Six NHS Trusts Denying Women Epidural Pain Relief

Pain relief is one of those strangely contentious childbirth subjects. You would think that the answer is simple: different women have different views and needs and these should be respected – and, of course, women must always retain the right to change their minds.

However, over the years, debate has frequently become polarised, with perhaps too much airtime given to the more radical voices on both sides of the debate.

Recently, the Health Secretary Matt Hancock intervened after learning of allegations that women in some British hospitals are being refused epidurals during childbirth. He said that women must always be offered the choice.

An investigation by the Sunday Telegraph found that six NHS trusts were denying women epidural pain relief by obstetric staff on the grounds that they were either over- or under- dilated.

However, the newspaper’s contention that this course of action was attributable to a “cult of natural childbirth” is unlikely to prove helpful to discourse around the subject as it seems to belittle the decisions of those who choose to go without pain relief.

At the moment, official NHS guidelines state the right of any woman to request and receive pain relief during labour and to choose what works best for them from the range of options, including Entonox, pethidine and, of course, epidural. This advice is mirrored by NICE.

The Health Secretary commented, “Clinical guidance clearly state that you can ask for pain relief at any time – before and during labour – and as long as it is safe to do so this should never be refused. I’m concerned by evidence that such requests are being denied for anything other than a clinical reason.”

Depriving women of choice is a serious concern. Not least because most experts, including The British Pregnancy Advisory Service consider an epidural to offer the most effective pain relief. This is because it is a kind of anaesthetic which provides enough numbness to offer almost total pain relief for most women. However, it requires an injection into the spine and must be administered by a hospital anaesthetist.

The British Pregnancy Advice Service (BPAS) commented, “We urge the Health Secretary to ensure that access to the pain relief women need in labour is a key part of plans to improve maternity care in this country. Women deserve nothing less.”

A choice, not a debate

Childbirth is the most important of all life events. It is crucial that hospitals empower women by giving them choice. Quite simply, this means letting them have a ‘natural childbirth’ by going pain-relief-free if they want or letting them make the perfectly natural choice to have pain relief, if that is what they desire.

This is an important issue and it is essential that no woman should be restricted in her choice or made to feel guilty for any choice she does make.