Have you been asked to book your epidural before going into labour?

I recently had a private consultation with a couple who told me they had to book their epidural before going into labour at a hospital here in Perth. Apparently they were told the hospital has too few anesthetists there to guarantee an epidural if women don’t book them before hand.

Apart from the fact that epidurals lead to more intervention, and it is therefore not surprising that this hospital has the highest caesarean section rate in Perth, 55.8% (source WA Health Dept), I worry that these women are not giving fully informed consent.

If you have been asked to make this choice here are some questions you should ask yourself and your obstetrician.

How do I know if I am really going to need an epidural? Most women, before birth, underestimate their ability to cope with labour contractions.

Am I making this choice because  I am afraid I won’t get an epidural if I don’t book one then change my mind? Consent under duress is not informed consent.

*I think it is really unfair on women who haven’t booked an epidural to have this constant fear in their minds while in labour. (I have another blog on how fear effects labour)

Have I been given enough information or attended good, unbiased prenatal education classes before booking my epidural? Again, if not then it is not informed consent.

What happens if I book an epidural then change my mind in labour? Do I still have to pay? This might mean your decision is a financial one rather than what you really want.

Is this is what happens at other hospitals?

*I really think this is a dreadful situation for pregnant women to be put in and they need to realise their power as consumers. Of course they should be allowed the pain relief of their choice at any point in their labour without having to make the decision before hand. And if the hospital they are attending is not offering this then maybe they should choose another hospital. They are paying a lot of money to private health insurers and providers not to be getting exactly the labour they want.

If you want more information on  epidurals you should read Dr Sarah Buckley’s excellent article through the link below.


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