This weekend I was at a party in a rented Air B and B manor house. It was a blissful spot, with enough room for 30 of us and you know what it's like when you're in a roomful of people you love and you've known most of them since school.
My lot are now all assorted doctors and dentists and are busy getting engaged and getting pregnant, not in that order. We wanted to meet up before everything changes and as always when I go to this kind of thing, the discussion got midwifery themed pretty quickly.
It started with considering old fashioned baby names life Audrey, Dorothy and Tessa.
Then on a windy beach walk, we talked about waterbirth.
And in the hot tub, where some of the pregnant people did join us, because it was the same temp as a bath, and we figured it couldn't be more of an infection risk than having sex (right?) we were discussing pain relief in labour, especially epidurals.
The conversation was prompted by a Guardian article that's making the rounds on Facebook right now. It does acknowledge that a lack of staff, or very fast labours can be reasons that a woman doesn't get an epidural, but overall it focuses midwives denying epidurals to women because it makes for a less natural birth.
So as we sat in the drizzly garden with the jets on, the chat got controversial. Denying anyone pain relief if they need it is a horrific thing indeed.
If you've read the Guardian article, you'll know there are loads of online comments ranging from I'm a midwife and I've never seen a woman denied an epidural all the way to this happens all the time.
It's a personal discussion to many.
On one hand, as someone with a clinical background as a midwife, it's hard not to feel attacked by this article.
It tears into a midwife's role in promoting physiological childbearing, ending "(we need to) eradicate the last remaining pockets of any outdated ideological support of so-called “normal births".
When in actual fact, we know from Better Births and many other sources that women feel denied all kinds of things, including their right to pursue a natural approach to childbearing.
Women are just not listened to as much as they'd like in general.
But then I can't help thinking about that David Foster Wallace short story about fish. Two younger fish are swimming along and an old fish comes over and says 'Hey, how's the water?' and the younger fish reply 'What do you mean?'
Most people can't see the water. Maybe what I'd see as a hard conversation about pain relief someone else would see as outright denial and part of a cult-like culture.
On reflection, I have heard midwives saying that an epidural isn't possible. But the times I can think of are often at the end of labour where an epidural might not have time to take effect, rather than denying a woman a choice to promote normal birth. Or during early induction when an anaesthetist might find it hard to get an epidural working because, to quote one of my anaesthetist friends you have to have pain to have it taken away.
As we walked back up the drive, across the village and towards the station to catch our train home, the results of the polled healthcare professionals were that only one agreed that sometimes midwives do promote normal birth in this way. I'm not sure if this is relevant, but the doctor was on first her obs and gynae placement, and was quick to tell me she was very new and very afraid of birth. Hmm.
I'd like to say I came to a solid opinion on whether women are denied epidurals. But all I can say for sure is the Guardian article lacks nuance, and because of this, I'm pretty sure it will blow away and be forgotten.
But I hope women's experiences won't be. When I'm back in clinical practice in September, I want to be able to see the water. I want to be good at listening. I want women to be able to tell me their opinions and discuss what they need as easily as if we'd known each other fifteen years and were sitting in the garden in a hot tub, whether that's an epidural asap or a waterbirth at home.
I'd love to hear from you about all this.
Do you have any experience with women being denied epidurals? Or anything to add on the subject of midwifery in the media?
Leave me a comment letting me know.