HOSPITALS are under attack from staff and patients for trying to stop large numbers of women from having epidural painkillers during childbirth.

An epidural, an anaesthetic injected into the spine, is seen by many mothers as a welcome and legitimate way of coping with the often extreme pain of childbirth.

However, under targets now being introduced into NHS trusts,epidurals are stigmatised as abnormal. One senior obstetrician condemned the implications of this policy as a “disgrace”.

The controversial restrictions, promoted by the “natural childbirth” lobby, aim drastically to reduce the number of women having epidurals, caesareans or other artificial procedures to 40%.

In some hospitals the proportion of first-time mothers now having epidurals is far higher at 60%.

The targets are contained in a guidance document, Making Normal Birth a Reality, drawn up by the National Childbirth Trust (NCT) with the backing of the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists.

The document argues that mothers and doctors are too ready to resort to medical intervention and that any such procedure brings risks. The guidance was drawn up 15 months ago, and NHS trusts are now striving to follow it - to the dismay of some of their own experts.

Kim Hinshaw, a consultant obstetrician at Sunderland royal hospital, said: “I have major concerns with this. I don’t think we will ever reach a figure of 60% normal delivery using this definition. For example, in Sunderland we have an epidural rate in first labours of 60%.

“This definition implies that if you ask for an epidural for pain relief, but go on and deliver normally after a six-hour labour, your birth was not ‘normal’. That is a disgrace.”

Professor James Walker, a consultant obstetrician at Leeds Teaching Hospitals NHS Trust, said his trust was working towards the target, but added: “This is a very rigid definition of what normal birth should be.

“Epidurals should not be done without reason; they should be kept to a minimum. There are some women, however, who require an epidural because they cannot cope with the pain in any other way.”

The use of epidurals has long been controversial and is condemned by the more radical proponents of “natural” childbirth as an easy option.

Belinda Phipps, chief executive of the NCT, argues, however, that there are medical reasons for trying to restrict the procedure. An epidural, she says, is more likely to result in a baby being delivered with forceps or a ventouse - a suction device - because the mother is less able to push the baby out.

A British review in 2005 of 21 studies into epidurals involving 6,664 women found the procedure prolonged labour and increased the chance of further medical intervention by 40%.

However, a study published in the British Journal of Anaesthesia in January said the risks to the woman’s health were lower than previously thought.

The authors of Making Normal Birth a Reality argue that better facilities and access to dedicated midwives would make women more confident and less likely to request epidurals. In line with NCT teaching, they say that breathing correctly, assuming the right position and pushing at the right time reduce pain and the need for epidurals.

Smriti Singh, 34, a management consultant from south London, objects to her labours being branded abnormal. Married to a doctor, she is a supporter of the Birth Trauma Association, which helps women who find the acute pain of childbirth unbearable.

Singh has had two children using epidurals, the most recent two weeks ago. She said: “I have done quite a lot of research into obstetric anaesthesia and an epidural was part of my birth plan. I had the epidural, the birth was fine, it was a vaginal delivery and I would consider it normal.”

After secretly having a caesarean for her first child, Kate Winslet, the actress, has spoken of the “triumphant” and “natural” birth of her second child, Joe, which was aided by an epidural.

Additional reporting: Brendan Montague, Helen Brooks

Explore UK News

• Crime News

• Education News

• Health News

• Scotland News

Times Recommends

• Should Knox’s trial even have reached the courtroom?
• All that glitters is not sold in Wright’s world
• Believe it or not, Big Brother is your friend