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Hospital that refuses epidurals? (punishment for home birth/birth center birth?)

post #1 of 10
Thread Starter 

I am on waiting list for the birth center right now. I just got on in fact. They are booked end of Sept due dates. But they are in the process of hiring a new midwife and hope to have her there in time so I would be added in. Fine.

 

BUT...I found out something odd about the hospital. I am thinking if I cannot get in at the birth center, I would deliver at home. Then I would go to the area hospital if there was a problem. BUT, I was told that they won't give epidurals or such to a woman who comes in who does not have her regular doctor. They said epidurals are elective so if you come in without an assigned doctor who knows your history, the anestesiologists will not give any of that sort of pain killer.

 

Do they just do this to scare people away from doing home or birth center births? Is this just a punishment? Does this rule even make sense?


Edited by Lisa1970 - 7/18/11 at 5:30pm
post #2 of 10

Where did you hear this from?  I would have a hard time believing that.  *IF* they did that, I don't see how they can legally do so and ethically eve more so.  


Maybe get in contact with some area doulas and speak with them about births they have done there?

post #3 of 10
Thread Starter 

I never thought of trying to find a doula to ask. I figure once I am with the midwives...won't they go to the hospital with me if I have to transport? I really wonder if they were telling me this..the nurse was...to try to scare me out of switching to the birth center. Or if they really would have this policy.

post #4 of 10

I would take a tour of the hospital and go ahead and ask them directly. that doesn't sound right. There aren't enough OB's in my city for every pregnant woman so I didn't have a doctor. I had whoever happened to be on call that day/night. No one I'd ever met before. I did have a regular doctor upstairs that only took high risk patients but he doesn't deliver babies.

 

I do know that epiderals have a specific time frame to be given. They won't give it to you until you are just about to give birth and won't give it to you a second late. They also remove it the second the baby is out :(  They jacked my pitocin and the nurse had to beg him to give me the epidural early. I did have to sign something practically AS it was given (annoying! I think I signed a big old X as I was having contractions). Maybe they have to schedule the guy to be there? I did have to give them warning I wanted one.

 

I would also like to add, in my city only midwives are available if you don't get your own doctor (which has to be done like within a week of conception or your sol). So OUR hospital worked with midwives and I had one I hated and moved to a different midwife center (which I liked better) who then sent me to this high risk dr. otherwise I would not have had a doctor (I had gest diabetes)

 

post #5 of 10

Typically, even women who have a regular doctor who knows their history don't have that doctor in the hospital with them when it is time to administer an epidural.  Most women deliver with whoever is on-call from their OB practice, which, depending on the size of the practice, may or may not be someone they have met before.  Some women walk into the hospital in labor with no prior obstetric care.  That shouldn't matter.  

 

If the hospital is depriving women of requested pain relief during labor, they are seriously out-of-sync with ongoing nationwide efforts to treat pain in hospital patients.  Also, epidurals are indicated for women with certain blood pressure problems, and they are obviously needed for women who have surgical deliveries.  

 

Based on your previous posts, it wouldn't surprise me if your local hospital is completely messed up.  If you're still seeing one of the two horrible OBs or the high risk guy who does all the ultrasounds, you could list one of them as your doc when you pre-register at the hospital and then you would "have someone" listed who would theoretically know your history and could approve an epidural if you want one.   

post #6 of 10

Wow. That doesn't sound right to me either... however, I do know that for me, if I do have to go to the hospital it will be pretty much because I need a c-section. Otherwise, I'll be at home. I would talk to your midwives at the birth center (or any home birth midwives you'd work with) about this, as it seems that they would know better. I'm not one to trust what hospital personnel say at ALL. But that's just me, based on my experience. :) 

 

Good luck and please do keep us posted on what you find out.

post #7 of 10
Thread Starter 

I will admit..I am afraid I will end up at the hospital anyway because I am afraid of how I will handle the pain, and that I will chicken out mid labor and ask to switch to the hospital. I am scared of the pain. Everyone says it goes so much better with the midwives. But I have even seen videos and those women still look like they are in horrible pain. I am worried I won't handle it well.

post #8 of 10
Everyone's labor is different. If you need pain relief you should get it. For me, knowing I had options helped me deal with labor a lot better. If it will help you feel safe and supported, you should find out what is available at your hospital, make the necessary arrangements to get an epidural there if you need one, and give yourself permission to go the moment you feel certain you need to.
post #9 of 10
Quote:

Originally Posted by Lisa1970 View Post

 

BUT...I found out something odd about the hospital. I am thinking if I cannot get in at the birth center, I would deliver at home. Then I would go to the area hospital if there was a problem. BUT, I was told that they won't give epidurals or such to a woman who comes in who does not have her regular doctor. They said epidurals are elective so if you come in without an assigned doctor who knows your history, the anestesiologists will not give any of that sort of pain killer.



So what happens if God forbid you need an emergency c/s? No anethesia for the surgery because you don't have a regular doc? I bet if someone came in with a heart attack and no regular cardiologist they'd be required to give treatment. I agree with the others, that just doesn't sound right to me.

post #10 of 10

Hmmm...

 

Several of the smaller hospitals near me (so rural community hospitals) do not have 24/7 anethesiologists.  Women who think they might want an epidural need to register for one prior to the birth, and in some cases pay a deposit for the epidural prior to the birth.  Or they need to accept that they may not have access to that sort of pain relief.

 

As for emergency c/s... it's a "risk" that comes with living more than a few miles from a major medical center/hospital.  Any emergency really, be it a c/s or a car crash or someone falling off a ladder.  If it happens when there is no anesthesiologist actually in the building, it's going to take a certain amount of time for the on call person to get there and/or a certain amount of time to life flight the individual to a facility that can provide the sort of care they need.  As a result, people may die or have a longer/slower recovery as a result of not having access to immediate emergency care.  But it's just sort of built into the system.

 

I'd ask at the hospital about the reasons for this policy... how are epidurals usually handled?  Do they need to be pre-scheduled or pre-paid?  Are they only offered during certain hours (also not uncommon in smaller hospitals, and the source of many of the "you can get it now or not at all" stories)?  Is the policy actually more specific than what you heard... perhaps they will not administer an epidural (or other specific types of drugs) without patient records, rather than that they wont do it without a specific doctor present?  And do they have a reason for the policy and does that reason make sense?  Are emergency cesareans routinely done under general if the patient arrives without records or an attending doctor?  And so on...

 

I dunno... a lot of birth sites and books simply assume that an epidural is always available, but I've heard (and seen) a lot to suggest that access to epidurals isn't as easy as many people assume.  I wouldn't jump to the conclusion that a hospital is trying to punish birthing women based just on a possible restriction to a specific type of pain medication.  It could be that is the underlying cause, but there are lots of other reasons for what you heard...

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