"Epidural to progress"

[sapphire_chan]

Has anyone heard of this concept? Do you know the reasoning behind it? I've seen it mentioned in a couple of places where a pitocin induced labor has stalled out.

Also, is there a reason one wouldn't just turn off the pitocin and send the woman home to wait a few days if dilation wasn't happening as expected? Assuming the waters aren.... oh yeah, right, with induced labors they "have" to put in an internal monitor and therefore the waters "have" to be broken. But if they didn't do that, would there be a reason, in a non-emergency situation, not to say "this isn't working, let's try again another time"?

[rightkindofme]

After fourty hours of labor at home with contractions every six minutes for the last thirty hours I only progressed to four. At that point I was so exhausted and delirious that I couldn't see straight (I hadn't slept a full night in months because pregnancy was so uncomfortable) so I transfered to a hospital. I got an epidural because I desperately needed sleep. I would not have had the strength to push at the rate I was going. I slept on/off (in between them waking me up to push pitocin, which I refused) for almost five hours. At the end of that five hours I was fully dilated and ready to go. So I suppose I did have an epidural for failure to progress and it solved my problem.

Once I got to the pushing stage my contractions went from every two minutes to every eight minutes. I was willing to start pitocin then because damnit I wanted my baby out. Holy crap for crisco that was not fun. Oh, did I mention I have a ridiculously high tolerance for pain meds (pain too, but that's a different story) so the epidural wasn't really working anymore. Yeah, I felt everything while pushing her out despite having an epidural. I don't freakin care how many doctors claim it isn't possible. Owie. It took three and a half hours to push her out.

Is that what you meant?

[Yarnista]

I just had my baby and was thinking the same thing. I needed an epidural to progress supposedly and the epidural didn't work. The labor still progressed despite it's failure. After I was hooked up to every machine known to man I was really wishing we could of waited longer for her to come on her own.

[BetsyS]

Sometimes the pitocin is turned off, nad people do go home. But, it depends on the reason for the induction. If it's a "just because" convenience induction, or if the induction was because the baby has hydrops and needs to be delivered (the most extreme ends of the spectrum I can think of right away).

And, I've seen an epidural used in Pitocin inductions to help break the fear/pain cycle. The pain of an induction can be intense, and I think an epidural can help with relaxation, which in turn helps a mama's body take over.

[sapphire_chan]

Gotcha, so the reason it's used, when done correctly, is to take away pain so mom can get on with the business of laboring.

So I'd guess, from that, that ideally it'd be the lowest possible dosage (epidurals can be adjusted, yes?) and done after some significant (as defined by the laboring mother) time had passed where other attempts were made at relaxation etc?

[Amila]

I'm no epi advocate, but I had PROM, with meconium, so I was augmented with Pit. 5 excruciating hours later I was only 4cm dialated. I got the epi, was able to relax, and went to 10 within 45 min. Pushed babe out in 10. So it worked out great for me. Luckily. Won't be trying it this time around though

[~*~MamaJava~*~]

What BetsyS said: it's about the fear/pain cycle sometimes, and then that epidural does work to help progress the labor. Not saying I agree with the idea, but when you're already in that situation of an induced labor etc...and stalling out...it works, sometimes.

[Onemagicmummy]

i had been in labour for 10.5 hours. had not progressed 1 bit (was 3cm) was on Pit, was sent in to overdrive, i was exhausted. i was in agony, much much worse than the previous 3 (2 of pit labours too) i was begging for a C-section i couldnt take it anymore.
i got the epidural still only 3/4CM
i realxed a bit i calemed down a bit i got incontrol of my self adn wham, bam baby was born less than an hour later. i dunno if it was epi or me sitting up that helped but it was worth it even tho i still feel a bit bad about it. it was the right choice at the time.

Kiz

[peskyflylady]

My understanding, although I never had Pitocin, is that if you are unable to relax and your body is fighting against itself, the epidural will help. That was my experience after 10 hours of being in back labor, trying the water and everything else available, and being only 2 cm. I was complete within 3.5 hours of getting the epidural, and it gave me the energy to push. And, yes, I kept the epidural down as low as it would go, so I still felt some stuff. Especially toward the end, I was feeling it in my back with a posterior baby. Pushing was excruciatingly painful and 2 hours long, so I was glad I had gotten a couple of hours of rest. The other thing about keeping the epidural really low was that I was still able to assume hands/knees position. I'd love to do without an epidural next time, but it definitely didn't slow down progress for me.

[ShannonT]

That's why I ended up with an epidural. The doctor looked me in the eye and saw me get all panicky during a contraction. I really couldn't ever get on top of the contractions. There was a while where they were 3 minutes long and 30 seconds apart, and I just couldn't handle that.

Labor started at 11pm, water broke at 2am, went to the hospital at 3am... finger-tip dilated at 4am. Hearing that really sucked. Doc suggested epi at 9am since I didn't seem to be relaxing enough during the contractions and was obviously exhausted.

Got the epi at 11am. Then they added pitocin when things still seemed stalled out. Supposedly no labor pattern on the external monitor. Three doses of pit later, hit transition at 9pm. And then an hour and a half of pushing.

[wendy1221]

I had an epidural with ds2. His birth was my very worst birth experience. I got the the hospital in transition and the nurses were very mean to me. They wouldn't call my doctor b/c I was "in early labor." They refused to check me to verify I was in factin transition, because my birth plan said "no unnecessary vaginal exams." SO they only followed the parts of my birth plan that they could be sracastic about. Needless to say, I stalled out at 9 cm, still contracting and it was excruciating. After being at 9 w/ transition type contrax for several hours, I finally got an epidural. I was pushing less than 20min later. Of course, NOT going to the hospital would have prevented that whole fiasco.

[Lorette]

Originally Posted by wendy1221

I had an epidural with ds2. His birth was my very worst birth experience. I got the the hospital in transition and the nurses were very mean to me. They wouldn't call my doctor b/c I was "in early labor." They refused to check me to verify I was in factin transition, because my birth plan said "no unnecessary vaginal exams." SO they only followed the parts of my birth plan that they could be sracastic about. Needless to say, I stalled out at 9 cm, still contracting and it was excruciating. After being at 9 w/ transition type contrax for several hours, I finally got an epidural. I was pushing less than 20min later. Of course, NOT going to the hospital would have prevented that whole fiasco.

Wow, that's awful about the mean nurses who wouldn't check you because of what you put in your birth plan!
I am due in 5 weeks and had to go and check what I put in my birth plan about vaginal exams.
I wrote "NO vaginal exams unless I request one".
I guess they would have checked you if you worded it that way?


Lorette

[sapphire_chan]

Originally Posted by Lorette

Wow, that's awful about the mean nurses who wouldn't check you because of what you put in your birth plan!
I am due in 5 weeks and had to go and check what I put in my birth plan about vaginal exams.
I wrote "NO vaginal exams unless I request one".
I guess they would have checked you if you worded it that way?

Probably would've taking her requesting one as permission to check over and over again. :

Really though, if they were competent and could tell what was going on by external signs, it wouldn't been an issue any way.

[JBaxter]

With DS1 I started contracting on friday night and was in and out of contractions 5-15 min apart till sunday I was so exhausted i had the epidural and slept for 4 hrs woke up at7 they started pit and DS was born at 10. I went from 6- 10 in 30 min. I had refused a cath so after my mom helped me on the bed pan to pee he was born really quickly. ( my mom was a l&d RN and was my advocate/doula after she drove 2 hrs because she was pissed my labor was so long and she didnt think they were doing everything they should be doing. She got my OB hopping LOL)

[courtenay_e]

My in-laws get hysterical from pain, stress, blood...they get hysterical, it's just what they do. SO, when my SIL goes into labor, with the first contraction she gets immediately hysterical, and no matter how long she labors, will not progress until they give her the epidural. With the last one, another SIL who is a nurse went along and convinced the staff to just give the darned epidural anyway, even though she was fingertip, or it would be a REALLY long few days. When they give her the epidural quickly, she has less than an average length labor. So what pp's have said about the fear/pain cycle can be true. If she is not afraid of the pain, she just HAS the baby.

On the other hand, I have seen it used as OTHER pp's have said, after a mother has labored for an exTENDED length of time, and are exhausted, and just plain old need some rest. At that point it generally doesn't take long for labor to progress...because mama is giving her body what it needs at that point...a jump start of energy. (NOT From pit, but from rest from tension).

It can also be used well in women who are sexual abuse survivors...sometimes the sensations of the baby moving through the birth canal are just too much for a mother to bear. SOme women prefer to labor on their OWN terms, whichever terms those may be...so there are survivors who can NOT handle the thought of being "strapped" to a bed...and there are others who prefer CHOOSING that over FEELING the baby move down (so...they still feel pressure, but in a different way than unmedicated). For that group, it can be a wonderful way to have a vaginal birth, and do it on their own terms. I have had different clients choose different options, and they have worked out for them...I think mainly because they are taking control of the options, you know?

[sapphire_chan]

Courtenay_e, thanks! That's a really great summary of all (most?) of the different uses.

It's fascinating how different people are. I've heard of labors stopping because of epis, and now here are labors that can only progress with epis.

[Belle]

I went to a birth as a doula where the epidural really helped her. She hadn't got any sleep the night before her induction. She didn't know she was being induced. They did an NST on her and decided on induction that day. They started her out on pit and kept lowering the dose. Her partner abandoned her during her labor. After several hours of quad-peak contractions and back labor she was exhausted. She got an epidural at 4cm. One hour later she was pushing. She was just too tired to do without it. She needed a little rest.

[wombatclay]

In my first birth they eventually (more than a day into labor) gave me a spinal in the hopes that the relative loosening of the muscles would help dd1 shift to a better birth position (OP, asynclitic, I'd sPROM) as well as in the hope that it would give me a chance to sleep/keep food down/regain energy. It didn't work and I ended with a c/s but those were the reasons I agreed to the spinal.

I tore badly with my vbac and was told that in a future birth I could "opt" for an epidural that would help me avoid any pushing urges until babe was on the perineum. I don't know that I'd try it, but it's one of the things the ob told me... so that might get labled "epi to progress". I dunno.

[barefootpoetry]

The epidural certainly helped my labor get moving. After forty-odd hours I was stalled out at 4. I got the epi, konked out, and two hours later was at 10. I'd had Pitocin too, which didn't do jack squat for me other than make my contractions unbearable. I'm guessing that it moved me along so fast because I finally had a break from the tension of laboring in a hospital and could rest.

[loraxc]

Ihad been stalled at 4 for 8 hours and in labor for 24 when we transferred for Pit and a "light" epidural. After the epi went in, I slept for a few hours and was at 10 an hour or so later. Baby was posterior and I had been in agonzing pain and without sleep. I do think the epi probably helped me progress and also helped me avoid a C. It was certainly not my ideal birth, but I got that the second time around.