lorijds
01-24-2004, 01:44 PM
I was at a birth last night that ended in a transport to the hospital for augmentation and pain relief (mom's choice, not ours). I went, planning on staying until mom got settled in and got her epidural. First we had to wait for the blood work; apparently they always do blood work before they do the epidural. Mom's contractions start to pick up. I'm thinking, if they examine her, and she has progressed very far, I am going to be sooooo frustrated!
But I have her on the ball, rubbing her back, dad is being very supportive, I'm kind of enjoying the opportunity to be a doula instead of the nurse; no paperwork, not responsible for anything but mom's comfort. So I start to think, well, I'll stay until mom is really comfortable and asleep; this is really fun; plus I just really liked this couple. I fully expected the epidural to slow things down even more, though pit was the plan as well, and I thought we would be there for hours and hours and hours. And really, if mom is alseep, I probably don't need to be there. These are my thoughts anyhow.
Anesthesiologist is at home, and won't come in until labwork is done and mom is established as a candidate for epidural. Mom is begging for the epidural. I'm thinking, hmmmm, do we even need pit? These are some strong contractions.
Then, after over an hour, the anesthesiologist comes in. He explains to mom that her white count is very high. He can't explain why that is, because she has no other sign of infection. He is hesitant to do the epidural, he explains, because he is concerned about hte risk of an abscess at the site or of the development of meningitis. The mom says, "I fully understand what you are saying. I understand the risks, and I want the epidural. " Doc says "I know you want the epidural. I am very very hesitant to perform it." Dad says "What are our other pain relief options?" Nurse says "Basically stadol (which we had already been doing)." Then mom says "Stadol isn't doing anything for me. I can't do this. I really want the epidural." I askt he doc "If this were your wife or your daughter, would you do the epidural?" Doc says "No way. Absolutely not." Dad says "Thank you. That's all I need." Mom says "NO! I *understand* the risks. But I still want it."
Then, when I'm already impressed with this doc, he blows me over by saying "But you started off at the birth center, right? Since the beginning of your pregnancy you have known you wanted a natural birth without pain medication, and you have been preparing yourself for this the entire time. You can do this. Women all over the world, for thousands of years, have been birthing without epidurals or anything else. I think it is much healthier for you to do this. You would be at too much risk for infection for my comfort if I did the epidural. I know it is hard for you to hear that right now, but I am sorry."
I couldn't believe it. i thought be would be like "Damn the risks, we can run antibiotics." Oh, and he did not know I was a nurse fromthe birthing center; my scrubs were covered by a sweater, and most everyone there, except the nurse, thought I was with the family.
So she did it. They did about 2 hours of low dose pit, and that woman progressed fantastically. She was a natural pusher, and she pushed her baby out in less than 30 minutes. I was so proud of her. Can you imagine, deciding you want pain relief, transferring to a hospital from home or the birth center, and then being told no on the pain relief? She was so brave, and her husband was right there, so supportive and positive.
I was happy for her, that she didn't get the epidural. But I was impressed with the doc, who counselled against it. It made me feel a bit better about sending women over to the hospital. I always feel like, whenever we transport, we are sending them to the lion's den to be preyed upon by everyone. The nurse was great, she didn't make me (as the nurse from the birthing center) or the woman and her family feel badly at all about the transport, and she made us all feel very welcome. She let alot of things slide, and was very flexible. It was reassuring to know that, in the event of transport, our clients weren't being abused or taken advantage of.
Anyhow, I thought you all would like to hear the story of the anesthesiologist who counselled against the epidural....I knew you would appreciate it!!
Lori
But I have her on the ball, rubbing her back, dad is being very supportive, I'm kind of enjoying the opportunity to be a doula instead of the nurse; no paperwork, not responsible for anything but mom's comfort. So I start to think, well, I'll stay until mom is really comfortable and asleep; this is really fun; plus I just really liked this couple. I fully expected the epidural to slow things down even more, though pit was the plan as well, and I thought we would be there for hours and hours and hours. And really, if mom is alseep, I probably don't need to be there. These are my thoughts anyhow.
Anesthesiologist is at home, and won't come in until labwork is done and mom is established as a candidate for epidural. Mom is begging for the epidural. I'm thinking, hmmmm, do we even need pit? These are some strong contractions.
Then, after over an hour, the anesthesiologist comes in. He explains to mom that her white count is very high. He can't explain why that is, because she has no other sign of infection. He is hesitant to do the epidural, he explains, because he is concerned about hte risk of an abscess at the site or of the development of meningitis. The mom says, "I fully understand what you are saying. I understand the risks, and I want the epidural. " Doc says "I know you want the epidural. I am very very hesitant to perform it." Dad says "What are our other pain relief options?" Nurse says "Basically stadol (which we had already been doing)." Then mom says "Stadol isn't doing anything for me. I can't do this. I really want the epidural." I askt he doc "If this were your wife or your daughter, would you do the epidural?" Doc says "No way. Absolutely not." Dad says "Thank you. That's all I need." Mom says "NO! I *understand* the risks. But I still want it."
Then, when I'm already impressed with this doc, he blows me over by saying "But you started off at the birth center, right? Since the beginning of your pregnancy you have known you wanted a natural birth without pain medication, and you have been preparing yourself for this the entire time. You can do this. Women all over the world, for thousands of years, have been birthing without epidurals or anything else. I think it is much healthier for you to do this. You would be at too much risk for infection for my comfort if I did the epidural. I know it is hard for you to hear that right now, but I am sorry."
I couldn't believe it. i thought be would be like "Damn the risks, we can run antibiotics." Oh, and he did not know I was a nurse fromthe birthing center; my scrubs were covered by a sweater, and most everyone there, except the nurse, thought I was with the family.
So she did it. They did about 2 hours of low dose pit, and that woman progressed fantastically. She was a natural pusher, and she pushed her baby out in less than 30 minutes. I was so proud of her. Can you imagine, deciding you want pain relief, transferring to a hospital from home or the birth center, and then being told no on the pain relief? She was so brave, and her husband was right there, so supportive and positive.
I was happy for her, that she didn't get the epidural. But I was impressed with the doc, who counselled against it. It made me feel a bit better about sending women over to the hospital. I always feel like, whenever we transport, we are sending them to the lion's den to be preyed upon by everyone. The nurse was great, she didn't make me (as the nurse from the birthing center) or the woman and her family feel badly at all about the transport, and she made us all feel very welcome. She let alot of things slide, and was very flexible. It was reassuring to know that, in the event of transport, our clients weren't being abused or taken advantage of.
Anyhow, I thought you all would like to hear the story of the anesthesiologist who counselled against the epidural....I knew you would appreciate it!!
Lori