Honest question: Why no drugs/pain relief? - Page 7

[wifeandmom]

Originally Posted by CookieMonsterMommy

Yeah, so I'll get an epidural just in case I need a crash section?

Do you know how rare a CRASH c-section is? Seriously. Even in emergent and urgent c-sections, they almost always have time to place a spinal.

I've seen them have to use general TWICE in my life, and you know what one of the reasons was? Because the doctor placing her epidural placed it too high (very short woman) and with a bit too much of a loading dose and paralyzed her diaphragm. She needed the general because she couldn't breathe and was thrashing all over the OR table. They knocked her out and put a breathing tube down her throat. Score one for preventive therapy, huh?

Getting an epidural in case you'll need a stat section? What a warped and sad view of birth.

Please look into who funded those studies...

Off to post at Baby Center or Parenting or whatever those other boards are.....

Please point out where I said it was a good idea to have a 'just in case' epidural placed. Or that it was something that SHOULD be done 'just in case' for no apparent reason whatsoever.

Oh, yeah, I didn't.

The example I *did* give was in regards to a baby that was already clearly in distress, quite a difference from just popping an epi in every women who comes through the door 'just in case'.

[CookieMonsterMommy]

There is one particular risk that comes to mind that is ADDED to the normal risks of a natural (med-free) delivery as a DIRECT RESULT of choosing to go med-free.

That is, if a woman who opts for no meds during vaginal birth ends up needing a crash section, she often has to be put under a general anesthetic instead of the less risky epidural anesthetic that could likely have been used had it been in place when the emergency occurred.

Is this a reason to justify epidural placement 'just in case' an emergency arises? The answer to that question lies in what particular risk factors a woman has that might make it more likely than not that she'd need an emergency section to begin with.

You mentioned no problems here in the bolded part. You didn't say for a woman who already had compromised fetal wellbeing.

Define "often" (see underline). Like I said, I've seen it used once for a legitimate emergent c/s--twice if you include when the doctor almost killed the woman putting in the c/s.

And complications from epis aren't common? Have you ever worked post partum or labor and delivery? It's not uncommon either. LOTS of women have "windows" where the epidural doesn't cover a certain area of her abdomen and she has intense pain there. Many women have needed 2, 3, even 4 attempts at placing the epidural. I've seen a LOT of spinal headaches in post partum women (I've had one myself and it was HORRIBLE), excessive bruising and pain at the catheter site, etc. I've also seen some rare things like meningitis following the epidural placement, localized infection, partial temporary paralysis of the legs (lasting almost 2 weeks) and cardiac problems following incorrect placement.

Rare vs. not uncommon vs. no chance? Yeah, I'll go with the 'no chance' option, thanks. ::insert little eyeroll and winking face here::

[DeeEast]

Originally Posted by mandib50

if you are making an informed choice and consent to the use of drugs, then i'm not understanding why you would feel guilty about that choice regardless of what others say to you?

I didn't say that I personally felt guilty because I have no reason to. What offends me is women who try to make women who choose pain relief during labor feel guilty. Big difference.

Also, to the PP who said "a little pain on my part". Ummm, its not a LITTLE pain by any stretch of the imagination.

[DeeEast]

Oh and I did have one of those "crash" C-sections where I had to undergo general anesthesia. My DS had a prolapsed cord and he could have died without an immediate C-section. He almost did die as a matter of fact, even with it.

[CookieMonsterMommy]

Originally Posted by DeeEast

Ummm, its not a LITTLE pain by any stretch of the imagination.

Not in everyones experience. Some women orgasm during labor.

[Kidzaplenty]

Originally Posted by DeeEast

Oh and I did have one of those "crash" C-sections where I had to undergo general anesthesia. My DS had a prolapsed cord and he could have died without an immediate C-section. He almost did die as a matter of fact, even with it.

But I have to ask, did you have AROM?

[CookieMonsterMommy]

Originally Posted by DeeEast

Oh and I did have one of those "crash" C-sections where I had to undergo general anesthesia. My DS had a prolapsed cord and he could have died without an immediate C-section. He almost did die as a matter of fact, even with it.

I'm glad he's okay. But I'm not sure if you were trying to proove something?

[wifeandmom]

Originally Posted by CookieMonsterMommy

You didn't say for a woman who already had compromised fetal wellbeing.

Perhaps it would help if you continued reading after the portion you bolded where I discussed this very issue. Then perhaps it would be beneficial for you to read further, where I clearly clarified by giving an example of where it might make sense to go ahead with a 'just in case' epidural given the circumstances.

Just after the bolded portion, I state:

Is this a reason to justify epidural placement 'just in case' an emergency arises? The answer to that question lies in what particular risk factors a woman has that might make it more likely than not that she'd need an emergency section to begin with.

Define "often" (see underline). Like I said, I've seen it used once for a legitimate emergent c/s--twice if you include when the doctor almost killed the woman putting in the c/s.

In an *emergency* section, which is QUITE different than an *emergent* section, if an epidural is not already in place, a general anesthetic is going to be used. Period. Unless you've got an idiot for a doctor.

Emergency sections are ones where mom and/or baby are dying, therefore taking the time to place a spinal or epidural where there is not one already in place simply is not an option. I'm talking cases where the 'decision to incision' time is 5 minutes and baby is out in under 5 minutes from incision.

5 minutes is simply not enough time for even a spinal to work, much less an epidural. And if a hospital has a much greater 'decision to incision' time for true emergencies, I wouldn't set foot inside there.

And complications from epis aren't common? Have you ever worked post partum or labor and delivery? It's not uncommon either. LOTS of women have "windows" where the epidural doesn't cover a certain area of her abdomen and she has intense pain there. Many women have needed 2, 3, even 4 attempts at placing the epidural. I've seen a LOT of spinal headaches in post partum women (I've had one myself and it was HORRIBLE), excessive bruising and pain at the catheter site, etc. I've also seen some rare things like meningitis following the epidural placement, localized infection, partial temporary paralysis of the legs (lasting almost 2 weeks) and cardiac problems following incorrect placement.

Life threatening complications are rare with epidurals and spinals. The end. I can't seem to find anywhere in what you quoted that you'd even get the idea that I was discussing complications from epidurals in any other context than the fact that epis are LESS risky than general anesthesia, which is simply fact. Sorry if you don't like it.

Rare vs. not uncommon vs. no chance? Yeah, I'll go with the 'no chance' option, thanks. ::insert little eyeroll and winking face here::

Wow. Care to elaborate on what birth choices you make that carry NO RISK WHATSOEVER? Cause I'd love to take part in that kind of birth.

Oh, wait. No matter what choices you make, there is *some* degree of risk. There is no option for 'no chance' of risk during childbirth. You have to pick and choose which risks you feel most comfortable with, but there are most assuredly risks to ANY choice you make.

That seems like a given, something that people wouldn't honestly try to argue, but apparently not. :

[boscopup]

Originally Posted by CookieMonsterMommy

I've seen them have to use general TWICE in my life, and you know what one of the reasons was? Because the doctor placing her epidural placed it too high (very short woman) and with a bit too much of a loading dose and paralyzed her diaphragm. She needed the general because she couldn't breathe and was thrashing all over the OR table. They knocked her out and put a breathing tube down her throat. Score one for preventive therapy, huh?

A friend of mine recently was induced (pitocin) for being 5 days late :, suffered the horrible pitocin-induced contractions and finally gave in to an epidural. She had that wonderful epidural window. Then, after pushing for a couple hours, they said she was FTP, so they decided on a C-section. The epidural didn't work, so they tried a spinal. The spinal paralyzed her diaphragm and she couldn't breathe. They had to put her under a general.

Score two for preventative therapy! And I don't work in a hospital... This was just a local friend of mine.

[wifeandmom]

Originally Posted by CookieMonsterMommy

Not in everyones experience. Some women orgasm during labor.

Would you say that is typical? Common? Does it happen often? Or is it rare?

[wifeandmom]

Originally Posted by boscopup

A friend of mine recently was induced (pitocin) for being 5 days late :, suffered the horrible pitocin-induced contractions and finally gave in to an epidural. She had that wonderful epidural window. Then, after pushing for a couple hours, they said she was FTP, so they decided on a C-section. The epidural didn't work, so they tried a spinal. The spinal paralyzed her diaphragm and she couldn't breathe. They had to put her under a general.

Score two for preventative therapy! And I don't work in a hospital... This was just a local friend of mine.

Well shoot. Maybe they should have just kept cutting despite the fact that she could feel them doing so. Would that be better?

Good grief. Nobody said that having a 'just in case' epidural was the thing to do, the way to go, the best choice, the safest route, etc etc etc.

If mom already has an epidural in place, it is LIKELY that it can be used instead of a general. Not always. Not 100% of the time. But certainly more often than being able to use an epidural that isn't in place at all when a true emergency arises. Cause at that point, the chances of a non-existant epidural being used is 0%. There simply isn't time.

FTP isn't a life and death emergency, so once the decision to section is made, there is enough time to allow for epi or spinal placement. Is it going to ALWAYS work? Um, no. Who ever said it did? :

If I found myself in a situation where an emergency situation seemed more likely than not, it would make sense to ME to have the epidural placed at that point instead of waiting until the situation became so critical that it was no longer a possibility due to time constraints. Of course, there isn't always adequate warning before things get to the point of a crash section anyway, which is where you see a general used for non-medicated mothers because there really is no other option at that point.

[Pandora114]

Originally Posted by wifeandmom

Well shoot. Maybe they should have just kept cutting despite the fact that she could feel them doing so. Would that be better?

Good grief. Nobody said that having a 'just in case' epidural was the thing to do, the way to go, the best choice, the safest route, etc etc etc.

If mom already has an epidural in place, it is LIKELY that it can be used instead of a general. Not always. Not 100% of the time. But certainly more often than being able to use an epidural that isn't in place at all when a true emergency arises. Cause at that point, the chances of a non-existant epidural being used is 0%. There simply isn't time.

FTP isn't a life and death emergency, so once the decision to section is made, there is enough time to allow for epi or spinal placement. Is it going to ALWAYS work? Um, no. Who ever said it did? :

I have Psychological reasons for needing GA for a section if I ever do need one.

It's pretty gruesome acctually.

I was raped. The Rohypnol Or GHB I'm not sure which, did NOT Render me unconcious. It acctually just paralized me from the armpits down.

Yeah...

So if I get an epidural/spinal block for ANYTHING I *will* go crazy and relive a PTSD Episode and have to be tossed under psychiatric observation for god knows how long till I come out of it.

My baby wouldn't have a mother for god knows how long...My children wouldn't have a mom...they'd have a raving lunatic they share DNA with.

My husband wouldn't have a wife. He'd divorce me and leave me in the assylum as I rave and go nutso...

So yeah...I KNOW I would be better off DEAD than a raving lunatic inside a psychiatric ward due to a severe PTSD flashback.

I think my husband would rather me be dead too than to have to deal with having POA over a lunatic ex wife for the rest of his days.

[boscopup]

Originally Posted by wifeandmom

Good grief. Nobody said that having a 'just in case' epidural was the thing to do, the way to go, the best choice, the safest route, etc etc etc.

Then why bother mentioning it?

Frankly, I'd be all for the GA... But I've been under GA before and had local anesthetic surgeries before, and the local anesthetic surgeries were MUCH more traumatic for me. I wouldn't have the reaction that Pandora mentions, but I honestly would probably rather have the GA for a C-section, even knowing the risks. I recovered SOOOO much better from my GA surgeries. Really, the biggest thing that scares me about a C-section is the being awake part, because of my previous non-GA surgeries.

Yes, I know FTP is not a crash C-section incidence. I never said it was. My point was that epidurals don't always work, spinals don't always work. Sometimes these items cause really bad stuff to happen (like not breathing). I'd rather take my chances that I won't need a C-section than to get an epidural "just in case" and face the possible complications of that. But again, my views are biased by my psychological problem with being awake during surgery and past experiences with such. My local anesthetic surgery was WAAAAAAY worse than drug-free vaginal birth... because I *remember* the pain of the local anesthetic going in and can feel it when I think about it. Not to mention all the friends I have that dealt with epidural after-effects from their normal births (headaches, backaches, etc.), and one friend who has a disabled child due to an epidural being placed too early (if you look up the risks, that is one of them, but I've only run into one person online that I know that happened to, so I know it's *incredibly* rare... and it's preventable by not getting epi too early).

[thefragile7393]

Originally Posted by wifeandmom

Would you say that is typical? Common? Does it happen often? Or is it rare?

I've read about it....don't know how common it is. While I wouldn't go around telling women this IS going to happen if you labor and birth naturally, it's certainly not impossible for some women. It wasn't that way for me but it's not impossible to imagine that it is how it feels for some women.

[dove]

Originally Posted by wifeandmom

Another thought is that an epi is going to naturally relax the pelvic floor in lots of women, so the baby might descend properly at first, but get 'stuck' closer to the end of delivery. Of course, this doesn't really explain why just as many babies were needing instrumental delivery in the no-epi group, only they were requiring assistance higher up in the birth canal.

or, that the "standard of care" was for the laboring woman (without epi) to be subjected to EFM instead of intermittent fetal monitoring (which has time and again been proven to be just as safe as continuous monitoring) and was unable to position herself in an optimal way to birth her baby.

Why bring up this horrible scenario when it is so rare? What is the point/motivation to do so?

btw, ECSTATIC BIRTH HAPPENS!!!
(but it's not something usually ever seen in a hospital due to the unnatural setting and intervention. Spend a couple years in a homebirth or birth center setting and you will see it. Treating a laboring woman like the goddess she is does wonders. )

[DeeEast]

Originally Posted by CookieMonsterMommy

Not in everyones experience. Some women orgasm during labor.

How ludicrous. Enough said. My pain was beyond excrutiating and so was every other woman's pain that I've ever personally spoken to, including my mother who had 7 children without pain relief. I just do not understand your mind-set nor do I want to.

[CookieMonsterMommy]

Originally Posted by wifeandmom

In an *emergency* section, which is QUITE different than an *emergent* section, if an epidural is not already in place, a general anesthetic is going to be used. Period. Unless you've got an idiot for a doctor.

Emergency sections are ones where mom and/or baby are dying, therefore taking the time to place a spinal or epidural where there is not one already in place simply is not an option. I'm talking cases where the 'decision to incision' time is 5 minutes and baby is out in under 5 minutes from incision.

1st of all, I am very well versed in the different classifications of c-sections, but I thank you for attempting to educate me. No, three is not a difference between an emergent c-section and emergency c-section. Just a similar term for the same level of severity. (There is a difference between urgent and emergent, yes).

Second, yes, I've seen c-sections termed emergent (or emergency) where there was enough time to place a spinal. GA isn't prefered because of the increased risks not only to mom, but to baby. If you have a baby who is compromised to begin with, you don't want to risk stopping the oxygen to the baby if mom can't be intubated immediately.

Third: Are you aware that a common side effect/adverse effect of epidural is low blood pressure? (which is why they bolus you with 500-1,500mL of fluid before/during) Do you know the consequence of low maternal BP? Decreased placental perfusion. Decreased PP=less blood through umbilical cord=less oxygen for baby=slowed fetal heart rate=deceleration=poor tracing=HUGE increase for "need" of c/s.

Fourth-

Life threatening complications are rare with epidurals and spinals. The end.

I never said they weren't. But it is not the end. Like I've said, I've had a spinal headache, and being laid up flat on your back for days, with morphine hardly touching the pain is nothing to sniff at--I can't imagine what that would be like while trying to establish a nursing relationship, bonding, going home, etc. The risks are there. I'd never make a general statement like "Epidurals are unsafe. Period" I'm not an idiot. I've seen epidurals do very good. I've seen them save a mother from a c/section. I just think it's very unsafe, unwise and unethical to say what I quoted. And most women don't know the risks to epidurals, spinals, stadol, demerol, etc. in part because people consider them rare and uncommon enough to not mention it.


Re: Risk vs. No Risk: I made the choice not to have pain meds in labor, and there is no risk in not getting pain meds, so I'm not really sure I should need to elaborate more. What else qualifies me? I refused an induction. Didn't stay on my back. No directed or purple pushing. No continuous EFM. I ate and drank in labor. Obviously laboring itself poses inherent risks, but I chose not to add to that. Is that a good enough laundry list for you?

Kelly

[CookieMonsterMommy]

Originally Posted by DeeEast

How ludicrous. Enough said. My pain was beyond excrutiating and so was every other woman's pain that I've ever personally spoken to, including my mother who had 7 children without pain relief. I just do not understand your mind-set nor do I want to.

Excuse me, why is that ludicrous? It has happened. To some mamas here, and it's been published. Yes it's rare, but worth mentioning. I wanted to enlighten you that not every woman's labor experience was like yours, since you seem to have been (and continue to be) ignorant to that fact. And yes, it's a fact.

My labor was *NOT* beyond excruciating. it was painful, yes. But I'd never cal it excruciating--even during the labor I did not.

You don't want to understand me? Then put me on ignore or don't respond. Don't waste both of our times.:

Kelly

[alegna]

Originally Posted by DeeEast

I just do not understand your mind-set nor do I want to.

Wow. Why wouldn't you want to understand? I did not have an orgasmic birth (don't we all wish, huh?) BUT it was not unbearable. It was not intollerable. I never even WANTED meds.

I think it has a lot to do with the fact I birthed at home and was in my own element, but perhaps I was just lucky

-Angela

[alegna]

Originally Posted by CookieMonsterMommy

there is no risk in not getting pain meds

this is worth repeating.

-Angela