Moms who want to feel absolutely NO pain

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Specializes in LDRP.

This is another thing I didn't realize was as common as it is-people who want to feel zip in the way of pain. granted, most women who want epidurals do say that they want to wait until the pain is unbearable, or at least hurts somewhat.

I've had a few now that wanted the epidural BEFORE they had any pain, so they wouldn't have any pain at all. Had a pit induction today. her family was encouraging her to get the epidural before we started the pit. she wanted it asap. So technically, she wasn't even really laboring.

here the doc has to give the okay for the epidural. (female)resident says she's not in any pain, i think she should wait. i was trying to get an answer from her as to when she could get it. (ps-pt is 41 weeks, g1, 2cm). she then told me to ask the other resident b/c she didnt know.

so i asked the (male) resident and the (male) attending. they said go for it, but be more aggressive with her pit. actually, the male attending said "if i was going to get pit, i'd want an epidural. if i was in labor, i'd want one asap".

so, are women allowed to get their epidurals as soon as they want them, even if not in pain? or do htey have a centimeter amount they have to get to first?

(my personal opinion is that they should be able to have it whenever they want it, if there is no medical reason to wait. of course, i also make sure they know that though it won't hurt, you can't eliminate the pressure. )

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Specializes in Nurse Leader specializing in Labor & Delivery.

We generally do not order an epidural until they're in active labor and at least 3-5 cm (at our discretion).

I would say that if they're feeling NO pain, then they're not in active labor, so they would not get an epidural.

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so, are women allowed to get their epidurals as soon as they want them, even if not in pain? or do htey have a centimeter amount they have to get to first?

(my personal opinion is that they should be able to have it whenever they want it, if there is no medical reason to wait. of course, i also make sure they know that though it won't hurt, you can't eliminate the pressure. )

I think the state of the cervix is usually how they judge who can get an epidural where I work. Having an epidural for a long time isn't good for you, and someone who is going to poke along at 1 cm for hours to a day like some inductions do is going to be immobile for a very long time.

OTOH, women who come in for inductions for FDIU or terminations tend to get epidurals as soon as they want them. I suppose there is risk that they could poke along too, but they usually don't.

As an aside, what I don't get is the people who are so afraid of pain yet also happen to be covered with tattoos and facial piercings. :rolleyes:

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Specializes in NICU.

I've heard some women say that they want an epidural and c-section because they don't want to feel pain. Don't they realize that the epidural will come out at some point after the section? Recovery from abdominal surgery HURTS! I had an exploritory lap when I was 17 and that was just a four-inch RLQ incision. I would imagine the pain while recovering from a c-section has got to be worse!

Many people are asking me the strangest questions lately. Some ask if I'm going to "try" for a lady partsl birth. Of course!!! I didn't know it was an option to not even try. Do many doctors schedule c-sections simply because the mom wants one?

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Specializes in OB, lactation.
Do many doctors schedule c-sections simply because the mom wants one?

At least a couple of the ones I work with probably wouldn't argue a whole lot... :(

About the epidurals... I'm not actually sure if we have a 'policy' on that. I really haven't had to deal with someone wanting it that early yet.

Plus, even if I do, by the time they get their fluids bolused for the epidural they have usually moved along some anyway, KWIM?

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At our hospital you have to be in active labour and at least 3cm for a multip and 4cm for a prime. I had one who wanted hers even though she was only contracting q15 min. The anesthesiologist would have never agreed to that.

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OP, I am with you. Pitocin is like being beaten with a bat. If I were to wait until I was 3cm to get my epidural, I would have been in agony for 12 hours.

Why should a pt have to feel pain, not matter what the cause?

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Specializes in Telemetry, Case Management.

Back in the day (early 80's) they made me wait until I was 5 cm to even call for anesthesia, was 6+ before he showed. Last year, DD was 2 cm NOT in any pain and got one ASAP!! I felt cheated!! Glad for her, mind you, but still!!!

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Specializes in Nurse Leader specializing in Labor & Delivery.
OP, I am with you. Pitocin is like being beaten with a bat. If I were to wait until I was 3cm to get my epidural, I would have been in agony for 12 hours.

Why should a pt have to feel pain, not matter what the cause?

Well, the problem there is that Pitocin can cause some really bad contractions, but the woman isn't actually in labor and her cervix is not changing. Under ordinary circumstances (a pit induction with no epidural) we could just shut the pit off, let her sleep or send her home, and try again when she's more favorable. If she has an epidural, we've pretty much committed to a course of action, and if the pit isn't working and her cervix isn't changing, we're setting her up for a C/S.

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Just a quick note: Here at our hospital....if they get the PIT they get the EPI, unless they don't want it, irrguardless of progression (or lack thereof) or previous deliveries/c-sect's. Nurse, Doc, Friend, Parent, spouse..whoever, should NOT have a say in how much pain a woman has to be in to recieve comfort, or relief, especially while on PIT. JMHO.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Pitocin is hell. BTDT. Made it to 8cm after 12 hours on the stuff and was BEGGING to have epi. After I got it, I progressed to complete in like 15 min. I was able to relax and progressed unbelievably rapidly after my epi was in place.

Did I want to feel "no pain"? No, but that was just way too much for me. And I am glad I had the epi. Son came out face-up and had sagittal synostosis, so I sustained a 3rd deg lac and had to have forceps to get him out. I can't imagine how bad it would have been w/o the epi.

Now, based on my experiences, I have come to believe many women come in asking for epidurals early-on due to the endless horror stories they hear from well-meaning friends, relatives and those *oh so wonderful* Baby Story shows on TV. Also, I KNOW many doctors are pushing epidurals early-on in pregnancy too. I have seen more than one doc roll his/her eyes and ask "WHY does she want to go natural anyhow? Seems so stupid to me". That attitude sure does not help....nor does the fact that many nurses have no clue HOW to care for naturally-laboring women. I do know most women fear abandonment in labor----so much so, that if a good support system is not in place, the pain they endure is perceived as MUCH WORSE than it may be IF staff/support people are prepared and ever-present in their labor process.....

That and we are a fast-food, convenience-oriented society in the USA. We want what we want, and we want it NOW, with a minimum of inconvenience or pain. Labor is a long, painful and difficult process, one that takes a lot of physical endurance and patience on the parts of the laboring mom and her support people. Face it: Many women (and their HCPs and support people) are not too keen on even trying to endure the arduous labor process w/o the epidural these days.

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Specializes in insanity control.

I had pit with both of mine cause water broke but no contractions, not one. I was pushed and pushed to get epidural. I told my doctors and nurses that the next one who suggested it would be fired. I did well both times. Yes it does make the contractions worse but could stand them.

On another note, I have worked so long in places that don't offer epi's that have gotten used to working with laboring pts. Have had many people wonder where I learned it. It can be done but takes time and commitment that most hospitals won't allow from the nurse.

So I guess to each their own. I could not work in a hospital that doctors routinely pushed epi's again. I love to labor my pts naturally. I get such a rush out of helping the 15 yo who repeats that she can't do it, not only do it but puts some adults to shame.

kelly

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