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

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]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.[/quote]

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.  [/quote]

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?[/quote]

Also, what are the other options for pain relief?  GA?  [/quote]

[b]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, ...[/b]

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.

[/quote]

I’m a person who knew in advance that she couldn’t have an epidural during labor. In my case, it was due to low platelets caused by an autoimmune response and made much worse with pregnancy. It was too risky for the anesthesiologist to do an epidural due to the risk of bleeding in my spine. As I knew it was likely in advance, I did everything possible to prepare. I took Bradley classes, tons of prenatal yoga, signed up with midwives,  and hired an amazing doula, and felt totally prepared. Let me tell you, it did nothing compared what labor was actually like. I ended up with an induction due to preeclampsia and was on full dose pitocin for literally days, including the last day with my water broken. I had a morphine (I think - I was so out of it at that point) shot at one point but it did nothing. The experience was like  torture and I finally begged for the c section I was trying desperately to avoid. I was ultimately able to get a spinal because the anesthesiologist determined there was a lower risk and lower platelet threshold for doing so; otherwise I would have had to go under general anesthesia.

Even though I wouldn’t have wished that on my worst enemy, I completely understand and respect the anesthesiologists’ position and I’m glad they didn’t take any unnecessary risks. [/quote]

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