Childbirth questions

[mommyrex]

If I give you morphine it has an effect and more of it will have more of an effect. Ealier administration will give it more time to have an effect. This seems like it is violateing normal rules of how drugs effect people in similar ways to homeopathy then.

Okay, we were talking about a *side* effect of epidurals, not whether they have *any* effect. You challenged that if there is no difference in this side effect (particularly, increased interventions, or maybe the paricular cite was on c-sections) between late and early epidurals, we could conclude that that side effect does not occur with epidurals. Your logic is still wrong.

And many people understand that a really good foot massage can cure cancer and such. It is about challenging beliefs of people who disregard evidence. Now mabey this evidence was not there when you where having your children. But there the complaints did sound like something I could simply replace epidural with some woo medicine and would sound the same.

My understanding (7 years ago, that epidurals were associated with higher rates of interventions) was supported by multiple studies pucblished in medical journals, not anyone promoting an alternative therapy. There's lots of woo offered for pain relief in childbirth, but simply not getting an epidural is not an actual alternative pain relief method. What evidence was disregarded?

And what is the quality of your data that says they increase interventions? Is it the same as the old data that stress causes ulcers and it has nothing to do with microbes?

Just because something is accepted thinking does not mean there is any data to support it.

I invite you to look at the PubMed citations I already posted to see that epidurals are associated with a higher incidence of some interventions.

I'm fairly certain that I'm not the one here disregarding the evidence.

 

[ponderingturtle]

Okay, we were talking about a *side* effect of epidurals, not whether they have *any* effect. You challenged that if there is no difference in this side effect (particularly, increased interventions, or maybe the paricular cite was on c-sections) between late and early epidurals, we could conclude that that side effect does not occur with epidurals. Your logic is still wrong.

I am sorry I did get you confused with someone else, and what dissonance was saying did sound like exactly the same thing that a beleiver in say acupuncture would say if they wanted that as their method of pain relief. So I was a bit mixed in what I was thinking.

 

[Dr. Imago]

Wow. I guess you mean "for all women having babies in U.S. hospitals these days." But still, wow. Pit (like the epi) wasn't available in my birth center, so we would've driven to the hospital if I'd needed it.

I actually overheard an L&D nurse say today about a patient that came in overnight, "Man, no epidural and no Pitocin and a 3 hour labor for a normal vaginal delivery. Must be a full moon out or something."

Anyway, interesting comment about the NICU nurse with the forceps delivery because I had an interesting case today... 31-year-old Type 1 diabetic mother with an "accidental" third pregnancy after a failed previous bilateral tubal ligation. (Her fallopian tube grew back together on one side.) So, she presented at 37 weeks for her third (and hopefully last) elective c-section. She also happened to be a PICU nurse at our hospital!

So, I set her up and give her a spinal (which worked like a charm), the c-section proceeds as planned, the baby, a floppy sumo-wrestler look-alike, was 11lbs. 11oz, the biggest of her three. Let's put it this way, there was no way that kid was going down the birth canal. Here's another word everyone can add to their personal lexicon: macrosomia. Not a good thing. That baby will spend a day or two in the NICU herself.

I placed one other epidural, and just before I left the hospital a little while ago, that 31-year-old lady had her second via normal vaginal delivery, a little 7lb+ baby boy. The other patient I was in charge of helping to provide care for today was a 20-year-old nulligravid female who initially wanted an epidural, but once she calmed down, got on the "birthing ball", and had a touch of Stadol, she decided to hold off. No problem at all in my book. I left her in charge of a colleague, still in labor and at 4 cm dilation without any epidural. I will find out how she did tomorrow morning (i.e., whether or not she opted for/got the epidural after all).

All in a day's work.

-Dr. Imago

 

[mommyrex]

I actually overheard an L&D nurse say today about a patient that came in overnight, "Man, no epidural and no Pitocin and a 3 hour labor for a normal vaginal delivery. Must be a full moon out or something."

Sure ... the full moon brings out the animal in birthing women ... or is it supposed to be a tidal thing? My first two babies came just hours before big snowstorms (two years apart). How can you dismiss that as coincidence?

As for the safe delivery (and postpartum care) of the 11+ pounder ... yay for modern medicine!!