The new mother who woke up ‘screaming in agony’ after being sent home from hospital after a caesarean section with nothing more than paracetamol.
The women left exhausted from traumatic labours – and in so much pain they couldn’t walk or look after their newborn babies – told by NHS staff they could not have stronger painkillers because ‘you’ve just had a baby, what did you expect?’.
The mum who sobbed and begged for morphine days after an emergency C-section but was refused as she ‘might get addicted’ – and others in a similar state simply discharged and told to pick up some tablets from the supermarket on their way home.
These horrifying tales, from postnatal wards across the country, have emerged after a prominent GP wrote on social media of her outrage that women having caesareans were routinely being discharged with only the most basic pain relief.
Caroline Farrow, with second baby Imogen, was discharged with paracetamol each time after four caesareans
Mother-of-five Ms Farrow, 49, who lives in Surrey with her priest husband, recalled waking up ‘screaming in agony’ after having Imogen at the Royal Sussex Hospital in Brighton in 2009
Posting a graphic picture of the aftermath of her own C-section, Dr Stephanie deGiorgio wrote recently on X: ‘This is the pretty big hole in my abdomen from where this little lady emerged.
‘Why…why…do women get discharged with paracetamol and ibuprofen? This is not enough for abdominal surgery. I hear it over and over again and every single time it enrages me.’
The post has now been viewed more than 600,000 times and led to a deluge of responses. They suggest hospitals fail to follow clear guidance set out by NHS regulators which list a range of stronger painkillers, including opioids, available to help new mothers cope with more severe pain.
And they are a further damning indictment of NHS maternity services which come just weeks after the publication of a seminal report by the All Party Parliamentary Group on Birth Trauma.
The report, the result of the UK’s first inquiry into birth trauma, found a litany of appalling care on the nation’s maternity wards, with women in labour being mocked, ignored and left with permanent damage by NHS doctors and midwives.
Some women interviewed for the inquiry described being laughed at when they asked for pain relief during labour, while some were offered only paracetamol to deal with their contractions.
One midwife told how a senior obstetrician insisted – shockingly – that ‘women do not have nerves in their vagina’.
Theo Clarke, the Conservative MP for Stafford, set up the APPG following the traumatic birth of her own daughter in 2022.
The 38-year-old suffered a third-degree tear and, while she was given codeine in hospital following surgery to repair it, she was not given any pain relief when she was discharged – despite feeling like she had been ‘hit by a bus’. Ms Clarke says the pain was so severe that she was not able to pick up her daughter, Arabella, for several weeks.
‘When we wrote our report it was very clear that access to pain relief was an issue,’ she told the MoS. ‘We heard cases where paracetamol or ibuprofen were the only drugs given after surgery and a number of very shocking stories where women were denied pain relief.
‘One of the mothers we spoke to said a nurse had told them that it would “bankrupt the NHS” if everyone got pain relief after birth.
‘Of course, there needs to be a balanced approach so that the NHS isn’t giving out opioids to too many women, but there is a big difference between a straightforward vaginal birth and a traumatic one, which might leave you bedbound and unable to do anything for yourself.’
Ms Clarke had ‘weeks of pain’ and was reliant on painkillers which she had to buy herself. ‘I was in a privileged position to afford it but many women cannot.
Dr Stephanie deGiorgio is concerned that so many women get only the most basic pain relief
One woman said she ‘begged and sobbed for morphine on day four after my section because I was in agony and so sleep deprived’ (stock image)
‘If you had surgery after a sport-related injury you would get painkillers, so why is that not the same for giving birth?
‘Women’s health during birth has been deprioritised and the Government needs to take action.’
While some women responding to Dr deGiorgio’s post insisted simple painkillers were enough for their pain, other stories were heartbreaking. One woman wrote: ‘I begged and sobbed for morphine on day four after my section because I was in agony and so sleep deprived. They told me no because it can be addictive.’
Another said: ‘I went back to hospital the same day I was discharged (with NO pain relief prescribed I might add), I had severe pain to the point I couldn’t concentrate, I got there to be told “You just had a baby. What do you expect?” And was sent away with no pain relief again.’
Dr deGiorgio, an urgent care GP in Kent, said: ‘It’s medical misogyny, whether the NHS staff are male or female, with the belief that it’s “just having a baby” and the pain is to be expected.
‘There are really clear guidelines on what drugs women can be offered following a caesarean, but many hospitals are not following those in practice. As GPs, we’re the ones who pick up the pieces.
‘Women call us from the postnatal wards to say they’re coming home following major abdominal surgery and they’re not being given any pain relief at all. It shocks some GPs, but it’s true.
‘Part of the problem is this myth that women who want to breastfeed can’t take pain medication, which is plain wrong. Part of it is Trusts trying to get women discharged from postnatal wards as quickly as they can and to save money.’
She added: ‘A large part of it is also about minimising women’s pain, particularly around childbirth, and expecting them to just cope. There’s no way you’d discharge a man home following major abdominal surgery without pain relief. So why are we doing it to women?’
Around one in four pregnant women in the UK will have a caesarean birth. It’s major surgery, which involves making an incision across the abdomen and opening the womb to deliver the baby.
It is usually performed while the mother is awake and anaesthetised from the waist down. After the operation, while in hospital, women are often given morphine.
The official guidelines on pain management following caesarean sections, which are drawn up by health regulators the National Institute for Clinical Excellence (NICE), are clear: medics must discuss pain relief options with women and make it clear that they have a choice of medication to take in the coming days, depending on the severity of their pain.
As a minimum, women should first be offered paracetamol and ibuprofen or another non-steroidal anti-inflammatory drug, such as diclofenac, ‘to reduce the need for opioids and to allow them to be stepped down and stopped as early as possible’.
For many women, these may be sufficient – particularly, Dr deGiorgio says, if women have had a planned caesarean which is likely to have been a straightforward operation.
Ms Farrow said she couldn’t walk for two weeks after the birth and was confined to bed
Emergency sections, which happen when there are difficulties during birth, can be more painful to recover from as they tend to be more rushed.
If more pain relief is needed, NICE recommends considering adding dihydrocodeine, an opioid painkiller, to paracetamol. If the pain is severe, women can be given a short course of stronger opioids such as tramadol or oxycodone at the ‘lowest effective dose’. The reason for the caution is that, in women who are breastfeeding, tiny doses of the medication can be passed to the infant via breast milk.
Opioid painkillers have been linked to an addiction epidemic in the US. But they are used routinely by the NHS to treat severe pain – and the risk of harm or addiction, based on taking a short course of them, is ‘very small’. Women are advised to watch their babies for side-effects such as lethargy, drowsiness and breathing changes.
Dr deGiorgio was given liquid morphine – along with diclofenac and paracetamol – after her own daughter’s birth by emergency caesarean in 2011. She says: ‘I needed that for a while and I was extremely fortunate to get it. In small amounts, there is no reason why you can’t have these drugs if you’re in pain.
‘If you’re in less pain, you’ll be more mobile, which will reduce the risks of blood clots in legs and lungs.’
Dr deGiorgio added there was a ‘myth’ that if women take just paracetamol and ibuprofen this will speed up recovery. She said: ‘If you’re more broken, having been in labour for 24 hours, anaemic from blood loss and from emergency surgery, you may need something more. And that’s OK.
‘There is ignorance in medical circles about what’s OK, but there is extremely clear guidance and those who are prescribing should know what is safe.’
Co-codamol, for example, is no longer recommended because evidence emerged which suggested some women metabolised it differently and passed on more of the drug in their breast milk.
Documents show it is policy for many hospital Trusts to discharge women without even basic pain relief, The Mail on Sunday has discovered.
For example, Manchester University NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust recommends women having a planned caesarean should ensure they have ‘adequate supplies of simple pain-relieving medications at home as these are no longer available on discharge from hospital’.
The official NHS website, referring to recovery from caesarean section, also recommends women make sure they have painkillers at home – and doesn’t mention other drugs which might also be available should they need them.
Dr deGiorgio says the problem is that the onus is being put on women to ask for it.
‘I used to work on postnatal wards and one of my jobs was to assess women and get an idea of their pain relief requirements,’ she said.
‘That was nearly 20 years ago. But I don’t hear of many women today getting a decent assessment of their pain relief needs before they go home.
‘Women are good at masking pain. There will always be women who can go to Tesco after the birth, and that’s great.
‘But the majority do it because they’re told they should be able to, or have that expectation themselves – not because they’re actually OK.’
NICE guidelines, which set out that patients should be offered stronger pain relief if necessary, are supported by the Royal College of Obstetricians and Gynaecologists
One woman who was refused pain relief after giving birth is mother-of-five Caroline Farrow, 49, who has had four caesarean sections. Each time, she was discharged with just paracetamol.
The Catholic commentator and writer, who lives in Surrey with her priest husband, recalled waking up ‘screaming in agony’ after having her second child, Imogen, at the Royal Sussex Hospital in Brighton in 2009.
‘I was given liquid morphine in hospital after the operation,’ she recalls. ‘But when I was sent home a day later it was literally with a couple of paracetamol. That was it. I just remember waking up that night absolutely screaming in agony because the wound was just so raw.
‘I couldn’t walk for two weeks and I was confined to bed. My husband had to do all the nappy changing and caring for Imogen because I was in too much pain to move. It felt, at times, as if I was about to split in two.
‘But when I spoke to my health visitor, and told them how much pain I was in, I was told to keep taking paracetamol and ibuprofen regularly. I was made to feel like I was making a fuss, and that I should just get on with it – that all of this was just normal.’
Caroline was in so much post-operative pain following the birth of her third child, Felicity, that she was given nerve blockers in hospital. But she was still sent home a day later with nothing more than paracetamol.
The NICE guidelines, which set out that patients should be offered stronger pain relief if necessary, are supported by the Royal College of Obstetricians and Gynaecologists (RCOG).
Professor Asma Khalil, vice-president of RCOG, said women ‘should be given pain relief in hospital and to take home’.
Dr deGiorgio added: ‘We need to make sure women are asked about their pain, believed about their pain, and that each individual person gets the painkillers they need both in hospital and at home.’
The NHS was approached for comment.