Epidural vs. nature births

Published

Is epidural encouraged on your L&D unit? I feel like it is where I work. It's almost frowned upson if any expecting moms wants a nature birth. Some nurses will try to convince the mom to get it... "You dont get any extra credit point going natural" As a new RN, I have to admit though, when a mother decides to get an epidural, it does make our job easier... I think.

I'm just wondering how epidural is viewed at other hospital... After watching the documentary, "The business of being born", it has changed my views on a lot of things, but I feel like I may stand alone in that view where I work.

labors with Pitocin, can cause more bruising in the newborn. More bruising means higher jaundice levels.

.

The pitocin packaging does state that it is associated with higher rates of jaundice in the neonate. I don't know if it is truly a causal relationship given the relatively high rates of pitocin use and neonatal jaundice in general, but I always found it interesting that it is on the insert.

Up Vote Up Vote ×

The hospital where I had my first baby totally pushed an epidural on me. I never asked for one but the nurse and midwife (obviously not a good midwife) kept telling me I wasn't doing well and that I needed an epidural. 4 hours later I was in the OR for "failure to progress." I HATED the epidural. It gave me the shakes and the numb feeling weirded me out.

I had several labor dystocia with baby #2 (she took almost 2 days to come out after several days of early labor). But that time I was in a hospital with a low epidural rate and (real) midwives on staff. No one brought up an epidural at all! Instead I would just walk, use the laboring tub, rocking chair, birthing ball, shower,etc. Every time the pain got really intense, I shifted positions or tried something else. I could not imagine sitting in bed without pain relief. I think you really need to be able to move and use other pain relieving options. I felt awesome afterward. It was totally worth birthing without the epidural.

Up Vote Up Vote ×

Elvish, I must say you can do it!

I really think it comes down to the hospital. If you're at a hospital with no residents and only nurses, they are usually going to want an epi so you can sit with a baby over an intact perineum while waiting for the physician! I am fortunate that I work at a hospital that has residents and has the only state approved natural birthing center in house. The hospital I delivered my first 3 at (not where I work) was very epi-pushy. I believe that within reason a mother should get the birth experience she wants, as long as they are educated and not just listening to her bestfriends mother's sisters brothers wifes mother who had this or that experience.

Up Vote Up Vote ×
Specializes in OB.
Elvish, I must say you can do it!

I really think it comes down to the hospital. If you're at a hospital with no residents and only nurses, they are usually going to want an epi so you can sit with a baby over an intact perineum while waiting for the physician! I am fortunate that I work at a hospital that has residents and has the only state approved natural birthing center in house. The hospital I delivered my first 3 at (not where I work) was very epi-pushy. I believe that within reason a mother should get the birth experience she wants, as long as they are educated and not just listening to her bestfriends mother's sisters brothers wifes mother who had this or that experience.

I usually find that it is the doctors who get impatient and want interventions, not the nurses in general as you state above. I've worked in every type of setting and find I can go much further to accommodate the patient's preferences without a doc/resident there watching the clock and wanting to perform interventions. More than once I've wanted to slap some doc's hands and tell them "Keep your fingers out of there!"

Up Vote Up Vote ×
I usually find that it is the doctors who get impatient and want interventions, not the nurses in general as you state above. I've worked in every type of setting and find I can go much further to accommodate the patient's preferences without a doc/resident there watching the clock and wanting to perform interventions. More than once I've wanted to slap some doc's hands and tell them "Keep your fingers out of there!"

You rock! I hope that there are more nurses like you out there!!! My post wasn't worded very well, I apologize. I was referring to physicians wanting the epi when only nursing is there! :) Although, even where I work, there are MANY nurses that would rather her patient have an epi.. I'm not a nurse yet, but it seems like much more work with an epi?

Up Vote Up Vote ×
Specializes in OB.
You rock! I hope that there are more nurses like you out there!!! My post wasn't worded very well, I apologize. I was referring to physicians wanting the epi when only nursing is there! :) Although, even where I work, there are MANY nurses that would rather her patient have an epi.. I'm not a nurse yet, but it seems like much more work with an epi?

It's unfortunate that many newer OB nurses are trained that this is "the norm" to have epidurals as well as many young patients who "can't imagine" not having an epidural. It seems to be the culture at some hospitals. I'm a traveler so when I'm at one of these types of places I'm the one in report volunteering "Me, me - I'll take that one" when the others are groaning at the prospect of a patient who wants to go "natural".

Over years of travel I've found this seems to be more prevalent in mid to large sized suburban hospitals, especially in what I would call "yuppie" communities. I try to avoid these "assembly line" OB depts. when possible.

Up Vote Up Vote ×
Specializes in Labor and Delivery.

I have had 2 out-of-hospital births (one home and one at a birth center). I teach childbirth classes and I am a L&D RN. I have an acronym for the pain in childbirth that I teach my students and patients.

P- Purposeful. This is not the pain of a broken arm or a gall stone for example. This pain has a reason!

A- Anticipated. You knew it was coming. You had lots of time to practice relaxation techniques to help you cope.

I- Intermittent. It comes and goes!!! You get breaks!!!

N- Necessary. This pain is necessary for you to meet your baby. There is a BABY at the end of all of this!

I have seen women who denied all pain (those were hypnobirthing moms) and women who wailed throughout labor but still refused pain meds because wailing was part of their coping. Labor pain is a subjective experience, no one else can assume that you need pain relief.

For me, I did feel pain but it was a completely manageable pain. It was not terrible. My second labor was much easier than my first simply because I had my bag of water intact for that whole labor. My bag was AROM'ed at 2cm with my first labor and that made the experience much more difficult, but still manageable.

But those of you that had kids without an epidural, was the pain that bearable? If it was, why do people make it seem like labor is this journey to hell that only a few brave ones come through unscathed? And those that got an epidural, what are the side effects you experienced?

Up Vote Up Vote ×
Specializes in Cardiac, OB.

Most docs I have known have been very respectful of mom's plan from the onset of labor, whatever it may be. Should that plan change later on, no judgements. It's refreshing!

OP, keep in mind when dealing with laboring moms, you may want to refer to it as an "unmedicated" birth as opposed to "natural". lady partsl is natural, with or without meds lol! Just may help a mom who has chosen some pain relief not feel like she is "unnatural". :)

Up Vote Up Vote ×
Specializes in Psych, Med/Surg, LTC.

I have had 3 births. #1 epidural, #2 and #3 all natural. I much prefer natural! The high and sense of empowerment are unbelievable after. My last 2 births the staff seemed shocked that I did it natural, like it was not a common thing to do. They went along with what I wanted, though.

Up Vote Up Vote ×

I learned and accepted when i started in labor and delivery that non-medicated births made me nervous i was scarred, I felt bad for the woman who was hurting and i wanted to try to make it better. Then one day I said to myself, this is HER birth experience, not mine I need to and can help her acheive whatever experience she wanted the best. (yes i have sort of fought with doctors to make this happen for some) I rarely talk anybody in to an epidural who didn't want one to begin with. I only do that as a last resort when there is been no change and dr is talking c/section. I have also been known to talk people out of epidurals (those are also few and far between) limited to the women who come in 9 cm and can push out a baby before the epidural will start working. (however if they insist I will start preparations for the epidural which usually doen'st make it

Up Vote Up Vote ×
I'm not a nurse yet, but it seems like much more work with an epi?

I find that it depends on the patient. A patient who takes responsibility for her birth and has a plan for managing her pain and who has a lot of inner resources is a pleasure to care for without an epidural even though she may require intensive one-on-one nursing care. A patient who is thrashing around, screaming and seems to have lost control without any interest in nursing support is someone I want to get an epidural ASAP. Epiduralized patients still need nursing support though: they have to be toileted, turned, BP checked every 15 minutes, etc.

Up Vote Up Vote ×
Specializes in L&D/Maternity nursing.
Thank you all for the different opinions. I've always thought to myself that when I'd be pregnant I'd ask for the epidural as soon as I get admitted. Wimpy me! My rationale was that I didn't want to embarrass myself screaming bloody murder through labor pain, (I couldn't live with myself if I screamed uncontrollably). I just haven't thought about or researched risks/benefits of getting an epidural. I think it's beneficial for a woman to know that waaay before labor starts.

But those of you that had kids without an epidural, was the pain that bearable? If it was, why do people make it seem like labor is this journey to hell that only a few brave ones come through unscathed? And those that got an epidural, what are the side effects you experienced?

I can only speak of myself, but yes, the pain was bearable. I mean, it certainly wasnt the most pleasant thing I've ever experienced, but I just moaned and rocked and swayed my hips through it all. That seemed to do the trick. and then when in transition, I got into the birthing tub and there I stayed until he came. No drugs. Only one cervical check (I was 9.5 at that time). Very very very little intervention. I did not give birth in a hospital though-I was at an independent, free standing birth center with CPMs. I knew for me, in order to get the med free/low intervention birth, I had to remove myself from the situation where birth is "managed" and medicalized (hey, I may have just made up a new word!)

I did do an internship on an L&D unit at a local hospital (actually in the hospital where I now currently work), and they are a fairly progressive unit. Their epidural rate is not bad-probably hovering around 50-60%, and at the time I was there, their c-section rate in the teens. I had a few opportunities to assist mom's in natural birth. It is possible and there are hospitals and nurses out there who are supportive of helping you reach that outcome.

Up Vote Up Vote ×
+ Join the Discussion