Sunday, June 15, 2008

If you give a Woman an Epidural...

You all know the book "When You Give a Mouse a Cookie"? Well, here we go....

If you give a woman an epidural, she'll need a big bag of lactated ringers to go with it, the lactated ringers will keep her blood pressure from plummeting when she gets her epidural, but it will also swell her tissue with excess fluid so her legs and breasts will swell and she'll be shedding water weight for days if not weeks. The fluid in her breasts will make it hard for the baby to latch on at first, so the nurses will think the baby's not able to nurse and they'll recommend some formula, just until the nursing goes better, this will probably make mom feel insecure and crappy about her mothering skills and it could interfere with bonding.

After the epidural's in, she'll probably need a catheter because she won't be moving around much anymore, and hey! she can't feel anything below her belly button anyway! If she gets the catheter, she might get a urinary tract infection to go with it.

Once she gets the epidural and the catheter, even with the extra fluid, her blood pressure might drop anyway in response to the medication she's getting, she might get some epinephrine which has the following common side effects:

Anxiety; difficulty sleeping; dizziness; fearfulness; headache; nausea; nervousness; paleness; sweating; tremors; vomiting; weakness.

If she's unlucky she might even experience these side effects:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fast heartbeat; irregular heartbeat; wheezing.

If she gets the fluid, the epidural, the catheter, and the epinephrine, the baby might not respond very well, so the doctor will want to know what the baby's heart rate looks like all the time, and the doctor will also want to see whether mom's contractions are strong enough to dilate her cervix, so an electronic fetal scalp electrode will be screwed into the baby's head, and another special catheter, one that measures the strength of the contractions, will be pushed up inside mom's uterus. Of course, to do this, the bag of waters would have to be broken, so that the catheter can go in. Once the bag of waters is broken, the doctor will be paying close attention to the time, because doctors don't like women to walk around with a ruptured amniotic sack for much longer than a day, even if the mom and baby need longer to birth.

When she gets her fetal scalp electrode and the intrauterine pressure catheter is in place, the contractions might not look very strong on paper, so the nurse or doctor will do some cervical exams, to see how things are going. Lots of people, from the nurse, to the doctor, to the resident, to the medical student might put their fingers up inside of mom's vagina, so they can get a better idea of what's going on. But it's no big deal how many people put their hands up there, because remember, mom can't feel it! If they put their fingers up there over and over again, mom might get sick. She might get a fever, she might even get a fever in response to the epidural! But the doctors won't know exactly what's causing it, so they'll just give her a full spectrum anti-biotic to cover everything.

And if they give her a bunch of anti-biotics over the course of labor, she might get a yeast infection to go with it! If she gets a yeast infection she might give the infection to her baby too, then the baby would have thrush, which could cause more breastfeeding problems.

Once she's got the fluid, epidural, iupc, fse, the catheter, the cervical exams, and the anti-biotics, her contractions might poop out altogether, so she'll get some pitocin. The pitocin will blast her body into labor, making her contract harder and harder, faster and faster, but it won't cross the blood-brain barrier like natural oxytocin does, which is what triggers our bodies to create nature's pain killers: endorphins, so the contractions will be excruciating and very difficult to work with.

And if the contractions are very difficult to work with....

chances are.....


She'll want an epidural!

17 comments:

Doulala said...

I love this!

DoulaMomma said...

oh my goodness - I've been saying (a much shorter version of) this in childbirth classes & to doula colleagues for years - brava!

Kimberly said...

That is just too perfect!

Hot Belly Mama - taking it all back said...

I really appreciate the support for natural and home births. I am going to share this. Thank you.

Hot Belly Mama - taking it all back said...

Thank you so much for posting this. I am going to pass this on!

Dorothy H. said...

That is so so true...thanks for posting this!

melissa said...

My daughter LOOVES the "give a mouse a cookie" books. You've done a great job using the same format for a funny yet informative post on the "cascade of intervention." I love it!

Mrs. West said...

Reading this has made me rethink everything I thought I knew I wanted when I have my next child. Thank you

Utah Doula said...

Oh my Goodness! I love this. Do you mind a repost on our new little blog? Great way to introduce the cascade of interventions!

randiedoula said...

Fantastic work!

fijimama said...

Love it! So clever, and a good summary of interventions and side effects also. Thank you!

Lisa Barrett said...

Lovely mail. Noticed you mentioned on a well known blog. There was no link. I think that's because what you are saying is so true.

Diana J. said...

Just wanted to let you know I love your blog! I've linked it on my own blog.

Is it okay to copy and paste your epidural article (referenced), or should I just put a link to your blog entry? I wanted to write something similar for my own blog, but you did it so beautifully that I want to reference yours in some way.

Anonymous said...

Wow. I guess I should go tell my dear friend whose birth I assisted at and respected HER informed choices ( yes, she wanted an epidural ) that she should feel ignorant, crappy and insecure?

Should I tell her that her profound tears of joy at the birth of her daughter and son ( I was at both ) were not as touching as the joy I have seen or had myself after medicated births or homebirths? I have had both myself. I saw her joy as NO less profound and just as lovely.

This second birth she had no pit, and pushed three times until she greeted her daughter with tears of joy and "she's so beautiful...while she cried with happiness" and held and nursed her daughter for the first hour after birth. They were never seperated. She loved her daugther's birth. Her son was born to a mother crying with joy again "he is the most beautiful baby in the whole world" Should I tell her she missed out? Oh yes, I forgot, she did need some ephedrine. She didn't experience

"Anxiety; difficulty sleeping; dizziness; fearfulness; headache; nausea; nervousness; paleness; sweating; tremors; vomiting; weakness."




It sure didn't look like she missed out on anything except for the experience of getting through labor without meds. One I valued myself, but I don't think everyone has to do things the way I do to feel good or be satisfied with her birth.

I have been a labor nurse for 20 years. I feel sorry for your moms who choose epidurals. If only they knew their nurse made fun of them, their births and choices on the web.

Anonymous said...

You know you've made some sense as an online childbirth authority when you attract the attention of Dr Amy.

Congratulations:)

I'm sure she didn't link it because it made far too much sense!

Red Pomegranate said...

Yee haw! If Dr Amy is pissed at me I'm clearly doing something right.

Dear Anonymous. No where did I say that women who have epidurals should feel crappy about themselves, what I did (in a satyrical manner) is show the cascade of interventions which too often comes with getting an epidural.

Don't concern yourself over the mamas I serve, I give compassionate care and frankly will do whatever she wants. I, however, would worry about your moms. Do they get that little thing we call "informed" consent when they ask for an epidural? If you don't know your options, you have no options.

P.S. Why to people with critisisms always sign themselves "anonymous"? Grow some ovaries ladies.

slh35661 said...

One intervention leads to more interventions. This was very well said.