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Routine Epidural Turns Deadly

This is an article I've gotten several times through emails or my doula groups, so I thought I would pass it on and share. It's a pretty sad tale, but I think it speaks more to hospital cleanliness & care than to the actual epidural procedure. Still, given the number of folks who make such flippant comments as "There's no risks with epidurals", it pays to be aware.

Julie LeMoult's Story

Also, take a look at the following:

Epidural Risks & Side Effects


Medical Risks of Epidural Anesthesia During Childbirth

Epidurals can be a blessing for women in labor, but it always pays to review both benefits and risks in order to decide what's best for each family. The misconception that epidurals are prefectly safe needs to be addressed. It's so sad to see a momma make a comment like, "I want my epidural when I get to the parking lot of the hospital!" Or even worse, the constant "Are you ready for your epidural now?" by nurses. Taken too early in labor, epidurals can slow labor progress and lead to even more interventions. With an epidural you immediately have: continuous fetal monitoring, catheterization, IV, and you must remain in bed. All too often, it also leads to more interventions like artificial rupture of membranes (to try to 'speed up' labor if it stalls as a result of the epidural), vacuum/forceps if mother can't feel well enough to push, episiotomies, and even cesareans.

I have supported mothers who received epidurals, and it allowed a much-needed rest. They certainly have their place in the birthing room, but let's make sure that the misconceptions are banished, and that the choice is truly an informed one.

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Comments

( 28 comments — Leave a comment )
dorianeldritch
Jun. 19th, 2006 01:08 am (UTC)
this may be a stupid question but im not well enough to really analyze the info, or think clearly but Ive just panicked madly so i have to ask. My Mom is going in for an epidural tomorrow in her spine because of injury in a car wreck. so its different from birth of course, but those rare and awful side effects listed are pretty scary.
Is all of this a function of the effects of the drugs on a person in the process of labor-or is it jsut the drugs?
Im not sure what time she is going in, i spose praying is the best idea-thats jsut very scary!
ahavah
Jun. 19th, 2006 01:36 am (UTC)
I have to admit that as a doula, I'm not really familiar with the uses of epidurals outside of the labor room. But every medication has its side effects on the body. Now I'm sure things like 'fetal distress' wouldn't come into account, but it's possibly that she could experience side effects. But one of the reasons epidural use is so widespread is because the instances of such negative effects are less than other labor relief options, such as narcotics. I would imagine that, outside of labor, the dosages would also be different, and that would be something to take into account. To my knowledge, the most common side effects are headaches and partial pain relief (as in, maybe only one side going numb). If she began to experience discomfort like this, she should let the anesthesiologist know, and they could likely adjust the dosage to help.

The lucky thing about this being so common is that most anesthesiologists are well versed in epidural use. If you look at any medication, they all have a long list of possible side effects (even cough syrup & allergy meds). It's very rare that someone would experience several of them - or the worst of them. But they are required to list them no matter how rare it is. It is scary when you use any sort of medications, but as long as she communicates well with her care providers, I'm sure they'll be fine. I'm sorry that this topic was poor timing for you, and I certainly don't want anyone panicking! I suggest talking over your concerns with the anesthesiologist, and discuss starting with low dosages if she has other problems like asthma or blood pressure issues. Remember - at least in labor, epidurals are used somewhere like 70-something % of the time, and most of the time without complications.

I hope it helps your mom! They really are wonderful for pain relief, and I have seen them used plenty with no complications whatsoever. If on the off chance she does develop unwanted effects, just speak up and let the nurses know. I hope that her procedure helps with her spinal injury. I'm sorry that I don't know more on that topic, and doubly sorry for causing distress. I will be glad to see your mom healthy & without pain.
a_treitell
Jun. 19th, 2006 12:37 pm (UTC)
It's funny, before my labor with Fiona, I never thought I'd EVER feel the urge to defend the epidural, it was a horrible,horrible thing for women who weren't strong enough to allow their bodies to do what they knew how to do.

*laughs* Now I HAVE to say thank you for pointing out that they do have their place in the labouring room.. It took me a lot of work right after she was born to keep from feeling like a total failure.

(for the whole story, http://peithecelt.livejournal.com/90133.html#cutid1 and http://peithecelt.livejournal.com/90609.html#cutid1)

What I left out was that I started on the narcotics, hoping that I just needed a little nap and I'd wake up fully dialated and ready too go (too much Birthstory on TLC ;)), then when that wore off, I moved up to the intrathecal... which also wore off with me still just at 6 or 7 at which point I was done (in case you didn't read the links, the narcotics were given after 24 hours of unmedicated backlabor to coincide with them starting pitocin, when I'd woken up after only about 2 1/2 hours of sleep in labor.... I was EXHAUSTED) and I got the epi...
a_treitell
Jun. 19th, 2006 12:37 pm (UTC)
lol, sorry... nothing like a woman rambling about her birth.. DIdn't mean to.. ;)
ahavah
Jun. 19th, 2006 01:04 pm (UTC)
Are you kidding? I LOVE birth stories! And yours sounded so sweet. I tell you, though, I wish shows like Birthstory or Baby Story showed a more realistic view of birth. Even the new one - I forget the name, but it's supposed to center around a birth center - raises hackles one proponents of 'normal birth'. It's a bit of a misconception that the "average" birth is 12 hours - maybe, but an average first birth is more like 18 hours.

And the first birth I attended was more like yours - I forget how long she labored all together, but I ended up staying with her for 36 hours. We were both tired! lol That was a momma that really wanted a natural birth, but after 16 or 20 hours, she asked for an epidural. I must say that I don't blame her. I think the rest really allowed her to regroup and have a more effective pushing stage. I always try to be sure mommas don't feel they 'failed' if they have an epidural when hoping for an unmedicated birth. Women are so strong, and I've seen those needles...I'm in awe of a woman even more if she can sit through that. ;) I do think that a woman should try to labor as long as possible without one, if only because staying upright and walking & moving around lets gravity help with the decent of baby, and it can shorten labor in the long run. But I'd never think less of a woman for choosing to avail herself of it if she needs it.

And please, never feel the need to apologize for talking birth here at my journal. ;) If anything, I'd love to hear MORE! LOL
ahavah
Jun. 19th, 2006 01:05 pm (UTC)
On* proponents of normal birth. Gah, I tell myself I'll never post before coffee, but I always do..
a_treitell
Jun. 19th, 2006 08:14 pm (UTC)
Well, even if the average first birth is 18, mine was double that.. LOL all backlabor... and I went six hours over that before I went for the meds..:)

I walked for about the first 14 hours or so, but after that, the contractions were so awful on my back that it hurt too much. :(

Seriously though, I came out my labor really believing that thereisn't ANYTHING I can't do. I went into it mostly wanting a healthy baby and preferably a healthy me with no abdominal scars... And I managed to get that..

that makes me SO happy..
ahavah
Jun. 19th, 2006 08:49 pm (UTC)
Oh, that's great! And that empowerment is really what's important in a birth. No matter what the choices, as long as mom did what's right *for her*...
a_treitell
Jun. 20th, 2006 08:50 pm (UTC)
*nods* Yup, I really gave a fully natural birth a fighting chance, and honestly, my midwives were fantastic about talking to me and letting me be the final decision maker, acting with lots of information about delivery.. I loooved my midwives (i had 2 over the entire thing *laughs*) (It is a CNM practice attached to an Ob-Gyn practice, so they do switch when the shifts end).
mysirensong
Jun. 19th, 2006 04:28 pm (UTC)
Last year, when the first round of intractable headaches started, I had a neurologist tell me she thought I had pseudotumorcerebri -- basically, a fake tumor on my brain that makes me produce too much spinal fluid and makes the occular nerve swell, increasing pressure behind the eyes and making bad headaches. She thought this because I had bad headaches with a clear MRI & C-T, and I was over-weight. Next move? Spinal tap. They couldn't get ENOUGH fluid out of me -- it was not a case of having *too much* -- and I spent the next two days with a "spinal headache" that was 10 times worse than the headache I originally went in for. The pain was so bad I can feel remnants of it while I write about it. Turns out, the spinal tap hadn't healed properly and I'd been left leaking spinal fluid for two days, decreasing the fluid that my BRAIN is resting in. So, I had to go in and have a blood patch done. They took blood from my arm and injected it into my spine -- it was the same thing as an epidural (exact same place) only it was blood, not drugs. The point was for the blood to sit there and clot, which it did, forming a patch that would keep the fluid from leaking out anymore. They filled me with various fluids while I waited and gave me lots of TLC.

What was funny was they were so impressed with how well I took the epidural -- I breathed out while the needle went in, didn't clench, etc. -- and the anesthesiologist said, "See, you're all ready for childbirth!" I said, "Yes, I'm all ready for childbirth but not because I can take a needle in my spine. This is the last needle I'll ever have in my back. I'm all ready for childbirth because I know what kinds of choices I want to make to have a natural birth -- not because I can handle anesthesia."
mysirensong
Jun. 19th, 2006 05:08 pm (UTC)
By the way, as a doula, I'll support any woman who chooses to have an epidural, too -- and I firmly believe they can be helpful if they are needed. And I'm not being all, "My choice is the right one" blah blah blah. I just know I could never let them come near my back with a needle again. Nothing larger than an acupuncture one, that is. Couldn't do it. My comment was more about the fact that they assumed that the fact that I could be still for a needle means I'm ready for birth -- like that's all it is, you know?
ahavah
Jun. 19th, 2006 08:48 pm (UTC)
I understand exactly! And, while I hate what a mess that spinal was for you, I couldn't help but cheer at your response! lol I wish I could have seen the look on his face. As a doula, I'll always support a woman in her choices - no matter what I would choose for myself.
mysirensong
Jun. 19th, 2006 09:01 pm (UTC)
*her* face. :)
ahavah
Jun. 19th, 2006 09:04 pm (UTC)
Oh, that hurts even worse....

:P
zjande
Jun. 19th, 2006 06:50 pm (UTC)
Oh god, so sad. I read that with my mouth hanging open & chills all over. What a sad, sad story. :(
zjande
Jun. 19th, 2006 06:52 pm (UTC)
Oh, and P.S. It's interesting, I've never even considered an epi just because the thought of a giant needle being stuck in my *spine* terrifies me!! In my mind that's always seemed more nightmarish than any labor pain.
ahavah
Jun. 19th, 2006 08:50 pm (UTC)
Oh, I know. It tore my heart apart. And if the docs or nurses had listened to her complaints, rather than blow them off as 'from the birth', who knows, the outcome may have been much different. :(
zjande
Jun. 19th, 2006 09:13 pm (UTC)
I've known women who've ended up with terrible headaches after their epis, for days. Maybe they just assumed that's what it was & so just offered painkillers. But, with the fever! You'd think THAT would've finally prompted someone to worry!

And that poor husband....and that poor mama-less baby.... :( :( :(
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ahavah
Jun. 20th, 2006 12:05 am (UTC)
I haven't heard anything like that. Taken too early in labor, epidurals can stall progress. Now I have heard of instances where moms have been laboring for a *long* time, and seem to quit progressing, and an epidural can help mom relax and *untense* enough to make more progress. But as far as I know, most anesthesiologists prefer not to give epidurals before 4-5 centimeters, because it can slow labor progress. If you happen to know of any sources or research that says otherwise, I would definitely be interested in checking that out, and I'm sure all my doula friends would want to know, as well. Those TV shows, though... well, I don't put much stock in them.
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ahavah
Jun. 20th, 2006 02:05 am (UTC)
Um, I've seen plenty of nurses and doctors in real life, and their advice is not always sound. That's why I'm a doula - to see people educated. Doctors are not infallible. I just feel for that poor girl. I think that the nurse probably said that to shut her awful mother up.
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ahavah
Jun. 20th, 2006 02:23 am (UTC)
I wasn't trying to find fault. I was only saying that's the opposite of what I heard. I did ask for research on the topic, because if I'm incorrect, I want to be sure that I'm giving my clients the right information.
nedia782
Jun. 20th, 2006 02:36 am (UTC)
for a nice review of the american OB, i suggest "women witches and midwives." shows how we have come to this place of us vs. them :)
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nedia782
Jun. 20th, 2006 02:31 am (UTC)
Sometimes labor can stall when the laboring mother feels upset, anxious, watched, tense. The nurse pushing for the epidural seems like it might have empowered this teenager. For her to see someone standing up to her mother for what SHE wanted, not her mother...And for the nurse to be pushing for something directly related to the pregnancy against her mothers wishes was probably a big deal. Seems like the mother was probably controling and negative towards the girl the whole way through.....SO by getrting the epi she probably felt empowered and confident in her choice. Sorry if that was redundant lol.
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nedia782
Jun. 20th, 2006 02:43 am (UTC)
thats what happens when births are put on tv for a profit. Its either drama or nothing ya know.
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