What are the risks of refusing a catheter in labor?

[Anonymous]

I have not used an epidural so can't compare, but I've had two babies without medication. I found pushing to be quite satisfying, and less painful than the dilation stage of labor, since I was working with the sensation and pushing with it, rather than letting the pain wash over me, if that makes any sense. The pushing stage with my second baby was very short, and I hardly remember it. I think generally the pushing stages for second and third and subsequent babies are very short. I honestly don't remember the "ring of fire" all that much -- if anything it was encouraging to me because I knew the baby was almost born. I don't recall it lasting very long the first time, and the second time, I gave birth in water, and didn't feel it at all (maybe the water muted it? Not sure...). One of the reasons I wanted to give birth without medication is because I'm prone to UTIs and I know how awful they are, and I wanted to reduce my chance if at all possible. I was able to pee on my own throughout labor, and right after, which was great.

Anonymous wrote:OP again. Pushing is pleasant? Isn't it the most painful part (ring of fire?)

[Anonymous]

I honestly liked the pushing part for both of my births. It was such a relief to actually do something activelyntonget the baby down and out. The ring of fire was so short a period of time that I can't even remember what it felt like. And you know when that's happening that the whole thing is on the brink of being done, it's a great feeling.

[Anonymous]

Anonymous wrote:I have not used an epidural so can't compare, but I've had two babies without medication. I found pushing to be quite satisfying, and less painful than the dilation stage of labor, since I was working with the sensation and pushing with it, rather than letting the pain wash over me, if that makes any sense. The pushing stage with my second baby was very short, and I hardly remember it. I think generally the pushing stages for second and third and subsequent babies are very short. I honestly don't remember the "ring of fire" all that much -- if anything it was encouraging to me because I knew the baby was almost born. I don't recall it lasting very long the first time, and the second time, I gave birth in water, and didn't feel it at all (maybe the water muted it? Not sure...). One of the reasons I wanted to give birth without medication is because I'm prone to UTIs and I know how awful they are, and I wanted to reduce my chance if at all possible. I was able to pee on my own throughout labor, and right after, which was great.

Anonymous wrote:OP again. Pushing is pleasant? Isn't it the most painful part (ring of fire?)

Pushing in water and peeing constantly won't cause UTI? Honest question.

[Anonymous]

I wasn't peeing in the water that I was giving birth in. I peed in the toilet before getting into the water to give birth. Not sure if there have been studies regarding water birth and UTIs, but I didn't get a UTI.

Anonymous wrote:

Anonymous wrote:I have not used an epidural so can't compare, but I've had two babies without medication. I found pushing to be quite satisfying, and less painful than the dilation stage of labor, since I was working with the sensation and pushing with it, rather than letting the pain wash over me, if that makes any sense. The pushing stage with my second baby was very short, and I hardly remember it. I think generally the pushing stages for second and third and subsequent babies are very short. I honestly don't remember the "ring of fire" all that much -- if anything it was encouraging to me because I knew the baby was almost born. I don't recall it lasting very long the first time, and the second time, I gave birth in water, and didn't feel it at all (maybe the water muted it? Not sure...). One of the reasons I wanted to give birth without medication is because I'm prone to UTIs and I know how awful they are, and I wanted to reduce my chance if at all possible. I was able to pee on my own throughout labor, and right after, which was great.

Anonymous wrote:OP again. Pushing is pleasant? Isn't it the most painful part (ring of fire?)

Pushing in water and peeing constantly won't cause UTI? Honest question.

[Anonymous]

I got an epidural during/right before transition. I didn't get cathed, but it was so quick there wasn't a need.

[Anonymous]

RN here again.

Anonymous wrote:I got an epidural during/right before transition. I didn't get cathed, but it was so quick there wasn't a need.

Right. If it's quick, they might not have a chance to cath you. Unless you have a super eager nurse who is following protocols in a timely manner and she does it immediately after epidural as she is supposed to. But, the point remains the same, unless baby is born within an hour or so of epidural, they're likely going to cath you to make sure bladder is empty when you're pushing.

To those wondering about UTIs in relation to water birth, no there haven't really been studies that I know of. There have been studies to show the safety of birthing in water, but not specifically about UTIs.

Question for OP, did you receive antibiotics during labor? (for GBS for example)

[Anonymous]

I got an epi at transition and they just did a straight cath (didn't know that is what it was called, but good to know) once. I think they did it right before I started to push? Don't recall exactly but they only did it once.

[Anonymous]

Anonymous wrote:RN here again.

Anonymous wrote:I got an epidural during/right before transition. I didn't get cathed, but it was so quick there wasn't a need.

Right. If it's quick, they might not have a chance to cath you. Unless you have a super eager nurse who is following protocols in a timely manner and she does it immediately after epidural as she is supposed to. But, the point remains the same, unless baby is born within an hour or so of epidural, they're likely going to cath you to make sure bladder is empty when you're pushing.

To those wondering about UTIs in relation to water birth, no there haven't really been studies that I know of. There have been studies to show the safety of birthing in water, but not specifically about UTIs.

Question for OP, did you receive antibiotics during labor? (for GBS for example)

No, I've been GBS negative thus far. I'm seriously considering either going unmedicated or just trying to hold on until 7 cm or so. I know it must seem trivial to some, but my UTIs are not run of the mill. The most intense, painful burning I've ever experienced. I'd rather have any type of pain but that one.

[Anonymous]

I think your concerns are very valid and I don't blame you for wanting to avoid a UTI. I imagine that even if you don't end up getting a UTI, it will be nervewracking if you end up with a catheter because you'll be worried that you're going to get one. If you're willing to go to 7cm without an epidural, I don't think it's that much of a stretch to continue through to the end. I would just make sure you have a provider/setting that is going to make unmedicated birth more manageable and knows how to support it. I'd also highly recommend having access to either a shower or bath -- for me, the bath offered really amazing pain relief. There are some great tools for managing labor, and you could also have a doula with you to help you. Good luck. You're in a tough situation and I hope it all works out!

Anonymous wrote:

Anonymous wrote:RN here again.

Anonymous wrote:I got an epidural during/right before transition. I didn't get cathed, but it was so quick there wasn't a need.

Right. If it's quick, they might not have a chance to cath you. Unless you have a super eager nurse who is following protocols in a timely manner and she does it immediately after epidural as she is supposed to. But, the point remains the same, unless baby is born within an hour or so of epidural, they're likely going to cath you to make sure bladder is empty when you're pushing.

To those wondering about UTIs in relation to water birth, no there haven't really been studies that I know of. There have been studies to show the safety of birthing in water, but not specifically about UTIs.

Question for OP, did you receive antibiotics during labor? (for GBS for example)

No, I've been GBS negative thus far. I'm seriously considering either going unmedicated or just trying to hold on until 7 cm or so. I know it must seem trivial to some, but my UTIs are not run of the mill. The most intense, painful burning I've ever experienced. I'd rather have any type of pain but that one.

[Anonymous]

OP, I'm so sorry. Would you update us on what you decide? I'm not sure what I would do in your shoes. I think I might hire a doula in this case to help you last as long as possible before getting an epidural, if at all.

What does your OB say? Can you pre-emptively take antibiotics if you get a catheter (a la how GBS positive patients do)?

[Anonymous]

Anonymous wrote:OP, I'm so sorry. Would you update us on what you decide? I'm not sure what I would do in your shoes. I think I might hire a doula in this case to help you last as long as possible before getting an epidural, if at all.

What does your OB say? Can you pre-emptively take antibiotics if you get a catheter (a la how GBS positive patients do)?

Thanks to both PP for the well wishes. I will try to remember to dig up this post after I deliver (late August). I have not discussed this issue with my current OB. My first 2 pregnancies I lived in DC, but have since moved out of state. I live in a place where OB choices are limited, only 1 hospital, and no birthing centers. I have an appt on Monday and will try to discuss with the midwife. If I get any useful suggestions I'll post back.

[Anonymous]

One other note OP: I had epi and STILL felt ring of fire and remember it. I wonder if PPs who were unmedicated don't remember b/c there was some natural pain blocking that epi blocked in me. I didn't totally mind though b/c I could feel what was happening and the pushing phase was less than 20 min.

[Anonymous]

Anonymous wrote:OP again. Pushing is pleasant? Isn't it the most painful part (ring of fire?)

Two labors without an epi, no ring of fire. This seems more common with my friends who didn't have the epi.

Once you reach 10 cms the contraction feel very different. If you have no epi and don't push until you have the undeniable urge, it will like feel good/satisfying and be pretty brief. You don't need to be coached and you can change positions if you want to.

[Anonymous]

I agree about trying to birth without medication. I've had two babies (both on the larger side, second was practically 10 lbs) and never felt the "ring of fire". I felt stretching and tightness when the head was being born, but that literally lasted 30 seconds. If you'd rather deal with 30 seconds of pain over weeks of your nightmare UTI, then it might be worth it. Personal decision though.

As far as pushing being satisfying, I think what the PP said about you being in control is key. Freedom to choose pushing positions, timing, etc is so important. Pushing flat on your back with your legs spread eagle and your nurse counting numbers while you hold your breath is annoying and inefficient. When you have to push, you push the way you want to and how you want to. Toilet, squatting, hands and knees, whatever. You know you're capable of birthing a baby if you've done it twice before.

[Anonymous]

NP here. I also think you may want to go for unmedicated. With baby #3, you should have a fast transition anyway.

FWIW, I had the ring of fire and it was crazy painful...but it lasted two pushes (and that was for my first labor). Seriously, it's like 3 minutes of pain tops. Definitely worth it to avoid an invasive UTI.

And prophylactic antibiotic use is being implicated in the explosion in allergy and asthma development. I would avoid them for the sake of your baby