how common is it for the anesthesiologist to refuse to give an epidural?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

Until about 100 years ago, women also died at incredibly high rates during childbirth. It's not sexist to point out that biology didn't make us the most efficient birthers of our large-headed progeny. Luckily, biology did give us big brains to enable us to solve problems that evolution did not by using tools and interventions...and it's not sexist to take advantage of medical advances.

Knowing that an epidural enabled me to sustain 2 very difficult labors without needing a c-section, I would absolutely argue that epidurals have contributed to reductions in maternal mortality rates. Also, it's more-or-less guaranteed that I and my babies would have died in childbirth without modern medicine...so talking about "what bodes are designed to do without medical intervention" is meaningless to me. Like many women throughout all of human history, my body wasn't properly designed to birth babies...and it's sexist to somehow imply I'm a defective human because of that.

No one is implying you're defective for having an epidural. But to OP's point-the anesthesiologist, who presumably had a medically appropriate reason for denying the epidural, isn't defective either.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

NP. I was also prepared for an unmedicated birth. Then PROM happened, contractions didn't start on their own, and I was put on pitocin. Then the pitocin was cranked up because I wasn't dilating at all. So, yeah, after 12 hours of that particular torture (which, sorry, all my planning/hypnobirthing/natural childbirth classes didn't help), I took the epidural when my midwife suggested it. It's wrong to suggest that women who eventually need an epidural just weren't well prepared. Stuff happens.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

NP. I was also prepared for an unmedicated birth. Then PROM happened, contractions didn't start on their own, and I was put on pitocin. Then the pitocin was cranked up because I wasn't dilating at all. So, yeah, after 12 hours of that particular torture (which, sorry, all my planning/hypnobirthing/natural childbirth classes didn't help), I took the epidural when my midwife suggested it. It's wrong to suggest that women who eventually need an epidural just weren't well prepared. Stuff happens.

Same. Maxed out pitocin and back labor with a posterior baby. I also took a natural birth course and it was laughably unhelpful. It was epidural or csection, so I chose epidural.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I used to listen to the Birth Hour and there would occasionally be someone on who would note they couldn't have an epidural, but they usually knew that in advance. Seems odd that this wasn't communicated to your friend until after the induction was started when they could have strategized to avoid her being in so much pain. That sounds like bad coordination/communication on the part of the medical team. Epidural analgesia can have serious side effects even among totally healthy people so I have to think it's not unheard of to risk someone out.

CRNA here from above. This is somewhat rare. Usually complications/conditions that take epidurals off the table are discussed during pregnancy. However it could be that the anesthesiologist on call that night was a little more conservative and didn't feel comfortable doing it despite her getting epidurals in the past. It could be be a condition that tends to worsen with each pregnancy so maybe its something that would get an OK the first time around but not for the 2nd or 3rd birth. Its really hard to say. I have made a few calls that are contested. I immediately call my boss who always backs us up. I had one woman call the head of the hospital (as in the CEO…not even a DR) who then called me and apologized but felt like he "had to try." I am a mom, I am a care provider, I want you to be comfortable but I mostly want you to be alive. As someone who has given birth with and without epidural I realize how much relief it can provide BUT that relief has to be compared to possible risks and I can't make you a good candidate because a.) you know "people" b.) you have had one before c.) Dr. ABC and Dr. XYZ said it would be fine.

Can you please share some conditions that would make you refuse an epidural? Who would be a candidate for a no-epidural decision if you were making it?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I used to listen to the Birth Hour and there would occasionally be someone on who would note they couldn't have an epidural, but they usually knew that in advance. Seems odd that this wasn't communicated to your friend until after the induction was started when they could have strategized to avoid her being in so much pain. That sounds like bad coordination/communication on the part of the medical team. Epidural analgesia can have serious side effects even among totally healthy people so I have to think it's not unheard of to risk someone out.

CRNA here from above. This is somewhat rare. Usually complications/conditions that take epidurals off the table are discussed during pregnancy. However it could be that the anesthesiologist on call that night was a little more conservative and didn't feel comfortable doing it despite her getting epidurals in the past. It could be be a condition that tends to worsen with each pregnancy so maybe its something that would get an OK the first time around but not for the 2nd or 3rd birth. Its really hard to say. I have made a few calls that are contested. I immediately call my boss who always backs us up. I had one woman call the head of the hospital (as in the CEO…not even a DR) who then called me and apologized but felt like he "had to try." I am a mom, I am a care provider, I want you to be comfortable but I mostly want you to be alive. As someone who has given birth with and without epidural I realize how much relief it can provide BUT that relief has to be compared to possible risks and I can't make you a good candidate because a.) you know "people" b.) you have had one before c.) Dr. ABC and Dr. XYZ said it would be fine.

Can you please share some conditions that would make you refuse an epidural? Who would be a candidate for a no-epidural decision if you were making it?

Also, what are the other options for pain relief? GA?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

Until about 100 years ago, women also died at incredibly high rates during childbirth. It's not sexist to point out that biology didn't make us the most efficient birthers of our large-headed progeny. Luckily, biology did give us big brains to enable us to solve problems that evolution did not by using tools and interventions...and it's not sexist to take advantage of medical advances.

Knowing that an epidural enabled me to sustain 2 very difficult labors without needing a c-section, I would absolutely argue that epidurals have contributed to reductions in maternal mortality rates. Also, it's more-or-less guaranteed that I and my babies would have died in childbirth without modern medicine...so talking about "what bodes are designed to do without medical intervention" is meaningless to me. Like many women throughout all of human history, my body wasn't properly designed to birth babies...and it's sexist to somehow imply I'm a defective human because of that.

No one is implying you're defective for having an epidural. But to OP's point-the anesthesiologist, who presumably had a medically appropriate reason for denying the epidural, isn't defective either.

Yes, when you talk about unmedicated birth being "what [women's bodies] were designed to do", it does imply that someone who can't birth a child without medical intervention is defective. In my case, an epidural allowed me to give birth without surgery...

That said, I defended, above, the fact that an anesthesiologist has medically sound reasons for denying an epidural. For both of my pregnancies, a pregnancy-related immune response to my platelets created the possibility that I couldn't get an epidural...and in that case I would almost certainly have ended up in surgery.

The point of my post was to simply shut down all of the "it's sexist to act like pregnancy and childbirth are medical events because women gave birth before modern medicine". My point is that women also died in childbirth, often, before modern medicine. And epidurals are one of the developments of modern medicine that, I believe, have contributed to lower rates of maternal mortality by enabling less risky and invasive interventions than c-sections.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

Until about 100 years ago, women also died at incredibly high rates during childbirth. It's not sexist to point out that biology didn't make us the most efficient birthers of our large-headed progeny. Luckily, biology did give us big brains to enable us to solve problems that evolution did not by using tools and interventions...and it's not sexist to take advantage of medical advances.

Knowing that an epidural enabled me to sustain 2 very difficult labors without needing a c-section, I would absolutely argue that epidurals have contributed to reductions in maternal mortality rates. Also, it's more-or-less guaranteed that I and my babies would have died in childbirth without modern medicine...so talking about "what bodes are designed to do without medical intervention" is meaningless to me. Like many women throughout all of human history, my body wasn't properly designed to birth babies...and it's sexist to somehow imply I'm a defective human because of that.

The incredibly high morbidity and mortality rates you're referencing had more to do with how medicine was practiced during the industrial age while more and more women started birthing at hospitals instead of at home and MWs were delegitimized. There is not a lot of data on birthing before the industrial age but what is available shows that mortality rates were not incredibly high. MWs did routinely and successfully deliver babies in cases that would automatically warrant a c/s today.

Saying that women can not birth without medical intervention is one strategy for removing women's agency -- if it's a medical condition then obviously a doctor should be in charge and decide how everything should be done (in ways convenient to them). It's how we ended up with the horrors of twilight birthing ~80yrs ago. It's also how even today women are dictated to on how they are allowed to labor and birth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I used to listen to the Birth Hour and there would occasionally be someone on who would note they couldn't have an epidural, but they usually knew that in advance. Seems odd that this wasn't communicated to your friend until after the induction was started when they could have strategized to avoid her being in so much pain. That sounds like bad coordination/communication on the part of the medical team. Epidural analgesia can have serious side effects even among totally healthy people so I have to think it's not unheard of to risk someone out.

CRNA here from above. This is somewhat rare. Usually complications/conditions that take epidurals off the table are discussed during pregnancy. However it could be that the anesthesiologist on call that night was a little more conservative and didn't feel comfortable doing it despite her getting epidurals in the past. It could be be a condition that tends to worsen with each pregnancy so maybe its something that would get an OK the first time around but not for the 2nd or 3rd birth. Its really hard to say. I have made a few calls that are contested. I immediately call my boss who always backs us up. I had one woman call the head of the hospital (as in the CEO…not even a DR) who then called me and apologized but felt like he "had to try." I am a mom, I am a care provider, I want you to be comfortable but I mostly want you to be alive. As someone who has given birth with and without epidural I realize how much relief it can provide BUT that relief has to be compared to possible risks and I can't make you a good candidate because a.) you know "people" b.) you have had one before c.) Dr. ABC and Dr. XYZ said it would be fine.

Can you please share some conditions that would make you refuse an epidural? Who would be a candidate for a no-epidural decision if you were making it?

Also, what are the other options for pain relief? GA?

If I wanted medical pain relief and couldn't have an epidural, I would make sure I delivered at a hospital that provided nitrous and that it would be made available to me. I would also hire a doula to provide other pain relieve techniques such as positioning, massage, pressure, heat, ...

I've also had fentanyl during labor but wouldn't chose to do that again or really recommend it. It gave me a chance to rest but it also made my loopy right as the Pitocin was kicking in and labor became really painful (it's just been long before that).

I've had 2 with no medical pain management and had fentanyl and pit with my 3rd. I asked for an epidural but progressed too quickly after starting the Pitocin so never received more than a hole in my spine.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

NP. I was also prepared for an unmedicated birth. Then PROM happened, contractions didn't start on their own, and I was put on pitocin. Then the pitocin was cranked up because I wasn't dilating at all. So, yeah, after 12 hours of that particular torture (which, sorry, all my planning/hypnobirthing/natural childbirth classes didn't help), I took the epidural when my midwife suggested it. It's wrong to suggest that women who eventually need an epidural just weren't well prepared. Stuff happens.

I think the point is that no one is guaranteed to receive an effective epidural, so it's best to be as prepared as possible for that eventuality.

[Anonymous]

Coming back around to the original post, remember that anesthesiologists make money by doing procedures like epidurals. It would be in their best financial interest to do as many of them as they can.

If they are not doing one, it is usually because they are in the middle of something that takes medical precedence, or they are a good doctor trying to put your best interests ahead of their own.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

Until about 100 years ago, women also died at incredibly high rates during childbirth. It's not sexist to point out that biology didn't make us the most efficient birthers of our large-headed progeny. Luckily, biology did give us big brains to enable us to solve problems that evolution did not by using tools and interventions...and it's not sexist to take advantage of medical advances.

Knowing that an epidural enabled me to sustain 2 very difficult labors without needing a c-section, I would absolutely argue that epidurals have contributed to reductions in maternal mortality rates. Also, it's more-or-less guaranteed that I and my babies would have died in childbirth without modern medicine...so talking about "what bodes are designed to do without medical intervention" is meaningless to me. Like many women throughout all of human history, my body wasn't properly designed to birth babies...and it's sexist to somehow imply I'm a defective human because of that.

The incredibly high morbidity and mortality rates you're referencing had more to do with how medicine was practiced during the industrial age while more and more women started birthing at hospitals instead of at home and MWs were delegitimized. There is not a lot of data on birthing before the industrial age but what is available shows that mortality rates were not incredibly high. MWs did routinely and successfully deliver babies in cases that would automatically warrant a c/s today.

Saying that women can not birth without medical intervention is one strategy for removing women's agency -- if it's a medical condition then obviously a doctor should be in charge and decide how everything should be done (in ways convenient to them). It's how we ended up with the horrors of twilight birthing ~80yrs ago. It's also how even today women are dictated to on how they are allowed to labor and birth.

This is a complete lie. Women frequently died from childbirth. Go and look at family trees going back to the 1600s in this country and you’ll see that men frequently had two wives. Why? Because their first wife often died in childbirth.

[Anonymous]

Anonymous wrote:I would demand a c section if they couldn't do the epi.

Then they would give you a general anesthetic.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For the birth of DD, the anesthesiologist was too late to the hospital (our fault -- long story) and by the time he arrived DW was already in labor. He wouldn't give her an epidural because she was already having regular contractions.

It looked like it really hurt. Certainly hurt my ears.

Hope the anesthesiologist is late to your vasectomy.

You don't need an anesthesiologist for a vasectomy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Isn’t this the case for any and all medical procedure and surgeries? I mean if they amputate a limb is pain relief really medically necessary?

Oh this is just about the dumbest thing I've ever heard. Birth is not a medical procedure any more than eating a sandwich is, or taking a big dump. Yes it can be uncomfortable and even painful. Yes sometimes things go awry and medical intervention is needed. But otherwise... it what our bodies were literally designed to do.

And yes, I had an umedicated birth, so don't @ me.

LOL. You’re insane. You are incredibly sexist. Who compares birth to taking a dump??

A person who understands biology, and was prepared for (and had) an unmedicated birth. I think its much more sexist to say "women cannot do the thing they were designed to do without medical intervention." Don't we trust women a little more than that? I have no problem with a woman who wants pain meds, getting pain meds. But to assume it should be the default, or is necessary, because women just can't handle it -- nope, that's sexist.

Until about 100 years ago, women also died at incredibly high rates during childbirth. It's not sexist to point out that biology didn't make us the most efficient birthers of our large-headed progeny. Luckily, biology did give us big brains to enable us to solve problems that evolution did not by using tools and interventions...and it's not sexist to take advantage of medical advances.

Knowing that an epidural enabled me to sustain 2 very difficult labors without needing a c-section, I would absolutely argue that epidurals have contributed to reductions in maternal mortality rates. Also, it's more-or-less guaranteed that I and my babies would have died in childbirth without modern medicine...so talking about "what bodes are designed to do without medical intervention" is meaningless to me. Like many women throughout all of human history, my body wasn't properly designed to birth babies...and it's sexist to somehow imply I'm a defective human because of that.

The incredibly high morbidity and mortality rates you're referencing had more to do with how medicine was practiced during the industrial age while more and more women started birthing at hospitals instead of at home and MWs were delegitimized. There is not a lot of data on birthing before the industrial age but what is available shows that mortality rates were not incredibly high. MWs did routinely and successfully deliver babies in cases that would automatically warrant a c/s today.

Saying that women can not birth without medical intervention is one strategy for removing women's agency -- if it's a medical condition then obviously a doctor should be in charge and decide how everything should be done (in ways convenient to them). It's how we ended up with the horrors of twilight birthing ~80yrs ago. It's also how even today women are dictated to on how they are allowed to labor and birth.

This is a complete lie. Women frequently died from childbirth. Go and look at family trees going back to the 1600s in this country and you’ll see that men frequently had two wives. Why? Because their first wife often died in childbirth.

Women don’t die from pain. They die from bleeding, postpartum infection, breech births, retained contents, etc.

A woman’s “agency” does not override her medical condition/ the judgement of a trained professional.

[Anonymous]

The strand of midwifery that fetishizes "natural" childbirth is unscientific, anti-feminist quackery.