is this not a step towards kind of privatising maternity care!!

it's all very well but those that have money won't be affected as such, they'll pay it because they can afford it. it's women from low income backgrounds that will suffer.
plus how many men would say "ooh it can't be that painful, you don't need it/we can't afford it"

i think it should be left as it is x

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STUDENT MIDWIFE TO BE (HUDDERSFIELD 2008)

I can understand and agree that women such as this (no disrespect to your cousin) should be made aware at day one that if they elect for a epidural before they even go into labour they should be charged. They arent even giving labour a chance. yes is gonna hurt, parts of your body are stretching to proportions u have never known before!

I also think that elective c-sections should be a topic addressed. unless a woman actually needs it, why should she get the service of the docs, operating staff, anethestatists (spelling?) etc for free when there are waiting lists a mile long for people who need operations that they actually need for everyday life. But i guess that thats a whole other subject.

I actually brought this up in my interview that i wasnt keen on the "too posh to push" culture that women appear to be jumping on and that i wanted to promote, natural, normal births.

Hey great posts everyone, keep em coming, no-ones taking offence to any of it, we're all entitled to our own opinion after all, thats not to say we let it affect our care provision in practice.
Our anaethetists would try and ban this if it came in anyway to be honest, which I don't think it ever will (well not in the immediate future, who can tell whats round the corner??)
It is frustrating when a woman comes in, in early labour and demands (not requests) an epidural. I have seen them given at 1cm, and have sat there for 12 hours at a woman's bedside whilst she sleeps intermitantly throughout her labour, only to return 12 hours later and care for her again, more often then not in these cases we end up down the road (aka theatre). Its annoying how women with epidural at our Trust get longer for descent, and 2nd stage overall, yet women having a natural labour (or different analgesia) are given (well its recommended) that they have maximum 2 hours (it was 1 hour, thankfully its increased) I mean is this fair??? And why do the NICE guidelines recommend active pushing for women with epidural after all the debates around the avoidance of active pushing, should we be doing it for these women?? The fetus may already have had reduced variability, sleepy heart patterns etc as a result all the way through (particularly following 1st dose then top-ups) so why then are we supposed to encourage active pushing???

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No. I don't think women should pay for anything at all. Though anecdotally I needed no other labour analgesia other than Entonox maybe my pain threshold is higher than others. It seems very unfair that because a woman feels pain perhaps more intensely than another that she would then have to pay. It would make us no better than a developing country sending family members off to find the money to pay for penicillin!

Though I understand the principle, as research suggests that epidural analgesia begins a cascade of intervention often resulting in instrumental/ c/s delivery and sadly this equates to cost (putting it simply) I will never agree to women paying for any aspect of their care, much as I want to promote normality sometimes it simply isn't possible

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Even of you work at the portland ??? lol

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No I don't agree with this.

Should women who already have a lot to deal with, have to suddenly start worrying about how much it will cost if they need certain treatments, pain relief etc. They are already having to deal with getting used to being pregnant, the upcoming responsibility and worry of becoming a parent and the money worries that go hand in hand with this ... and of course all the hormonal and emotional changes and strains!

I truly believe this would take away a lot of womens choices and especially the informed choices as all they will be remembering when they are making these decisions will be how much it costs and can they afford it. After all, many women will be taking time off work either temporarily or permanently and a large number will return part-time after the baby is born so there will be a change in their financial situation as it is - most likely a drop in inccome and a rise in outgoings ... do we really need to be adding to all the pressure and strain they are already dealing with with charging them to birth the babies, medical need or not?

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Its penalising women.

Women always end up suffering in some way because historically their belief in their bodies, themselves and childbirth has been taken away. Yes the culture needs to change and yes some radical measures should be taken but not ones that are so cruel.

Women have enough to deal with in pregnancy and birth without the threat of anything 'being taken away', we need to concentrate on the positives, restore womens faith in their bodies and their trust of childbirth so they actively make informed choices - instead of expecting childbirth to be painless. Culturally attitudes need to change, midwives and women need to work together to claw back the art, science and normality of childbirth as it slowly morphs into the realms of medicalised surgical procedure. Forcing working class/low paid women to suffer in childbirth because they cant afford an epidural is not the answer.

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Josie
StudentMidwife.NET Co-founder & Director

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Coffeebean xx



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This is so interesting . . .those of you who are saying its about re-educating woman, I couldnt agree more. From personal experience . . .I ended up on a synto drip to get me going again. Now i was desperate to have a water birth, alas due to drip was unable too. The pain was (as you all know) agony and I got in the frame of mind, well if I cant have a water birth and I am restricted to bed anyway, I may as well have an Epidural. (I had previously declared I did not want one and my husband was well clued up on this) I asked the midwife to organise it all. My husband advised the midwife that I had for all my pregnancy been adament about not wanting an epidural. In the end the Midwife sat down next to me and talked to me like a "friend" and said "go on give it a go, you were made to do this" . . . .and I did with Gas and Air . . .I wander how many woman in similar positions get that care which is much needed . . . and believe in themselves to do it. i personally believe that epidurals shouldnt be so readily available.

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Never stop believin

Personally, I don't believe women should have to pay for epidurals. Especially not in the NHS as it is today, where women cannot be guaranteed 1:1 care during labour. Some women have epidural through need, but many women who choose to have an epidural, in an otherwise uncomplicated labour, do so through fear. If these women had 1:1 care, with a midwife they feel they have built up a trusting relationship with, in a comfortable environment etc. then they may cope better in labour and may not feel the need for an epidural. But, for the majority of women this simply isn't the case. So, I don't think they should be penalised. The service is there and they should be able to use it, without cost.

Now, if we were to be talking about elective sections, at patient request, I would advocate that the woman pays. However, I don't want to take this thread

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