conscious sedation for childbirth?

fergus51 · Jul 13, 2004

I have never heard of this and can't imagine a doc being willing to do it.

I may be completely out of line for saying this, but I think your daughter may be making a big mistake by looking at it this way. Parents who lose a child can lengthen the grieving process when they try to lessen the experience. My own birth mother has told me again and again she always regretted not seeing me and saying goodbye because at the time she thought it would be easier, but it just made things worse for her. Even if your daughter doesn't want to see the baby, can I suggest you take some pictures and put them away somewhere just in case she changes her mind? I hope you take this in the spirit it was meant, I realize I don't know your daughter and could be completely wrong. I think she is very brave for doing such a loving thing for the baby. Birth mothers are amazing people.

Jolie, BSN · Jul 14, 2004

First of all, my greatest admiration to your daughter for having the courage to place her precious baby for adoption. My husband and I longed for the opportunity to adopt, but it never happened.

Secondly, having worked with a number of birth parents who gave their babies up for adoption, I agree with Fergus that it may be better in the long run if your daughter sees and holds her infant. Has she been offered pre-natal adoption counseling? Many agencies (both private and state) offer this to birth parents, and I find it to be very helpful. She will experience grief over placing her baby for adoption, and may find that counseling will help her anticipate these feelings, develop an understanding of them, as well as plan for how to deal with them. The same holds true for other family members, as the birth father, grandparents, aunts and uncles are all experiencing a loss.

I was once assigned to care for and DC a birth mother who was placing her infant for adoption. When I went in to do her DC paperwork, I was asked to cover the portion of the infant identification sheet that listed the baby's sex, as the birth mother had elected not to see or hold the baby. I couldn't see how she could legally authorize the DC of and relinquish parental rights of an infant whom she could not personally identify, as she had never seen the baby, and didn't know its sex. I refused to do so, and notified my supervisor. I was not trying to impose my beliefs on the birth mother, but had legitimate concerns over the validity of her consent. I don't know how administration handled the issue.

The only case I was ever personally involved in where a birth couple changed their minds was that of young college students who hid their pregnancy from their families, delivered the baby without the knowledge of any family members or friends, refused all counseling, then left the hospital without seeing their infant. Literally hours before the baby was to be discharged to the adoptive parents, the birth parents returned for the baby. To avoid a long, drawn out legal battle, the adoptive parents bowed out of the picture, but not without broken hearts. If only the birth parents had accepted counseling, perhaps everyone would have been spared the heartache. Fortunately, your daughter is not alone. God bless you for seeing her thru this experience, amid your own emotions.

Getting back to your original question, I don't believe that conscious sedation would be appropriate for delivery. Narcotics are typically avoided within 2-4 hours of delivery because of their potential effect on the newborn's respirations. Also, I doubt that your daughter would be able to effectively participate with positioning, pushing, etc. while under conscious sedation. Effective pain relief can and should be provided, but an epidural would probably be a better choice. I encourage her to discuss all these issues with her OB or midwife, and ask for his/her input on what can be done to make her delivery as positive an experience as possible.

Again, she is truly heroic. She will be in my thoughts and prayers.

Betty_SPN_KS, LPN · Jul 14, 2004

Thank you for your kind responses. I am sharing them with her. It will be an open adoption. She has met the adoptive parents and feels very good about them. They will be sending pictures to the adoption agency where they will be kept in a file. My daughter can see them when she wants to. She chose not to have the pics sent directly to her.

Again, thank you.

SmilingBluEyes · Jul 14, 2004

I applaud your daughter on her selfless act. Please thank her for me. You are a wonderful family. I have nothing to add that was not stated so articulately before me. Best wishes to you and your daughter. You all have my utmost respect.

nekhismom · Jul 15, 2004

My understanding of conscious sedation as a NICU nurse is that you are medically paralyzed, but you still feel pain and are aware of your surroundings. When we have babes on conscious sedation, we have to be very cautious around them to avoid agitating them. It makes the babies much more sensitive to stimuli than under normal conditions. I would find this to be completely terrifying during childbirth. I would definately choose an epidural!

(((HUGS))) to you and your daughter.

rndani · Jul 16, 2004

I've been an L&D nurse for 6 years and have seen conscious sedation during labor done once. It was a nullip who had a significant history of child abuse and regressed back to it in front of our very eyes. Her husband had no idea what was going on. The midwife consulted with the CRNA and they both agreed the conscious sedation along with a heavy epidural would be to the patient's benefit. She labored down and delivered a baby girl in thankfully 4 pushes. Nursery was standing by and the baby transitioned quickly and was back in the room before morning.

Gompers, BSN, RN · Jul 16, 2004

My understanding of conscious sedation as a NICU nurse is that you are medically paralyzed, but you still feel pain and are aware of your surroundings. When we have babes on conscious sedation, we have to be very cautious around them to avoid agitating them. It makes the babies much more sensitive to stimuli than under normal conditions. I would find this to be completely terrifying during childbirth. I would definately choose an epidural!

Conscious sedation is when you give an analgesic and a sedative to put the patient in like a "twilight" kind of a state. I had it when I had kidney stones removed and also with my wisdom teeth. They usually give Fentanyl and Versed, I believe, but I could be wrong. You are actually a little awake during this (hence the term "conscious") but you don't remember it usually because of the Versed, and don't feel anything because of the Fentanyl. This is just what I've experienced myself, and what I've done in my NICU with very old chronic babies having tests done.

You're saying that your unit will pavulonize a baby and then not give any analgesics or sedatives?!?! OMG that's horrible! We have a policy that any baby on the vent gets at least small doses of morphine around the clock, and all of our babies that are pavulonized are on continuous morphine and fentanyl drips. I can't imagine being medically paralysed with no pain relief or sedation.