‘There’s nothing natural about giving birth in agony’: As health chiefs admit women are routinely refused epidurals, a furious MARINA FOGLE shares her own harrowing story
- Mothers-to-be across the UK are increasingly being refused epidurals
- Marina Fogle had an emergency C-Section with her first-born son, Ludo, now ten
- Antenatal class teacher examined why women aren’t being given pain relief
- She said women are told that giving birth without relief is being a good mum
- Kim Thomas of the BTA warns long periods in pain contribute to PTSD after birth
Sitting cross-legged in a circle with other pregnant women, I listened intently and tried to visualise how I wanted my impending birth to be.
Because, according to my antenatal yoga teacher, such a visualisation — combined with calmness, relaxing music and regular attendance of her classes — was enough to obliterate what she termed the ‘risk and discomfort’ of an epidural. We could simply ‘breathe’ our babies out.
She urged us to focus on the birth we wanted, ‘because then, that’s what you’ll get’. It feels ludicrous now that I fell for this nonsense, but I did.
As my belly distended and the Braxton Hicks contractions started to ready my body for labour, I imagined the moment I’d meet my child for the first time: in a birthing pool with relaxing music in the background.
Marina Fogle (pictured) who had an emergency Caesarean section with her first-born child, explored the rising number of women who are being refused an epidural
Someone would take a photograph as my baby was effortlessly born, capturing the moment we first locked eyes, my hair tousled and face flushed — not like I’d actually worked out, of course, but glowing like a girl in a Sweaty Betty advert. It would be a framer.
The actual photograph is very different. I’m lying on an operating table, my face grey with the fatigue that comes with a two-day labour, my hair lank rather than tousled.
I do have the biggest smile on my face — but mixed with the joy at meeting our first-born son, Ludo, now ten, is undoubtedly rather a lot of relief.
The agony of labour was over, my ‘visualisation’ of a perfect birth punctured by a sorely needed epidural and an emergency caesarean section.
It may not seem like it, but I believe I am very lucky. I had a supportive midwife who encouraged me to have as ‘natural’ a labour as I could — but who also recognised that, after 24 hours of vomit-inducing contractions, when I said I needed pain relief, I actually did.
When my epidural started working, I felt like kissing the anaesthetist.
Not all women, sadly, can say the same. Recently, an investigation by the Department of Health revealed that, in spite of official guidelines stating women in labour should never be denied pain relief if they want it, mothers-to-be are increasingly being refused epidurals.
Today, I myself am an antenatal class teacher. Every week I come across women who are consumed with whether or not they should opt for an epidural. It’s viewed as almost illicit — a terrible thing even to consider.
Marina (pictured) argues there is a cult of natural childbirth flourishing, where women are encouraged not to ‘succumb’ to pain relief
That midwives and doctors are refusing to let suffering mothers access this pain relief certainly must fuel the idea that epidurals are somehow improper.
To add to this, the cult of natural childbirth is flourishing — where women are encouraged to believe that being a good mother starts with the ability to give birth without ‘succumbing’ to pain relief.
On the one hand, there’s something appealing about the idea of being able to cope with the pain generations of women before us endured in order to bring new life into the world.
But rationally, why are women in labour picked on as the ones who have to prove their strength by refusing pain relief?
There’s no cult of natural tooth extraction, nor shame in accepting a general anaesthetic for an appendectomy.
However, such shame certainly exists, as I can attest from my antenatal classes.
Jess, whose baby is now one-year-old, describes to me how she felt that giving birth was somehow less of an achievement because she’d had an epidural.
‘I really believed I was one of those strong women who could endure the pain for the sake of my baby,’ she tells me. ‘But nothing prepared for me for the intensity of the contractions.’
One mother revealed that, at 8cm dilated, she was told it was too late for her to have an epidural. She knew from our classes that, unless her baby was born by the time the epidural was in and working, there was no such thing as ‘too late’.
Sam Pointon, 25, who lives in Saffron Walden, Essex, has vowed never to have another child because she was denied an epidural three times during her labour (file image)
After she reminded them of this, an anaesthetist was called and her final two hours of labour were pain-free.
Women like Sam Pointon, however, weren’t this lucky. She says she begged three times for an epidural, only to be refused, without any real explanation.
So terrible was her experience, she says, despite being just 25, she will never consider having another child. ‘I look at my beautiful girl and sometimes it hurts so much because she reminds me of how she was the cause of so much pain,’ says Sam, who gave birth to daughter Darwin — known as Winnie — now two, in October 2017.
‘Some mums say things like: “She was worth the pain. Every woman has an awful labour, you’ll get over it.” But it doesn’t help. For a long time I couldn’t stop crying and struggled to leave the house.’
Sam, who lives in Saffron Walden, Essex, with her husband Damon, a data scientist, also 25, believed antenatal classes had prepared her for her birth.
‘After going into labour naturally, I felt that, as the hours passed, the pain became indescribable. I just couldn’t cope — I thought I was going to die and there were moments when I wanted to. I asked three times for an epidural, but each time the midwife fobbed me off.
‘She said things like: “Are you sure? Why don’t we just give it some more time? Here, have some more gas and air.” I felt helpless. Winnie was born 30 hours after my labour began and I was left with second-degree tears.’
Sam acknowledges that it’s possible she didn’t receive her epidural because ‘the labour ward was at capacity — so maybe they were too busy. But there’s also a part of me that feels my pain wasn’t taken seriously’.
She says she was taken aback by the impact the birth had on her mental health.
Kim Thomas who is CEO of the Birth Trauma Association, claims being left in severe pain for long periods can contribute to women being diagnosed with PTSD after birth (file image)
‘It’s still so raw. I suffer from severe postnatal depression and flashbacks. Although I love Winnie more than anything in the world, my labour was so traumatic I never want another child. I just cannot go through that again.’
My heart goes out to Sam. Because, as I know only too well, deciding whether to have an epidural is not a question of weighing things up. You either don’t need an epidural and don’t think about it, or you absolutely need one and you will kill someone to get it. To suggest that it’s a choice is dangerously misleading.
Kim Thomas, CEO of the Birth Trauma Association, agrees, saying: ‘We shouldn’t treat labour pain any differently than any other sort of pain.
‘Being left in severe pain for a long period of time contributes to women being diagnosed with post-traumatic stress disorder (PTSD) after birth.
‘Around 4 per cent of women who give birth — around 30,000 —develop PTSD. These women suffer intense flashbacks, heightened anxiety and insomnia. A lot develop postnatal depression.’
I try to lessen the pressure on the pregnant women I instruct. Epidural or not — who cares? It’s the baby, and the quality of your future life together, that matters.
So it baffles me that so many ‘birth advocates’ perpetuate the lie that women who give birth ‘naturally’ have triumphed over their compatriots.
I’m certainly not saying every woman should have an epidural. Many don’t need them.
Indeed, whether or not you need an epidural depends on the shape of your pelvis internally, the size and position of your baby and the length of your labour. It has nothing to do with your parental ability.
Louise Burgess, 31, from Milton Keynes, said she feels ‘deeply traumatised’ because her midwife told her to focus on breathing instead of giving her an epidural (file image)
That said, even mothers who have sailed through several births can need pain relief for subsequent deliveries — and can be shaken if they don’t receive it.
Louise Burgess, 31, has a five-year-old son. She describes her first labour ‘as near to perfect as can be’, with just gas and air for pain relief. Yet the birth of her second baby, Ivy, just 17 weeks ago, was very different.
Louise says midwives refused to give her an epidural, despite her asking for one. After being induced, she says her pain went ‘from nothing to extreme in minutes’.
‘The midwife said not to worry, I could have a lavender bath or bounce on the birthing ball. But I was starting to panic. The pain was nothing like I had ever experienced,’ says Louise, a pet-sitter who lives in Milton Keynes with her husband, Rick, 30.
‘It was so extreme I vomited all over the bed. I was beside myself in tears, begging for an epidural.
‘The midwife simply replied: “Just do your breathing, you can do this by yourself, the baby will be here before they get the epidural in.”’
Yet four hours were to pass before Ivy was born, with just gas and air granted for pain relief.
‘I feel deeply traumatised,’ Louise says. ‘Those four hours were the worst of my life, even more than the agony we went through when my son, Emmett, had heart surgery after he was born. I never want to be pregnant again. It’s affected how I feel about Ivy. I just wish I had been listened to.’
Research suggests epidurals don’t increase the risk of a caesarean section or postnatal back pain (file image)
It’s hard to understand why Louise’s pleas weren’t listened to. After all, should you choose an epidural, you’re not being reckless. This is a procedure that has now been around for a century.
A 2018 review of more than 50 studies showed epidurals cause no increased risk of a caesarean section, postnatal back pain or to a mother’s ability to breastfeed.
And a decade-long population study in the Netherlands concluded that epidurals did not increase the risk of assisted delivery.
But this is not the message that is being shared. A few years ago I heard a talk from a doula (a trained birthing companion who is not a healthcare professional) and listened in horror as she warned of the risks of paralysis after an epidural. Had her ‘expertise’ included a basic understanding of spinal anatomy, she would have realised that this was impossible; epidurals are administered well away from the spinal cord.
Marita Moore, 39, from Stockport, certainly didn’t plan to have an epidural when giving birth to her first son, Harley, 15 weeks ago.
A fitness and wellbeing instructor, she wanted to forgo pain relief, and had decided hypnobirthing would help her achieve this.
In peak physical fitness, Marita felt positive her labour would go according to plan. Yet when she had to be induced, her pain quickly became unmanageable.
‘All my plans for a natural birth went out of the window. I was crying out for an epidural. The diamorphine injection and gas and air just didn’t do anything.
‘Then a doctor said: “An epidural might not be the best course of action for you.” I didn’t understand and, to be honest, I could hardly hear him over my screams.’
Marina argues it’s cruel for anyone to be denied relief from a pain, so profound it makes them feel like they are dying (file image)
With severe tearing and terrible flashbacks of the birth, Marita is still traumatised. ‘My partner, John, said he’d never heard noises like the screams I made.
‘I had been told I may never have children as I have endometriosis, so I felt guilty for not bonding with Harley immediately.’
The fact I’ve avoided these feelings of guilt over my own epidural must be in part linked to my supportive midwife agreeing it was the best course of action for me and my unborn baby.
Yet my birth story didn’t end at the epidural. After two days, I was told that my ‘failure to progress’ in labour was making Ludo distressed. I was urged to have a caesarean, which I did.
As I sent that happy, exhausted picture of my baby and me to friends and family, it was clear not everyone felt the same delight I did. ‘What a shame,’ texted one friend. ‘You had a caesarean.’
‘Yes I did,’ I wanted to scream at her, ‘and that’s why he’s alive.’
But her disappointment weighed on me. I wanted to give my son the best. Had I already failed?
These sentiments were swiftly brushed aside as Ludo was rushed to special care. His breathing was rapid and the team diagnosed a punctured lung.
As I looked at my tiny son in an incubator, I felt nothing but gratitude for medical innovation and a wretched sense of injustice that anything that’s not ‘natural’ is so systematically demonised.
After all, the idea that it’s right that women should suffer in childbirth is rooted in the Bible — the punishment meted out by God to a sinning Eve. Yet, 2,000 years later, in the age of reason and of evidence-based medicine, it seems nothing short of cruel that anyone should be denied relief from a pain so profound it makes them feel like they are dying.
Additional reporting: Rebecca Evans
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