwife to put on your birth plan that you want one straight away that's what mines done because of how scared I am She said that I'd get one as soon as I got to the hospital so that I wouldn't feel any pain and wouldn't have to be waiting around for a long time

I've heard that midwives try and put people off epidurals because they require more specialist care and cost quite a bit.

I think if you have it your birth plan that you want one straight away and reiterate that on arrival you should get it. I was in on a busy day at a busy unit (on week day though) and hadn't initially wanted one but when I had been at 8 cm for hours and they put me on a syntocin drip to speed things up I requested one and I got it quickly (and they made sure I had plenty of gas and air whilst I was waiting). As it's your first birth it's less likely it will be too fast to have time for one. I don't want one this time but if things get complicated again I will request one - it was complete pain relief. Gas and air was also surprisingly effective.

I didn't want an epidural (massive needle phobia) but both times I was in labour I ended up asking for one. I was too far along both times for them to do one - first time they didn't believe I was as dilated as I was and second time I dilated very quickly (although they were getting me the paper work to have one). The midwife said to me it's often the case that just when you think you can't take any more pain you are very close to delivering. I know this won't always been the case but for me it was very true.

I think I must have terrified my midwife because she couldn't get me the epidural quick enough! 😂 I was induced and contractions came fast after my waters were broke and I had no breaks between contractions, plus back labour. She didn't even bother checking me because I told her if I don't get the epidural soon I would scream the whole birthing ward down. Of course I was extreamly embarrassed and apologising after I got it and she just laughed and said she's had 3 kids she understands lol. When she checked me right after I got it I was already 10cm and pushed baby out easy peasy. After 3 days in labour the epidural was my saviour! Although I was already 10cm when I got it I have no regrets at all

@CMAYF11

I've heard that midwives try and put people off epidurals because they require more specialist care and cost quite a bit.

I can honestly say that midwives care MUCH more about the woman being comfortable and dont give a toss how much something costs, rather than get a complaint about refusing analgesia!

Of course individual midwives aren't managing the budget and actively calculating costs before allowing epidurals but there is certainly a culture around epidurals which means that most women have to fight to get them.

This culture has arisen because, yes they are expensive. Mainly because it costs a lot to have enough anaesthetists available at all times, plus the extra time (which equals money)needed for midwives to do the extra monitoring required. A whole narrative goes with this, about how much better 'natural' births are ie. women who need them are weak and don't care about the risk to their babies.

There's a whole set of tricks and gas lighting that has grown up around this. I don't think that midwives do this deliberately or even consciously, but they do it. It starts with telling pregnant women they really should not have one because they are risky and unnatural. Then once in hospital women in labour are ignored when they report pain and say they think their labour has progressed. They are told they should be more resilient and that their labour can't possibly have progressed that quickly and could they just wait a bit until they check for dilation or whether the anaesthetist is available. Then, oh dear too late for an epidural now and maybe you were being a bit silly about it anyway. It was fine after all wasn't it?

No. It is not fine at all. I am still traumatised by this many, many years after this happened to me with both my labours. And any time a thread like this starts in MN (and there have been so many over the years) so many women report the same.

This has traumatised so many women.

Thanks for all the replies and sharing experiences. Helpful to know what to expect.

@martysouth I’m so sorry you are still traumatised by it all and for it to happen twice. I am assuming there is no way around it? Even if I put it on my birth plan it could easily get dismissed or ignored. I guess there is no guarantee they can offer it which terrifies me.

My friend had this and still suffers to this day.

Begged for a epidural when 5cm dilated -refused as "you are doing well without it" and screaming her head off and begging then 6 hours of begging for it was told "too far gone now"

Make it very very clear and make sure your birthday partner is not pushed over by midwives or doctors but gets what YOU want.