I have questions. I hope you don't mind answering, but in order to grasp some of what's actually going on around me when people talk about their birth experiences nowadays, I hope you can indulge me and answer a few.
From what I hear, birth can pretty much be pain-free with an epidural. Is that true?
The epidural isn't given until Mom is how many cm?
I've heard that the epidural is turned off at a certain point. When do they turn it off? Why? Does it affect contractions or the baby or both?
What if delivery takes awhile--like hours? Does Mom have to push for hours without any pain control?
Are there any other options available for pain control besides an epidural or does Mom just have to go through it?
Thanks for answering. You don't know how many times I've wanted to interrupt coworkers with these questions, but I really don't want to spoil their stories.
Our epis run on PCEA pumps, can't remember the brand. The pt gets the button, along with the "this won't take away the pressure, your nurse needs to know if you push the button" lecture. I can't tell you the number of times I've walked in at shift change to find pts in pain with the button hanging from the IV pole. My first question is always if they've been using it, and 9/10 times they didn't even know it was there, much less that they could use it.
Irritates me to no end! The anesthesia dept chose these pumps for the pcea function, and nurses aren't letting their pts use them. :trout:
Specializes in OB high rish low risk PP antepart..
Turning off the epidural around my facility is usually not done, with the exception of one physician who truns them "down" to half when the pt is 7cm and sometimes has the pt push when not fully dilated in order to bring the head down, not that he will admit that. Turning the epi down or off at 7cm regardless of parity is cruel and unusual punishment. These pts have no idea that this is going to happen and are angry at the nurse when it does. But for the most part we leave epidurals alone until delivery. According to AWWHON Rns cannot do anything to an epidural except to turn
it off. No adjustment at all so if Dr wants an epidural decreased he has to do it himself. But there are those who do. Almost no epidural is going to take care to the pressure of the fetal headas it descends unless there is a c/s dose on board, but ther are those pts who testify that they feel nothing. Power to them.
My epidural was awesome--as soon as I got it I felt no pain whatsoever. (Granted, I was 8cm already when I got it and was entering transition phase and still experienced contraction pain up to those 8cm). I never felt pressure either. The midwife decided to check me when they noticed baby was having early decels and it turned out I was complete at +2 station. I pushed for 40 minutes and didn't feel any of it. I am hoping and praying that with my next baby I'll be able to have a great epidural again.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
NO! we do not turn it off. The patients are on PCEA as well. Sometimes the epidural rate is adjusted down by the MDA if need be, but that need is very rare.
nursejohio, ASN, RN
284 Posts
Our epis run on PCEA pumps, can't remember the brand. The pt gets the button, along with the "this won't take away the pressure, your nurse needs to know if you push the button" lecture. I can't tell you the number of times I've walked in at shift change to find pts in pain with the button hanging from the IV pole. My first question is always if they've been using it, and 9/10 times they didn't even know it was there, much less that they could use it.
Irritates me to no end! The anesthesia dept chose these pumps for the pcea function, and nurses aren't letting their pts use them. :trout: