Posted by My OB said WHAT?!?.
Apr
13
Posted by My OB said WHAT?!?.
“…I Have Never Heard Of An Epidural Not Working.”
“In 25 years of experience in L & D, I have never heard of an epidural not working.” – L&D Nurse to mother who said that the epidural was not relieving her pain.
There are 44 comments to this post.
“Well, now you have. Go page the anesthesiologist.”
[Reply]
Jane Reply:
April 13th, 2012 at 1:08 pm (Quote)
See, this would have been fine had the nurse said, “Oh, that’s awful! I’ll page the anesthesiologist right now!” and then come back and tried to help the mother with comfort mechanisms until the anesthesiologist got there. And while she was doing this, said to the patient, “In 25 years of this job, I’ve never heard of an epidural not working, so I’m not really sure what to do for you, but I’ll try whatever I can think of.”
But this nurse sounds like she’s discounting the mother’s experience, and that’s No Good.
[Reply]
Nicci P Reply:
April 13th, 2012 at 2:55 pm (Quote)
Just wondering about your take on why the nurse responded this way. I always love hearing you break down the reasons behind the way people phrase things.
A similar thing was said to me. “I’ve been an OB for 20 years and I’m telling you that you are not in labour” – not sure if you remember but it was posted a few months ago. And I’d like to have a bit more understanding about why some doctors/nurses feel the need to discount an experience by telling you how long they have been working there.
[Reply]
Jane Reply:
April 13th, 2012 at 3:04 pm (Quote)
My guesses?
Why they say it at all:
1) She doesn’t know what to do if the epidural doesn’t work, so she denies it didn’t work
2) She has been working to the point of burnout and no longer cares about what the woman feels. Her emotions are worn down to a wisp and she just has nothing left to give
3) She knows the way things are SUPPOSED to go and therefore they must go that way.
Why they give the length of time they’ve done something:
4) You have only done this once (or twice, or three times — but it works better on first-timers) and they now have the authority of having done it for 20 years. In a pissing match, they will have won.
5) They want to intimidate you into believing you are a freak because in nearly a quarter century no one has ever been like you
I would bet that sometimes it *does* work. Sometimes the woman really isn’t in labor. Sometimes the epidural really is working and the woman mistakes tingling for pain and panics. But they need to assess the woman rather than put on their blinders.
Those are my guesses. 
I’ve been reading people for well over thirty years, and I’ve never…oh, wait. LOL!
[Reply]
Bonita Reply:
April 13th, 2012 at 3:46 pm (Quote)
She also could have been afraid of what other things might go wrong. If the epidural doesn’t work, then maybe the woman will realize that other things are wrong with the way they treat her. A drugged mom is a quiet mom, a cranky mom in pain is more likely to find fault.
[Reply]
Does anyone know the statistics of how many women that birth in hospitals wind up with epidurals? I would image it’s a pretty high number. How is it possible that this woman has worked for 25 and hasn’t seen a failed epidural?
I’m thinking that this nurse is lying in the hopes of getting her patient to comply with her wishes.
[Reply]
Dreamy Reply:
April 13th, 2012 at 1:45 pm (Quote)
Without looking it up, I *believe* the number is somewhere between 80 and 90%. IIRC, the percentage of patients with epidurals who end up with incomplete or no relief is about 15%. Don’t quote me, but that’s my recollection.
[Reply]
Tee Reply:
April 13th, 2012 at 2:11 pm (Quote)
Ach, thank you! That’s even higher than I had anticipated. How sad. I can’t help but think that a whole lot of those women would be just fine birthing naturally if they only had a bit of support and reassurance that they could do so. (Not to say that there is anything wrong with a woman having an epidural. It’s certainly her right to do so! I just know that so many women get them because they think it’s the “right” thing to do.)
[Reply]
Laura Reply:
April 14th, 2012 at 8:10 am (Quote)
And some more of us because we are pressured! My first, I planned to go natural. The nurses kept pushing the epidural. Then, when I was pretty clearly in transition in retrospect, they told me I had to get it then, that it was my last chance as the anesthesiologist was going for a c-section in a bit. I freaked and gave in. 
[Reply]
auderey Reply:
April 13th, 2012 at 2:11 pm (Quote)
depends on the hospital. sometimes you can get that data. for nj, look here: http://romancathanachronism.typepad.com/ican_somerset/2009/02/nj-hospital-birth-statistics-2008.html. 75% of all nj hospital births use epidurals. a bunch of hospitals are around 94%. zomg.
[Reply]
Kate @ Modern Alternative Mama had this to say,
Apr 13, 2012 @ 2:02 pm (Quote)
“Well, now you have. Call the anesthesiologist, already!”
[Reply]
I had a great experience with my epidural, but, truth be told, I know a lot of women who experienced partial or no pain relief at all. There are a lot of factors that go into a successful epidural IMO.
This nurse is either lying through her teeth or unbelievably incompetent.
Scary. If I were a medical professional and a patient told me she was in pain, I think I’d go with what my patient SAID not my prior experience.
Ugh.
[Reply]
Tee Reply:
April 13th, 2012 at 2:14 pm (Quote)
And that, in my opinion, is the worse part of this entry. This nurse was dismissing the woman’s concerns, rather than listening to her patient. I’ve never had a child so I can’t say as much in the childbirth field but I have a lot of medical problems and therefore, I have a lot of experience dealing with doctors/nurses/whoever. I’ve had people accuse me of lying and it always raises my hackles. It really saddens me to hear about this happening to anyone.
[Reply]
The Well-Rounded Mama had this to say,
Apr 13, 2012 @ 4:25 pm (Quote)
This is part of the culture of denial around epidural failure.
Statistically, the research is VERY clear that “windows” in an epidural or incomplete pain relief is a relatively common thing. MOST epidurals give good pain relief, especially if the anesthesiologist is willing to do a second placement if the first fails, but even so, some still don’t give adequate relief. The number varies a LOT from study to study, depending on the definition of what they consider inadequate pain relief and how much they do about it, but initially it’s around 1 in 10 in many studies, and then around 1 in 50 after multiple placements.
http://www.ncbi.nlm.nih.gov/pubmed/15477051
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505163/?tool=pubmed
But there is a culture of denial about this in many people in obstetrics. They just believe the woman is misperceiving her sensations, exaggerating, hallucinating, or lying.
This happened to me, only my epidural failure happened during my first cesarean. I was traumatized both by it and then by the total culture of denial at what had happened afterwards. No one spoke to me about it, most ignored it. I’ve even had nurses and doctors tell me that no, I could only have felt a little pressure and pulling, not REAL pain, even though what I felt was more like being eviscerated with a blowtorch. Were they in my body at the time, to know what I was and wasn’t feeling? Of course not. But they have repeatedly told me that I didn’t experience what I experienced.
There is a conspiracy to not admit that this happens. Sometimes it’s self-serving, out of fear of lawsuits, but often there’s a lot of self-delusion in it too, rather than deliberate lying. One reaction to witnessing suffering is sometimes to deny that there IS any suffering. It’s bizarre but it happens.
The research is clear that while most work well, some epidurals do fail. But women are often lied to that it does, and many care providers often self-delude that it doesn’t happen. The likelihood of this nurse not having seen a failed epidural in 25 years of practice is miniscule. But she may be telling the truth from her own point of view because of the culture of denial around it when it happens. It probably happened, and she probably went right on denying it, just as she is doing with this mother.
[Reply]
Jane Reply:
April 13th, 2012 at 4:36 pm (Quote)
I’m so sorry you endured that. And even worse was the way you were treated afterward.
[Reply]
Celina Reply:
April 13th, 2012 at 11:54 pm (Quote)
I am so sorry this happened to you. I’ve had bad luck with epidurals in the past and like you my epidural failed during my first caesarian (4th live birth). I was absolutely not believed and no one asked me about it afterwards while I was still in the hospital and even deflected when I asked about it directly. With my next c/s they at least agreed to let me have a spinal instead. With the c/s after that, it was a bit more difficult as I was diagnosed with a brain tumor the week before and from what I understood in the short amount of time that I had between the diagnosis and the birth was that an epidural would be safer. Still a very scary thing to face on top of everything else (premature delivery). Thank God my son turned out okay.
[Reply]
Gosh, not only did I have three epidurals that gave NO relief but I was afraid to try without one because I thought if it was that bad with an epidural how does anyone do it without? Guess what, I actually birth naturally not once but three times (c-section the first time with a spinal that worked perfectly)! There was no point in getting the first epidural (which was placed before the c-section, lucky me it fell out so they had to do the spinal).
[Reply]
I had 2 failed epidurals during one labor. The first made my legs useless but didn’t relieve the heinous back labor. It just made it to where I couldn’t shift positions to try to relieve the pain. They had to try for a 2nd when I had to have an emergency c-section. It didn’t work and I kept feeling everything. The docs kept saying “Oh no, you are just feeling pressure, that’s normal.” Nope. When I screamed during the 1st cut they finally believed me. Total nightmare. My poor husband thought I died when they knocked me out after the screaming.
[Reply]
Jespren had this to say,
Apr 13, 2012 @ 7:52 pm (Quote)
Denial that pain meds in general don’t always work seems to be aggressively common among medical professionals. Due to genetic issues I am very resistant to pain meds and it’s hellish getting many doctors/dentists to believe that the shot either never took or has already worn off when getting stitches or dental work.
They expect that drug A will give relief at dose X for Z amount of time, and if you fall outside of that box you *must* be lying or drug seeking for a ‘high’ because everyone *knows* drug A at dose X works for Z period of time!
[Reply]
Tee Reply:
April 13th, 2012 at 8:10 pm (Quote)
Girl, I feel your pain! Due to chronic kidney stones, I am rather well acquainted with IV Dilaudid. No narcotic has ever made me groggy or drowsy, not ever. (Ironically enough, IV Benadryl will knock me out, though!) Apparently, Dilaudid would ordinarily knock an elephant off its feet. I just keep going. In fact, it makes me ridiculously chatty! About two years back, I was in the ER and the doctor ordered a dose. The nurse gave me half the dose and told me to ask for the other half if I was still hurting. About an hour later, I asked for the second half and she flat out refused to give it to me. “You’re obviously nothing but a drug addict seeing medication. This medicine puts everyone to sleep!” I tried to explain to her that it has been this way from the very first time I received the drug. I fought and fought with her until I finally cried and that only proved her point in her own twisted mind. God forbid I might be crying because I hurt so badly and had to deal with her. No, people only cry when they “want” drugs and can’t have them.
Ugh, just thinking about it makes me mad and that’s only one of many examples. It’s downright hellish, having a different than the norm reaction to pain medications. I really am sorry that you have the same problems.
[Reply]
Lynn Reply:
April 13th, 2012 at 10:45 pm (Quote)
Tee that is awful!
I worry about my husband if he ever has to have surgery for anything in his life because he does not get knocked out completely. His body is asleep but his mind is not, he can still hear everything going on & feel everything. Like being trapped in your own body & not being able to scream out. When he had his wisdom teeth out he was even flailing his arms and he remembers the dentist telling him to stop. When I had my wisdom teeth out I was completely out. They counted down and last number I remember saying was 8. The thought of anesthesia during surgery not working just terrifies me! My MIL can’t take any pain relievers because they all make her vomit. She has a terrible reaction to them.
Doctors, nurses, whoever need to realize not everyone is the same. Tylenol doesn’t do jack for me and I know it doesn’t for a lot of other people too. I also had an epidural that only numbed one side of my body. I could still completely feel everything on the other half of my body, but thankfully they called the anesthesiologist back in & he got it right.
[Reply]
Tee Reply:
April 14th, 2012 at 12:39 pm (Quote)
I so wish there was a site like this for non-OB/GYN related things. I could fill up a book! I’ve actually considered starting one but don’t think I have the skills to do so.
And for what it’s worth, I told my Mom to go track down the doctor. I’m not sure what he did or said but the next thing I know, a different nurse was coming in to give me the other half of that medication and I was treated appropriately and politely from there on out! Thank you, doctor! ::grins::
The idea of being awake during surgery absolutely petrifies me! Your poor husband! I made the mistake of watching a movie (based on a true story) about a person that was awake during a surgery and I had nightmares for a week!
[Reply]
Jane Reply:
April 14th, 2012 at 12:51 pm (Quote)
Did you file a complaint with the hospital about a nurse deliberately violating the doctor’s orders?
Part of me wonders what she was going to do with the other half of your medicine dosage…
[Reply]
Tee Reply:
April 14th, 2012 at 2:05 pm (Quote)
I did, yes, but I don’t know if anything came of it. In that particular hospital, it was pretty common for them to give half of a medication dose and then just wait to see if you needed the other half. If it hadn’t happened several times before, my brain would have been going right where yours went. And who knows, she might have been one to inject herself. I reckon I will never have a way to know. I never particularly minded only getting half a dose because up until then, I always received the other half as soon I asked for it. The syringe was labeled with my name and the nurses just kept it in their pocket.
This is the same hospital where I had a (different) nurse do all sorts of crazy things, including throwing an IV needle at my head. ::sigh:: One of the most well known hospitals in Louisiana but they had some seriously crazy people working there!
[Reply]
Aunt4God Reply:
April 14th, 2012 at 2:21 am (Quote)
I know exactly what you’re talking about Jespren! Thankfully, my D.O. and naturopath believe me that when my joints get back, Vicodin’s about the only thing that hits it. Excedrin helps, but on a bad day/night, even that doesn’t help. I also don’t get the loopy reaction to Vicodin that most people do, is just makes me tired. Dayquil puts me to sleep fast than Nyquil, and Benadryl may or may not help me sleep. Go figure! I have been under a general twice, so I have requested general instead of local if/when I ever get my wisdom teeth out. I just don’t get as much pain relief w/the shots during dental work.
[Reply]
first time mommy had this to say,
Apr 13, 2012 @ 9:00 pm (Quote)
The epidural failed my friend and I. All it did basically was paralyze our legs. I felt everything though and when I felt like I needed to get up and change positions to push, I could not b/c my legs were dead weight I fully believe the epidural is what led to my c/sec. Thankfully, my friend did not end with a c/sec
[Reply]
My sister had her second baby on April 4th. 3.5 hour labor, all of which was at the hospital. Her epidural failed. She swears she’s NEVER doing a “natural” birth again because of the pain.
[Reply]
Christie Reply:
April 15th, 2012 at 5:33 am (Quote)
thats really sad that she feels that way, i truly beleive that a short labour is much much more intense than a longer one, the only good thing about it is its over sooner really. if it was all at the hospital does that mean she was induced? that might be why she was in so much pain, i had a 4.5 hour labour and OMG was it painful, full back labour (but bub came out anterior so i dont know why) no drugs at all as i was pushing when i walked in but i would totally do it again. i hope that before she has her next baby she reads Hypnobirthing or Birth Skills, i read both and i would have totally lost it if i hadnt had that knowledge to keep me going
[Reply]
Kristin Reply:
April 15th, 2012 at 10:45 am (Quote)
She wasn’t given a drop of pitocin. She had been walking around at 5cm for a week, and the doctor send her to L&D, where they did AROM. That’s all it took to get things going. She said labor wasn’t that intense, since she was already halfway done when she was admitted, but she couldn’t cope with the “ring of fire.”
To me, it sounds like a silly reason to ALWAYS get an epidural from here on out, but I’m not her, and I have no right to dictate what she does, even if I do think she could use a hefty dose of education regarding childbirth techniques and researching the pros and cons of medical procedures. I’m the informed one, she blindly trusts her OB’s. Needless to say, I was un-invited from being there in delivery with er.
[Reply]
Foleygirl 24 had this to say,
Apr 14, 2012 @ 5:51 am (Quote)
My first epidural didn’t work at all. The anesthesiologist had to give me what she called ‘the super version” of the drugs. great. even those didn’t last as long as they should have. i ended up having 3 doses of it, the last of which only lasted for an hour and was given in the middle of pushing. i do have to say though, that i could not feel anything during pushing when the epidural wore off. no urge to push, could not feel the nurse touching me, could not tell what i was even doing, the pain was so distracting. tolerable, but distracting. once i talked them into giving me another epi, then i could finally feel the urge to push! the nurse told me something similar, like in 20 years i’ve never seen a woman have the urge to push with an epi. well, now you have! and i would have ended up with a c-section without it, because til then i had made no progress pushing.
[Reply]
Darsy Reply:
April 14th, 2012 at 10:43 am (Quote)
Never seen a woman with urge to push with an epi?? I know on Easter morning when I had my daughter this year, even with the epidural I had I could feel that I needed to push! I even told my husband I was a bit scared because I could tell I would ‘feel’ the pushing stage. I had to spend a bit of time convincing the nurse that I really did feel the baby’s head coming and knew that it was time, but that had more to do with my pushing stage being very very fast and that not being the norm, I think. She certainly didn’t belittle me; she called in a resident to check me and when they saw I was telling the truth they had my OB come in ASAP.
In the end, I felt pushing her out, but it only took 5 pushes out of two contractions, and when I was about to hit the 5th push, someone said ‘okay, push one more time for the shoulders’ and I didn’t even realize her head was out! That was the sort of epidural I would gift to other women who feel they need them–I could move my legs, didn’t feel the painful contractions, but felt my body’s cues when I needed to.
[Reply]
Foleygirl24 Reply:
April 14th, 2012 at 12:02 pm (Quote)
yeah my epi wore off right as it was time to push, and they refused to give me another because “i wouldn’t be able to feel to push”. total bullshit. i can see how that might be true for some women but it is definitely not true for all. i couldn’t feel anything until they gave me another epi. no pressure, no urge, nothing. i couldn’t even tell if my body was in the right position, the contractions were so distracting. 2 hours and no progress later, i finally convinced them to give me another and lo and behold, he was out within the hour! my pushing stage would have been two hours shorter if they had just listened to me to begin with!
[Reply]
With my son the epi didn’t work when it was supposed to, but kicked in after he was born. I have no idea how that happened, but it did (I’ve been told its not possible, anyone know anything about it?)
I didn’t plan on an epidural the second time, but since my DH was supporting their admonition that I stay in the bed (though admittedly, I get very compliant in hospitals) I agreed to the epidural. I will say this for the attending OB- she wasn’t cut happy, (I did a thoughtful thursday for when I was given the choice to come back out of the OR when my daughter’s HR stabilized and ended up with a vaginal birth)
[Reply]
Jane Reply:
April 14th, 2012 at 11:14 am (Quote)
With my son the epi didn’t work when it was supposed to, but kicked in after he was born.I have no idea how that happened, but it did (I’ve been told its not possible, anyone know anything about it?)
I love how what you experienced wasn’t actually possible. When they say that, do you look at them as if they have three heads and say, “Are you being serious?? That’s what happened to me! OBVIOUSLY it’s possible. Now let’s talk about how!”
The how, to me (I AM NOT A DOCTOR) would seem to be that during or after the birth, you moved in such a way that the epidural catheter probably shifted around in the epidural space so the medication started going into the right place. If the tubing went into the wrong space, it might have been blocked, and that’s why it provided no relief until it was moved.
That is one of the ways they get a nonfunctioning epidural to work: by moving the tube around. So I can see it happening kind of by accident if the placement was marginal to begin with.
But yeah, the thing you experienced was totally impossible. **eyeroll**
[Reply]
Jen Reply:
April 15th, 2012 at 8:47 am (Quote)
I have fired two pediatric urologists for that very reason: they told me what my children were ACTUALLY EXPERIENCING wasn’t possible. And I just went through it again yesterday. I’ve been in the ER three times in the last week with trouble breathing that improves if I lie flat. Apparently, SOB is supposed to be worse lying flat and improves sitting up, so I can’t be having any *real* problem. The doctor (4th I’ve seen, 4th diagnosis) thinks it’s anxiety. Wow, I had no idea anxiety could cause you to cough up blood! Idiot.
[Reply]
Add Your Comment.
That’s because you don’t listen to your patients. There’s a lot more to pay attention to than what the machines are picking up. Now go fetch the anesthesiologist and don’t waste more time trying to convince yourself that I’m feeling fine.
[Reply]