Patient Controlled Anesthesia for labor/delivery

Has anyone heard of this before?

How does it work for labor/delivery?

I'm at 32 weeks in my pregnancy and this is what my OB is suggesting I
ask for if I feel a need for pain medication. She said that I would
have a button to push whenever I felt that I needed more medication
and if I didn't feel that I needed anything then I just wouldn't push
the button.

I need to find out more about this; I'm planning to ask my OB for more
details, but I thought I'd post a message and see if anyone out there
had heard of it before.

Thanks,
annafine

annafine wrote:
Has anyone heard of this before?

How does it work for labor/delivery?

I'm at 32 weeks in my pregnancy and this is what my OB is suggesting I
ask for if I feel a need for pain medication. She said that I would
have a button to push whenever I felt that I needed more medication
and if I didn't feel that I needed anything then I just wouldn't push
the button.

I need to find out more about this; I'm planning to ask my OB for more
details, but I thought I'd post a message and see if anyone out there
had heard of it before.

Thanks,
annafine

I've heard of this for post-surgery; a friend of mine who had a
c-section had something like that to self-administer morphine (I'm
pretty sure it was morphine) after she woke up.

When my mother had at least some of us in the 50s and 60s,
she could self-administer some drug with an inhaler strapped
to her wrist. I can't remember the name of it, but I don't
think it's used any more.

Clisby

Judy,

I've heard of PCA for things other than birth as well. My Mom had one
at one time and she was in a LOT of pain (I don't remember the exact
reason for her pain) and she said that it was not working...she was
getting morphine, and there was a block so that she had to wait a
certain period of time before she got more of it so that she could NOT
overdose on it. She swore it was not working.

Yes, I think this is hooked up by IV...but I'm not 100% sure of that.
However, my OB suggested that I request an IV early on any way because
as she put it, "IF there's a problem later we don't have to take the
time to put in the IV." However, she also told me that she would
encourage me to walk around, go up and down the hall, etc., so they
must have mobile IV units or something.

You're right, it could make it a bit TOO easy to get medicated...I
completely see what you mean. Yet at the same time, I'm really hating
the idea of a needle in my back when I'm in labor IF I decide that I
need something.

I'm sort of between a rock and a hard spot on "how" to give birth.

Part of me wants to go all natural to avoid needles and pain
medications at all cost. However, my OB did mention the PCA as an
option, and since she's recommending an IV anyway, I'm wondering if I
may as well ask for the PCA, so that I have some pain relief IF I need
it at some point.

annafine

"annafine" wrote in message
om...
Judy,

I've heard of PCA for things other than birth as well. My Mom had one
at one time and she was in a LOT of pain (I don't remember the exact
reason for her pain) and she said that it was not working...she was
getting morphine, and there was a block so that she had to wait a
certain period of time before she got more of it so that she could NOT
overdose on it. She swore it was not working.

Yes, I think this is hooked up by IV...but I'm not 100% sure of that.
However, my OB suggested that I request an IV early on any way because
as she put it, "IF there's a problem later we don't have to take the
time to put in the IV." However, she also told me that she would
encourage me to walk around, go up and down the hall, etc., so they
must have mobile IV units or something.

You're right, it could make it a bit TOO easy to get medicated...I
completely see what you mean. Yet at the same time, I'm really hating
the idea of a needle in my back when I'm in labor IF I decide that I
need something.

I'm sort of between a rock and a hard spot on "how" to give birth.

Part of me wants to go all natural to avoid needles and pain
medications at all cost. However, my OB did mention the PCA as an
option, and since she's recommending an IV anyway, I'm wondering if I
may as well ask for the PCA, so that I have some pain relief IF I need
it at some point.

annafine

Well it's a tricky decision isn't it. I had an epidural last time and this
time I really want to go drug free to help with my recovery. To be honest
while the pain is pretty bad personally I know I can handle it, you may well
find that you are the same.

But if you are planning to have a IV anyway and you can move around with it
then the PCA sounds like it would be quite good.

Well hopefully you have a nice short labor and there's no time for either!

While I think it's best to avoid pain relief and will try to myself this
time, there's also no shame in it, some people find it invaluable.

Sorry not much help I'm afraid

Judy

On 26 Aug 2003 14:53:55 -0700, (annafine) wrote:

However, my OB suggested that I request an IV early on any way because
as she put it, "IF there's a problem later we don't have to take the
time to put in the IV."

I am sorry, but if there is a problem later, you can be sure that they
will get an IV in if it is needed. I wouldn't have an IV unless there
was a problem.

--
Daye
Momma to Jayan
"Boy" EDD 11 Jan 2004

annafine wrote:


Part of me wants to go all natural to avoid needles and pain
medications at all cost. However, my OB did mention the PCA as an
option, and since she's recommending an IV anyway, I'm wondering if I
may as well ask for the PCA, so that I have some pain relief IF I need
it at some point.


I think you may want to feel your way through this
issue a bit more before you decide. I can't imagine *anyone*
having the PCA and not using it--heck, *I* probably would
have used it if all that stood between me and pain relief
was the push of a button! And I really never perceived the
need for drugs in any of my three labors otherwise! Also,
for some people at least, having an IV or hep lock *does*
have an impact on how one copes with labor, just because
it's an irritant that can sap away attention and emotional
energy. Honestly, it shouldn't take hardly any time for
a competent person to get an IV in should it become
necessary or desireable. It's always convenient for staff
to put in an IV earlier, but for some people it's very
annoying to have one. And depending on the situation, it
can inhibit mobility. Even if there are IV stands you can
push around with you, that's just one more thing you have
to do. It's much easier to get up and move around when
unfettered.
Really, it ultimately boils down to how you really
feel about what you want, which is something you obviously
aren't really settled on yet. If you're leaning towards
drugs for pain relief, then maybe all these little things
don't matter much in the big picture. They decrease the
odds that you'll go without drugs, but if you think you're
likely to want them anyway, no big deal.
On the other hand, if you *really* want to go
without pain relief drugs, then these little issues
become salient because they really can make the difference
between feeling like you really need the drugs and feeling
like you can cope without them.
As far as comparing the PCA with an epidural, I
think that's also difficult. When they work, epidurals
are far and away more effective as pain relief than
anything you can get through an IV, and drugs administered
via an epidural are likely to affect the baby less than
drugs administered via an IV (depending somewhat on the
timing of the doses). Also, different women react
differently to the drugs. Some women say that narcotics
really help them relax in between contractions and take
the edge off the pain, and others say that the narcotics
just make them feel doped up and out of control.

Part of what I think I hear you saying is that
you'd like to go without any drugs, but you're afraid
of being overwhelmed by pain and running out of options.
If that's true, I think you really can proceed with
the idea that you're going to do this without pain
meds. Set yourself up to be able to do that by learning
about alternative ways of coping with labor pain and
by staying out of bed and avoiding things like IVs,
continuous monitoring, fasting, going to the hospital
too early, etc. that increase the likelihood that you'll
feel you need pain meds. Read positive stories about
birthing without drugs and talk to people who've done
it. Raise your confidence level, because your beliefs
about yourself are very likely to become self-fulfilling
prophecies.

Then, if you do all that and lay the
groundwork for giving yourself a good chance at going
without drugs, if you get in the middle of labor and
decide you need the drugs anyway, you'll still be able
to get them, no problem! They can put in an IV and
give you narcotics or an epidural or whatever seems
best according to the risks and benefits in the particular
situation you're in at the moment. You don't have to
decide in advance to have drugs (whether the PCA or
an epidural) in order to get them, but you *DO* need
to plan in advance to have a real chance of going without
the drugs. (Well, some people just fall into it and
have no problems going without drugs, but I think most
people need some preparation.)

I think we get a little too hung up on this
issue of deciding in advance, and I think part of it
has to do with lacking confidence in our ability to
give birth without drugs and part in a hesitation to
commit wholly to going without drugs Just In Case.
We don't want to say we're going without drugs because
so many have told us we'll cave at the first contraction
and we don't need to be martyrs and we're crazy for
considering it. So we think our odds of being successful
aren't good and we don't want to have to eat our words
or feel like we've "failed" at what we set out to do.
So we hedge our bets. But the downside of that is that
all that hedging *affects* us and our thinking. Even
though we don't mean it to, it undermines our confidence.
Once again, it becomes a self-fulfilling prophecy.

The way to break out of this cycle is simply
to refuse to believe that there's any "failure" in
changing your mind while you're in labor. I mean,
really--how crazy is that? You haven't been through
labor before, and even if you had, you wouldn't have
been through *this* labor before! How could you
possibly be expected to know what you might or might
not need or want? There's no shame in deciding that
you want to go without drugs and planning for that,
and then changing your mind if you get into a situation
that you believe warrants it. In fact, maybe a
potential solution to your dilemma is not to worry
about whether you want drugs or not, but to discuss
*under what circumstances* you want which drugs. So,
under circumstances A you want to go drug free, but
under circumstances B you would consider the PCA, and
under circumstances C you would opt for an epidural.
Define A, B, and C, plot your strategy for staying in
category A, and you're good to go.

Best wishes,
Ericka

However, my OB suggested that I request an IV early on any way because
as she put it, "IF there's a problem later we don't have to take the
time to put in the IV."

This is another hint that your OB may not be as open minded as you suggested. A
'just in case' approach to labor is one that can easily lead to more
interventions than you had in mind. The fact is that, in an emergency, any
doctor or nurse worth her salt can start an IV in about two seconds flat, so
there is NO reason to have one from the beginning 'just in case you might need
one later.' If there is an emergency, or if you opt for meds that require an
IV, you can get it at the time. And you aren't then hampered by having it
early.

However, she also told me that she would
encourage me to walk around, go up and down the hall, etc., so they
must have mobile IV units or something.

Well, IV poles ARE generally portable, but she might also have been talking
about having a hep-lock, which is just the IV cathater in your hand. It isn't
actually hooked up to anything until/unless you need it. Some people don't
mind the hep-lock, others find it very uncomfortable.


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)

"annafine" wrote in message
om...
PS. Can you recommend or suggest a good Breast Pump for occasional
pumping? (I've posted a separate message about this on the
breastfeeding section, but thought I'd throw it out here too).

IMO (and many others), the best breast pump out there for occasional pumping
would be the Avent Isis. Stay away from anything sold in drugstores like
Evenflo or Gerber. While cheap, I've never heard anything but horror stories
about them. The Isis is actually a pretty darn good value for the top
quality pump that it is. The Avent is sold at Rite Aid I noticed recently so
disregard anything in a drugstore *except* the Avent
--
JennP.
mom to matthew 10/11/00
EDD 4/4/04

annafine wrote:


PS. Can you recommend or suggest a good Breast Pump for occasional
pumping? (I've posted a separate message about this on the
breastfeeding section, but thought I'd throw it out here too).


After having miserable luck pumping with my first
two (where it was fortunately not at all necessary for me
to pump), I've been having very good luck this time (when
I've really needed to be able to pump) with the Avent Isis.
It's worked like a charm, at least compared to previous
experiences. I wouldn't want to use it if I had to do
a great deal of pumping, but for occasional use I'm quite
pleased.

Best wishes,
Ericka

IMO (and many others), the best breast pump out there for occasional pumping
would be the Avent Isis. Stay away from anything sold in drugstores like
Evenflo or Gerber. While cheap, I've never heard anything but horror stories
about them. The Isis is actually a pretty darn good value for the top
quality pump that it is. The Avent is sold at Rite Aid I noticed recently so
disregard anything in a drugstore *except* the Avent

Thanks!

I've actually been considering the Avent pump...but I wanted to get
some input from others as well.