Ok, so we've all heard the horror stories of bad outcomes from epidurals, and the fact that "natural" childbirth is much healthier for mom and baby has probably been drilled into every nurse (maybe not, but this has been my experience). Then there are those occassions when an epidural is a necessity.
So, I'm just curious: what is your personal opinion of epidurals? Whether you work with laboring moms, or have had a baby yourself, or both. What are some personal opinions about and experiences with epidurals...
I am surprised to see this thread still hanging around.
Well I had my baby on August 20th all natural and I have to say it was quite an experience....but next go round I am definitely getting an epi.
I am almost 37 weeks pregnant, it's my body and if I want to have an epidural I'm getting one. If that makes my L&D nurse thinks that I am a "wimp" then that is her/his problem! It's not about the nurse it's about the patient. Sorry if medicated births are making your job "less fun." Also, I pay a lot of money for my health insurance and to suggest that I should have to pay out of pocket for pain relief is absurd. Who is going to judge whether an epidural is medically necessary anyway? I certainly would hope that it wouldn't be left up to a nurse with your attitude that women who want epidurals are "wimps."
I am really tired of this attitude that makes women feel they have to prove a point by suffering. With my first child the contractions really did feel like menstrual cramps and even though I had a c-sec in the end because he was transverse I did make it to 6cm with no pain relief. I don't think that makes me better or tougher than anyone...I just had an easier labor. If I have a similar experience with this baby then I likely won't request an epidural. However, if I feel like the pain is more than I am willing to tolerate I am getting my epidural and my nurse can go sit on a tack if she thinks that makes me a wimp.
I'm not a nurse yet, but I did give birth to two children....one totally natural and one not so natural. I perferred the natural birth (even though it was 24 hours longer). With my DD, I mostly labored at home. I did go to the hospital several times, but I was sent home because I wasn't dilated enough (under 4 cm). My labor with her ended up lasting 36 hours (and almost didn't make it to the hospital though), but it wasn't so bad even though it was back labor (and she came out sunny-side-up). Yes it hurt, but I was able to tolerate it. I think what made it tolerable was that I was in my own environment (my house).
With my DS I had to be induced at 38 weeks. He wasn't moving enough, so the doctors thought I should be induced. It ended up being a really bad experience. I had to have oxygen because my bp and his hr kept dropping. I also had to have internal monitoring. What made it worse was that I couldn't really move. One of the doctors came in several times and suggested an epidural because I was in a lot of pain (I think it was more uncomfortable than painful). I said no, but she kept trying to push it saying that epidurals weren't a big deal and she had one. I still said no, but I did end up getting something through my IV (which didn't work....only made me feel drunk). Later I found out (through my own research) that epidurals can make a patients bp drop. I was kind of surprised that the doctor would suggest one when my bp was already really low.
I would like to have my next baby at either a birthing center or at home. I don't know how my husband would feel about me having a baby at home. I don't know if I'm totally comfortable with the idea either. I just know that I rather not labor or give birth in a hospital again.
I'm not a nurse yet, but I did give birth to two children....one totally natural and one not so natural. I perferred the natural birth (even though it was 24 hours longer). With my DD, I mostly labored at home. I did go to the hospital several times, but I was sent home because I wasn't dilated enough (under 4 cm). My labor with her ended up lasting 36 hours (and almost didn't make it to the hospital though), but it wasn't so bad even though it was back labor (and she came out sunny-side-up). Yes it hurt, but I was able to tolerate it. I think what made it tolerable was that I was in my own environment (my house).
With my DS I had to be induced at 38 weeks. He wasn't moving enough, so the doctors thought I should be induced. It ended up being a really bad experience. I had to have oxygen because my bp and his hr kept dropping. I also had to have internal monitoring. What made it worse was that I couldn't really move. One of the doctors came in several times and suggested an epidural because I was in a lot of pain (I think it was more uncomfortable than painful). I said no, but she kept trying to push it saying that epidurals weren't a big deal and she had one. I still said no, but I did end up getting something through my IV (which didn't work....only made me feel drunk). Later I found out (through my own research) that epidurals can make a patients bp drop. I was kind of surprised that the doctor would suggest one when my bp was already really low.
I would like to have my next baby at either a birthing center or at home. I don't know how my husband would feel about me having a baby at home. I don't know if I'm totally comfortable with the idea either. I just know that I rather not labor or give birth in a hospital again.
my BIL and his wife are using a midwife and are being as natural as possible but will be in the hosital "just in case something does happen" kinda the best of nboth worlds- i would imagine many hospitals would allow this. just an idea.
The more important question is do they really need the PITOCIN? That's another critical issue in this day and age when we want everything to be comvenient - including birthing times. I don't think that insurance companies should pay for epidurals that are not medically indicated because we're ALL paying for this - they do not come cheaply! And birthing should be returned to a natural process with stand-by safety precautions. The large majority of births should be attended by mid-wives, not OB-GYNs who don't have the patience to hand hold a women who refused to educate herself about the process but relied on the system to make delivery as inconvenient as a tooth cleaning.
Great post! :biggringi I work at a big teaching hospital and our residents feel like they should get everyone delivered before checkout. They essentially want us to up the pitocin until the baby shoots out. After a couple nights of dealing with staff pts, it's hard to remember that women are able to, and for eons did deliver without pit :uhoh21:
The anesthiologists think it their mission in life to make sure you know all about it from the second you walk in the door. I've even had them go into a patient's room even though I told them the patient is not wanting an epidural
Yep. Sorry, but you are not the deciding factor on whether or not I'll go talk to a patient. Do you have any idea how many patients have refused epidurals at first, only to call me back later to get one? Do you have any idea how much easier it is to talk to a patient when they are not yet in pain, rather than try to obtain a health history from a writhing patient? Any time I go into a room, I make absolutely sure that the patient is aware that I am not there to sell them anything. In fact, I'd far rather them not get an epidural than to have to hang around until 2 AM when they finally deliver. But guess what? It isn't up to me!
And then there are the times when they'll go in and say,"well, I have another case, so if you want one, you'd better get it now." Is that a veiled threat or what? It really makes me angry when that happens.
Would you rather the ologist not told them they were about to do a case in the OR? That way, when the patient decides she is ready for her epidural, you get the pleasure of telling her "sorry, but anesthesia is in the OR now, so you have to do it my way." It's not a threat, it is providing the patient full information so that her decision can at least be considered to be informed.
Someone during this thread stated that I (tntrn) was less fulfilled when women choose an epidural. On one level that is true and I see no problem with that. One should choose employment so as to be fulfilled and I chose this kind of nursing 30 years ago because it was fulfilling to me.
Yep. That was me. Let's look at your original statement, shall we:
"Now that everybody has to have one the second they walk in the door, a part of me is unfulfilled as a labor nurse...There's a lot to do for the epiduralized patient, but I don't find she needs the support that I prided myself in being able to give her...
I'm real close to transitioning myself out of Labor anyway, too much intervention, for dubious reasons, IMHO"
Sorry, but that does not come across as supportive. That comes across as controlling. These darn patients just don't want to have babies the way I think they should. Because of that, I'm thinking about leaving. I encourage you to examine your beliefs. The day a woman delivers isn't your day, its hers. As much as possible, we should make that happen for her. If you can't get past your own prejudices, then perhaps it is time to move on.
My patients who choose an epidural never know my own personal preferences. If they ask, I will tell them what my preferences for myself are, but never do they get a guilt trip from me one way or the other.
Sorry, but I doubt that. I've have worked with a nurse with the same attitude as you, who swore she never let her attitude affect how she dealt with patients. You would be surprised at the number of patients who, out of her presence, let me know that they had been afraid to ask for the epidural for fear of incurring her wrath. One, stronger than the most, told her to "take her ancient ideas out of my room and don't come back!" That was what forced her to reevaluate how she interacted with patients.
I do think that way too many patients are given the message from early on that they won't be able to "do it" without an epidural. That is bogus and unfair, not to mention untrue. In my opinion, it gives women the message that they are weak and puny and that is just not the case.
Presented that way, you are correct. Women can and do give birth, every day, without epidurals. But let's go back to that original post, shall we?
"In the 70's and 80's I worked in a hospital (300 a month) and we did NO epidurals. The population was prepared for birthing without them and they did just fine."
Maybe you missed it, but a lot of things have changed since the 70's and 80's. For example, in the 70's and 80's, we did cholecystectomies "open," which caused enormous pain, and led to a minimum one week hospital stay. Now, most choles are done laparoscopically, and are done on an outpatient basis. Closer to home, now when a woman is having a particularly slow, painful labor, we have an alternative to offer them that will help them relax, and in almost 100% of cases that will let the cervix relax and labor will progress at a more reasonable rate. They still may not deliver till 2 AM, but at least that's better than 2 AM 36 hours from now. Unfortunately, you may find that "less fulfilling" than you continuing to coach that woman for the next 36 hours, but we are not really there for your fulfillment, are we?
Seriously, examine your own prejudices. If you can't get past the need for control, perhaps it is time to find another area to work.
Seriously, examine your own prejudices. If you can't get past the need for control, perhaps it is time to find another area to work.
An L&D nurse stating that she feels she's at her best when she's helping a woman deliver naturally isn't being prejudiced or controlling. She's simply stating that those are the times she really feels she is helping her patients in the way that she enjoys the most. There's nothing judgemental about being excited to help a woman naturally go through the birth process without analgesia! Birth is a natural thing and has been since the beginning of time. I can totally understand an L&D nurse being kind of bummed at how much childbirth has changed in the past 30 years or so - especially if they decided to do L&D nursing way back when epidurals weren't the norm. It's a different field now, and L&D nurses have every right to have their opinions on whether or not these changes are good or bad.
Specializes in postpartum, nursery, high risk L&D.
Seriously, examine your own prejudices. If you can't get past the need for control, perhaps it is time to find another area to work.
dude, that's harsh. I don't see enjoying taking care of laboring patients without epidurals as being judgemental or controlling. those feelings are totally valid.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I see all sides here. I think it's a good exercise for ALL OF US to examine our feelings, emotions, personal birth experiences, histories, and prejudices regarding birth here, and take a step back now and again and breathe. One thing passgasser is right about; it's not OUR birth experience we are talking about here. And no matter how strongly we feel the "heart and soul" of birth process is affected negatively by what appears excessive use of anesthesia, (I feel it too, believe me)----we must keep our feelings in check and be neutral in how we present to our patients and families. Education is key---as well as an open mind.
Another point passgasser makes, is trying to discuss/educate patients about anesthesia is really inappropriate when a woman is out of her mind in pain, willing to sign ANYthing to relieve the pain. I think there IS merit in educating a person (who expresses interest) about the risks/benefits of this procedure PRIOR to very active and painful labor---otherwise, are we TRULY getting INFORMED consent when they BEG us to help them? Something to think about......
In the end: It's not our day, after all, but theirs. All we can do is facilitate the safest and most joyful birth experience for our patients and loved ones as possible. If we cannot bring ourselves to do that and enjoy it, too, maybe then it IS time to take a leave from this area of nursing, or perhaps, find another venue to practice it in. JMO as always...
I have to say, I just started taking a birthing course with my dh. The topic last night was pain control during labor, and a number of women simply wanted to know "when can I get my epidural?" ONe woman actually asked, "so, can I just schedule a cesarean?"
I'm sorry, but this mentality is CRAZY to me! HOw do you know you'll even NEED an epidural if you've never expereinced labor? NOne of these women has had a baby previously.
In fact, the only women in the class who has both delivered a baby previously and had an intrathecal injection said she would rather try to go with out meds. I found that interesting. SHe hated the side effects.
I just think it's a little premature to ask when you can get your epidural when you have no idea what labor will feel like.
i have to say, i just started taking a birthing course with my dh. the topic last night was pain control during labor, and a number of women simply wanted to know "when can i get my epidural?" one woman actually asked, "so, can i just schedule a cesarean?"
i'm sorry, but this mentality is crazy to me! how do you know you'll even need an epidural if you've never expereinced labor? none of these women has had a baby previously.
in fact, the only women in the class who has both delivered a baby previously and had an intrathecal injection said she would rather try to go with out meds. i found that interesting. she hated the side effects.
i just think it's a little premature to ask when you can get your epidural when you have no idea what labor will feel like.
to me that doesn't seem crazy, they're just asking questions. if they're rookies, shouldn't allowance be made for their curiosity?
The anesthiologists think it their mission in life to make sure you know all about it from the second you walk in the door. I've even had them go into a patient's room even though I told them the patient is not wanting an epidural.
See, the thing is, when we get consent, we are getting consent for ANESTHESIA, not necessarily just an epidural. So, when its 3am and time for a C/S for FTP or fetal intolerance, I don't have to get consent from a scared-to-death mom with a rapidly decompensating baby. Plus, choice of anesthesia depends quite a bit on medical history. It's much easier to be ahead of the game and talk to them about anesthesia options when they are not in extreme pain, not begging for pain relief, and not to the point of fetal distress. I would much rather have an anesthesia provider talking to me early. I always tell me patients that they I am not trying to sell them on anything, but I do have to present the options they have, along with R/B/A, so that if they change their mind, or their case becomes an emergency, we have consent.
Lovely_RN, MSN
1,122 Posts
I am surprised to see this thread still hanging around.
Well I had my baby on August 20th all natural and I have to say it was quite an experience....but next go round I am definitely getting an epi.