To epidural or to not epidural?

[jumperoo2738]

Second pregnancy here. My first birth was a vaginal water birth. Back to back baby. 27 hours (not pain that whole time but I was exhausted from the length)

I had pethadine and they broke my waters to help dilate. I definitely asked for an epidural at times! 2nd degree tear.

Once baby was here, recovery was okay (minus spd not disappearing straightaway!)

I opted for hypnobirthing and the birth centre because it was covid and hospitals were giving everyone a c section (in my nct group everyone had one but me) but I lived on the top floor of flats so I was realllllly trying to avoid that. So I was never anti epidural but you are forced to pick between the birth centre and hospital.

Second time round I'm intrigued by an epidural aka less pain. It will be my last child.

Other mums make comments like I'm silly as most people want a water birth which I completely get but doesn't mean it wasn't still hard! I wish I was anti medicine more as it would be easier.

Any insights from other mums? Some say an epidural really messed up their backs etc. Not having an epidural would hopefully mean a quicker recovery so I can get home to my first.

TIA xx

Could you give us said links on epidural migraines please?

Depends on where you go to the classes. Some places are awful at scaring mums. Ive had so many in tears afterwards for feeling like a failure for "giving in to an epidural'. I've had many anaesthetic mates attend nct classes to make friends predominantly and have listened to and had to correct grossly inaccurate information about risks of anaesthetics (in any format)

They don't prevent you from listening to your body as they don't numb sensation, only pain nerve fibres, so people still can feel the need to push, it just feels like pressure

Ive worked on 10 labour wards, I've spoken to hundreds of women, nct experience is incredibly variable by who runs the classes

I think the issue is often that because non-medics don't know what information they're being given is correct or incorrect it's harder to judge the accuracy of what are being told by the midwives (I know many a midwife that has v little idea of what we do). From anaesthetic mates that have done classes in different areas of the country they've often had to step in and correct medically inaccurate information

The over medicalisation of Birth is a well understood pattern that I wouldn't expect someone who passes out epidurals to understand.
Yes they are medically 'safe' but often not needed and whilst there should be no judgement on women who choose one there is also nothing wrong with empowering women to believe that they can birth naturally. Your ideas about NCT poisening women against pain relief is ridiculous. Without NCT or other such courses women would not have the knowledge to challenge NHS pressure to intervene in birth and would feel they have no choice but to agree to anything.
Personally I have been gaslighted and pressured into interventions by consultants enough times to know that the best route for birth is one where women are able to advocate for themselves. NCT is not the problem.
I see no point in engaging with you further. This is mumsnet not anaethetist net.

I wasn’t prepared to wait to see if I needed an epidural - how do you decide when you need one?

I couldn’t see the point of being in pain (apparently I have a high pain threshold but who knows) so wanted every drug available. An early epidural enabled me to have a good sleep, watch tv and give birth without any pain.

NCT was a disaster - I wanted a pain free birth, was going to use formula from day one and wasn’t going to be a SAHM. The NCT staff were useless.

OP, if you are still watching the thread. There is another pain relief option that may be available and might be worth exploring if it appeals. More and more units are introducing remifentanil PCAs - it's an ultra-short acting opioid given by a drip when a woman presses a button in time with contractions. Probably the group for whom it works best are multips who are predicted to have a fairly quick straightforward vaginal delivery and who might feel like a epidural's a bit much but want something other than gas and air. It's only used on labour wards, not MLUs and, just like everything else in medicine, there are side effects to weigh up against the benefits and it may not be suitable for everyone, but if it is an option it maybe worth thinking about (IIRC the labour pains website has a chunk of info about it as well as the other options).

@Parker231 you made the right choice for you then, if you decided you wanted a pain free birth.

Other women make different choices. I didn't want to give birth in a hospital with an anaesthetist there and the monitoring and restrictions which an epidural brings. I preferred to have non invasive pain relief and I was keen to be in water.

IME the NCT outlined all pain relief options in a factual way, but the focus of my classes anyway were relaxation, learning breathing techniques etc. If like you I'd decided from the outset that I wanted an epidural I'd have saved my money and not bothered with NCT. Horses for courses

I have no personal opinion of NCT and never went. I don't know why you are directing this at me.
We sound like very different people and I'm not engaging with this back and forth.

Am not specifically directing my comment to you - just making an observation on your post.

Unfortunately the NCT I went to wouldn’t include epidurals or formula feeding information in their classes. It was a non epidural and breast feeding only approach.

Right, so that’s why the NHS website says one of the side effects is that you may be unable to feel your contractions, have to be told when to push and this can often lead to instrumental intervention then is it? That’s just wrong? Because that tallies with many many women’s experience.

Look, I’m not saying epidurals are wrong or bad, but they’re not for everyone and there are down sides. As long as women have accurate information and can be empowered to make the best decision for them, that’s all good.

Also you can make out like non-medics don’t know anything, that’s fine. But in my experience (and evidenced by researchers like Dr Sara Wickham) hospital based obstetric teams and midwives can be quite poor at understanding physiological birth - they are biased towards interventions and see the worst case scenarios, giving them a skewed idea of how risky or dangerous birth is and/ or how much is needed by way of intervention. My homebirth team midwife said she wishes hospital obstetric teams had to witness a certain number of homebirths per year because they just often don’t trust women to be capable of giving birth.

Anyway this thread isn’t for this debate. As I said, if women are getting good quality information and are empowered to make the best decisions for them, then that’s great. That doesn’t mean pushing anything on them - epidural or not.

The operative word is "may". Epidurals are patient controlled. If you click it on the 20min, bang on when you are allowed another dose, then yes you may be pretty numb. But having done 9y of labour ward its incredibly rare to not be able to feel your contractions at all.

If you come to theatre then yes the anaesthetic dose of an epidural will completely numb contractions hence rely on the midwives telling you when to push, but if you just have a labour epidural then you are entirely in control. Want to be less numb? Stop pushing the button, "problem solved" your contraction pain will return. Midwives often tell people not to click and top themselves up in the later stages of labour for this reason.

I haven't said that non-medics don't know anything, don't twist my words. I said they don't have rhe knowledge of someone that has done 5 yrs at uni and countless years as a Dr, I'm pretty sure that isn't up for debate

Don't dispute that, I've only seen 2 normal deliveries since I was at uni, and probably about 2k csections and forceps so yes we are skewed as we only see LW when things don't go to plan or very wrong. So yes youre very unlikey meet an anaesthetist that deliberatrly home births, doesn't mean that's not great for those that want them

It sounds like part of the problem is variable levels of competence, which is unfortunate. My own experience of NCT was excellent. The marketing about classes was quite upfront: it was clear that while factual information would be given about all methods of pain relief and delivery, the focus would be on aiming for non invasive pain relief. I knew what I was buying into and it was great.

Sadly, competence isn't always at the same standard in many roles: the same is true of medics and any area of workers really.

It’s clear that some women want an epidural, that's their intention and if I were one of them I wouldn't go to NCT classes because I wouldn't see the point if I was aiming for a medicalised birth. Ultimately all women are not the same. Some may plan an epidural from the outset, some may plan a natural birth but then want an epidural when in labour, some may decide against one from the outset.

100%. You have no idea what the pain of labour is like as a 1st time mum so knowing all the options is the best way to approach it. All my medical mates even ob&gynae drs still do nct as the breathing exercises are really helpful (I use it a lot with patients that are either panicking or can't focus due to pain), but also to find local people as a support network

I had epidural with my first (induction).
Wanted it with my second, but things happened way too fast - went into with little, uncomfortable contractions at 4cm. They got me a bed, and 20 minutes after my water broke, I felt the need to push.
Gosh, the pain! My labour was straightforward, but I never even imagined feeling that kind of pain.
I would definitely go for an epidural.

I hate when people say, "Women gave birth without painkillers for tens of thousands of years." Sure. Just like people before modern healthcare, removed teeth and chopped off legs.
Would you tell someone whose teeth will be removed to "don't get any medication" for it? I don't think so.

I didn't plan on getting an epidural with my first labour, but I was induced and my son was back to back, so the contractions were irregular and there were no breaks. I got an epidural at about 9cm and honestly would have married the anaesthetist. I got to rest and nap for an hour with a peanut ball between my legs to keep my pelvis open and encourage the baby to finish turning fully.

My epidural was great, it was on a pump and I didn't do anything with it. I could move my legs throughout and I could feel some pressure etc. but no pain. My son was born in 7 pushes across 2 contractions. I remember when his head was born I could still feel quite a lot but no pain, and being so grateful for the epidural. It was such a positive birth experience.

I'm pregnant now and will definitely be asking for one this time too!

I think the point is that a lot of women don't view childbirth in the same way as a medical procedure is needed because of some disease or injury, such as needing teeth pulled out or a limb amputation.

I would have pain relief if I needed surgery; I didn't want it when giving birth because I didn't view it in the same way.

Nothing wrong with wanting it to be pain free if you choose, but for many women, childbirth is not something they want medicalised