Posted by My OB said WHAT?!?.
May
25
Posted by My OB said WHAT?!?.
“…There’s No Longer Any Such Thing As Gravity.”
“We have an epidural in. There’s no longer any such thing as gravity.” -L&D Nurse to a mother who wanted to remain sitting up even though she had an epidural.
There are 54 comments to this post.
Gravity Police had this to say,
May 25, 2010 @ 4:27 pm (Quote)
Sarah Dorrance-Minch had this to say,
May 25, 2010 @ 4:28 pm (Quote)
*dropping large, heavy object onto nurse’s foot*
News to me.
If you like, we can get the aromatherapy drums and twinkle lights and hold a seance to contact the ghost of Sir Isaac Newton, to get a second opinion, but I think his answer would concur with mine.
[Reply]
Yet another reason why doctors, nurses and the epidurals THEY provide are all powerful.. they can change the very concept of how our world works!
Oh wait, they can’t. Sorry dear, gravity still exists despite the epidural. Is it that big of a deal for her to sit instead of being flat on her back??
[Reply]
:O My nurse is GOD?!
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 8:05 am (Quote)
I’m sure she’d like to think so, at least, when the doctor isn’t around to play that role.
[Reply]
Jena Reply:
May 26th, 2010 at 2:25 pm (Quote)
Oh wait. Silly me. My nurse isn’t God. My nurse is Elphaba!
*cue Defying Gravity from Wicked*
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 2:35 pm (Quote)
I think I’d rather have Ezkedelia from _Tin Man_. It would be kind of fun to get a nurse so worked up that mobats started to fly out of her cleavage.
[Reply]
OOOOHHHHH….. so THAT explains why they put your legs in stirups…. I SO understand it now.. no gravity to hold them down once you get an epidural…
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 8:08 am (Quote)
Thing is, I imagine that would partly negate the desire for an epidural. One advantage of labouring and birthing in the water is the feeling of weightlessness. It provides a certain amount of pain relief, especially when you’re dealing with lower back pain, round ligament pain, etc. The body is supported, so about the only pain would come from the opening of the cervix and the uterine flexing and so on.
You’d want a fish net or something to capture poop, blood, etc, but I imagine giving birth in outer space in zero gravity would be a lot easier than giving birth on the ground.
[Reply]
I think she meant “there is no gravity except where the epidural is concerned.” After all, the reason they don’t want women continuing to sit is that the epidural could settle too low (at least that’s their reasoning). And obviously that has *nothing* to do with gravity.
Maybe that nurse should abide by the adage: It’s better to keep your mouth shut and be thought a fool than to open it and remove all doubt.”
[Reply]
Sheva Reply:
May 25th, 2010 at 9:27 pm (Quote)
Settle too low – isn’t that the whole point?? That the pain meds settle looooow down in the pelvis where they’ll have the greatest effect?
There’s no longer such a thing as gravity… I agree with Jane, there’s no way to make this sound any stupider.
Congratulations, nurse, you get the idiot award of the year!!
Sheesh.
[Reply]
Cmat Reply:
May 26th, 2010 at 4:34 am (Quote)
“Maybe that nurse should abide by the adage: It’s better to keep your mouth shut and be thought a fool than to open it and remove all doubt.”
Yes.. that. I think remembering that would solve a lot of problems for people working in the medical community.
[Reply]
I’m a biochemist, my husband a space physicist now working on fusion…I almost hope a nurse says something so stupid while I’m at the hospital. I’m pretty sure he would tell her she’s an idiot and ask if there’s a nurse who has completed first grade.
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 8:12 am (Quote)
Gee, I should have put my comment about birthing in outer space in your comment field.
It’s my theory that birthing in space in a zero g environment might actually be easier on the mother than birthing on the ground. Some of the benefits of waterbirthing, such as relief of back pain, would apply. I wonder what he would have to add to this? I’m really curious, now…
[Reply]
meghan Reply:
May 26th, 2010 at 8:33 am (Quote)
You would have to take into account that there is no leverage due to gravity in space (or zero G). Doing anything is counter-intuitive because of this. Imagine trying to turn a wrench to tighten a bolt – you wouldn’t you would just spin your self around.
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 1:58 pm (Quote)
OTOH, the motion sickness from all that spinning might help vomit the baby out. Barfing can strengthen pushing efforts.
I wouldn’t consider that an easier way to birth, though. Good point.
[Reply]
Sarah Dorrance-Minch had this to say,
May 26, 2010 @ 8:16 am (Quote)
On Facebook, when this was posted, another comment by an idiot nurse took the cake. Get this: the nurse actually told her patient that if she did not lie down cooperatively (like a good girl), gravity would cause the medication from the epidural to pool at her feet.
Apparently nurses are no more familiar with Hervey’s theory of circulation than they are of Newton’s theory of gravity.
What is the world coming to?
Note to self: if ever (heaven forbid) in a maternity ward in labour again, be sure to quiz the nurse about her views on Copernicus. Because for all we know, the earth might also be flat once you enter the Deliver Me Zone.
[Reply]
Wow, I miss one day of MOSW and we’re treated to a gem like this. Anti-gravity epidurals. I’ve always wanted to experience space flight. I had no idea I could do that during labor. Maybe I shouldn’t have had the waterbirth and should have gone with the epidural instead. Then I could have floated away.
[Reply]
OK, I’m going to have to jump into the frenzy here. The epidural medication is in a space that bathes the nerve endings from that particular space and down due to gravity with numbing medicine and pain medicine. It doesn’t enter the circulatory system and affect babies like pain medicine does in an IV. This is why it is preferred over general anesthesia for C/S. Generally speaking, it covers a woman from the belly button down. When the woman sits up, the level does go down. All patient’s deserve to be presented with this information to include the pros and cons of it. Ultimately, it is the patient’s decision. I have never had much success with high fowlers to bring the stubborn babies down after an epidural. The patient’s cervix always seems to begin swelling or it was swollen prior to the epidural. I’ve achieved better results with positioning my patient’s from side to side with them almost on their stomach and the upper leg bent and rotated to the side she is lying on. I love high fowlers, walking, squatting, lounging etc for natural birth and allowing the patient to ambulate to the bathroom for some measure of control. The delivery of this information was lacking in professionalism. Don’t kill the messenger.
[Reply]
Sheva Reply:
May 26th, 2010 at 12:37 pm (Quote)
According to research, the baby does receive the drugs that are in the epidural, in at least as high a concentration as in the mother. And it takes longer for them to clear it out of their system, due to their immature liver.
Also, in my research, I don’t remember ever learning that the effect of the epidural can move from one place to another.
What it does is block the transmission of signals to and from sensory and motor nerves so that all the nerves in the area of the injection site will be affected.
It is true that if the mother is lying totally flat the medication can flow upward and impair her ability to breath, but that doesn’t take away the analgesia from her lower body. I do think the effect of the epidural can spread. But I don’t think that it can quit one place and move to another.
One more thing – the epidural has narcotics in it. So women who choose it because they don’t want to subject their unborn child to drugs are being misinformed.
Just because it isn’t injected into her blood stream doesn’t mean the baby won’t get it.
Anything that goes into (or onto) a pregnant women will get to her baby to some degree, like hair dyes, nail polish and remover, any foods, drinks, drugs (legal or otherwise), medications (topical and oral), alcohol, and cigarettes.
[Reply]
Aron Reply:
May 26th, 2010 at 2:12 pm (Quote)
I’ve seen the epidural effects shift from side to side as my client rolled over. She never could get complete coverage: whichever portion of her body was higher would have full sensation. Still doesn’t necessarily mean a woman couldn’t sit up.
[Reply]
Birth Unplugged Reply:
May 26th, 2010 at 2:40 pm (Quote)
The effects of the epidural being on one side or the other is different from it moving up and down her body, though. The medication can settle on one side or the other of the spine, leading to one-sided pain relief. As I understand it, the local anesthetic portion of the epidural numbs a point of the spine, which numbs the rest of the body below that point because pain messages travel up the spine to the brain. The idea that the anesthesea would “move” from her spine down to her feet makes no logical sense whatsoever.
[Reply]
Sheva Reply:
May 26th, 2010 at 3:15 pm (Quote)
I’m looking and looking and looking at the A&P section of my textbook, and I can’t find the bottom of the spinal cord!
I mean, I thought it ended in the coccyx, but people are talking about the epidural stuff going lower and pooling at the feet. How does it get there?
[Reply]
Birth Unplugged Reply:
May 27th, 2010 at 10:03 am (Quote)
Okay, after a little more research, I think I understand it. The epidural numbs the spine at a point above where the nerves for the lower half of the body join the spine, if the medication were to settle down her spine, it could move lower in her spine, causing her to have the feeling return to parts of her body meant to be numb. I think “pooling at the feet” is probably not an accurate description, but I guess the epidural not working properly because of upright positioning IS technically possible, but as Nurse/Thea mentioned below, this could only happen if the epidural had been turned off, because if medication was still flowing through the epidural catheter, the point of entry would continue to receive medication.
[Reply]
Sheva Reply:
May 26th, 2010 at 12:44 pm (Quote)
Also, is it possible that the high Fowler’s position (sitting upright with knees bent) doesn’t help or swells the cervix because the women with epidurals often have HUGE doses of pitocin which cause extremely intense contractions whose strength the cervix was not created to handle? (Is that a run-on?)
So that it wouldn’t be the upright position that is affecting the cervix, but the additional and uncalled for abuse of the lack of sensation in the mother that is Pitocin?
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 2:28 pm (Quote)
Pushing on the arbitrary ten-centimetre mark, with coaching, rather than pushing when the body feels a natural URGE to push, is notorious for creating swelled cervixes that don’t let a baby emerge without some sort of instrumental assistance. Assistance that hurts bad enough that it’s a good thing the area is numb due to an epidural – of course, if the area below the waist weren’t numb in the first place, there probably wouldn’t have been any need to coach the pushing.
It’s a self-creating problem.
[Reply]
Sarah Dorrance-Minch Reply:
May 26th, 2010 at 2:06 pm (Quote)
“Don’t kill the messenger?”
This is a site specifically designed so that those of us with plenty of spleen to vent can kill the messenger… as nastily and messily as possible. I thought you knew that walking in.
Anyway, your explanation doesn’t change the fact that in theory, a mother CAN have an epidural and still push in an upright position, for instance, kneeling – especially if she has been unhooked from the drip for her pushing phase and is no longer tethered, in which case she can get up and dance around the room and wind up squatting in the shower, if she really wants, although most mothers who have epidurals do seem to keep the pain relief going for the pushing and not just the dilating.
And yes, gravity still works.
And even kneeling is better for the perineum than lying supine or semi-reclined, legs bent, feet up in the air, making a nice display for the doctor, a nice “sterile field” that is easy to control, and a position that gives the mother the appearance and the pushing power of a dead bug. A semi-squat is also possible, even in bed, hooked up to an epidural pump, and is a better position for getting some strength into one’s pushing efforts. Also for widening the pelvic outlet if there is a baby with large shoulders, a nuchal hand, etc.
[Reply]
Lucia CLC Reply:
May 27th, 2010 at 5:20 pm (Quote)
Actually we have excellent evidence that Epidurals no only effect the baby but often have severe feeding repercussions for the baby after birth. Fentanyl in the epidural is greatly associated in studies with babies who will not nurse, but every Dr uses a different cocktail. Cases have been found of muscle relaxants being used and causing women to end up with “inverted” nipples because the drugs prevented them from becoming erect. Add that to a baby who will not search for the nipple and has low tone from the drugs and you have a nursing nightmare. Evidence based medicine is where it’s at, Nurse.
[Reply]
Birth Unplugged had this to say,
May 26, 2010 @ 2:29 pm (Quote)
This website is called “My OB *said* what?” not “What my OB (or nurse, in this case) *meant* to say.” Obviously the mother didn’t understand that the nurse *meant* that the epidural could settle in her feet (though I can find no evidence of this supposed phenomenon, and I don’t think it logically makes sense), if that is, in fact, what she meant, and I’m not entirely sure. I am more inclined to think she meant that there is no such thing as gravity-enhancing positioning with an epidural, as in, “you wanted to use ‘gravity’ to help with a natural birth, but now that you have an epidural, that plan is out the window”
[Reply]
LaughingHusband had this to say,
May 26, 2010 @ 7:16 pm (Quote)
I think this one is being read into too much – my wife was loopy as hell after her Epidural – she’d have fallen off the table if she’d stayed sitting up.
It may well be that this nurse was just trying to keep the patient calm and working with her.
That said, if an Epidural really did break the laws of gravity, you could power starships with it – just get a group of pregnant women in a nice suite somewhere in the middle of the ship, light ‘em up with epidurals, and turn on the engines…
[Reply]
OK, bring it on. I can handle it. Seriously, I thought this site was about mature women with bad experiences that were looking for affirmation, support, information and change. I entered this site feeling I could make a difference with exchange of information, in addition, I take your experiences and teach new nurses what to say and not say. Sheva, you share your resources and I’ll share mine. Now I do know there is a possibility this information is anesthesia propoganda(sp)?. Reading back over my response, I can see where I should have clarified my point better. I often place my patient on her side post epidural to reduce swelling of the cervix if present. Also sitting up right away will make mom hypotensive and she could faint decreasing blood supply to baby. With side positioning, this allows the baby to finish rotating and move down till mom feels the urge to push (Fredick’s Sign). I then sit her up and we use open glottis pushing. If I have a questionable appearing tracing, then she pushes on her side for better blood flow to placenta. If she is persistent OP, then she pushes on all fours. I have never seen an epidural pool at anyone’s feet unless it has been turned off, however; I have seen the epidural go down to her perineum usually causing a complaint of pain because she is feeling her contractions again. I have also seen epidurals work better on one side than the other due to the skill of the CRNA, due to how mom’s body is made and or due to being on one side longer than 2 hours. If the epidural medication can settle on one side or another, it can move up and down. I like nipple stimulation or accupuncture points before pitocin but I don’t always have a say. Yes, sitting up opens the pelvis by 25-30%. Thea
[Reply]
Aron Reply:
May 27th, 2010 at 5:22 am (Quote)
Thea, you sound like a great nurse, and one I would want to have attend me if I ever needed L&D care in a hospital.
[Reply]
Sarah Dorrance-Minch Reply:
May 27th, 2010 at 7:57 am (Quote)
“Seriously, I thought this site was about mature women with bad experiences that were looking for affirmation, support, information and change. I entered this site feeling I could make a difference with exchange of information, in addition, I take your experiences and teach new nurses what to say and not say.”
You can probably still get plenty of information regarding what your student nurses should feel safe saying and what they ought to keep to themselves. And yes, we do exchange information and it can often be very supportive and helpful.
However.
Take into the account the fact that a lot of us are EXPLODING with rage. We’ve had botched and miserable births, we’ve even occasionally dealt with the tragedy of losing our baby, and on top of the experiences themselves, we’ve had to deal with tactlessness, callousness, and outright lies from some members of the medical establishment.
A lot of us have had what we considered to be totally unnecessary surgery, and grieved for the loss of the joyful, natural birthing we had thought ourselves safe in envisioning. Some of us have seen our bonding become difficult due to postpartum depression and/or the pain of recovering from a major operation. Some of us have been in too much pain to nurse during our convalescence, and we had previously been determined to nurse for reasons both personal and health-related.
And we have been told on practically all mainstream fora for mothers, “You should be glad you have a healthy baby.” “Stop living in the past. Your baby needs you now.” In short, stop being so selfish and put on your big girl panties, already. You don’t count any more. You’re a MOTHER, not an individual, and the sooner you realize that, the better.
We have nowhere to vent our frustration and rage acceptably. Well, maybe not nowhere, but we don’t have very many places to go.
It HURTS.
It hurts to have to bottle up all of that anger and pain and sorrow because it’s not nice to talk about in polite company. It hurts when we know that our own miserable experiences and the abuses we endured at the hands of the medical establishment are unimportant to the vast majority of our peers, including most other mothers (who might not want to hear us talk because it might make them angry, too).
This is a safe place to explode.
We don’t name names, we don’t list exact hospitals or birth centres, we don’t damage any professional reputations. In its own way, this is a very polite barbeque pit.
We also have Thoughtful Thursdays, so we don’t always have roasting forks at the ready.
If we seem immature, bitchy, and nasty, it’s because this is one of the few opportunities we have to let the negativity out before it hurts somebody for real.
[Reply]
I take everyone’s comments here seriously. I have walked away from this site just shaking my head about all the thoughtless, insensitive, uncaring comments and actions. So much of these events could have been prevented with listening skills and communication. I have also recommended this site to a handful of nurses that I know, like myself, will walk away the better nurse for it. For some medical persons out there well….there’s just not any hope for. I have always felt honored to share a birthing experience with families. I have laughed, cried, blessed deceased babies and have tried at all times to be not only a patient’s advocate but also a woman’s advocate. I have learned so much in the last few months from this site that is not in any textbook; it’s invaluable. I grieve at the awful things that happen especially when there has been a loss. I welcome different opinions. A person is demonstrating security in who they are when they voice an opposite opinion from the group. Wouldn’t the world be a boring place if we all thought the same way on everything. I am just as much a straight shooter as most of you are, however; I am also representing my profession, my Christian beliefs, and my age. In other words, I’m too old to be told to “go screw myself”. My husband doesn’t speak to me that way, my son doesn’t speak to me that way, the providers don’t, nor any of my patient’s and families. Here in the south we refer to it in one of two ways, “good manners”, or “poor upbringing”. I realize I crashed this party, but don’t mistake me, I am not anyone’s whipping boy. I see the mother in me has taken over. Thea
[Reply]
Birth Unplugged Reply:
May 27th, 2010 at 11:07 am (Quote)
I think it is wonderful that you are able to use this website as a learning and teaching tool. It does take guts to express a dissenting opinion, and I respect you for that. You have knowledge and experience that many of us don’t, and I, for one, think it is helpful when you share it and appreciate opportunities to learn. I hope you will continue to read this site and continue to comment.
[Reply]
Birth Unplugged Reply:
May 27th, 2010 at 3:54 pm (Quote)
Oh, and I don’t think anyone was directing “go screw yourself” at you or anyone else. If I’m reading that right, it was a joke about what trying to tighten a bolt in outerspace with no leverage would be like.
[Reply]
fly me to the moon
let me not have any scars
let me please just have a nurse
who’s not stupider than ours
in other words, let me sit up
cuz epi’s don’t defy gravity
hehe when i read this post, i just started singing “flyyyy me to the moooon” and then this song just made itself up
[Reply]
Lucia,
Share your resources and I will take it to the OB staff meeting, in addition to anesthesia. My information is coming directly from anesthesia personnel so with evidence (contolled studies) supporting the effects of fentanyl and breastfeeding in hand, I can help promote change. Thea
[Reply]
Lisa Reply:
June 20th, 2010 at 3:39 pm (Quote)
Here’s one: http://www.internationalbreastfeedingjournal.com/content/1/1/24
Another: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595306/ (search for fentanyl)
[Reply]
Add Your Comment.
Previous Post
« “Hey, Are You Back For Your Yearly Lube Job?” Next Post
“…You Could Tear In Five Places…” »
« “Hey, Are You Back For Your Yearly Lube Job?” Next Post
“…You Could Tear In Five Places…” »
Yeah, didn’t you know, epidurals cause weightlessness? *rolls eyes*
[Reply]