Posted by My OB said WHAT?!?.
Jul
28
Posted by My OB said WHAT?!?.
“You Are Reading Too Much…”
“You are reading too much, we don’t even do those here!” -OB to mother who inquired if walking epidurals were available.
There are 30 comments to this post.
“That’s why I asked *if they were available.*”
Sounds to me as if the doctor is defensive that his or her hospital doesn’t have all the technology the patient would like. Rather than say, “No, we don’t offer those” or “we don’t have the equipment for that,” the doctor tries to shame the woman into thinking her request itself is ridiculous and that she is defective for “reading too much.”
Suggested response: “Perhaps the hospital administrator and the head of L&D can read the same books and articles I do?”
[Reply]
“Walking epidural” is a scam. There is no way a hospital is going to have a laboring patient with an epidural walking around, no matter how good her leg muscle control is. It’s too much of a liability risk if she falls down. If you get an epidural, you’re buying a ticket to bed-land.
Has anyone ever seen someone actually walking with a “walking epidural”? Am curious to know.
[Reply]
Heather Reply:
July 28th, 2010 at 9:14 am (Quote)
I haven’t seen it, but I’ve talked to moms who did. While I felt like I could walk with mine, it was 3am and I just wanted the sleep I was waiting for it to provide, lol. I woke up to roll a little more onto my side (unassisted) now and then and then when I fully woke up, it was because I needed to push.
I only had one because I had the labor from hell and I really wanted my VBAC and knew that wasn’t going to happen if I fell into the same trap as my first (natural) birth that led to the cesarean (exhaustion–I was too excited to sleep all day >_< and when I got tired, the contractions kept me awake)
[Reply]
CNicole Reply:
July 28th, 2010 at 9:17 am (Quote)
Yes I have. I agree it is very rare, but I have had a client whose nurse encouraged her to walk around with her walking epidural (at least until it either shifted or something and she became too numb on one side to be able to walk, she literally couldn’t move that leg) But the head anesthesiologist at our hospital likes to talk about his part in the development of the walking epidural 
From what I hear from other moms and doulas it is rare, that the nurses do this, but it does happen.
[Reply]
Jane Reply:
July 28th, 2010 at 9:37 am (Quote)
You know, despite the obvious emotion in what you said, and the fact that you conveyed the same basic information that the doctor did in the OP, you did it without ridiculing a person who would ask such a question.
Any way you could give doctors a lesson in saying, “No, that will not be possible”? 
[Reply]
Katie Reply:
July 28th, 2010 at 11:32 am (Quote)
@Jane, lol! It makes me irritable that epidurals light enough, and well enough placed, to allow for leg movement have been labeled as “walking epidurals” by the industry. This dr clearly hadn’t talked to the OP about what exactly an epidural entails in most hospitals, which is on _her_, not the client. I’m hoping to model good behavior once I start working (CNM new grad in a tough job market).
FWIW, it would freak me out to have a client walking with an epidural. The level of anesthesia can def. change. I doubt I could catch a pregnant lady whose epidural suddenly went from “walking” to “prostrate”! Plus it would be easier for her to twist an ankle or something without even noticing.
If mobility’s important to you, your best bet is not to take meds. Most places won’t “allow” a woman out of bed with IV medication, either.
[Reply]
Kim Reply:
July 28th, 2010 at 2:42 pm (Quote)
You’re right. “Walking Epidural” is a misnomer. No hospital would let you *actually* walk around, it’s just to describe a “light” epidural. However, every body is different, every hospital, end even different anesthesiologist concocts a different “coctail”. It effects everybody differently. They can try, but they really can’t garantee anything. Some don’t work at all, some “light” epidurals result in complete numbness… depending on the skill level of the person doing it, and any number of variables. And that’s not even getting into the risks or possible complications. The dooface that gave me my epidural was in a hurry and went past the “dural space” in my spine, accidentally giving me a partial epidural, partial spinal block. This resulted in IMMEDIATE complete numbness that lasted 4-5 hours, I had no control over my legs, no feeling to push WHATSOEVER, my blood pressure and thus baby’s heart rate plumeted, putting her in distress causing there to be tons of mec. when she came out. Oh. And I had a spinal headache for 6 days after. Nice, eh?
[Reply]
Kim Reply:
July 28th, 2010 at 2:47 pm (Quote)
Ok, maybe not “NO” hospital… but it would be a rare thing, indeed. What with lawsuits being what they are.
Oh, and I’ve had clients with FABULOUS epis– even if mine sucked. One mama was able to move all around, she got herself up on her hands and knees, swayed back and forth- she was amazing! But she didn’t walk anywhere.
[Reply]
The Deranged Housewife had this to say,
Jul 28, 2010 @ 7:42 am (Quote)
I’ve never had an epidural, but I know many women who say they had no feeling whatsoever and there was no way they could walk around while in labor, much less feel to even push without being told to do so. I don’t know how you even could if you have no feeling.
I did meet an anesthesiologist a few months ago who told me “epidurals are so light these days!” as in, they can make them as weak or “heavy” as you want them, which, with all due respect, I thought was bullcrap. 
[Reply]
Kayla Reply:
July 28th, 2010 at 7:49 am (Quote)
No it’s true. I ended up getting an epidural b/c I couldn’t take back labor, but I asked them to make it “light” so I could still feel my legs. The never let me walk around (I asked – liability reasons), but I was able to feel my contractions, and could concentrate on pushing with less pain. I didn’t want to “purple push” or be completely numb and wanted to listen to my body, and with the epi I could still feel when my body told me to push and even felt myself tear. They just don’t add as much medicine.
[Reply]
Heather Reply:
July 28th, 2010 at 9:18 am (Quote)
Same as Kayla, only I didn’t even ask for it to be light, they automatically did it (maybe because they knew I had wanted a natural birth, but 8 hours of transition-level psychosis and piggyback contractions with almost no progress and I needed help… that I’d been begging for for 6 hours). It was amazing how much I could move and feel and how instantly I felt better. Pushed that baby out in 20 minutes and the last 10 minutes, I wasn’t really pushing (the first 10, it just felt so GOOD to push–like scratching an itch).
[Reply]
cheeks023 Reply:
July 28th, 2010 at 10:29 am (Quote)
I got an epidural after only dilating 2cm (from 4-6) in 14 hours. I was stressed because I HAD to be at the hospital (breech vaginal birth) and I got the epidural to relax and maybe catch some sleep. When they first put it in I could feel nothing. When I woke up, the nurse put this little rod in my hand, and said, whenever you start to feel something you just push this little button and it will give your epi a boost. This way you are in “control” of your pain meds. I never pushed to button after that! I felt rested, had progressed to a 8-9 and was waiting for the cervical lip to be gone. I wanted/needed to feel what was going on so I could push.
When I got up to use the bathroom half an hour after giving birth, the nurse just about lost it. “You shouldn’t be able to do that. We just took your epidural out.” etc. etc. She was annoyed (putting it mildly) that I let it wear off, and only kept up with the lightest does they were giving me.
[Reply]
Emily had this to say,
Jul 28, 2010 @ 7:56 am (Quote)
Multiple women in my Bradley class had light epidurals that allowed them to rest and/or relax during long labors while still being able to move around into different positions. I don’t know if they were allowed to walk but they were definitely not forced to labor/push on their backs. They were very pleased with their experiences. This was Northern VA 2009
[Reply]
I have read, and been told by medical professionals, that the term ‘walking epidural’ is just the name for an epidural that is light enough that women retain some contol over their leg movements. The term is a misnomer, no one medically expects the woman to actually be able to walk. But they should be able to sit up under their own power, possibly get into a supported squat, a side laying position with one leg raised with assistance, or sometimes on all 4s, again with assistance. I’ve never had an epidural, walking or otherwise, so this is purely parroting what I have been told/read from a couple of sources.
[Reply]
Katie Reply:
July 28th, 2010 at 11:37 am (Quote)
I have had clients with epidurals squatting w/squat bar, side-lying pushing, all fours, and moving between different positions, all in bed. I have also had clients who were unable to move anything from the waist down. It’s a matter with how much medication, type of medication, placement of the catheter, and just individual quirks of anatomy. Hard to predict what’ll happen.
[Reply]
Alyson Miers had this to say,
Jul 28, 2010 @ 8:46 am (Quote)
“How DARE you try to make informed decisions about maternity care! This is MY hospital, and you are MY prisoner, I mean patient, and if I want to cut you open without medical indication, how dare you try to protect yourself!”
[Reply]
Sarah Dorrance-Minch had this to say,
Jul 28, 2010 @ 12:03 pm (Quote)
You’re right. I do read too much. That’s why I’m opting out of this whole epiduralized, hospitalized, medicalized birthing scene entirely, and hiring a cheaper, more client-friendly, more flexible midwife. I like evidence-based care. The evidence shows that I probably won’t need an epidural if I am given enough freedom and support in labour, anyway. And am able to experience my labour in a manner other than “flat on my back to allow the monitor a good, consistent reading.”
(Note: In practice, the so-called “walking epidural” usually isn’t. It’s a slightly lower dose of bupivicaine or some other -caine that numbs sensation, so that the mother can actually feel a little bit of what is going on below the point of insertion, mixed with a narcotic. Most people tend to get a bit groggy and uncoordinated from narcotics. The amount of the grogginess will depend on the dose, and on the individual’s natural tolerance. In general, however, a “walking” epidural is usually more of a “stumbling” or “crawling” epidural. Or at least a “walking with assistance” epidural. That’s assuming that the patient is even allowed out of bed, since a continuous monitor is usually part of the standard package, and not all hospitals have telemetry available. Oh, and then there’s the pulse oximeter on the finger to measure the mother’s oxygen levels, and sometimes, the urinary catheter…)
[Reply]
@Sarah- Really, don’t you think things like continuous EFM, pulse ox, catheter, become necessary once you start doing things like getting epidurals and IV meds? Once you introduce these things, you accept certain risks, such as a drop in blood pressure leading to the baby’s heart slowing way down. Many/most women can no longer urinate under their own power with an epidural, and an overfull bladder can keep the baby from descending and be a cause of postpartum hemorrhage. I totally agree that these things are unnecessary in a normal labor, but once you start adding medications to the mix, frankly, it’s no longer such a low-risk situation.
[Reply]
Sarah Dorrance-Minch Reply:
July 30th, 2010 at 3:14 pm (Quote)
Sure. Why the frak do you think I choose to birth at home, without meds and without interventions?
I don’t need no stinking epidural. (To misquote a famous line from comedy. Which reminds me, birthing at home means I don’t need a badge of identification to see my own baby and take my baby home after my hospital incarceration. I mean, stay.)
[Reply]
Sarah Dorrance-Minch Reply:
July 30th, 2010 at 3:19 pm (Quote)
PS. As to risk management (i.e. am I “high risk” or “low risk”) I prefer to use Heather “Hathor the Cow Goddess” Cushman-Dowdee’s paradigm.
I.e. by avoiding the obstetrician’s office entirely and only using an OB if I am transported to the hospital for an obvious emergency, and sticking with a direct entry midwife whose philosophy considers birth natural and healthy until proven otherwise (as opposed to mainstream obstetric philosophy, which considers all birth a medical emergency until proven otherwise in retrospect, starting from the moment pregnancy is confirmed by a pee test) I bypass the whole “are you high risk or low risk” paradigm altogether.
[Reply]
This was at an army hospital (I was active duty) in 1997. I knew it wasn’t technically a “walking” epidural, but I did want to be able to move arounda bit more into positions. I still tried the squawt bar, but I was too numb w/ the regular epidural. This is the same hospital that wheeled in an ultrasound machine (they thought the baby was too small; he wasn’t) and wheeled it back out 2 hrs later, as they didn’t know how to use the thing. Gota love military hospitals. Mine was at Ft Campbell, KY (101st Airborne). I labored hard for 17.5 hours; 3.5 of them pushing & the baby was born with an APGAR of 2. It took them 5 minutes of resescitating him before he could breathe. He’s a healthly 13 yr old now.
[Reply]
Sarah Dorrance-Minch Reply:
July 30th, 2010 at 3:23 pm (Quote)
Wow, I lived in Cincinnati when I was growing up, and then later after my college years with the Psycho Ex From Hades, and I didn’t even know about that particular hospital. Base hospitals don’t exactly advertise, though, do they?
I’m glad everything worked out in the end.
Are births in military hospitals different from births in civilian hospitals?
[Reply]
StaudtCJ Reply:
July 30th, 2010 at 9:09 pm (Quote)
I’m not the OP, and I can’t speak to how dependents are treated, but as a military member, birth is EXTREMELY different in a military hospital. I had no voice. I was inconveniencing the military by having a baby and taking my maternity leave, and why didn’t I just marry a sailor instead of *pretending* to be one. I was treated poorly by everyone there, from corpsmen to doctors. I had no choices about my doctor or my birthing location. I wasn’t the customer.
By contrast, in a civilian hospital, even with “poor service”, I got treated like a person (though a very annoying/stupid one), and got to make some choices, and wasn’t afraid of long-term consequences to my career/job because of what I might say or do in labor. Just being able to get a drink of water after my 2nd baby was born without ASKING someone was heaven.
[Reply]
Elizabeth Reply:
July 31st, 2010 at 1:00 pm (Quote)
Eeek, I’m so sorry for your experience. We actually just PCSed from Campbell on Wednesday to Germany (thank the Lord) and I still hear horror stories about BACH. I opted to have an unassisted birth at home in 2008 rather than stepping foot in BACH!
[Reply]
THey are a bit different because you get whoever is on call there to deliver you, and your OB that you go to your regular visits is not the one that ever delivers the babies. At least it was how it was in my case. It was the worst of my 3 deliveries. My best was #2 at Swedish in Seattle.
[Reply]
Add Your Comment.
Previous Post
« “Don’t Touch Anything Blue, That’s *MY* Space!” Next Post
“…Your Baby Could Become Decapitated…” »
« “Don’t Touch Anything Blue, That’s *MY* Space!” Next Post
“…Your Baby Could Become Decapitated…” »
Silly patient, trying to have an easier birth.
[Reply]