Pregnant while in monitoring

NurseJackie69 · Jan 9

You will not get out of monitoring early. That won't happen. I've seen 4 or 5 nurses have monitoring extended for 6 weeks after maternity leave, but have never heard of it extended "until you go back to work", except for one and it was for a reason.

1. I would speak with my case manager and ask for a monitoring interruption for 1 week which is during the week of your labor.

2. Have the anesthesia team right down all meds used and if you have an epidural tell them no Fentanyl in the epidural but only local anesthetic which works very well and used most often anyway. If you have a CSection, you will need opioids for pain post op. Get a copy of your record. Tell them you are in recovery.

3. It's annoying and painful to be testing one week post delivery but if you do it this way, you may find your time ends quicker than taking 6 weeks off of monitoring only having to pay it back.

4. Fair warning....if you have a C Section and you start having major pain issues after surgery and have to stay an extra day or so or have to have an opioid script at discharge, prepare for a major increase (2 or 3 months longer) in monitoring. Do everything in your power to avoid going this route. It happens some and that's when they start extending people. They know we often get narcotics (not always) at some point in the labor and post labor process and have stress with our newborn so in their eyes, it's a trigger or risk or recovery stressor that "wake up" the addiction process or in short....an increased risk for relapse.

It Is possible, if you don't have to have a C Section, to have an epidural with only local anesthetic and go gome with Motrin/Tylenol and not recieve one controlled substances in the entire process. It Doesn't always work out like that, but it does happen and if you able to go this route, you are going to have far less issues.

I feel for you in having to take your little one into a testing center. That can't be easy and it would concern me also. You are close to finishing though. Hang in there

Healer555 · Jan 9

You can ask for a brief interruption in monitoring. Call your case manager to discuss. Tell everyone in the hospital you don't want controlled substances. Fir a c section they often give Valium. Discuss everything with your case manager. We are able to take anything if it's prescribed

Where I am we can take less than 12 weeks for medical issues without an extension of the monitoring agreement but we need a doctors note. I think it's 4 or 6 weeks and any additional time will result in a longer time.

They won't let you out early to have babies.

LMRN2003, MSN, RN · Jan 10

Hi there,

I went through probation in CA and became pregnant about 2 months into the program. I was able to have a normal pregnancy and my OBGYN wrote me a letter requesting for me to be excused from testing 6 weeks postpartum, which was granted. I was very communicative with my monitor and he did ask me to obtain a record of everything given to me in the hospital. I don't understand why it is being suggested that you request to not have Fentanyl in your epidural? Honestly, that should be up to you and your care providers. I had an epidural that contained fentanyl, and there were no issues as it is a typical treatment for pain during what is one of the most painful things to experience. I did NOT have any time added to my probation (was actually granted early termination about 8 months early).

This was my experience and I know every state is different. Probation and Diversion are very different as are monitors/case managers. My case manager was great and fair/understanding. I also followed all the rules, never missed a meeting or a check in, never had a positive test or anything. They DID Peth test me as soon as I resumed testing after the 6 weeks off.

NurseJackie69 · Jan 10

Obvuously, it's a personal choice to have Fentanyl in the Epidural or not. I was an OB OR nurse for 2 years on 3 different labor decks. Our Nurse Anesthetists and Anesthesiogists would put Fentanyl in the Epidural maybe one or two out of every 10 Epidurals and they only did it with drawn out labors where the Epidural had been in for more than 12 hours and wasn't working quite as well as the first 12 hours. The Numbing part of the Epidural is the local anesthetic which is Ropivicaine or Bupivicaine. Fentanyl is actually, NOT more likely to be in more than 50 percent of Epidurals across the country. Most, not all, but most Epidurala contain only the local anesthetic. This is why I wrote most people simply don't need the additional Fentanyl.

The thing is, if your pain is well controlled with the local anesthetic in the epidural without Fentanyl, then why? Why would you add the potential hassle that is overwhelmingly likely to possibly be a problem 2.5 months later and you having once again to do battle with the Board? What do monitoring programs love to do? They love, they thrive on those hair tests in the final month or 2 of monitoring, even in the last week of monitoring. You get a hair test which looks back 3 months and positive for Fentanyl. Sure, you are covered and you have the written report showing you received Fentanyl in your Epidural, but why add stress to your life and have to hash out and explain the hair test?

You should Absolutely Take the Medicine you need to control your pain and if I were in pain, I would take Fentanyl. But, I'm saying at least consider the idea of starting with only local in your Epidural (which is most common anyway) and then if it's not enough, have them add the Fentanyl. When I was working in OB and OR, about 8 out of 10 patients who had vaginal deliveries with epidurals never received Fentanyl. On average, 2 in 10 did. Fentanyl wasn't even put in Epidurals until about 2003. For well over the previous 30 plus years, local anesthetic was all that was used and even in 2024, it is all that is used the majority of the time.

Lunacat28 · Jan 12

Thank you everyone for your replies. My state doesn't do hair or PETH testing. The only time they'll do a PETH is if you pop positive for a urine. I'm not really stressing about the epidural because I don't even want one, I kind of just want to go natural while giving birth (or atleast try to for as long as I can LOL) simply to avoid the extra BS. My case manager is so nice and supportive which I'm grateful for. My next progress meeting with the program is in about a month and I'll probably tell them I'm pregnant during that meeting and then hear what they have to say regarding testing and such after birth. If I could just have my testing paused for a week or 2 rather than 6 weeks, I'll be happy. Narcs and all of that isn't my issue, never have I ever even tried any of that stuff. It's just annoying that I pretty much have to give them my PRIVATE medical record from the hospital in order to prove that I've been hospitalized on this day to that day, the reasoning and how I was given such and such medications. NYS is pretty forgiving compared to the horror stories about other states on here, but I'm also just venting because it's irritating no matter how long you have to do this for. I was super sick this past week & couldn't even take ANYTHING for relief which caused me so much stress because I worried so much about whether my baby is still okay or not.

Healer555 · Jan 12

You may want to tell your case manager now that you're pregnant in case you have dilute urine

Make sure toy drink enough water for you're pregnancy.

How long is your monitoring agreement?

NurseJackie69 · Jan 13

Lunacat28 said:

Thank you everyone for your replies. My state doesn't do hair or PETH testing. The only time they'll do a PETH is if you pop positive for a urine. I'm not really stressing about the epidural because I don't even want one, I kind of just want to go natural while giving birth (or atleast try to for as long as I can LOL) simply to avoid the extra BS. My case manager is so nice and supportive which I'm grateful for. My next progress meeting with the program is in about a month and I'll probably tell them I'm pregnant during that meeting and then hear what they have to say regarding testing and such after birth. If I could just have my testing paused for a week or 2 rather than 6 weeks, I'll be happy. Narcs and all of that isn't my issue, never have I ever even tried any of that stuff. It's just annoying that I pretty much have to give them my PRIVATE medical record from the hospital in order to prove that I've been hospitalized on this day to that day, the reasoning and how I was given such and such medications. NYS is pretty forgiving compared to the horror stories about other states on here, but I'm also just venting because it's irritating no matter how long you have to do this for. I was super sick this past week & couldn't even take ANYTHING for relief which caused me so much stress because I worried so much about whether my baby is still okay or not.

Understand that 76% of women who are in labor for the first time change their mind who want to go natural as labor progresses and they request an epidural. That study was done in Boston 3 years ago. If you went natural with the first labor and decide you want to go natural again, 95 percent of nurses remain natural with their 2nd labor and don't request an epidural.

If this is your first fullterm labor be prepared to have a backup plan and good communication with the Anesthesia Provider in case you change your mind.

Lunacat28 · Jan 18

Healer555 said:

You may want to tell your case manager now that you're pregnant in case you have dilute urine

Make sure toy drink enough water for you're pregnancy.

How long is your monitoring agreement?

I already told my case manager back in December! I try scheduling my tests when I'm picked in the mornings so that way I don't have to worry as much about dilution. My agreement is for 2 years, I'm supposed to finish in early 2026