DO MOTHERS REALLY NEED AN EPIDURAL?

 

The Royal College of Midwives said last week that pregnant women are often given epidurals unnecessarily during childbirth, and suggested they should be charged up to £500 if they choose to have one.

 

Tess Stimson, 38, is a novelist and author of ‘The Adultery Club’. British-born, she lives in Florida with her husband and three children aged 11, 8 and 3.She says:

 

 

here has been a suggestion that fees of up to £500 should be levied on women who have no ‘need’ for an epidural – the local anaesthetic injected into the spine to numb the lower half of the body during labour.

 

Putting aside the contentious issue of having to pay again for medical treatment already funded out of our taxes, the proposals still leave a nasty taste in the mouth.

 

How many women having epidurals is ‘too many’? One wonders if there’s to be a quota system: sorry, we’ve used up our allowance of epidurals for the month, here’s a nice aspirin instead.

 

And who will decide what level of agony is required to ‘need’ pain relief?

 

The mystique still surrounding the pain of childbirth in the 21^st century is extraordinary. No-one these days would be expected to ‘breathe through the pain’ of a root canal filling or down a tot of rum before having their leg amputated. Yet women are still expected to grin and bear a torture akin to having a football pulled from your nostril.

 

There’s the subtle but insidious implication that ‘good’ mothers will endure agony for the sake of their babies, whilst ‘bad’ ones scream for drugs.

 

If men were the ones giving birth, you can be certain this wouldn’t even be an issue. You don’t hear too many men volunteering to undergo vasectomies with just a bit of stoic panting to help them through.

 

If they were the ones looking forward to episiotomies and the unpleasant sensation of splitting in half like a ripe melon, epidurals would be routinely administered the moment they waddled into the hospital lobby.

 

I gave birth to my two sons, now aged 11 and 8, ‘naturally’ at a top London hospital. In both cases, I had textbook labours where the pain built up slowly but steadily, so that by the time I started screaming ‘Give me an epidural now!’ it was too late. I remember very little of the moment of their births, my brain fogged by pain.

 

My daughter, now three, was born in the US, where there is no system of free health care. I was six months pregnant when I moved here, so I was ineligible for insurance coverage for my pregnancy, which was considered a ‘pre-existing condition.’ This meant that I had to pay for prenatal care, and for giving birth.

 

I’d never considered the cost of all those free scans and check-ups at home, but now every time I peed into a cup for the urine test, I was mentally totting up the bill.

 

When I discussed my birth plan with the obstetrician, she presented me with a list of pain relief options, including IV drugs and an epidural, with prices printed next to them like a restaurant menu.  A straightforward epidural would cost me $1,500 (£850).

 

Initially, I elected to do without pain relief, since I had managed it twice before. But I’d be lying if I said price didn’t factor into it. After all, £850 buys you an awful lot of babygros and nappies, and with a new baby in the house, you need every penny you can save.

 

In the event, after 12 hours of labour my daughter went into distress and I had to have an epidural. By that stage, of course, I didn’t care how much it’d cost – I’d have paid anything for someone to take the pain away.

 

I was awake and fully alert throughout her birth, which I actually enjoyed, since I wasn’t half out of my mind with pain. I kept trying to remind myself of that over the next two years it took me to pay off the bill, which amounted to more than $10,000 (£6,000).

 

 

ertainly, there is a case to answer in terms of the number of elective epidurals women are having. Research suggests that epidurals raise the likelihood of other interventions, such as caesarians, which increase the risks to both mother and baby. But what’s needed is not a stealth tax on pain relief, which will inevitably discriminate against poorer women.

 

If doctors and midwives want to bring down the number of epidurals, they must educate women about the alternatives, such as the Tens machine, which uses electronic pulses to stimulate the brain into releasing natural pain-killers.

 

The National Health Service was founded on the principle of giving free health care to all, regardless of status or income. Despite its faults, it’s still the envy of much of the rest of the world. We should all do our very best to keep it that way.