Should midwives who delay or deny epidurals be prosecuted for assault?

Doctor's hand with handcuff

It happened 37 years ago, but I never forgot.

I was on my medical school obstetrics rotation and had just watched the birth of a baby. The mother had sustained a large second degree tear and the obstetrician was repairing it … without anesthetic. It would have been easy to give the mother local anesthesia but the doctor didn’t do it. The mother was screaming in pain yet the doctor was telling her she was “doing great.” There was no reason for the doctor to forgo the anesthetic beyond the fact that he couldn’t be bothered to administer it and wait for it to take effect.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]What’s the difference between a doctor who performs a painful exam over a woman’s protests and a midwife who denies an epidural over a woman’s protests?[/pullquote]

The doctor’s behavior was inexcusable.

That ugly incident came to mind as I read Assault during childbirth increasingly common in Australia says International human rights lawyer:

International human rights lawyer Bashi Hazard says an increasing number of devastated Australian women are likening their experience of childbirth to assault.

For example:

Brisbane mum Hayley Hackenberg, 34, was diagnosed with post-traumatic stress syndrome three months after giving birth to her second child Tobin.

“I was assaulted,” she says, tears filling her eyes. “It made me feel vulnerable and violated.” …

Hackenberg recalls a doctor coming into the room and telling her she was going to do a vaginal examination – in between talking to a midwife about what she was going to have for dinner.

“It really, really hurt, sending pain deep into my stomach. I asked her to stop, I screamed for her to stop, I whispered for her to stop, but she didn’t,” Hackenberg says. “She was looking at the midwife.”

At this point Hackenberg says she told the midwife: “I can’t do this anymore, I want a caesarean”.

She thought about suing the doctor:

She also spoke with a lawyer who said she could press criminal charges for assault but she decided not to.

Lawyer Hazard considers this situation, a patient in serious pain and a provider doing nothing to mitigate or relieve it, to be assault.

Hazard says the numbers affected are significantly higher and increasing but legal action for mental health issues and nervous shock cannot be brought without physical injury and women are often told there is no real injury.

Which raises the question:

What’s the difference between a doctor who performs a painful vaginal exam over a woman’s protests, all the while insisting she is “doing fine” and a midwife who delays or denies an epidural over a woman’s protests, all the while insisting that she is “doing fine.”?

There is no difference.

The practice is shockingly common:

A forum post that asked mothers “anyone else tricked out of epidural?” attracted 1,000 replies in under two weeks…

For example:

When Murphy entered the maternity ward to give birth to her daughter in February 2016, she was told that she couldn’t have an epidural until she was in active labor. When she entered labor, she requested one repeatedly. She never received it…

Months later, she questioned her care at a meeting with the Head of Midwifery at her ward. She was told that the staff had made a clinical decision not to give her the pain relief she requested. They thought she was going to deliver before it took effect.


Danielle … planned to have an epidural. She even included it in her birth plan. Instead, she was refused all pain relief—including gas and air (a.k.a. nitrous oxide, which is widely used in the UK for pain relief during labor).

“Firstly because they told me I wasn’t in labor and to go home half an hour away,” [she] tells Broadly. “Then I was continually told over the phone I still wasn’t in labor [even though] I was in horrendous pain.” When she was finally examined, midwives told her it was too late for an epidural—or even gas and air.

If painful exams and failure to respond to patient entreaties is assault, midwives who delay or deny requested epidurals have also committed assault.

Human rights lawyer Bashi Hazard is correct that assault of women in labor is unacceptable.

Hazard claims hospital staff suffer excessive fear of liability and disciplinary action, so their response is to be more coercive to a mums-to-be as they deliver their babies.

“They no longer perceive the woman as their priority,” Hazard insists. “It is a really toxic workplace environment with everyone ready to point the finger at everyone else.”

In the case from my medical school rotation, the doctor denied the mother local anesthesia for a laceration repair because he didn’t want to be bothered and he believed the woman “didn’t need” pain relief.

When midwives delay or deny epidurals it’s because they don’t want to be bothered and because they believe women “don’t need” pain relief.

If Hazard and other birth activists truly believe that ignoring women’s entreaties about pain is assault, they should call out and even prosecute the midwives who do exactly the same thing.

62 Responses to “Should midwives who delay or deny epidurals be prosecuted for assault?”

  1. Kelly
    September 6, 2019 at 8:32 pm #

    So grateful for all my nurses who got me my epidurals as quickly as possible. My nurse at the last delivery went and found the anesthesiologist before they went into a C-section so I could get it quickly. If she hadn’t, I wouldn’t have had it in time before I delivered my daughter.

    • AnnaPDE
      September 7, 2019 at 11:04 pm #

      The way that my OB handled the “anesthesiologist is busy” scenario for another patient during one of my appointments was when I knew she was the right pick: She got the message from L&D, spotted another anesthesiologist through the car park from her window, and when he didn’t respond to shouts and phone calls, literally ran after him and caught him just in time. He went back inside and did the epidural.

      • Kelly
        September 8, 2019 at 5:50 pm #

        That is awesome that both of them did that. Pain relief is so dang important .

  2. nata
    September 3, 2019 at 11:03 am #

    Did anyone here mention another ridiculous excuse to decline epidural: well, the anaesthetist will need you to stay very still and you can’t sit still in this pain, can you?

    • MaineJen
      September 4, 2019 at 9:38 am #

      ……seriously? >:(

    • Voly
      September 5, 2019 at 6:27 pm #

      I had a great anesthesiologist give me an epidural between two Pitocin induced contractions. It was awesome! He also came within 5min of me asking for it, and even tried to make me feel better with some jokes.

    • Kelly
      September 6, 2019 at 8:41 pm #

      I always tell them when I am having a contraction and they wait until it is over to continue. I have had four and every time they wait. That is a ridiculous reason. The only reason I have had to wait was because the anesthesiologist was in a c-section but they still did it when I was at a 9.

  3. Allie
    August 29, 2019 at 8:26 pm #

    We need a hash tag. #metoo is taken. How about #Ialso? Absolutely zero excuse to erase/ignore a patient’s pain. I gave birth in a hospital specializing in OB/GYN. Relatively woo-free, but I was not offered pain relief and laboured for 5 hours. I erroneously believed it was too late for an epidural by the time I got there, which I learned later it wasn’t. They just kept saying “you don’t need it.” Thankfully, they did administer opiod-based pain relief while they sewed up my ruptured clitoral artery and tearing. However, it took an excruciatingly long time to get it in me as they don’t do routine hep-locks. If I had it to do over, I would ask for the precautionary hep-lock and insist on discussing pain-relief options.

    • sdsures
      September 5, 2019 at 2:32 pm #

      I was denied pain relief during a colonoscopy performed when I was fully conscious last October. A Heplock had been installed before starting the procedure, but the medication wore off. She refused to top me up and told me to stop screaming because “you’ll scare the patients”.

      I screamed back, “They SHOULD be scared!”

      • MaineJen
        September 5, 2019 at 2:43 pm #

        Whaaaaaaaat 😮

        I’ve already decided I want to be fully asleep for mine. I don’t care how long it takes the medicine to wear off afterward. It will be worth it.

        • The Bofa on the Sofa
          September 5, 2019 at 7:57 pm #

          It was my first experience with propathol

          No problemo. An hour later I was back to normal

        • Eater of Worlds
          September 6, 2019 at 9:54 am #

          Around here, that’s the routine way to have a colonoscopy. They are all under sedation unless you request or require otherwise. My spouse had never had any surgical procedure besides LASIK, so didn’t have any understanding of that level of pain nor how those kinds of anesthetics work for them. I told them that having a colonoscopy is the absolute best way for them to experience their first procedure of anything. They won’t have pain and they will be out and they ended up being one of the type that gets goofy on anesthetics. They were concerned about that, being fuzzy headed but with reassurance that it’s temporary and to enjoy the feeling while it lasted they had fun.


          Our GI practice (different docs but same practice) uses propofol and not midazolam (Versed). It is given by an anesthesiologist and the entire thing is billed in such a manner you don’t have unexpected “doctor not covered by insurance” fees. The Versed does NOT control any pain from the procedure. Midazolam is a benzodiazepine, just like xanax (alprozalam) or valium (diazepam). It makes you sleepy, decreases anxiety and prevents you from forming active memories. But if you have pain, your body will feel it and you will mentally and physically react to the pain, in that you form an association with the pain but your brain doesn’t know why or how. If you have enough pain you can actually get PTSD from what procedure they are doing to you unless they treat the pain, and places are willing to do that to you, to either not treat your pain at all or under treat it because “you won’t remember it.” I have proof from an attorney this happens in a hospital setting (NOT for a colonoscopy in your doctor’s surgical center. Mine has his in the same place as his office and regular doctor’s appointments, it’s just an attached surgical center in a regular office building). If anyone wants to read the horror story that happens in interventional radiology in a major hospital with only midazolam, I will be happy to post an attorney’s experience with that shit show. The attorney is a health care law attorney and they are still debating suing the hospital.

          This is why my practice does not routinely use versed. Propofol (What Michael Jackson had in his system) knocks you out fast. The recovery from it is equally quick and you’re not left loopy all day. Midazolam takes longer and needs higher doses to get you to the level where they can do shit* to you so it takes longer to recover from and this recovery can make you loopy for hours after you have it. Propofol is an actual anesthetic, it stops your pain. Propofol hurts when you get it injected so they work to fix that. I’ve never felt any overwhelming pain and you’re out so fast, in under 30 seconds, it’s not like you’re waiting in agony forever. I’ve never woken up in pain from it either.

          So when you do your colonoscopy make sure that you’re not having “twilight sleep” which is another word for the midazolam (versed). Go for the “milk of amnesia” or go home. Propofol is oily and it reflects light so it looks milky, like milk of magnesia which is a laxative and an antacid. I refrained from using shit* here…no I didn’t…

          *but and shit because I am a 12 year old boy.

          • The Bofa on the Sofa
            September 6, 2019 at 10:33 am #

            Propofol is oily and it reflects light so it looks milky, like milk of magnesia

            That’s why Michael Jackson called it “milk.”

            When I had my colonoscopy, I resisted the temptation to say, “More milk….” as they were putting me under (MJ’s reportedly last words)

          • Mishimoo
            September 15, 2019 at 6:04 am #

            I had propofol as part of the mix for my hysterectomy, and it turns out that I’m one of the people who takes a while to wake up afterwards and kept scaring the nurses by not breathing (It also messes with my liver and changes my urine colour – it was bright green!). They kept waking me up and I kept thinking “Why don’t they just give me Narcan?” but didn’t say it out loud because I was sure I was wrong.

  4. Azuran
    August 29, 2019 at 4:16 pm #

    The whole ‘too late for an epidural’ seems very dumb to be in most cases.
    Doing an epidural isn’t all that long. Any half decent hospital could just have pre-made epidural kits ready to be used at a moments notice. It took hardly more than 5 minutes for both my epidural and spinal and it started to have effect as little as 5 minutes later.
    So unless the baby is already halfway out or has a very worrisome heartbeat, I highly doubt pushing couldn’t be delayed by 10 minutes.
    And even if, in the end, the baby comes before you are completely numbed, well, at least you are still numbed if you need a tear repaired.
    And if they deny an epidural, then there is a 100% chance you are going to give birth without one. Compared to at the very least a good enough chance to have at least some pain control if you take the time to do one.

    • Sue
      August 29, 2019 at 11:41 pm #

      It’s even less likely to be ‘too late’ for nitrous oxide, which has a really rapid onset and offset time.

      • mabelcruet
        August 30, 2019 at 9:11 am #

        When I was a medical student, we were on delivery suite being supervised by one of the registrars (its a middle grade doctor, like residents in USA). He let us try nitrous oxide to give us an idea of what it was like and how it might affect women in labour. Literally, it was a couple of puffs, that’s all. It was almost immediate-to me it was very like when you have a glass of wine when you haven’t had any alcohol for weeks-it makes your head spin a little, but it only lasted a minute or two and then you’re right back to normal. So saying there was no time for nitrous oxide is completely untruthful-if a midwife is telling people that then its an out and out lie.

        • nata
          September 3, 2019 at 11:02 am #

          I think usually enthonox is readily available and not restricted. Actually, the midwives love using it. However, when the woman is pushing, she is often discouraged from it because does affect your ability to focus on a task :/.

          • sdsures
            September 5, 2019 at 2:34 pm #

            I’m sure the MIDWIVES love using it.

            They’re not actually in labour.

          • Cristina B
            September 5, 2019 at 11:59 pm #

            I used it with my first. By the time I was pushing, it was no longer effective.

    • Anoni
      August 30, 2019 at 3:17 pm #

      I was “too late” with my third kid. My hospital’s policy is to run two bags of saline before administering an epidural. I don’t know if that’s typical, but my blood pressure dropped sharply with my previous epidural, so it sounds reasonable to me. By the time the nurse placed the IV, I only had about 35 minutes to delivery, so I never got through the second bag.

      But my midwife (a CNM who has delivered all of my kids, so she knows how my labors go) did actually put the order in, despite warning me that I probably didn’t have time.

      • Azuran
        September 4, 2019 at 12:01 pm #

        There was not any kind of such requirement where I gave birth.
        For my first, I was induced and I had an epidural when my contraction started, about 2 hours after the induction started. I indeed also had an IV, but it was started at the same time as my induction and was at a maintenance rate, I didn’t even have anywhere close to 1 bag when I had my epidural
        On my second birth I had a planned c-section. IV was placed right before (as in, maybe 1-2 minutes) I had a my spinal. So basically I had 0 fluids beforehand.
        Did you have that 2 bags for all your births? or only because you had a massive blood pressure drop?

      • swbarnes2
        September 5, 2019 at 2:57 pm #

        Like to fill you up with 2 bags of saline before the epidural?

        I thought the idea was that the saline was there to “top you off” if your blood pressure dropped, not that you were supposed to be bloated before the epidural even starts.

    • MaineJen
      August 30, 2019 at 4:48 pm #

      One of the reasons I loved my OB is that she told me for first time moms, there is no such thing as too late for the epidural! Because even if you are fully dilated, it could still be hours before you deliver. So any time you ask for it, you got it.

  5. EllenL
    August 29, 2019 at 2:13 pm #

    You know you’re in trouble if you ask a doctor “will this hurt?” and he says, “most patients tolerate it well.”

    Midwives use similar language. “Most women handle the discomfort of labor well.” This is midwifese for “It hurts like hell, but since everyone experiences it, it’s no big deal.” The very fact that labor pain is ubiquitous makes it unimportant to them.

    What’s more, they’ll make you feel guilty for bringing it up.

    Midwives are only willing to treat labor pain if they judge it to be extraordinary – and 99% of the time they don’t.

    • mabelcruet
      August 29, 2019 at 2:39 pm #

      We used to lie to children-we would tell them injections wouldn’t hurt a bit. However, we know better now-we tell kids they’ll feel a sting, or a pinch that might hurt but it won’t last long. So why are we still lying to adult women going through one of the more painful experiences they will ever go through? Why are we not being honest and saying ‘different people experience it differently, but there are all these techniques we have available, we can do something about it as soon as you want us to do something about it’.

      I posted recently about this-I had abdominal surgery a few years back-I was written up for a PCA (patient controlled analgesia pump), but it wasn’t put in place. When I came round post-surgery, the nurse asked if I needed something for pain relief, and when I said yes, her response was ‘I’ll come back in an hour and see how you are then’. There was a doctor nearby in the unit and he sorted things out. The PCA pump was then erected, but I barely used it. However, I needed it because I couldn’t trust the nursing staff to give me analgesia when I said I needed it. If I had had the trust in them to do their job properly, I wouldn’t have needed the pump, but them being unhelpful and overriding my autonomy ended up with them having to do more work monitoring the pump and the injection site.

      • PeggySue
        August 29, 2019 at 2:46 pm #

        This is just so wrong in every way. I’m sorry.

        • mabelcruet
          August 29, 2019 at 4:40 pm #

          I complained afterwards, not so much for an apology, more to highlight that I felt this was a significant issue. The response from the hospital was that the nurse had not refused to give me analgesia and I must have interpreted her comments wrongly. So even with a witness who overheard her and who made sure I got pain relief because the nurse wasn’t offering any they didn’t believe me. Why would the doctor have needed to intervene if the nurse didn’t refuse to give me the prescribed medication? I was basically gas-lighted-usually I’m good at standing up for myself and being assertive, but when you’re exhausted, naked, a couple hours after major surgery with catheters and drips in, its hard to put up a fight and make demands.

          • PeggySue
            August 29, 2019 at 5:01 pm #

            Which, of course, is the whole point–that’s why they get away with it, and that’s why they SHOULDN’T get away with it!

          • rational thinker
            August 31, 2019 at 10:23 am #

            I have been thinking about something for awhile and wanted to ask about it or if it has occured in any hospitals that you know of. Some nurses choose not to give pain meds that the doctor has ordered for their patient when the patient was in pain because they think they know better or accuse a patient of being a drug seeker even when the patient has just had surgery. Sometimes the patient never finds out until after they leave the hospital that they were supposed to have been given pain meds.
            Do you think that maybe some nurses who dont give patients their pain meds may have a drug addiction themselves. If you think about it it is the perfect way to feed a drug addiction without getting caught. This way no meds are actually missing and the records say they went to the patient even though they did not.

          • mabelcruet
            August 31, 2019 at 1:23 pm #

            It’s an interesting point-I honestly don’t know. The last time I was a ward doctor was in 1992-I did a couple of years in general medicine before I went into pathology. At the time, nurses generally didn’t do injections or intravenous drugs-they did the oral medication drug rounds, but any IVs had to be given by a doctor. Controlled medication, like diamorphine, were held in a locked cupboard, and the process was that the senior nurse in charge held the keys, and escorted you to the cupboard, and witnessed you preparing the dose, and signed off to say that you both had checked the dose and any residual was disposed of immediately. In theory, that was supposed to prevent any going missing. However, it was completely commonplace for the keys to be handed over to the doctor and me doing it all on my own, especially if the ward was busy, so it would have been very easy for me to pocket the diamorphine for myself, or to make up IV infusions and syringe driver infusions with less than the prescribed dosage and keep the rest.

            Nowadays, the vast majority of IVs and injections are done by nursing staff. Generally, IV infusions are made up in the hospital pharmacy and delivered to the ward, rather than being made up on the ward, so that would reduce the chances of drugs going missing at ward level. As for oral medication, the drug round is supposed to have two nurses doing it, to check the dose, the drug, the patient and the timing and both are supposed to sign off. So theoretically, that should lessen the risk. However, medication being stolen from the ward happens, every year there are a few cases reported in the media of nurses (and occasionally doctors) stealing drugs-usually opioids, sleeping pills and the like. I can see it happening maybe more easily in emergency departments, or in theatres perhaps, in less controlled and emergency situations.

            Hospital pharmacists are responsible for drug stock control-they are supposed to oversee drug use, ensure that the ward has sufficient stocks and account for missing items. I suppose you could have a scenario where the drug round takes place, the two nurses put the patients pills into the little plastic cup thing they dole them out in, and one of the nurses then surreptitiously changes the opioids for the patient with a couple of sugar pills/vitamins that she’s got ready in her pocket and gives those to the patient instead. That would mean that the pharmacy stock taking would be apparently accurate, but it would be very risky. Mind you, if you were an addict, taking that risk wouldn’t be a issue.

          • rational thinker
            August 31, 2019 at 5:01 pm #

            One case I heard of was I think in a nursing home and it involved a fentanyl patch- the kind with the gel in them. A older lady was on them for round the clock pain control and a nurses aide would go to her room and help the patch “work better” for the lady by massaging the patch while it was on the woman. So she got away with this for awhile but they eventually figured out that she was massaging the patch and she was pushing the gel out so she could eat the gel and get high. They caught on when she was off one day and the lady asked the nurse if she could massage her patch for her like that nice nurses aide does.

          • Who?
            August 31, 2019 at 8:27 pm #

            Can I just say:


          • KeeperOfTheBooks
            September 2, 2019 at 11:36 pm #

            FWIW, here in the US, I’ve never, over the course of four hospitalizations, had more than one nurse handling my medicine in my room/at my bedside. So while there might be a nurse in the hall with a medcart or something, I imagine it would be fairly easy for a nurse to pocket/exchange a pain pill in that scenario.

          • mabelcruet
            September 4, 2019 at 2:56 am #

            Back in the day, when I was a clinical doctor on the wards, we mostly had the traditional ‘Nightingale’ wards, one long room with patient beds in a row down each wall. This meant the drugs round was visible to everyone. Nowadays, most wards give patients a little more privacy and are divided up into individual rooms or ‘bays’ which hold 2-4 patients. That means the drug round is probably run like you said-one person delivering drugs to each room, the other manning the trolley. That might facilitate drugs being misappropriated more easily.

          • KeeperOfTheBooks
            September 6, 2019 at 4:47 pm #

            Ahh, gotcha! Many hospitals in the US have private rooms as a standard setup, especially in the OB units, which is where I spent all my hospitalizations. Very nice, of course, if you don’t want, say, random strange-to-you people trotting through your room at all hours (or even just visiting hours), rather less so from a drug oversight perspective.

          • mabelcruet
            September 6, 2019 at 6:45 pm #

            The Nightingale wards have mostly been phased out on the grounds of patient privacy-there usually was only a curtain between them and the next patient. But from the point of view of care, it was so easy to spot anyone in trouble-you just looked and down the ward. In the newer systems of bays and individual rooms I think its possible that patients might get overlooked-the nursing staff have to be continuously circling the unit

          • Eater of Worlds
            September 6, 2019 at 10:04 am #

            Hell, I posted in response above and a big name hospital intentionally doesn’t treat pain during interventional radiology. They give midazolam instead so people won’t remember that they haven’t been given pain meds, but they still develop PTSD from untreated pain and their brains not being able to place where or why they have pain thanks to the midazolam. It was horrifying for the person who refused the full dose to have to watch everyone screaming and crying in pain, and being punished by doctors for wanting pain medication instead of a huge dose of a benzo. I can provide a link to their story.

          • Eater of Worlds
            September 6, 2019 at 4:27 pm #

            My response was marked as spam, sorry folks that it’s gone.

          • sdsures
            September 5, 2019 at 2:35 pm #

            That’s horrible. I’m so sorry.

  6. mabelcruet
    August 29, 2019 at 1:42 pm #

    Yes, absolutely. I’ve seen it as a medical student, women being told they were too close to delivery for an epidural but who then continued to labour for hours. Women who were told that the anaesthetist was busy, except the anaesthetist had never actually be informed the woman was asking for one. NICE (national institute of clinical excellence) which sets standards for health care in the UK, has very clear guidance on this and states epidurals should be given as soon as the woman wants it. Trouble is, midwives can act as a rate-limiting step and block access.

    This is from the Association of Radical Midwives-its an old website, but the attitudes towards epidurals by certain midwives are still very prevalent:

    • Sarah
      August 29, 2019 at 3:28 pm #

      That happened to me! When the anaesthetist did rock up and it was too late, he made it very clear to me that he had only been contacted 5 minutes earlier. Readers will not be shocked to hear that I had been asking for an epidural for hours…

  7. andrea
    August 29, 2019 at 12:17 pm #

    Really fascinating. To me, the best comparison, and probably less moralistic/emotional than birth-but still very common-would be whether or not oral surgeons should be charged with assault if they deny some form of general or local anesthesia for wisdom tooth removal. I also think the whole not explaining bit is a huge problem. “You’re doing great” is obviously better than “shut up,” but it’s still not a good enough explanation. I can see why someone wouldn’t want to explain, though, i.e, “I don’t want to.” When I was 21, in college, needing wisdom tooth removal, and still insured under my parents, I was under the impression I would be asleep during a wisdom tooth removal. I wasn’t personally acquainted with anyone under 40 who *hadn’t* been asleep during their extraction. Needless to say, I was pretty terrified when I found out I would receive only local anesthetic. After a crying jag, though, the surgeon and surgi-tech showed me my insurance, which explicitly stated the insurance didn’t cover general anesthesia and showed me the receipt that my mom had paid $100 to the practice for my after-hours appointment (to accommodate my class schedule) and then said my options were to reschedule and duke it out with mom over whether or not we could or would pay out of pocket, or just go through with it that day under local numbing. My teeth hurt so bad I just went through with it. The sounds in my mouth and ears were really disgusting, but it didn’t hurt as much as I thought. My mom was thrilled (good woman, but *zero* empathy for dental procedures considering what her mouth has been through). Nevertheless, I will always be grateful to my late surgeon and his amazing tech who were thorough enough to show me my options and give me a few minutes to choose. They had plenty of business and many more complicated clients who screamed harder. I was just a random young person in need of more information they had at their fingertips

    • swbarnes2
      August 29, 2019 at 3:58 pm #

      Looking around, I’m not sure that “general anesthesia” is that common for wisdom teeth, but there are things you can get on top of the novocaine, like gas, or IV sedatives, that make things easier, and might make you fall asleep.

      • andrea
        August 29, 2019 at 4:30 pm #

        Good distinction. I recall something in the insurance policy about “no IVs at the oral surgeon,” but that’s about it.

        • Chi
          August 30, 2019 at 5:31 am #

          Here in NZ, dentistry isn’t part of our public health system once you turn 18 (it’s only free for kids) and it can be EXPENSIVE. Plus not all dentist clinics offer IV sedation for wisdom teeth removal because it requires a specialist nurse to oversee the placing of the hep-lock and monitor the patient during the procedure and not all clinics can afford to have one of those on staff.

          So I’ve had 3 wisdom teeth removed and only ONE was done with extra pain relief and that was only NOS. Because it’s expensive enough to have a tooth removed with just local anesthesia.

          My hubby got his wisdom tooth removed with sedation because we now have really good private health insurance which covers wisdom tooth removal because it’s counted as surgery.

          • andrea
            August 30, 2019 at 7:32 am #

            I acknowledge my weakness!

          • Chi
            August 30, 2019 at 7:48 am #

            Oh no, I’m not saying you’re weak! I’m acknowledging that dentistry is shitty for using the minimal amount of pain-reduction for procedures.

          • andrea
            August 30, 2019 at 8:03 am #

            Money talks. The specialist nurse thing in your country reminds me of the urban-rural split in dental anesthesia in the US. Anesthetists can get way better pay in urban core areas, so they avoid rural places like the plague.

    • Johanna K Eby
      August 31, 2019 at 12:44 pm #

      I actually required a pretty complicated surgery when I had my wisdom teeth removed – there was impaction, infection, and problems with my sinuses and jaw bone that needed to be fixed at the same time. I was referred to a specialist and I had to be put under general anesthesia for the procedure.

      I received a nasty shock a few weeks later, when I received the bill, and found out my insurance would cover the surgery because they did not pay for general anesthesia during wisdom tooth extraction. So if I had scheduled three separate surgeries with that maxillofacial surgeon – one for my sinuses, one for my jaw, and one for my teeth – they would have paid for two under general anesthesia, and the third with local anesthesia. But doing it all at once under general anesthesia, they would not cover.

      I think your analogy between childbirth and wisdom tooth extraction does seem like a good one – there is a lot of pushback to pain relief for patients and “unnecessary” surgical intervention – even if that intervention would prevent further problems and emergencies.

      • Johanna K Eby
        August 31, 2019 at 12:45 pm #

        sorry, meant to say “they would NOT cover the bill”

        autocorrect is not that helpful

      • andrea
        August 31, 2019 at 12:49 pm #

        Ugh, that sucks about the jaw, impaction, and sinus. I was lucky all mine had at least poked through the gumline a little.

  8. Cartman36
    August 29, 2019 at 12:00 pm #

    What makes me angry, is that this would never happen to a man. Can you imagine a man being told he doesn’t need pain management for his vasectomy? Never!

    One of the smartest things I ever heard Dr. Amy say was if alternate pain relief methods (hypnosis, a shower, lamaze) we would teach it to soldiers to use on the battlefield.

    • MaineJen
      August 30, 2019 at 4:46 pm #

      My husband had an epidural for pain relief after abdominal surgery. It caused his blood pressure to drop dangerously low at one point, but AT NO POINT did anyone suggest that he didn’t need pain relief, the epidural was too risky, or that he should just tough it out.

  9. no longer drinking the koolaid
    August 29, 2019 at 11:58 am #

    Not to mention that women feel pain differently, as in more intensely. This should be taken into consideration and pain relief offered.

    • mabelcruet
      August 29, 2019 at 2:20 pm #

      We were always taught that pain is what the person experiencing it says it is, and existing when the person says it does. Denying epidurals to women who are saying they are in pain denies their autonomy, and sends a very clear message of ‘I’m not listening to you’, and ‘I don’t trust you to give me a truthful account of your pain’. Denying an epidural because you think you know better than the person experiencing the pain is sheer professional arrogance. Denying an epidural to someone because you don’t believe in epidurals, or because you place a greater value on a ‘natural’ birth than you do on helping your patient overcome their pain is paternalistic, patronising, unethical, cruel and utterly unprofessional, and any midwife who has done this should be ashamed of themselves. Repeat offenders should be struck off-they aren’t fit to be allowed anywhere near women if they can’t be trusted to treat these women respectfully and professionally.

      • PeggySue
        August 29, 2019 at 2:52 pm #

        If you watch “One Born Every Minute” you will see a number of candidates for striking-off–I found the patronizing attitudes very off-putting. On one episode a patient came in wanting no medications but the labor did not go as she expected because the baby was posterior. The midwife continued to deny pain relief per the original plan, and it did not seem as if the team offered the woman the chance to understand how the baby’s position was affecting the labor and then review her birth choices. The midwife was a bit reflective at the end but resolved her questions by deciding she had done the right thing by “supporting her wishes.”

        • mabelcruet
          August 29, 2019 at 4:33 pm #

          I’ve seen it a few times but it worries me at times, and then I end up shouting at the TV! There was a trailer shown for a new series a while back-in it a midwife was discussing issues with mum and dad, and she asked how many children the couple had. It was their 5th baby, and the midwife made the comment ‘haven’t you worked out what’s causing it yet? I’ve no doubt the midwife though she was making a humorous comment, but to me it came across as snide and a bit nasty.

          • StephanieJR
            August 30, 2019 at 9:12 am #

            I keep seeing the adverts for one programme that includes a water birth. I would not be able to hold back from yelling at the tv.

          • sdsures
            September 5, 2019 at 2:39 pm #

            Those make me wanna pick up my laptop and throw it across the room.

          • KeeperOfTheBooks
            September 2, 2019 at 11:34 pm #

            True story: when I was pregnant with Baby Books the Third, I got a nasty kidney infection late one night, and ended up in an ER. The ER decided to transfer me via ambulance to the nearest OB unit. One of the paramedics who handled the transfer got a brief patient history, and when she heard that I’d had four pregnancies actually sniped, “Don’t you know how that happens?”
            It was 3:30 AM, I was feeling quite miserable from pain/discomfort/fever/being very pregnant/not sleeping for about 23 hours straight, and I raised a suggestive eyebrow and snarked right back, “Yes, and we’re damn good at it,” which caused the very nice ER nurse next to me to choke on her water. Heh.
            (To the paramedic’s credit, she semi-apologized and then shut up when she heard that we’d had a miscarriage in there.)

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