Shocked at epidural rates! - Mothering Forums

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Old 03-03-2010, 04:12 PM - Thread Starter
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My wife and I went on a tour of our hospital maternity area last night. Our guide told us the rate of epidurals at the hospital was over 90%! This floored me. 9 out of 10 women seems shockingly high.

What are the numbers like in your area?
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Old 03-03-2010, 04:33 PM
 
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I am at a different hospital this time from my previous births. I know I have always had to work hard to convince my L/D nurses that I do not want/will never ask for, or consent to an epidural.
I am actually a bit worried about my current hospital in that regard. I delivered a 14 week loss there last summer. I went in in labor and they augmented it a bit (at my request) Every hour someone was in my room asking me to take an epidural. I wasn't making a sound, I was able to converse fairly freely, even my husband was not worried or concerned about my pain level. They could not figure out what objection I had to it. "Ummm, not in THAT much pain, plus there are risks to ME in getting one, not just to a live babe."
All that to say, the attitudes at both hospitals lead me to believe the rate for epidural is very high, though I don't know the percentages.
Both hospitals are in Southern California.

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Old 03-03-2010, 05:13 PM
 
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I'm almost certain that around 90% is very typical - like a national average. Sorry I dont' have any stats to point to though. www.thebirthsurvey.com is working to get intervention rates from facilities through states' departments of health - but that doesn't always include epi.
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Old 03-03-2010, 05:17 PM
 
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I think it's pretty typical. My first three dc were born in the same ward and (I had an intrathecal with #2's induction right before he came out) I was told twice I was the only person they'd seen recently w/o an epidural except those fortunate to come in with the babies' head already out.

With #4 I had a UC transfer and I was told by several nurses they can't even comprehend that women can give birth w/o a c-sec or epidural. It just doesn't happen on their ward. They kept asking me questions like I was some sort of freak of nature. So I think 90% is pretty accurate.

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Old 03-03-2010, 05:23 PM
 
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...snip...I was told by several nurses they can't even comprehend that women can give birth w/o a c-sec or epidural. It just doesn't happen on their ward. They kept asking me questions like I was some sort of freak of nature. So I think 90% is pretty accurate.
That is what I got too. Even my postpartum ward nurses had "heard about me" and kept coming in and asking more questions.

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Old 03-03-2010, 05:26 PM
 
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Yes 90% is typical around here too. Even many of the hospital midwives have rates this high (though their other intervention rates are significantly lower). It's what women expect these days. I think most don't even give it much thought - they just assume that they'll get one.

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Old 03-03-2010, 07:38 PM
 
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Yup, 90% sounds about right for my area too. I am somewhat of a celebrity/anomaly in my (hospy) MW group for having a completely unmedicated birth with my DD. I only know of one other person who did not get the epi or some type of pain relief while in labor.

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Old 03-03-2010, 08:04 PM
 
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The rate at the hospital I gave birth in was 40%. I expressed to my midwife that I thought that rate was very low. She said something like "Are you kidding me?! 20 years ago it was 5%!!" This is in southern Wisconsin.

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Old 03-03-2010, 08:20 PM
 
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I'm not surprised, really. 1, woman are taught that childbirth is excruciating pain. And 2, most labors begin or are augmented with Pitocin which makes comtractions more painful. More women are choosing inductions, unfortunately.

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Old 03-03-2010, 08:38 PM
 
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that's typical here too, in south carolina. when i had my dd, there were nurses in the room that had *never*, in years of OBGYN nursing, seen a spontanious, unmedicated vaginal birth before. kind of boggles the mind....

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Old 03-03-2010, 08:43 PM
 
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I think my hospital had a 40% rate in 2005. We have a large Amish population here though and the head nurse said they contributed to most of the percentage.
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Old 03-03-2010, 08:52 PM
 
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I think its probably normal, but I wouldn't worry about it. What some women do with their bodies and their babies doesn't have to be what you (or your wife) do with yours. "Just say no" if you want to!

I'm the only one of my friends who want to have natural childbirth and even though they know the risks of getting an epidural, they choose them anyway because they want pain management. That's fine. Just like in high school, just because everyone else is doing it doesn't mean you have to do it also.

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Old 03-03-2010, 10:05 PM
 
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95% is typical in our area. One of the nurses at one of our many local hospitals said 93% and I couldn't believe it was that LOW.

Jamie, DW to Jeff, birth and postpartum doula and Hypnobabies instructor.
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Old 03-03-2010, 10:28 PM
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I don't know about our hospital's current rates. However, 7 years ago I delivered my second child naturally at our hospital. It was also the first day for the new student nurses. Lots of babies were born that night (my mw held the last room for me). My child was the only one born to a drug free mother. Our nursing student (the one assigned to us) thought it was soooo cool that she got the "alert" baby, she thought it was amazing that I was up and about (even caring for my own child) and that I wanted to go home. She was very interested in my birth choices. So, 90% wouldn't surprise me.

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Old 03-03-2010, 11:50 PM
 
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Only 90%? most hospitals I've birthed in are more like 98% epidural rate

Karen, homeschooling Catholic mom to 8. #9 due 6/10
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Old 03-03-2010, 11:57 PM
 
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It's shocking. They have an over 90% rate at our local hospital as well. I know back home it's about 25% (Germany), with a growing tendency...
While an epidural is a valid choice and sometimes even medically necessary (super exhausted mom, or god knows what kind of circumstances, one never knows) it is completely overused and overadvertised as soooo harmless. 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.... It's sort of expected that women are incapable of giving birth without an epidural. I'm not saying it's bad to have an epi, I just don't like how it's looked down upon or even rare to not choose one.
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Old 03-04-2010, 12:26 AM
 
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At the hospital where I did my OB rotation, I dunno what their official rates were but in my (6-week) experience it was 100%. That's right, I did not see a single unmedicated birth the whole time. I would say about 20-30% of the women came in saying they did not want an epi but none of them actually delivered without having gotten one. (Obviously there was not any support or non-pharmacological pain relief available for an unmedicated birth there.)

The MW practice I used for my own birth said they had a 40% epidural rate. However, at their hospital most of the patients are OB patients. The L&D nurses were kind of surprised at my intervention-free birth and they told me "we don't see that very often" after my delivery.

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Old 03-04-2010, 12:29 AM
 
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At the hospital where I did my OB rotation, I dunno what their official rates were but in my (6-week) experience it was 100%. That's right, I did not see a single unmedicated birth the whole time. I would say about 20-30% of the women came in saying they did not want an epi but none of them actually delivered without having gotten one. .
This seemed to be the case where I had my oldest. The nurse looked at me skeptically when I said I wanted an unmedicated birth and didn't want to be offered drugs. They weren't sure what to do when I refused the heplock and my doctor backed me up. 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.
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Old 03-04-2010, 12:34 AM
 
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Pretty normal here. I called in to schedule my pre-admit at the hospital this week. The lady said it would take an hour, and 20 min of that would be watching the epidural video. I asked her if we had to watch it if we were not having one. She said, "what do you mean, like, at all?"...lol. I said yeah. She said, "a lot of first time moms say that but they all get them, so the video is useful". I told her I am having my 3rd and made it through my last with 8 hr of max dose pit and no epi, do I am sure that short of cutting the baby out without one, that I will need one, lol. She backed off and just told me it was mandatory. I just said ok and let it go. But her first comment made me laugh.
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Old 03-04-2010, 12:47 AM
 
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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.
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Old 03-04-2010, 12:57 AM
 
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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.
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Old 03-04-2010, 01:31 AM
 
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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.

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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.

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Old 03-04-2010, 04:05 AM
 
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Here it is 99%.


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Old 03-04-2010, 01:14 PM
 
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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!

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Old 03-04-2010, 04:24 PM
 
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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.
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Old 03-04-2010, 05:51 PM
 
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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.

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Old 03-05-2010, 11:45 PM
 
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Hey KGB --

Just curious, which hospital was it?
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Old 03-06-2010, 12:22 AM
 
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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?

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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Old 03-06-2010, 11:53 AM
 
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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.

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Old 03-06-2010, 02:19 PM
 
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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.


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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.

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