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08/12/2013 at 21:32
Just pondering. I've been surprised at the general negativity towards them in the UK, and considering the statistics for assisted delivery and emergency Caesarian are about the same in the UK as in Canada and the States where epidurals are far more widely used, I'm a little flabbergasted.
So, what are your thoughts on epidurals? Are you pro or against? And why? is your stance based on personal belief, advice from midwives or doctors, Internet forums like this or mumsnet, personal experience of those close to you (or you), medical journals or studies, books, etc?
Do you feel that the information and data needed to make theses types of decisions is made readily available to us during pregnancy?
i do have a definite stance on this, and you might guess which way I lean, but I'm really curious to hear other views.
08/12/2013 at 21:37
I didn't have one for either of mine (only because there wasn't time!) but I heard it said somewhere that you wouldn't have a tooth pulled without getting it numbed first! I thought this was quite a good analagy (sp?) I went into both of my deliveries with an open mind and if I did need one I wouldn't beat myself up about it. I think there's a lot of pressure for women to do it without an epidural - I'm not sure why.
08/12/2013 at 21:41
08/12/2013 at 21:46
I wouldn't let somebody amputate my arm without anaesthetic....
My instinct is I want one, but need to do more research as not something I've ever looked into in detail as it didn't affect me personally until now.
Wispa - i think in UK there's an attitude which is generally a little anti-pain relief etc when it comes to giving birth which isn't something I understand. Not saying I've seen any of that on here but have heard other people talking about it generally.
08/12/2013 at 21:56
I did NCT classes and was led to believe that there is a chain of intervention, where once you start things are more likely to go down that route. So if you have an epidural you are then more likely to go on and need further interventions. I will admit that i didn't do personal research in to it but it is something that I had often heard quoted. When going in to my first birth I was very much of the mindset that "my body can do this", I was planning a home water birth, had been to pregnancy yoga, everyone and everything around me was very much of the natural birth mindset.
As it turned out my body couldn't do it :lol:
Second birth I chose an elective section, but I had considered a VBAC but one of my stipulations was that I would want an early sited epidural not so much for pain relief at the time, as to be honest with my first labour where I got to 9cm dilated I found that the pain wasn't unbearable and being in water was amazing, but to avoid having another general anaesthetic if I required an emergency section.
08/12/2013 at 22:03
MamaD, if I'm lucky enough to have quick labours, I will be in your boat, but if not... Open mind :)
AR, the attitude towards epidurals in the UK means that far far fewer women have them here (25-30% in UK, closer to 90% in Canada/the United States), but the statistics of assisted deliveries don't correlate. I find it difficult to believe that the numbers are not skewed by the fact that the majority of births with epidurals In the UK are already long and difficult labours, which are precisely the kind that would end up with assisted delivery even without the epidural. I'm not saying I plan to rock up to the hospital as soon as I'm in active labour and demand a catheter in my spine, haha, just that I'm not sure they're as evil as they have been painted in the UK.
CJ, I like the analogy, though I suppose you wouldn't be worrying about the health of your amputated arm (that being said, there aren't any real risks to baby associated with epidurals, unless you count the possibility of being given antibiotics when they might not be needed).
Jelly, that's an interesting point about emergency sections and having the epidural in place, I hadn't considered that..
08/12/2013 at 22:17
I’m not going to plan to have one, but if I end up needing one due to a long/difficult labour where I physically haven’t got the energy to continue then so be it. Whatever gets baby out safely :)
08/12/2013 at 22:20
Wispa, generally even with an emergency section they have time to put in an epidural and there are generally earlier indications that things aren't going to plan. Mine was all rather dramatic and there just wasn't time. I know from the consultant that they don't do GA sections too often at all, but having had one then the most important thing to me second time around was being awake. If the way to guarantee I was "there" when baby was born was to have an epidural then that was what I was going to do.
08/12/2013 at 22:21
I don't have strong feelings about them either way, but I also haven't come across the 'epidurals are evil' attitude. I have heard you're more likely to need assisted delivery as they can make it harder to push, feel the contractions etc, and I also wonder if a contributing factor also is because you can only have epidurals in labour wards, rather than MLUs/birth centres/home where there is a higher percentage of 'normal' births. Regardless of this, I'm not against requesting an epidural in the least when I'm in labour if it's needed, but at the same time I would prefer to go without because epidurals do carry significantly more risks than other pain relief options- but then again they are the most effective so swings n roundabouts I guess!
Interesting stats, I had no idea the number of epidurals was so high in America/Canada.
08/12/2013 at 22:24
08/12/2013 at 22:27
08/12/2013 at 22:29
I'm having trouble pinning down the actual rate of assisted deliveries in the US, though. My internet is being slow at the minute. From the looks of things it might be as low as 5%! That is amazing considering in the uk it's 13% of all vaginal births and in Canada it's 13.1%... I'd be interested if anyone has the answer?
08/12/2013 at 22:33
08/12/2013 at 23:05
I'm wondering if maybe comparing nhs to the us healthcare system might be problematic.. Maybe I'll stick with Canada, which at least has a similar gov-funded system, and they do have double the rate of epidural use compared to the UK, as well as a remarkably similar assisted delivery rate. And even within Canada, the province with the highest epidural rate (Ontario) has a lower assisted delivery rate than the western provinces, which have the lower epidural rates.
Looking again at the difference in the systems, though.. In Ontario only 10% of vaginal births are overseen by a midwife! the rest are with an obgyn, but I'm not sure what real difference that makes as the doc would really only be in the room for the second stage of labour! and the fact that the assisted delivery rates between the two countries is basically the same makes me think that it doesn't make a difference,
Oh, but there are real risks with epidurals.. Raised temperature is one. And since doctors won't know whether it's just due to the epidural or if you have an infection, your baby might get antibiotics after birth. And the limits to position, but then with mobile epidurals you can adopt an assisted squat, or stand with one leg up, lie on side, etc. it's not all just lying prone on your back...
And of course, you've got to wait for the anaesthetic to wear off. However, you can request they lower your dose prior to pushing, or stop it altogether, which would limit this effect at least somewhat.
08/12/2013 at 23:09
CS rates in the US are 30% compared to 22% in the UK, good call, AR!
09/12/2013 at 06:33
09/12/2013 at 06:45
I made the decision with my first that I wanted to give birth in a MLU where epidural wasn't an option. Having had active birth classes through the nhs I was confident I could get baby out without the need for one. As it happens I was lucky in that my labour was v v quick and I wasn't in pain....a few puffs of G&A sufficed. I wouldn't be 100% against BUT for me the risks we learnt of, plus those I knew in advance (my friend lost a lot of feeling in her legs for good after a mis-sited epidural) meant I wouldn't have opted unless completely necessary to get me through.
I will be taking the same approach this time x
09/12/2013 at 07:18
Tbh I think if you want one/need one then have one. There is no prizes for doing it without any form of pain relief and I do tend to think when people go on and say o I had nothing, that they are looking for some sort of praise/pat on the back (not anyone here but I remember being at baby groups and some people were very quick to tell you how they did it all with no pain relief, which is great for them but to me its a bit like rubbing your face in it when you needed a crash section under general anaesthetic and a short HDU stay due to a mw f*ck up!). When really, their baby has just been in a good position and been ready to be delivered (ie no distress etc)
Put it this way if I'd have had an epidural with my first I wouldn't have needed a category 1 section under general anaesthetic, as I'd have already had an epidural, I could have been taken to theatre to see my first baby being born, rather than having to be intubated!
Epidural arent offered straight away, you lead up to them so its often given in long drawn out labours which do often lead to intervention, so I don't think its the epidural per say that leads to intervention, I think its the situation. We all know that there's more intervention nowadays, if there wasn't then we would be back in the Pre war years with lots of maternal and neo natal deaths.
09/12/2013 at 07:39
If I was having a procedure and had the choice between GA and local I'd go local, because I want to know what's going on and don't like the idea of being detached from my body in that way. That's how I feel about an epidural. I want to feel the contractions and want to be as engaged and active in the birthing phase as possible, so an epi doesn't appeal. If that route isn't looking likely and the pain is unbearable etc etc then I'm sure I'd be open to it/begging for it!
09/12/2013 at 07:40
Before I had my first baby I was pretty sure I was going to need an epidural as I thought I had a low pain threshold and would faint at the drop of a hat although saying that I was still just going to see how it went and have one if I couldn't cope. Turns out I actually have really quick labours and therefore no time get an epidural anyway. Daughter no 1 born an hour after arriving at hospital and no 2 born 40 mins after getting there.
I was completely open minded as someone else has said there are no prizes for doing it without pain relief.
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