Increasing epidural rates?

Hi everyone,

I've been looking up questions people have been asked at interview to get an idea of what research I should do.

One question I noticed someone had been asked was - Why do you think epidural rates are increasing?

So I was thinking about it and I'm unsure what stance you would be expected to take on this. i.e. Why should it not increase, we have epidurals, if woman want them, then fine? OR It's not necessarily positive due to the increased risk of intervention etc. If this is the case, why *are* rates increasing?

Is it just the way society (and childbirth) is changing? Is there a way to reduce the epidural rates in Britain?

From speaking to friends etc, those who felt empowered by their midwife prior to labour that they could do it without pain relief, ended up feeling out of their depth and unable to cope in labour as they didn't expect it to be so bad and ended up with an epidural. Alternatively, I think there is a risk of not allowing woman to believe they can labour with minimal or no pain relief. For example, at my parentcraft classes we were told we would breath through/ use TENS for contractions until 3cm, entenox would then get us to 5cm, pethadine/diamorphine would get us to 7cm then an epidural could be given to get us through the delivery. I found this attitude disappointing, but maybe more realistic at helping woman to prepare that it would be painful?

In general how do you / your mentors educate woman on what to expect during labour (if this is done at all)?

I hope this has made sense, and fear I've veered slightly off the original topic but I find this very interesting.

Natalie

Great post Natalie by the way, and I think you have answered it without realising!!
I think alot of women are encouraged to have epidurals, by their friends/family/birth partners etc.. Who hate to see them in pain-as its not like any other pain is it? It is progressing towards a goal however I think unless you get that into womens mindset it is difficult to turn opinions around.
That said, I have seen them work fantastically for some women, yet I have ended up in theatre lots with others, for trial of instrumental, or C/sections.
I think there is a real fear of being left alone in labour, and perhaps the almost guaranteed relaxation and painfreeness that women gain from an epidural makes it an attractive choice for pain relief, however they are also given one-to-one care (or certainly should be) in labour, thus you have a midwife with you at all times, and you are painfree.. mm you can see why it is an option.
Conversly...
Women do not have the same benefits to antenatal classes as they once did (mock the breathing techniques all you like-well the midwives do) so they are not educated now as they once were. Women gain alot of info now via the internet, which as we all know can have been written by anybody!! So if the particular website they go on raves about all positive aspects of an epidural, then I guess it contributes to the increasing rates.
I also think it is a trend as the epidurals have become increasingly fashionable since the 1980's and we are now seeing the next generation whose mums had epidurals, so i think that has contributed immensely. A lot of women have nothing else on their birthplan but... epidural please asap!!! So what can we do??
Employ more midwives, sort out the antenatal care, get back to basics and change the mindset, its like bottle feeding i suppose isnt it?? Breastfeeding was common and popular, but we now have the next generation, and perhaps another whose mothers and mothers, mothers etc... who all did it.
PHEW, pause for breath Tracy haha, does all that make sense???

__________________
Forum Buddy


Have you just been offered a place? If so and you want a mentor please post in post this forum (also post here if you would like a mentee)

I have been pondering this...

Lately, these seem to be connected to another increasing trend.

Occipito posterior position.

I had a read up as am fascinated as to why this this fetal postion is increasing and its subsequent effect on labour and birth outcomes.

I have read that women are alot more sedentary these days than historically and this increases the incidence of persistant OP. Also that genetically women have smaller pelvis' and this may also contribute to this position.

I think it is very relevant to epidural use as it increases pain during labour significantly and causes rectal pressure and pushing sensation far earlier on.

I remember the first lady I looked after with an OP baby, my mentor kjept coming and taking me out of the room, she was really suffering and using gas and air, on VE was 5cm dilated, but was struggling to cope with the continuous bak pain, that worsened during a contraction. She screamed and screamed and when I was comforting her (or trying to) she squeezed me so hard I bruised. Though my mento said she was making too much fuss!

She had an epidural in the end and forceps several hours later.

__________________