The epidural is my friend!?!?

Since starting the actual catching of babies, one of the things that has changed the most are my feelings about epidurals. A lot of my patients get epis and honestly, I don’t think I could have made it through some days (and nights) without them. I started school feeling like epidurals had their place but where way overused and often unnecessary. I then went to feeling that an epidural is a necessary evil and I just had to accept it. Next was that it's about patient choice and while I might not agree, it’s not my labor as a midwife my job is to support her choice.

While I still feel that it’s about supporting choice, I never thought I would be talking women into epidurals. A few of the women I have been with, especially the very young ones, just can’t relax and stop having cervical change. An epi and a nap later they are fully. One could argue that labor support could have the same effect, but in reality there isn’t always the ability or time to do that. At least in the practice I’m with. I do feel like sometimes the epidural has at least in part been for our benefit. Between multiple patients in labor, triage, rounds and discharges we often don’t have the time to stay with a patient. There is also the fact that sometimes I need to eat and sleep. I remember when we first started call, the preceptors were always talking about how we should eat and figuring out good times to get food. The whole experience was so intense, eating was the last thing on my mind and skipping a meal didn’t seem like that big of a deal – who cares about eating, someone is having a baby! While it is still intense, I’m now to the point where I’m planning labor management thinking about when I can grab some food. Missing lunch very now and then is okay, but I’m realizing I can’t not eat and expect to keep going for 12-24 hours. I’m learning that sometimes it’s the epidural that allows time for food. Epidurals are also great when a first-time mom who is 4cm dilated gets admitted at midnight. Getting her comfortable and tucking her in to get some sleep also allows me some time to look at the inside of my eyelids.

Maybe someday I’ll be in a practice where I can sit with and support a woman throughout her labor, or every woman will have a fantastic support system, or even a doula. And there will also be puppies and hugs for everyone. Even if that happens, I'm pretty sure epidurals will still be used. Heck, after a long call shift - I'm ready for one.

2/26/2009

So celebrating my 30th birthday was not nearly as bad as I was expecting. The last 2 birthdays haven't been the bestest due to having finals the day after so I have kind of gotten out of the habit of doing the whole birthday thing. I wasn't planning on doing anything, but my roommate talked me into it. She organized a little shindig and seeing as though I only have 1 friend in town, she invited all of her friends. I went out to dinner with dinner with 2 people I knew and 10 that I didn't. I think that was the most people I've had at my birthday in a long while. I had macaroni and cheese and a side of brussel sprouts with bacon. I also had some cheesecake, which wasn't that good, but I ate it anyway. My roommate also bought me the birthday flowers pictured above.

I did do clinic on my birthday and actually took the next day off. No baby catching, which I think would have been nice - sharing my birthday with someone new. I guess there is always next year, and the year after that, and the year after that, and so on.