[globetrecker]

Okay, this is a little premature and I'm not expecting a baby ... yet;), but I had a conversation recently that freaked me out (a little). I live in Thames and was told by the hospital that no women are allowed to get an epidural for the birthing pain and I quote, "It is just not done here in New Zealand and frankly, midwives frown upon giving an epidural for pain. You will not get one here." I thought that sounded pretty crazy. After asking around a little more, I found that most women in NZ actually do get an epidural for the pain (why not IMHO:D) It's just the rural hospital midwives that frown upon it, but most women in other hospitals get it if they want it. Nice! :)

Although not pregnant yet, I've heard people in this area really need to plan far ahead and get things sorted as early as possible. So, does anyone have any experiences or suggestions for having one at either Waikato Hospital in Hamiliton or Auckland?

[JandM]

My d-i-l had the grandchildren in the Waitakere Hospital in Auckland - good care, good experiences. This link also talks about some other places. http://www.waitematadhb.govt.nz/SecondaryHealthServices/ChildWomenandFamilyServices/MaternityServicesatWaitakereHospital/tabid/172/Default.aspx

[KatieBen]

Will ask around at work (one of my colleagues has worked at Waikato recently) but whatever you were told, patients can and do receive epidural analgesia for labour.

Nelson (where I work) is counted as a rural hospital and if you want an epidural, all you have to do is ask for one. Make sure it's well documented in your birthing plan that you would like one and make sure you mention it at your booking visits with GP and midwife. If necessary, ask around and make sure you have a supportive midwife who is happy and competent to look after patients with epidurals in situ.

There will be an anaesthetist on call 24/7 (trust me, the last 2 epidurals I sited were at 0300 and 05:30 respectively - for some reason I always get them in the middle of the night!) in any hospital offering obstetric services.

I get *REALLY HACKED OFF* when women are informed that their choices for delivery will not be acceded to - this is the 21st century, you do not need to be in pain for labour any more than you need to be in pain after surgery. And if some smart arse tries to tell you that pain during birth is natural - well, so is pain after an open abdominal operation but we put epidurals in for those!

Edit - sorry, got a little hot tempered with the suggestion that "it's not done in NZ / you will not get one". Some people don't need them during labour, everyone has different pain thresholds and different coping mechanisms. Some women are fine on nothing, some are fine on gas & air, some women need epidurals - go into it with an open mind, but make sure if you think you might want one that you mention it early on.
(Anaesthetist who had brilliant delivery experiences with both of the gorgeous boys - and a very good epidural each time. I'm a wimp ;) )

[globetrecker]

Whew. Thanks for the response! I'm much more at ease knowing that there is the option, just not in this particular rural hospital. You're right, there really is no reason to be in unnecessary pain and if you want help, you should get it, not be told that you'd not get it even if you begged!

I'd be interested in hearing from anyone with great experiences. I think Auckland is a little closer and on better roads than Hamilton.

[sophiedb]

Just putting my hand up to say that for me, labour without an epidural was fine. Ok, it was painful and there was a little growling involved, but not that bad that I wouldn't consider doing it again :D

(the fact that it didn't complete put me off another child leads husband to presume that labour is therefore less painful than a kick in the goolies *head!desk*)

[movergroover]

get *REALLY HACKED OFF* when women are informed that their choices for delivery will not be acceded to - this is the 21st century, you do not need to be in pain for labour any more than you need to be in pain after surgery. And if some smart arse tries to tell you that pain during birth is natural - well, so is pain after an open abdominal operation but we put epidurals in for those!

Edit - sorry, got a little hot tempered with the suggestion that "it's not done in NZ / you will not get one". Some people don't need them during labour, everyone has different pain thresholds and different coping mechanisms. Some women are fine on nothing, some are fine on gas & air, some women need epidurals - go into it with an open mind, but make sure if you think you might want one that you mention it early on.
(Anaesthetist who had brilliant delivery experiences with both of the gorgeous boys - and a very good epidural each time. I'm a wimp ;) )

Not a whimp (had one ) and totally agree, your choice.........:wah

I must admit whilst doing some research on NZ i believed that you couldn't get epidurals for childbirth. Also this was NZ midwives saying this.

Kinda believed all this!

[Flutterby]

well i wouldn't bank on an epidural even if you do plan on it, some babies just come far quicker than expected and theres no time for an epidural.

[GrumpyGoat]

well i wouldn't bank on an epidural even if you do plan on it, some babies just come far quicker than expected and theres no time for an epidural.

Agreed!
I had my 2nd child in an ambulance on the way to a hospital. Twenty minutes from water breaking until birth!!
I held her in as long as I could trying to get to the hospital. The natural way was easy really. Just push that baby out fast and the pain goes away.

If we do have another child, OH is going to read up on delivering children. If each child comes faster than the last, I may likely deliver at home.

[Ana&Steve]

my sis was in painful labor for hours. The Dr finally ordered an epidural even though she was barely dilated; the baby was born within an hour! The explanation was that the amount of pain she was in was actually stopping her body from progressing.

[GrumpyGoat]

my sis was in painful labor for hours. The Dr finally ordered an epidural even though she was barely dilated; the baby was born within an hour! The explanation was that the amount of pain she was in was actually stopping her body from progressing.

It has occurred to me that I am very lucky. (if you call big hips lucky)

[Flutterby]

i managed to last almost an entire 60mins from breaking waters to birth, but when you factor in a drive to the hospital, waiting for a room, and the midwives doing their thing that doesn't really leave much time for finding the anesthetist etc unless you demand it the moment you walk in the door LOL

[YouMeAndThree]

I've never been allowed one, due to problems with my blood whilst pregnant. Would also not be allowed a local anaesthetic either, so I'd have had to have GA if a c-section was needed (my biggest fear about giving birth). Thankfully I got by on G&A each and every time and one with a little pethidine thrown in too.

I did have one very mean midwife whilst in labour with DD1. She told me I couldn't have any pain-relief or sleeping tablets (which one midwife had gone to get me, but got called away to an emergency). "I like to see my ladies in lots of pain before I hand anything out"............nice!:exit

[Flutterby]

i bet you are glad she got called away to an emergency!

[Jo Jo]

My understanding is that epidurals aren't available in Thames hospital because it only has a primary birthing facility (i.e. midwife-only, non-medical, facility). The new birthing facility is due to open some time in the next few months, but it will still be a primary birthing facility, so presumably no epidurals still, but at least labouring mothers will be able to suffer in nicer surroundings!

Most people from this side of the peninsula go to Hamilton to give birth, I think mainly because it is in the same DHB, (though we are more or less equidistant from Hamilton and Auckland), and I've been told that many of them actually go to stay in Hamilton for the last six weeks of pregnancy to avoid having to travel over the Kopu-Hikuai road during labour!

I think your choice of LMC will affect where you can give birth as well, so that's something to check out (you can get a list of LMC's from your doctor).

[Mrs Pony]

Sorry for the slight hijack here...

I've always wondered where exactly the epidural goes in the back. I only have the last 5-6 vertebrae that aren't fused to...adamantium... So when the time comes, would I even be able to have one? I sure hope so!

[Joolzr]

I had a baby in Auckland and was really impressed by the care I had at the hospital. I also did an antenatal course at Birthcare (the maternity hospital most people transfer to after the birth). They were quite pro 'natural births' and anti epidural. But at no point was it suggested that we would not be able to get one if we requested it. They did even suggest that if we were totally stressed out by the idea of a normal birth, we would be able to find someone who would give us a C section.

Out of the 8 girls in my class, two of us had C sections, and at least one had an epidural. But the others managed without using water baths and gas and air. So you may find you don't need one. But I agree it's a good idea to have the option!

I had a great Dr- PM me if you want his contact details.

[lindreth]

This is a very timely thread for me, being 13 weeks pregnant and doing lots of investigation on this topic!
down in Christchurch, only one birthing option offers epidurals (Christchurch Women's) and that is because (according to our LMC) it is the only tertiary care hospital. I'm told that anyone can choose to give birth there and to have an epidural if she wants, but that the beds are primarily for women who need special care, so you may get booted out as soon as your baby arrives and transferred to another hospital.

I have never been pregnant before and had always thought that epidurals would be handed out like lollipops when the time came, so this news came as a shock to me! I've been doing more reading and talking with other women and now think I may try to go without. Our LMC (that's Lead Maternity Carer for those not in the know...) is very supportive of natural birth but I don't get the feeling that she'd think less of me if I asked for an epidural. She's made it clear that the choice is mine. There certainly seem to be advantages to foregoing the drugs, but that's probably a discussion for another forum!

lindsay

[Park City Partner]

I had my daughter at North Shore hospital. I was going to have a c-section due to a low lying placenta. I was seeing a specialist as I was having an IVF baby and wan't all that familiar with mid-wives at the time. My water broke at 35/4 and I went into labor at 9:30 pm! So not the plan! I had my baby via c-section the next morning. I too was worried about the spinal as I had back surgery on L4/L5 and other disks in that area was screwed up. It all went fine and I fell in love with the guy that did it because that whole labor thing is totally over rated in my opinion! I wasn't prepared for it and I didn't handle it well....and as far as I could tell she was headin' out the other way and had to be pulled back! No one ever checked how far along I was (for medical reasons) but I am guessing it was pretty far along. I was very pleased with my doctor and North Shore hospital. I got great care. I also had huge problems breast feeding and was pleased that I didn't encounter any BF Nazis....

Oh, and welcome to you from Salt Lake from a Park Cityite! Small world.

[bob_the_engineer]

I’ve never given birth, no intention of doing so lol,,,,,,,,,, but some things confuse me a little about NZ and birth.

I’ve heard this (I know a lot of people in healthcare)

Some procedures can only be carried out by doctors ( I think an epidural
may be one, although I’m not sure).

Not all places where people give birth have doctors.

Midwives get a reduced fee if an intervention by a doctor is needed.
Does that mean that it’s in the midwives financial interest not to give you an epidural? (Although I’d like to think nobody is that mercenary, it’s just IMHO a situation that should not exist)

I find it quite frightening to think that you can give birth without access to a doctor, the thing that frightens me most is the classification of risk, if you have never had a problem giving birth then your low risk, that’s all the first time and medically unknown mums!

I’ll share my plan with you, I’ll be hiring a doctor to take care of my wife when the time comes, she will have the baby in a hospital with access to emergency C-sections O&G doctor’s, Paediatricians and any other advantage that modern medicine has to offer and that includes an epidural).

Let me share an experience with you, one that shaped my views on child birth and the entire natural thing. While at uni a friend (a newly qualified doctor) was sat watching TV with me. It was “midwives in action” or some similarly named idiotic programme.

This woman was giving birth at home, her sole assistance was the midwife. All very nice all very natural! Anyway there was a problem, the baby got into trouble, its heartbeat began to drop, they called it distressed. The baby began to die. My newly qualified, very green doctor friend was jumping up and down in her seat actually shouting at the TV “ roll her, roll her for god sake roll her the baby has trapped the cord its going to die!!”

The midwife looked confused then after waiting a while called in a senior midwife. There was quite a wait until the senior midwife turned up. By the time the senior midwife arrived my friend was actually biting her own foot and swearing at the midwife on the telly!

I thought it was all very funny, I thought she was over reacting! Newly qualified enthusiasm and all that.
Then the senior midwife turned up, rolled the mother around to release the cord and ran her off to hospital with the baby in distress.

I remember thinking this is a qualified midwife, qualified enough to take on a sole home birth. It’s a good job the more experienced midwife turned up in the nik of time!

My poor friend was actually in a real state by this point, she looked at the TV and said “if the mother understood what just happened, that midwife would be in court tomorrow! “

She turned off the TV, shook her head and that was that.

It left an impression on me. that was in the UK.

One more thing to add, do you know that a chemical is released into a woman’s brain AFTER childbirth so that she forgets the pain (quite cruel IMHO). Logically I’d say never take advice about pain relief from a woman who has given birth, she doesn’t remember the worst of it, look at a film of a woman giving birth and head for the drugs cabinet…

Bob

[James 1077]

I also wouldn't let a midwife anywhere near OH without a doctor present! My cousin almost lost her first child after the midwife didn't figure out the placenta had detached at 31 weeks (even though my cousin had all the symptoms of detached placenta). By the time the baby was born the placenta was virtually non-existent and my cousin's baby weighed almost nothing. She is still very small but, luckily, seems to be healthy.

When OH was pregnant with our twins we were consultant led from the start (even before we knew we were having twins). It cost a lot but I wouldn't have it any other way!

[sophiedb]

My understanding is that epidurals aren't available in Thames hospital because it only has a primary birthing facility (i.e. midwife-only, non-medical, facility).

Yes, we have something like that here too - the maternity ward in the next town's hospital is midwife-led only, so if any medical intervention beyond gas & air, ventouse and/or forceps is needed they get sent by ambulance the hospital nearest to us. There they have midwife-led unit, and a doctor-led - I was aiming for the midwife-led birth, but DD was difficult so ended up going up the corridor for the final stages.

[Familyofmonkeys]

I find it quite frightening to think that you can give birth without access to a doctor, the thing that frightens me most is the classification of risk, if you have never had a problem giving birth then your low risk, that’s all the first time and medically unknown mums!

Statistically it is just as safe to have a planned homebirth after a normal pregnancy. Most of the time problems that occur such as failure to progress etc allow plenty of time for transfer to hospital. Of course there are extreme cases when this is not the case, but for most people with 'normal' pregnancy the risks are very low, which you can balance against other risks in hospital such as the risk of the baby contracting infections etc.





I’ll share my plan with you, I’ll be hiring a doctor to take care of my wife when the time comes, she will have the baby in a hospital with access to emergency C-sections O&G doctor’s, Paediatricians and any other advantage that modern medicine has to offer and that includes an epidural).

And how does your wife feel about this? Would you support her decision if, when the time came, that she did not want this for herself? Or would it become an area of conflict and stress for her?
It is quite possible that your wife shares your views, but in cases where the woman does not have full support for her wishes and an anxious birth partner, it can stress the woman during labour and heighten her experience of pain, putting pressure on her for medical intervention....and my understanding is that in some cases this can actually cause the baby to become distresses.




This woman was giving birth at home, her sole assistance was the midwife. All very nice all very natural! Anyway there was a problem, the baby got into trouble, its heartbeat began to drop, they called it distressed. The baby began to die. My newly qualified, very green doctor friend was jumping up and down in her seat actually shouting at the TV “ roll her, roll her for god sake roll her the baby has trapped the cord its going to die!!”

The midwife looked confused then after waiting a while called in a senior midwife. There was quite a wait until the senior midwife turned up. By the time the senior midwife arrived my friend was actually biting her own foot and swearing at the midwife on the telly!

I thought it was all very funny, I thought she was over reacting! Newly qualified enthusiasm and all that.
Then the senior midwife turned up, rolled the mother around to release the cord and ran her off to hospital with the baby in distress.

I remember thinking this is a qualified midwife, qualified enough to take on a sole home birth. It’s a good job the more experienced midwife turned up in the nik of time!

My poor friend was actually in a real state by this point, she looked at the TV and said “if the mother understood what just happened, that midwife would be in court tomorrow! “

She turned off the TV, shook her head and that was that.

It left an impression on me. that was in the UK.



In most areas of the UK (not all) there are generally 2 midwives present towards the end at home births in case of emergency....one to deal with the baby and one to deal with the mother. I think the arrangements are pretty similar in many areas of NZ.

And you are right.....the midwife doesn't sound that competent as cord issues are pretty common. Generally if there are signs of a baby in distress, unless birth is absolutely imminent an ambulance would be called for transfer to hospital.



One more thing to add, do you know that a chemical is released into a woman’s brain AFTER childbirth so that she forgets the pain (quite cruel IMHO). Logically I’d say never take advice about pain relief from a woman who has given birth, she doesn’t remember the worst of it, look at a film of a woman giving birth and head for the drugs cabinet…

Bob


Your body also releases endorphins during unmedicated labour, which can for many people make it less painful...in some cases quite chilled out and sleepy (personal experience here). A persons state of mind during labour can have a huge effect on how well you are able to tolerate the pain, woman who are stressed and anxious will often feel more pain rather than relax and let your body do what it is supposed to.

I also don't entirely buy into this forgetting about the pain business.....yes it's hard to actually imagine the physical pain afterwards, but you can still remember your thoughts and emotions from that time. Why else would many of us go back for second go...and a third one etc.....

[Mamee & Co]

It all went fine and I fell in love with the guy that did it

Park City, I second your emotion here. I wanted to kiss my anaesthetist. (Katie, does that happen to you often???) It was immediate relief. I could have fought against an epidural and laboured to about 5cm without, but being a twin Mum was advised that this was safest for me...and was a blessed relief...though I swore when they told me that the first anaesthetist was taking off in the helicopter I could here outside the labour ward window with a bad head injury case.

From what I am reading here the care is very similar to that which would be expected in rural areas in Scotland. In the midwifery units there are quite stringent criteria for delivery to ensure safety and you have to meet these before you can deliver there..but no epidurals either.

I think at the end of the day it is a personal choice for the woman in labour....and the best laid birth plans are subject to change. I remember after chatting with friends starting mine with "I want as natural birth as possible...until I change my mind!"

[sophiedb]

A persons state of mind during labour can have a huge effect on how well you are able to tolerate the pain, woman who are stressed and anxious will often feel more pain rather than relax and let your body do what it is supposed to.

This. Epidurals (and other drugs) during delivery can make babies sleepy and unwilling to nurse. C-sections are major abdominal surgery that make the first few weeks quite awkward. Both can be an excellent solution to a very sticky solution though, I am very happy to acknowledge that - I know several people who owe either their or their babies lives to such interventions.

My problem is with people who opt for medical interventions without waiting to see whether a normal labour will work for them. Our society has gotten into a state where many seem to think that anything involving blood needs a doctor, expecting a risk when none has been detected, when babies have been being born for thousands of years.

(and yes, maternal death was a huge risk once upon a time, but that was in the days of fever, unpatched bleeding, etc etc - rare today, in the developed world)

[Kanga]

Bob- I see where you're coming from with your anecdote but I am certain there are as many bodge-Doctor stories out there in relation to birth as midwife ones, so lets not bash midwives, who on the whole are incredibly skilled, knowledgeable professionals.



My problem is with people who opt for medical interventions without waiting to see whether a normal labour will work for them. Our society has gotten into a state where many seem to think that anything involving blood needs a doctor, expecting a risk when none has been detected, when babies have been being born for thousands of years.

Do you mean the medics opt too early or the women? If you mean the medics then I think there's some truth in that more often than is OK. If you mean women, then I think choice is the key for me. Birth floats some people's boat, but not others. I got very annoyed with the NCT during my second pregnancy because they practically told my ante-natal group that birth was a right of passage for women. It isn't, it's one day- it's the next 60+ (hopefully) years that define you as a parent. Ditto breastfeeding- I did it for quite a while with both and think it's a good thing to do but I couldn't give a crumpet if my kids/friends/sisters choose to do it or not.

[sophiedb]

Do you mean the medics opt too early or the women? If you mean the medics then I think there's some truth in that more often than is OK. If you mean women, then I think choice is the key for me.

Medics, yes - I think some feel more in control when a situation is regulated by something that has been studied, measured and analysed to the nth degree rather than giving a woman the chance to choose. Maybe that's partly because I hate anyone telling me what to do, or worse, what they will do that effects me without really consulting me.

A little with the women too though, in an inadvertent way. I did the local NHS and NCT antenatal classes (overkill, I know) and was shocked by how little info was contained in the NHS classes. This is going to sound awful, but I'm guessing you know how the NCT is: mostly white, mostly middle class, mostly well educated and more likely to try to maintain control, ask questions etc. Of course they also have something of an agenda going on, but at least you can leave those classes knowing that you've been informed and can delve further with greater confidence.

The NHS classes, on the other hand, just talked *at* you and made irritating comments like "25% of you will have a c-section". It was almost a case of "bish bash bosh". I suspect that few of the women attending those classes made any attempt to look into their options following the class, few will have made a birth plan, and so few got the chance to exercise their right to make an informed choice about how their labour will progress. I could well be wrong, but there was a definite difference in how women attending each class were treated/respected, how motivated the teacher was, and the quality of handouts.

(money money money...)

[Flutterby]

i can't comment on NCT because i never went to those but the NHS classes did cover a lot of stuff for me allowing me to make an informed decision, however it was all too little too late with the classes being sceduled to finish on my due date leaving no time for a birth plan to be communicated, having said that, most people who attended did have a birth plan before their babies were born and felt that they were able to make an informed choice.
i turned up at the hospital in labour to be greeted by the midwife saying "i didn't know that you wanted a homebirth" but by that stage it was too late to even correct her.

So i'd stress that not all NHS classes are of the same quality, but there are other administrative errors going on sometimes.

is there a moral here? umm do lots of your own research well in advance, don't rely on others.

[dharder]

I got very annoyed with the NCT during my second pregnancy because they practically told my ante-natal group that birth was a right of passage for women. It isn't, it's one day- it's the next 60+ (hopefully) years that define you as a parent. Ditto breastfeeding- I did it for quite a while with both and think it's a good thing to do but I couldn't give a crumpet if my kids/friends/sisters choose to do it or not.

Totally, absolutely and utterly agree.

I so absolutely don't care how much pain relief anyone had, or how little, or where they had the kids, if they breastfeed, whatever. As time moves on and the kids get older, those things become less and less important anyway.

My mother came to see me in hospital when I had the girls and was shocked at the state of it. I told her that this is a week out of my life, the most important part is still ahead of me, I have healthy kids and am fine. What do I care if the recovery room is graffitied like a bus stop, the agency nurse is from a far away country and on her very first shift in the NHS, or that I have to bring pretty much everything myself, including disinfectant.

We just had my older kids' 10th birthday, and 10 years ago to the day I was in above mentioned hospital, totally out of my depth with two little babies, no help from the nurses to speak of. I didn't have a good time, and can't say this whole birth experience particularly impressed me. But I think whatever it's like, if you get a healthy child (or two) and a healthy mum out of it, you'll be fine :)

Daniela

[Sam B]

It's hard to appreciate how wonderful that piece of perspective from Daniela above is when you are on the pre-birth side of the fence, but it is SO true. You stress and angst and worry about the birth and early days when really the hard work begins a few months later, just like emigrating really.

I am sure there are just as many incompetent doctors as there are midwives. I had a home birth 2nd time round. The midwives were very able and when things went badly wrong (haemorrage) they acted speedily to ensure that I got to hospital in time. I felt very safe with them. A very tired junior doctor practised her stitching "skills" on me first time round. 'Nuff said.

[Tia Maria]

Totally, absolutely and utterly agree.

I so absolutely don't care how much pain relief anyone had, or how little, or where they had the kids, if they breastfeed, whatever. As time moves on and the kids get older, those things become less and less important anyway.

But I think whatever it's like, if you get a healthy child (or two) and a healthy mum out of it, you'll be fine :)

Daniela

Totally agree. Too much pressure and guilt is put on parents to do things the 'right way' or the 'trendy way' or just the way that the current health professional in the room says is the way it should be.

For many women the thought of childbirth is very scary and being surronded by people who support you rather than those that believe there is only ever one way to do it, can make the whole experience so much better.

Give yourself plenty of options, do your best, do what works then move on to the next challenge - there will be plenty of them.

Cheers

Tia

[Paul]

Just putting my hand up to say that for me, labour without an epidural was fine. Ok, it was painful and there was a little growling involved, but not that bad that I wouldn't consider doing it again :D

(the fact that it didn't complete put me off another child leads husband to presume that labour is therefore less painful than a kick in the goolies *head!desk*)

Yes my wife didn't with either of ours and therefore I have come to the same conclusion as your husband, especially having had the "surgical" kick in the goolies so we don't have any more little ones, recently. Not quite gone to plan and I am still in discomfort 3 weeks later therefore I win as she only did 30 hours labour......... :):exit

Advantage of not having drugs seems to be the recovery time is better immediately after the birth and you can go home within hours if all goes OK.

Personally just because something is available doesn't make it the right thing to do. For instance there are too many C-sections carried out IMO because people choose that route rather than the way nature intended. Guess everyone is different and bottom line is choices are there for people if they want them....

EDIT
Just read the rest of the comments - we had some absolutely great midwives on NHS and we stil remember the two that delivered our kids very fondly (we got through a few shifts on the first child!). On the whole I think they do a great job and other comments how this all becomes a distant memory once the "real" parenting starts are so true

[Familyofmonkeys]

My problem is with people who opt for medical interventions without waiting to see whether a normal labour will work for them. Our society has gotten into a state where many seem to think that anything involving blood needs a doctor, expecting a risk when none has been detected, when babies have been being born for thousands of years.


That is pretty much how I feel about birth too......lets not forget that medical intervention carries it's own risk. Epidural is not without risk, for example leaking of spinal fluid causing a massive headache!



lets not bash midwives, who on the whole are incredibly skilled, knowledgeable professionals.


Absolutely....midwives are healthcare professionals, just the same as doctors and nurses. They are trained to be experts in 'Normal' birth. Generally, doctors are trained to deal with all the things that go wrong and high risk births. In fact experienced midwives often mentor junior doctors so that they can get some hands-on experience delivering babies with normal labour.....a close friend of mine is involved in this at Warwick Hospital in UK.

And comments such as is are really unhelpful and demean the skills and experience of many very competent midwives......

I also wouldn't let a midwife anywhere near OH without a doctor present!



And I also very much agree with Daniela's comments above. A person's birth experience is not a competition...it's about doing what's right for you and having the right support around. I've had 3 homebirths and I found it really annoying when I was expecting my first child having people question whether or not I was doing the right thing when the decision was mine, in the same way that the choice to use pain relief is purely down to the woman giving birth. I didn't take any antenatal classes at all for all of the reasons mentioned above.....they are often biased towards particular desired outcomes. Instead I decided to do my on research before making my decisions.......

http://www.aims.org.uk/
http://www.cochrane.org/reviews/en/ab000352.html

[JandM]

:clap:clap:clap to Daniela and Tia's posts.

[Debbie P.]

Speaking as someone who had an epidural, I think I'd try very hard next time not to succumb. TBH, I felt like a slab of meat! Couldn't feel to push, the labour slowed right down and I ended up having a forceps delivery. Baby too sleepy to feed at first, and we never got it established (and yes, the BF fascists made me feel guilty for ages about that). Also, the ****** thing wore off and I got into a right state - high on gas and air and saying all sorts of embarrassing things!

Not saying you won't go down the epidural route at some stage (I probably will end up shouting for drugs next time too!), but I wished I'd been more aware of my choices for early pain relief - I might have been able to hold off if I had, and might have had a baby several hours earlier than I did! Instead, I was in a consultant-led unit, and the attitude seemed to be when, not if, when I was going to have the eppy.

I have a friend who gave birth around the same time, in a midwife-led unit with no access to pharmaceutical pain relief. She's paranoid about losing control and told her OH that under no circumstances would she have drugs. I'm sure she felt like punching him out when she DID want them and he said no! but also, I feel her birth experience was more satisfying because she was in control.

Just a thought. Oh, and don't let 'em push you around beforehand. I was told that I 'had' to be induced - if I refused, they wouldn't provide care for me in labour. I only found out afterwards that that was ********.:mad:

[globetrecker]

Most people from this side of the peninsula go to Hamilton to give birth, I think mainly because it is in the same DHB, (though we are more or less equidistant from Hamilton and Auckland), and I've been told that many of them actually go to stay in Hamilton for the last six weeks of pregnancy to avoid having to travel over the Kopu-Hikuai road during labour!


Jo Jo, thanks for the info. So if women to drive to Hamilton (hope to make it in time while in labour!), have a baby there, they obviously make it in time even with the drive. Whew. How do they pick a midwife over in Hamilton when they live an hour and a half away? How do they get care (check ups, scans, assistance) during the pregnancy in their town when they want to have the baby an hour and a half away in Hamilton?

Hope this makes sense:)

[Jo Jo]

Hi globetrecker, I'm not quite sure exactly how it works as I've never been through it myself, but my understanding is that you can choose a local midwife, and get most of your pre-natal care locally, and that some of the midwives will travel to Hamilton or Auckland for the birth. You might have to go to Hamilton or Auckland for scans and tests, though, I think, but I'm not sure. I do know that it is very common for women on the peninsula to give birth off the peninsula - apparently about 50% of births take place in Hamilton, Auckland or elsewhere - so if you choose to do this you won't be unusual. Speak to your doctor, as they are the first point of contact for maternity services, and should be able to explain how it all works to you.

[James 1077]

And comments such as this are really unhelpful and demean the skills and experience of many very competent midwives......



I don't see how it demeans the skills and experience of many very competent midwives. If you are a very competent midwife then you are probably aware that there are a number of incompetent ones. Unfortunately my cousin came across one of these and, as such, my views were formed. I wouldn't let a midwife look after my wife without the supervision of a doctor but I also understand that this is "non-standard" and as such was quite happy to pay for it (I wouldn't expect to get it off the government as it is a personal choice and, as such, shouldn't be funded). We got absolutely brilliant treatment throughout my wife's pregnancy by our consultant and there were a couple of midwives present at the birth too.

My personal view is that, in addition to the bf facists, there are far too many "natural birth" facists out there too. How you give birth should be a matter of personal choice and nobody should be allowed to make anybody feel bad about their decision.

[dharder]

(I wouldn't expect to get it off the government as it is a personal choice and, as such, shouldn't be funded). We got absolutely brilliant treatment throughout my wife's pregnancy by our consultant and there were a couple of midwives present at the birth too.

But didn't your wife have twins? Then you'd be with a consultant anyway, not a midwife, as it is considered a risk, and you'd get it on government money... At least that's how it worked for me in the UK.

Nothing to do with the initial post, sorry for the tangent.

Daniela

[James 1077]

But didn't your wife have twins? Then you'd be with a consultant anyway, not a midwife, as it is considered a risk, and you'd get it on government money... At least that's how it worked for me in the UK.

Nothing to do with the initial post, sorry for the tangent.

Daniela

We only found out about the twins following our first consultation anyway.

But yes, we could have got it for free once we found out, but then we would have been reliant on the NHS and had to have the babies at our local NHS hospital (Whipps Cross). Going private meant that we didn't have to have the kids at Whipps Cross - which is worth spending large amounts of money to avoid in my opinion!

[dharder]

Going private meant that we didn't have to have the kids at Whipps Cross - which is worth spending large amounts of money to avoid in my opinion!

What? You didn't like my description of Whipps Cross in the above post?! :eek:

You probably had the same consultants as we did, though, as all the ones at Whipps Cross have their own private practice days in other places, too :)

Anyway. I found care had actually improved between the first time I was there and the second, especially the staff bedside manners.

Daniela

[James 1077]

What? You didn't like my description of Whipps Cross in the above post?! :eek:

You probably had the same consultants as we did, though, as all the ones at Whipps Cross have their own private practice days in other places, too :)

Anyway. I found care had actually improved between the first time I was there and the second, especially the staff bedside manners.

Daniela

Our consultant was a Whipps Cross consultant who also practiced at Holly House Hospital - Mr Henry Annan. Holly House isn't a maternity hospital though so we ended up having the kids at the Portland in London.

If we decide to have any more then we'll probably use the Health Service here as the hospitals I've seen don't look like they may kill you and the medics I know over here don't warn you against them like they did about Whipps!

[Joolzr]

It's funny- I get odd looks from people when I say I had an elective C section. Even health professionals who know that elective just means planned, rather than emergency. They let me off when I say it was because DD was breech. And always say 'Ahhhhh'. (Breech babies are not usually allowed to have normal deliveries in case they get stuck halfway). As it was, the Dr had quite some difficulty getting her out so I thank my lucky stars for C sections.

I also get annoyed by the assumption that 'natural' things are good. I don't really see any evidence for that. After all, lots of bad things are 'natural'. Earthquakes, floods, the plague, breech babies...

[dharder]

It's funny- I get odd looks from people when I say I had an elective C section. Even health professionals who know that elective just means planned, rather than emergency.

I am forever trying to tell people that elective doesn't mean 'couldn't be bothered to push' (another one of my many pet peeves, along the same lines I go nuts when people think Frankenstein is actually the name of the monster)!!!

I always groan when reading those newspaper articles that give you the 'horrendously high' number of elective c-sections as opposed to the emergency ones, and never do I find the little note explaining how many of those elective ones where actually elected because of non-medical reasons...

Daniela

[KatieBen]

This. Epidurals (and other drugs) during delivery can make babies sleepy and unwilling to nurse.

Absolutely not. Anything injected via an epidural (or spinal, for C-section) works in the mother's spinal cord and stays there. It does not cross the placenta into the baby. Epidurals will make absolutely no difference to whether your baby is sleepy on arrival, or feeds poorly initially.

Some drugs given by midwives (pethidine) will cross over into the baby. Pethidine is an awkward one as one of its by products is toxic and tends to concentrate in the baby rather than the mother - babies are therefore likely to be quite sleepy if the mother has received pethidine within a few hours of delivery.


(and yes, maternal death was a huge risk once upon a time, but that was in the days of fever, unpatched bleeding, etc etc - rare today, in the developed world)

Maternal death still *is* a huge risk. We have a large reporting system into it which audits deaths during pregnancy (early/late), delivery and for the first year after birth in the UK - they publish a summary every 3 years. Every death (and luckily there are very few) is investigated to see if it was preventable and sadly some of them probably were. The reason it is so rare in the developed world is because we can intervene if we need to - the low death rate is not a reason not to have intervention, it's as a result of it.

Most births are happy events, most of them proceed normally without any intervention whatsoever and everyone is happy. At the end of the day, the goal of anyone working with pregnant/labouring women is a happy healthy mum with a happy healthy child. This can take access to 21st century healthcare - let's be grateful that we have the skills available to minimise the risk now.

Oh and yes - I have had more than one patient ask to hug me when I have taken away the labour pain for her! I also seem to recall being given a bear hug in the local supermarket by a grateful husband (wife next to him cuddling 3 week old) because when his wife was in pain and he couldn't bear to see the woman he loved going through it, I sited an epidural and allowed her to rest during labour (which then allowed everything to progress normally and she pushed the baby out 5 hours later). I believe a few of my colleagues have also had marriage proposals (I will settle for having left a few small girls in the UK with "Katie" as a middle name!).

What else - oh, where do the drugs go. Spinal injections (e.g. for elective section, or emergency if there is time) go straight into the bag of fluid around the spinal cord. It's like a lumbar puncture only instead of taking fluid out for testing, we put anaesthetic and morphine in. Epidural catheters sit just outside the bag of fluid, the local anaesthetic and morphine slowly cross into the fluid and then into the spinal cord. They all go in at around the L3 level (exactly where depends on the size of the spaces in the back and the size of the patient! sometimes it's difficult to know exactly where you are in the *cough* larger lady) It's also possible to put them into people with metal rods going up and down the spine (I have a friend who had scoliosis surgery who had a very lovely c-section under spinal) - however, there's a higher failure rate associated with the scar tissue around the back and sometimes they don't thread in so easily.

I also get annoyed by the assumption that 'natural' things are good. I don't really see any evidence for that. After all, lots of bad things are 'natural'. Earthquakes, floods, the plague, breech babies...

Lots of unnatural things are great, though! I mean, who ever thought that some nut when dried and ground and mixed with milk and sugar would taste so amazing? (here is where someone tells me that chocolate is a naturally occuring substance after all....)

[Mamee & Co]

Katie

I'm glad it's not just me....though it does give you an insight into why various torture techniques work!

Personally I was so glad of the epidural and having two babies in there, wanted to get them out safely and be awake to see them. Through no fault of the epidural I had one of mine turn slightly at the last minute, jam his head and needa "Dyson" delivery and as he was delivered the other got over-excited with too much space and did a whirling dervish impersonation in my tummy. He needed the salad servers, and came out feet first, not breathing.

At no time did I blame the epidural. I wanted to have a normal delivery, rather than CS, and due to my size (I delivered 6 8 and 6 10.5 twins)my contractions were not quite as effective but my pair tolerated my labour beautifully. Pre this I would have tried for a natural birth, but as our midwife said in our ante natal classes "Never say never". There are too many things which can affect one's perception of pain, be it time of labour (overnight can be more painful), how rested you are, babies position etc. and the main aim is to have healthy mum and baby/(ies) after it, so be prepared to change.

The only thing I was adamant about (and the hospital did agree with me) was that I did not want diamorphine as I knew it could have an effect on the babies and also that as twin 2 can have a rough time I wanted to minimise any bad effects for him (as I found he was afterwards!).

For each of us it is different and my comment is always do what you need with commonsense attached to it. As to the skills of midwives, they can be brilliant and Doctors may not be as skilled or vice versa and as generally happens you get both. As with any professions there are ranges of skills and abilities. I had brilliant care throughout, even up to the Consultant Anaesthetist checking me the day after delivery to ensure everything was OK and my pain relief had been sufficient. I can't thank the medics and midwives enough for the safe delivery of my sons for what I was told was an "impressive obstetric delivery".

[Debbie P.]

Sophie, just realised you're in my neck of the woods. Did you have yours in the prefab Nissen huts at Poole Hospital?(!) Ok, maybe an over-exaggeration, but that's what it reminded me of!

They were supposed to building a whizzy new unit, but have had to call it off due to the recession - shame.

Agree with you on the NHS antenatal classes. We had an annoying young newly-qualified midwife who read off cards. She'd never had kids and she said that BF doesn't hurt at all if they're latched on properly. Yeah, right...! (actually in the postnatal unit, when I was particularly despairing, there was an older midwife who whispered to me that for some women it DOES hurt, no matter what).

BTW, I'm not anti-midwife - I teach IT skills to them at the University and they're mostly a very nice bunch, but a good/bad midwife can make all the difference in the world. The best of it is the bunch of midwifery tutors who have a quick fag in the smoker's area at work - one of them once was clearly pregnant and smoking away - I think she was trying to make sure she had a small baby!!


A little with the women too though, in an inadvertent way. I did the local NHS and NCT antenatal classes (overkill, I know) and was shocked by how little info was contained in the NHS classes. This is going to sound awful, but I'm guessing you know how the NCT is: mostly white, mostly middle class, mostly well educated and more likely to try to maintain control, ask questions etc. Of course they also have something of an agenda going on, but at least you can leave those classes knowing that you've been informed and can delve further with greater confidence.

The NHS classes, on the other hand, just talked *at* you and made irritating comments like "25% of you will have a c-section". It was almost a case of "bish bash bosh". I suspect that few of the women attending those classes made any attempt to look into their options following the class, few will have made a birth plan, and so few got the chance to exercise their right to make an informed choice about how their labour will progress. I could well be wrong, but there was a definite difference in how women attending each class were treated/respected, how motivated the teacher was, and the quality of handouts.

(money money money...)

[James 1077]

... one of them once was clearly pregnant and smoking away - I think she was trying to make sure she had a small baby!!

My aunt didn't do the smoking thing but she only ate really small portions in the last couple of months with her third as she had gone from a girl who was 9 10, to a boy who was 13 12 and really didn't want to go bigger than that!

He ended up as a very healthy 12 pounder - she winces when she thinks how big he could have been!

[sophiedb]

Sophie, just realised you're in my neck of the woods. Did you have yours in the prefab Nissen huts at Poole Hospital?(!) Ok, maybe an over-exaggeration, but that's what it reminded me of!

Another local person! :D

LOL the baby or the antenatal classes? I had both in the main maternity building - which used to be the Poole Workhouse back in ye olden dayes!!!! - but the classes were held in the antenatal reception area. Brilliant, esp the day when a woman and her partner who'd just been told by ultrasound that she'd miscarried were bawling (understandably) their way back to the car park :wah

Absolutely not. Anything injected via an epidural (or spinal, for C-section) works in the mother's spinal cord and stays there. It does not cross the placenta into the baby. Epidurals will make absolutely no difference to whether your baby is sleepy on arrival, or feeds poorly initially.

My apologies - I was given to believe otherwise :uhoh

It's funny- I get odd looks from people when I say I had an elective C section. Even health professionals who know that elective just means planned, rather than emergency.

A friend has said the same thing, after 1 emergency c-section and 2 electives. Her husband is 6' 4" while she's 5'0", and all three kids were far too big for her poor pelvis (also resulted in dreadful SPD during pregnancy). She's even been told that there's no way that her body would grow a baby too large to squeeze out, despite evidence (in triplicate) to the contrary.

But overall yes, choice is key. And realising that being "informed" is not the same as "expert" (mental note to self).

[Ally Bally Bee]

I don't know why you're already discounting Thames, I've friends who have given birth there no trouble and have found they get what they want. I suggest you find a decent midwife - and there are some better than others (my sister-in-law had a shocking midwife but I can't remember her name to even PM you).

Thames will be getting a better maternity unit now the redevelopment of the rest of the building is done and they have a birthing pool now (yeah I know that's like so last century).

And just think about the drive to and from Auckland or Hamilton, why would you want to add that stress in to the delivery?

Just my two cents worth (and I'm also not pregnant but if I were and still living in Thames I would have no hesitation but to give birth there). Although, if you elect for a caesarean or have any other difficulties then they refer you to Waikato (same DHB).

[Familyofmonkeys]

My aunt didn't do the smoking thing but she only ate really small portions in the last couple of months with her third as she had gone from a girl who was 9 10, to a boy who was 13 12 and really didn't want to go bigger than that!

He ended up as a very healthy 12 pounder - she winces when she thinks how big he could have been!


Not sure about anyone else, but there was so little room left inside me I couldn't eat anything but small portions for the last couple of months during any of my pregnancies :laugh

[JandM]

Quite right - that 'heels under the ribs' thing...

[Kiwi Mac]

"Most births are happy events"

Jeez - I sure wouldn't have wanted to see the lady in the video I saw of a birth when she was unhappy then....!!

[Trendynana]

I had an epidural for my second child and it had only just come on the NHS (early 1970's). Before that you had to pay for it in a Private Hospital and it cost a lot of money for the drug. There was only one Anaesthetist who visited the hospital where I was having my baby from another bigger teaching hospital in the city, that had been trained (non of the Anaesthetists who worked in the hospital where I was had been on the training course yet)!! :wah

The visiting Anaesthetist only came on a Thursday and Friday - so I kept praying that I would have my baby on these two days and guess what - I did!!! Phew!!! :)

[madmax]

Hi, I recently had a baby at Waikato after my planned home birth went out of the window! I had a c section and the delivery suite was brand new, very modern and all drugs and services supplied! Also there are 2 birth centres in Hamilton which I believe are like 5 star hotels although epidurals are not available BUT you can move out to one of them from the hospital after the birth! You wouldn't have a problem in hospital with pain relief but you never know you might not need as much as you think :-)

[AliIsmailNZ]

Hi, there, we got another daughter few days ago.

We had a bad experience with our first daughter as the water broke at midnight and the curfew ends at the dawn. While we reached the hospitals with difficulty. The doctor decided to go into Caesarian Section.

Here the case is much different, the brilliant midwives in Middlemore hospital are much patient with my wife's labour as it was very slowly. They considered my wife's anxiety and the treatment was magnificent.

I can provide the exact time frame with details for those who are interested, my wife asked for EPIDURAL too. The labour has been examined by the midwives in middlemore hospital at 8am and we got "Leen" at 8am next morning.

Lots of kits, drugs and spiritual efforts has been supplied with my sincere thanks.

[Familyofmonkeys]

Hi, there, we got another daughter few days ago.



Congratulations :clap

[JandM]

Congratulations :nice1, and welcome to the world for your new little girl. :)

[Jo Jo]

Globetrecker - I was at the doctors today, and they had a big poster on the wall about the new birthing centre at Thames. It said:

Thames Birthing Unit, a primary birthing facility, is for natural, low-risk births under midwifery care.

The unit will not offer medical interventions like epidurals or caesarean sections.

If you require secondary care, your midwife will have planned this with you as part of your birth plan discussion.

The vast majority of births are normal and only a small number of women require intervention.

In the event of any complications, your midwife will work within strict referral guidelines and transfer you to secondary care at Waikato Hospital in Hamilton.

The unit will be a midwife-led for low-risk births and Waikato Hospital will continue to provide specialist, secondary maternity care when and if required.

(I didn't memorise that - they've updated the info about it (http://www.waikatodhb.govt.nz/page/pageid/2145847107) on the Waikato District Health Board website!)

[Joolzr]

But surely a third of women have C sections? I'd say that is more than a 'small number'!!!

[Familyofmonkeys]

But surely a third of women have C sections? I'd say that is more than a 'small number'!!!

Not quite that many, but the rate in NZ is still significantly above the WHO recommendation of 15% in developed nations.

Caesareans have become an almost common place way of giving birth today - while only 50 years ago it would have been quite unusual. In 1983/84 the caesarean section rate in New Zealand was 9.6%. By 2003 this had increased to 23.1% of all births in that year.

[newarrival]

AliIsmail, congratulations!:cheers

[biff63]

Reading this it sounds like there are quite a few people on here with twins. I have twins too. Both girls, aged 6 now, born at home in Sheffield with independent midwives.

Do they have independent midwives or an equivalent in NZ, out of interest? Not that I'm likely to be having any more. 4 is enough for me ;)

[auskiwi]

This thread made me curious about the US C-section rate (seems everyone I know here has had a c-section except me (3 girls, the old fashioned way ;-). Check this out!:

The national U.S. cesarean section rate was 4.5% and near this optimal range in 1965 when it was first measured (Taffel et al. 1987). However, the national cesarean section rate is much higher and has been increasing steadily for more than a decade. With the 2007 rate at 31.8%, about one mother in three now gives birth by cesarean section, a record level for the United States.

From the following website: http://www.childbirthconnection.org/article.asp?ck=10456

[mattybain]

Sorry for the slight hijack here...

I've always wondered where exactly the epidural goes in the back. I only have the last 5-6 vertebrae that aren't fused to...adamantium... So when the time comes, would I even be able to have one? I sure hope so!

Hi I was a midwife for 20 years. basically the epidural is put in by an anaesthetist whilst you are sitting up resting forward on a table,or lying on your side with your back curled out like a letter "C". this opens the vertibrae so the doctor has a good space between the bones. it is postioned around the middle of your back, well under breast lung/height. so if you have fused vertibrae it would be difficult to administer. however, during pregnancy,you would need a consulation with the anaesthetist to decide if it was possible for you or not. if not, there are lots of other methods of pain relief to help you...so dont worry yourself at this stage :D

jacqui

[BkyMonster]

Do they have independent midwives or an equivalent in NZ, out of interest? Not that I'm likely to be having any more. 4 is enough for me ;)

The midwives here are more similar to what I think the UK has as private midwives. I was able to choose mine and see the same set (though there are individuals, I chose a team) throughout.

[Squiffy]

Having got a 10 month old daughter (and so been through pregnancy and birth fairly recently) can I just say that in the UK most births are 'midwife led' and an obstetrician will only get involved if things get complicated or you have an epidural. With my first child I had pethidine which was great and I had a drug free birth with my second child (because she was so fast, there wasn't time for drugs), but if you have an epidural there will be more people in the delivery room than just you, your birth partner and the midwife and you will probably be confined to a bed, ie you won't be able to move around, stand up or have a water birth. I hope this might clarify why some birth units in NZ don't 'do' epidurals.