Shocked at epidural rates! - Page 2

[DeChRi]

Originally Posted by MiaMama

I have recently read on boards for OB nurses that some hospitals have +90% pitocin rates.... and some nurses saying that it is standard practice where they work to augment labors. That mean that every laboring woman who comes in to those hospitals gets augmentation with or without indication unless they specifically deny it.

When I read THAT, I was floored. No wonder the epidural rates are so high.

Agreed. I admit to watching A Baby Story and Birth Day, mostly to raise my BP and remember over and over why I strive for natural births. But almost EVERY single bith where mom goes into labor on her own, she goes to hospital and they kick in some pit to move things along. I just do not get it. I had pit with #2 after my water broke and later the next day depsite all natural methods, I had not so much as a contrx, and was GBS+. And I still question if it was right, although I dont have much for regrets.

I just cannot imagine why they pump it into everyone. It completely fried me in a way I do not care to repeat.

[mambera]

Originally Posted by lunita1

When my daughter was born I got a lot of attention from nurses who were fascinated and amazed by my wide awake, alert newborn. They just weren't used to seeing unmedicated babies.

That's odd - so were there high rates of IV analgesia there? Most places use epidurals and as far as I know those don't have any effect on the alertness of the baby.

Originally Posted by MiaMama

I have recently read on boards for OB nurses that some hospitals have +90% pitocin rates.... and some nurses saying that it is standard practice where they work to augment labors. That mean that every laboring woman who comes in to those hospitals gets augmentation with or without indication unless they specifically deny it.

Now THAT is a sad statistic - much more horrifying than a high epidural rate. That sounds more like malpractice than anything.

[GreenMamma]

Here it is 99%.

[RedOakMomma]

I don't know what the percentage is here, but no one at our hospital was surprised by my choice for natural births. In fact, the nurses there were so busy trying to read and accomodate my birth plan (I arrived late for the second birth) that they almost missed I was in transition!

Likewise, none of the nurses were thrown by following the birth plan, and none of them were surprised by an alert baby. They seemed to expect the baby to be alert, and were right there to work on a proper first latch.

This was at a pretty traditional hospital, in a large midwestern city...no midwives practice there, and as far as I'm aware they don't even have labor tubs. Even so, natural births feel and seem like a very normal occurance there, and nurses are totally comfortable with it.

...Heck, even with my twin birth (which was also natural), the anesthesiologist came in and practically apologized for being around because my birth plan said I didn't want pain medication. He had to be there in case I needed an emergency c-section (ds2 was breech and both boys had heart issues), but after introducing himself (and acknowledging my birth plan), he backed way up into the corner of the room and was respectful as can be.

So even in the most traditional pockets of America, at the most normal hospitals, you might be surprised!

[gcgirl]

You know, I didn't even ask at my hospital, but later found out 90% is totally common. It IS shocking. I totally support women's right to choose an epidural, but I'm surprised anyway how many women actually take it. Then again, everybody at work except one person told me to get the epidural as soon as I got to the hospital. There's a lot of scaremongering and not a lot of support for natural birth out there.

Lucky for me I know plenty of people who've gone natural.

[tygrss]

I think it depends on where you are.
Where I went to medical school I think that it was probably about a 60% epidural rate. I definitely saw unmedicated births. In fact, I also saw breech births because a couple of the older OBs still did them and taught the residents. I also saw women walking the halls and sitting/bouncing with doulas.

However, where I did my residency (in a totally different state) the epidural rate was at least 90%. It was probably almost 100% on the MW side, of all places. The only exception was for the super-low risk multigravida women (who birthed with MWs upstairs above the regular L&D). Up there it was about 25%.
Also, there were NO breech deliveries, no walking, beds would only be elevated up to 30 degrees once the BOW was broken, etc.

The two places were night and day.

[phoebemommy]

Hey KGB --

Just curious, which hospital was it?

[RedOakMomma]

I was just chatting it up with several labor nurses about this thread. At their hospital (which has a 75% epidural rate and a 28% c-section rate), they said that they don't see much of an alertness difference between epidural babies and natural birth babies. They see sleepers and wide-awakers in both categories in equal amounts. They did say that natural birth babies are often more vocal, though. Not sure what that's about.

It was interesting to talk with these nurses...it seems like natural births are something they really enjoy and appreciate, genuinely. That's nice to hear/see in a hospital, yk?

[Turquesa]

Keep in mind that these rates are high for both understandable and nefarious reasons.

L&D nurses are phenomenally overworked and under-appreciated. They have to attend multiple births at once. Women undergoing epidurals stay quiet and, in their minds, require less individual attention. It's a horrible system, and hospital short-staffing keeps it that way.

The more nefarious reason, in my mind, is that epidurals keep women sedated, encumbered by medical machinery, and lying down...."in their place," as it were. That's not to say that women who choose epidurals are seeking this status; but I wonder if providers who push epidurals on women do want this scenario.

[mambera]

Originally Posted by RedOakMomma

I was just chatting it up with several labor nurses about this thread. At their hospital (which has a 75% epidural rate and a 28% c-section rate), they said that they don't see much of an alertness difference between epidural babies and natural birth babies.

There have been a number of studies on this and none that I know of has found an alertness difference. Here's one reference, but there are plenty more on pubmed.

http://www.ncbi.nlm.nih.gov/pubmed/2718709
Acta Anaesthesiol Scand. 1989 May;33(4):320-5.
The effect of lumbar epidural analgesia on the neurobehavioural responses of newborn infants.
Kangas-Saarela T, Jouppila R, Alahuhta S, Jouppila P, Hollmén A.

Originally Posted by Turquesa

The more nefarious reason, in my mind, is that epidurals keep women sedated, encumbered by medical machinery, and lying down...."in their place," as it were. That's not to say that women who choose epidurals are seeking this status; but I wonder if providers who push epidurals on women do want this scenario.

I do think women with epidurals are much easier for the L&D staff to handle.
They don't want to do things against protocol (like walk around without a baby monitor or get in the tub) because they can't, so nobody has to have an argument about that. Also the screaming of women birthing without pain meds is probably disruptive for other laboring women on the unit.

[Spiralshell]

My midwife group had a rate of about 50%.

Unfortunately, I presented with preeclampsia, and was induced at 39weeks because my blood pressure was 150/110 and they were concerned about me and the babe. I really really wanted to have a natural birth, even with an induction, but I was forced to have an epidural because once they cranked up the pitocin and my contractions started, my bp went up to 160/120 and they insisted that the epidural would bring it down. It held it steady, but didn't bring it down.
My birth experience was very difficult, and ended (predictably) in a c-section. But the only part where I really cried desperate sad tears was when I got the epidural. It was the moment that I was made to relinquish all control of my labor and birth, and I was horribly disappointed in my body. I had spent 9 months imagining bouncing on the birth ball, laboring in the shower, walking, etc. etc. and all that was gone the minute that needle went in. The hours of labor after the epi were miserable. I couldn't feel him move any more. Everyone who entered the room (midwife included) talked to the monitors, not to me. I was not permitted to move except for a few attempts to turn the baby by going on my hands/knees.
Between the pitocin and the epidural, my temperature also went up, which put me on antibiotics and put my baby in the NICU for observation for 3 days.
Thankfully he and I were both healthy, but it was very hard.
For the record, even after induction, epi, and c-sec, Nate was 100% alert and looking all around right after his birth.

[gcgirl]

Originally Posted by mambera

Also the screaming of women birthing without pain meds is probably disruptive for other laboring women on the unit.

Not disagreeing that screaming would be disruptive, but interestingly, the videos I've seen of women laboring naturally don't include ANY screaming. And I didn't scream, cry, or curse anybody out during mine, even with pitocin. Is it possible that the SCREAMING is a cultural expectation that doesn't happen all that often?

[mambera]

Originally Posted by gcgirl

Is it possible that the SCREAMING is a cultural expectation that doesn't happen all that often?

Possibly! I was a screamer so that may color my expectation. I remember thinking, "oh crap, I'm that crazy screaming lady where everyone is like, 'why doesn't she just get an epidural?'" Of course I didn't care at all by that point.

[japonica]

When I had my daughter a few years ago, the nurse that came to do PP care commented that I was the only one on the whole L&D floor who didn't have an epidural.

I guess she didn't have to fuss over me as much or whatever. I met another mom in the nursery who had been given one and still couldn't pass urine on her own 24 hours later.

[RedOakMomma]

I agree on the screaming...I think it's a stereotype that only fits a percentage of natural-birthing women. I've known very few screamers, and some of the screamers I know were people who had epidurals and pain meds. I also think it's a pretty negative view of labor nurses, many of whom love supporting women and love birth, to think that there's a dark, lurking desire to keep women put and keep them quiet. Same for OBs.

[Honey693]

Originally Posted by gcgirl

Not disagreeing that screaming would be disruptive, but interestingly, the videos I've seen of women laboring naturally don't include ANY screaming. And I didn't scream, cry, or curse anybody out during mine, even with pitocin. Is it possible that the SCREAMING is a cultural expectation that doesn't happen all that often?

I had a totally natural birth and I screamed. Crowning hurt like nothing else. I also told the nurse I was going home and not having a baby though.

I don't know what the epidural rate where I delivered was, but every time someone came into my room they asked how my epidural site was.

[FireWithin]

I went into the hospital, after 48 hours of non sleeping laboring at home, with full intention of not getting an epi. I got a mixed response from the staff. There were a couple of nurses who were really happy to be involved with me, very happy to have a very natural experience. I had one who was rather aggressive and told me in a mean tone that she would leave me alone since I wanted to do things my way. What she said and how she said it was dismissive and cruel. I was really on my own especially when the first group of nurses went off shift. They told me that the nurses were taking bets that I wouldn't be able to do it without an epi. It was humiliating, angering and intensified my desire to not use one. Around 15 hours into my time there and around 4 hours of intense transition my mw strongly encouraged me to get an epi she was really worried that I was beyond exhausted and wouldn't be able to push my posterior baby out. I agreed. I was worried I was getting close to a c-section. When getting it in I started throwing up bright green bile. I was just sooo exhausted. about 8 hours into the epi, while I rested my bp dropped scary low and I fought so hard not to pass out. Soon afterward, when I was at 10 cm, I decided to start pushing even though I felt no desire. My posterior baby corkscrewed out of me in less than an hour even though my next shift midwife told me i wouldn't be able to do it without assistance from an OB. I did it and I don't think I could have done it without an epi, but I do believe if I had the epi any earlier my BP would have gone down even lower and I would have had a section.
It was an intensely difficult 72 hour labor. I wonder if it would have been different at home. My second was a breech section. I am pregnant now and am hoping for a homebirth so that I can have the support I need.

[Bea]

Originally Posted by nia82

When I expressed my wish to not have one my obgyn smirked at me saying that's like a root canal without anesthesia and shook his head....

Yup.

Giving birth is just like having your TOOTH DRILLED OUT AND A METAL PIPE CLEANERS RAMMED AND TWISTED INTO THE NERVES OVER AND OVER.

I'd take a general anesthetic for a root canal if given the choice. For childbirth, the way I experienced it, very bad language sufficed.

[nia82]

@ Bea: SO agree. Never had a root canal, but for dental, I'd take whatever anesthesia you'd offer. Labor was no fun, but I'm so offended by that obgyn, I have no words.... How does HE know anyways? I'm so glad I ended up with his midiwfe. And for his bedside manners..... When I was still bleeding 8 weeks PP and seeing sutures, he decided to yank silver nitrate thingies inside of me to chemically burn skin flaps on my scars. He said it doesn't hurt when I said it did. So much for his compassion anyways.

[honeybee]

When I had my first 6 years ago, my family doc told me the epidural rate was about 98% at the hospital. I made a joke about how I had to be the "difficult" one or something, and she immediately retorted "Different is not difficult." I love our family doc.

I switched to homebirth after that, to avoid the hospital, but much as I loved my midwife, part of me still wished my family doc made house calls.