That was exactly what I thought when I saw that quote.

This. If it’s posted here, it’s more likely a nurse blowing off mom’s wishes than a nurse afraid of getting in trouble with doc.

That was the exact image that popped into my mind, ripping out the IV.

Yep, at that point I would be taking it out myself and telling her to turn it off or it will start “inducing” the floor. lol

Sadly, nowadays they can turn that argument around and use it on the laboring patient.

To be fair, we also don’t know whether the nurse obtained consent before starting the pitocin. If the nurse started pitocin without consent and then said “I need a doctor’s order to turn it off,” then the whole situation is reprehensible.

If OTOH the pitocin was ordered because the mom had Pre-E (for example) and the mom was panicked because the contractions were coming too fast and too forcefully and she desperately needed pain relief, then the nurse’s statement makes more sense…but only if it’s then followed up by suggestions to help the mom cope, even if it’s an epidural or medication.

But saying you need paperwork and a proper legal trail to someone who’s in pain because of something you could stop — that’s not compassionate. The mom can’t go get a doctor to order it turned off. At that moment, her legs and voice are the nurse’s, so if the nurse says “I need a doctor to do that,” then the ONLY acceptable next step is for the nurse to page a doctor stat.

“But reality is, once you’ve submitted to a procedure, it’s much harder to stop it after it has begun.”

But that’s only true for certain procedures. It’s one thing if the mom is in the middle of a c-section and changes her mind. You can’t exactly put the baby back in and tell mom to go ahead and push. It’s an entirely different thing if the procedure is as simple as medication being administered through an IV. Pitocin can be turned up, turned down or turned off all very easily. At the very least, the nurse should have talked to the mom about what she was experiencing and explained why the pitocin levels were set the way they were and worked with the mom to find a good solution, whether it be administering pain medication or turning the pit down/off.

If it were an antibiotic that the mom was suddenly having a severe allergic reaction to, you can bet that the nurse would be stopping the IV flow without looking for a doctor to give her orders first.

*LIKE*

My second daughter–who is quite the spunky one–ripped a hypodermic needle out of her arm when she was 5 years old. A nurse tried to “sneak up on her” to give her a vaccine instead of the normal procedure of having her cuddle up with a parent, who would hold her hands still. The nurse didn’t even warn my husband, and he was STEAMED. But we’ve all gotten a good laugh out of it after we finished being mad at the stupid nurse. Katie is such a tiny little thing…she’s 11 now and her 9 year old brother is as tall as her and 20 lbs heavier. But you don’t get ANYTHING past her that she doesn’t allow!

I didn’t realize this. I was under the impression that the “rapid induction protocol” dosing favored by OBs called for a dose increase every 15 minutes for 6 hours. If they only increased it by 1 each time, that would still be a max dose of 24. I know this was the protocol followed with my first induction, but I don’t know by how much they increased it each time. This nurse was cranking it by 3 each time. After 6 hours it would have been at 72.

Yes, all the time! Pitocin is routinely given either IM or IV after delivery. Unless a woman is actively hemorrhaging, it’s so unnecessary. I’d go as far as to say that it’s even dangerous.

They did with mine. I had my son in 2009 and after the c-section, they loaded me up with massive amounts of pitocin because my uterus wasn’t “shrinking as fast as they’d like”. I was actually grateful that my spinal was still mostly working. What I could feel was horrible enough.

There is some research which suggests that prophylactic use of pitocin immediately postpartum helps prevent hemorrhage. So the latest recommendation is that all third stage management include pitocin.

BUT Those studies did not distinguish between labors which had not included augmentation and those that had. Plenty of evidence suggests that when a uterus has been stimulated by pitocin or other augmenting methods throughout labor, afterward it will either be too tired or simply unresponsive to the body’s own signals to clamp down effectively. In other words, they are creating the very problem this blanket policy is designed to solve. A rare situation in obstetrics, I know.

Yes. And even after unmedicated labours it is often still warranted, and especially if labour has been long. A tired uterus is ripe for a haemorrhage, even with good management (ie no cord traction etc) and pitocin post delivery is often better than a bleed which can make lactogenesis II (ie the milk coming in) later.
My crunchy granola midwife was actually pretty strong in her recommendation of syntocin (Pitocin is the US name for the drug) after delivery, as I’d had a 24 hour labour and delivery and my uterus was tired. While it probably is overused in third stage management, it is important to remember that haemorrhage was a major cause of post-natal death in the ‘olden days’. So, even with good and non-interventive labour care, syntocin in third stage is one of those interventions that just can’t be blindly dismissed. However, whatever happened to the right of informed refusal?

Did you even read the pink link? She was crowning! Even if she has ripped out the IV she still would have had twin #1 crowning! I can’t see anybody making it all the way home at that point. Sure maybe she could have had one baby in the elevator and the second in the car, but I don’t see how she should be expected to make it all the way home to her sanitized tub. That is just silly talk.

It’s been so long since I attended a birth, I have forgotten what I did know about dosing pit, and I know IV pumps are different. But removing an IV is really not difficult and I have never found them particularly painful (YMMV, though.) Getting the tape off is the most difficult part to do without hurting the person.

When my son was in jr high, he needed some IV meds every 8 hours for 48 hours. A home health nurse came to our house, placed the hep lock & showed me how to push the meds. When it came time to remove it, the neuro’s nurse was horrified that I was going to do it, so I called the home health nurse. Her response was that she’d be glad to come out, but did I *really* need her to? I didn’t think so, told her my plan was to remove the tape carefully, fold a gauze pad, place it over the insertion site, pull the thing out & then put a band-aid over the gauze. “You don’t need me, but you know where to find me if you do. Go for it!”

That was close to 15 years ago, and my son seems to have survived it intact!