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Dropping epidural during delivery ?

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I finally give birth to my baby girl and grateful she was born healthy 7 lbs 7 onz.

I would like to describe what happened during delivery as I and my doula think was not right and want to know what is your opinion...the baby was my first and I requested to have an epidural in my birth plan. Well after my water broke and I got admitted the contractions began full force and I was given epidural when I was about 4 cm dilated. The epidural worked wonders...until I dilated 10 cm and the nurse told me to begin pushing. Well I begin to push and nothing and so the nurse said she was going to drop down on the epidural so that I could have the sensation to push to speed things up. Well she didn't told me but she dropped the epidural completetly and so with that I really end up having a total natural birth with all the excruciating pain in the world. I was into exhaustion and the doctor had to anyways use vacuum to get the baby out and 3rd degree tear. So my question is, is it common to drop entirely epidural to speed up delivery??? and is the nurse allowed to drop down the epidural without doctor consent?? Did I had the right to tell the nurse not to drop the epidural until consulted with the doctor?? I will appreciate feedback.
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replied January 8th, 2009
Extremely eHealthy
Congratulations on your baby girl!

If your Doula is questioning it, I would too. I've never heard of a nurse doing something like that without the doctor, and after saying she'd 'lower' it, than shut it off completely.

I can't find the article, but a woman sued her hospital for not having enough pain relief during her childbirth.
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replied January 8th, 2009
Especially eHealthy
While it was painful to you (as birth is painful), it was right for her to turn the epidural off so you could get the sensation of how hard to push, when to push, etc. A lot of first time births are really long on the pushing part. With my son I pushed for more than 2 hours and broke blood vessels in my eyes and face. At my hospital there was no pain medication option and I had an excruciatingly long labor (more than 48 hours) that was augmented with pitocin.

Women sometimes get a lot of regrets about their birth experience and what they have no control over (labor).

I hope it was very helpful to have a doula with you!

At your next doctor's appointment, take some time to discuss with him what your experience was and how it has affected you.

You had the best outcome though! You have a perfect little girl! Congrats.
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replied January 9th, 2009
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Mabel but my question is if obviously epidural cuts the sensation to push to everyone why it is shut down only to some?? As far as my labor was going I was dilating very well and I needed no pitocin. My doula told me the nurse told me to push too early. I was about two hours pushing by mandate with all the sensation pain but no need of urge to push..
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replied January 9th, 2009
Especially eHealthy
When women are given an epidural, they do not get the same urge to push, especially if the epidural is strong. Another thing going against the pushing, is that you are unable to feel how hard you are pushing - so the epidural will be turned off. It is at that point you no longer need it anyway, since you've labored with it and that is what epidural is for.

You felt your child slide from your body, which I believe is a really miraculous feel. Something you'd have never felt if your epidural was still on.

How many births has your doula attended? Were you dilated to 10 when you began pushing?
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replied January 9th, 2009
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I think I was 10 cm dilated but can't exactly recall. My doula has attended around 30 births and said she had never seeing anything like it. She has 4 children herself begining first baby in hospital and last birth at home in the tub.

I did felt the baby comming out although in the end they had to use suction vaccum to get her out. I would like to have another child in the near future since I'm older but right now I'm frightened to death of going through that kind of painful experience again..
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replied January 9th, 2009
Especially eHealthy
No two births are the same, so it would be doubtful your second birth would mirror your first. It is also very very common for first time mothers to have a long, hard time pushing. As I said earlier, I pushed for two hours with my first. With my second it was a fraction of that time and knowing what I knew, I was able to deal with not only the pain, but the fears surrounding the events.

I would not wish to say anything negative about your doula, but she is there to support and protect you and insist on what your wishes are. It sounds to me as if she is feeding your disappointment with how things turned out instead of turning things into a positive, you have a beautiful daughter and the birth was just a drop in the vast sea of your lives together.
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replied January 9th, 2009
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Well the doula was really supportive, she told me about this after the facts but now that you say I preferred now to have not known the thruth hehe.

I didn't mind the pushing, I could push forever, the problem is pushing with not urge to push and with a deep pain. The pain takes away concentration to push
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replied January 9th, 2009
Extremely eHealthy
Then look I was in the pediatric office and this lady had her baby the same day like me in the same hospital and she was telling me how painless her labor was with the epidural, she told, they didn't shut down my epidural and only felt a little pressure when her son was born..

After all yes I'm grateful that aside of the pain the baby is fine and healthy it just makes mad that I wanted to have epidural all the way and this wasn't the case.
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replied January 9th, 2009
Especially eHealthy
Her epidural was not shut off because she was pushing easily, your pushes were not working. That is the reason it was shut off.
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replied January 9th, 2009
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Congratulations Mari
How wonderful your beautiful baby girl has arrived. Thank God she is healthy and well. I have been thinking of you the past few days as I know today was to be your delivery date.

Sorry about the horrible pain from your epidural. I know exactly what you mean. I was only 18 years old and they gave me two epidurals as they said I was not dialating fast enough. I literally passed out, missed out on the birth of my daughter and did not wake up until the next day.

It seems to me better monitoring and more patience needs to be shown to women in delivery.

Roberta
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replied January 10th, 2009
Extremely eHealthy
It's very common for epidurals to be turned down or cut off during the pushing stage of labor.
It's hard for most women to push effectively with it.
Unfortunately, not all women retain the numbing aspects of the epidural once it's turned off. Many women do still feel no pain though.
Congrats on your baby girl!
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replied January 14th, 2009
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Grats on the baby. Ok number one, your doula is not a doctor or nurse, is not trained in the medical field. (Unless she is a CNM/doula). So what she says should have little bearing on the medical aspect. Doulas are support coaches, not nurse-midwives. Number two, are you sure that the nurse was not told by a doctor to come turn your epidural off? Mine was turned off at the end with my daughter because I could feel nothing on one side and everything on the other and my brain was getting confused about which signals to believe-the numbness or the contractions. It is actually very common for nurses to turn the epidural down or off with the expressed orders of a doctor or the anesthesiologist. You may have not heard the orders being passed from doctor to nurse, but they probably were. As far as you not able to feel the urge to push, that is a real big indicator that your epidural was working a bit too well. Sometimes the nurse will ask you to push before you are fully dilated (and btw 10cm is fully dilated) to push out the last bits of a cervical lip or to see if it thins out the cervix even more. Pushing too early has little to do with tears around the vaginal opening. Those are often caused by first time births, pushing too FAST, or just a small body delivering a big head. The tears you would expect to see due to pushing too early are tears in the cervix from the cervix not being dilated all the way.
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replied January 14th, 2009
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You are right mother, the nurse might have of gotten instruction from the doctor that I didn't noticed as I did saw she call him at times..I will do want to discuss with the doctor in my next appt about what happened. I just didn't know this was a common thing to do that of dropping off the epidural. I still have questions that I want answer...Why instead of dropping it entirely off wasn't just the dose lowered, I mean with less pain I feel I could probably have been able to push better? See cause the pain goes so intense I can't concentrate to push at all. I guess they thought in my case after dropping it off that I was going to push effectively and the baby to continue to decend but that didn't happened. So they had me pushing until I reached exhaustion and then doctor had to do intervention as the baby was not coming out without a little help. Yes, I guess now that's how it was..I have had no problem recovering from the tear I'm glad to say. I think the doctor did good job with that one...
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replied January 15th, 2009
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Hun, it all depends on a few factors, like what the original dosage on your epidural was. If it was already low, then they may have shut it off entirely. But if it was on a higher setting, I tend to agree with you and wonder why they didn't turn it down instead of shutting it off completely. I am glad that you at least healed well. I never teared but for some reason, my OB sewed up a small part of my hymen that had torn...maybe that is a blessing lol. I am sorry to hear things ended up painful but I know it was all worth it for you.
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replied February 6th, 2009
turning epidurals off
NICE guidance says epidurals should not be turned off until after the baby and afterbirth are delivered. There is a research paper showing that it makes no difference to instrumental deliveries. (On pubmed) what it does do is traumatise the mother and make it more likely that she will get post traumatic stress disorder and have negative memories of the birth. Appalling practise and health care professionals need much better training.
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replied February 6th, 2009
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nightangel73 wrote:
Mabel but my question is if obviously epidural cuts the sensation to push to everyone why it is shut down only to some?? As far as my labor was going I was dilating very well and I needed no pitocin. My doula told me the nurse told me to push too early. I was about two hours pushing by mandate with all the sensation pain but no need of urge to push..


I think you answered your own questions......NO need to push

that has to be why it was so much for you. Your body and baby usually know more than the doctors and nurses. I think you pushed before you were completely ready. Especially since the doctor didnt consent to the drop.

My birth was natural but the sensation and need to push was so overwhelming my body took over and basically did it for me. I was along for the ride.

Sorry you had so much pain in the end. I know how disappointing it is when your birth doesnt go the way you had hoped.
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replied February 12th, 2009
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Re: turning epidurals off
Mowey wrote:
NICE guidance says epidurals should not be turned off until after the baby and afterbirth are delivered. There is a research paper showing that it makes no difference to instrumental deliveries. (On pubmed) what it does do is traumatise the mother and make it more likely that she will get post traumatic stress disorder and have negative memories of the birth. Appalling practise and health care professionals need much better training.


Indeed appalling practice!

Today I had my post-partum checkup and was able to question the doctor on why they shut down the epidural. Well he said he did not ordered to shut down the epidural and that he would never do such thing and so that this was done by the nurse alone. He asked me who the nurse was (he couldn't remember) and apologized many times. He said I should have asked for him when the nurse said she was going to "lower" the epidural dose that he would not allowed her to do that. But what I'm suppose to know right? You think the nurse knows what she is doing. Now I know and this won't happen again.

So ladies out there if you are pregnant beware of this call your doctor if the nurse says about dropping down the epidural. It's not right!!
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replied February 12th, 2009
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Mowey- Thanks for telling this of the NICE guidelines. I google search them and read and i think every pregnant lady should read them so they have knowledge of what is right and wrong during childbirth. In the guidelines also said that after you reach full dilation they have to wait an hour before encouraging you to push so that your body is ready. They didn't do that to me neither. I was ordered to push as soon as reached dilation and my doula said she has seeing this over and over during deliveries. It's all rushed and they put you to push as soon as reached dilation.

I will be bringing this guidelines with me for a next time.
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replied May 15th, 2010
to original post
Sorry to say, it sounds like I had the EXACT birthing experience that you did. It was aweful, I'm terrified of having another baby, the pain was excrutiating. I'm now 8 weeks post-partum, still very tender down there, still bleedig and not healing well. Still haven't been able to sleep with my husband, and when I saw the doctor last, she said it would be another TWO months before anything can happen. NOTE TO PREGNANT LADIES: NEVER DELIVER IN A MILITARY HOSPITAL. I know, I'm active duty Army, and I wish I had been able to go to a civilian hospital.
Good luck to all.
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