Making Decisions about Labor
©1993 Beth Weiss, Posted to misc.kids Usenet newsgroup, July 10, 1993
I had originally written:
No woman can be sure how she'll respond to labor....If
a woman decides, after looking into the situation and discussing the matter with
her doctor that an epidural (or other pain medication) is the best choice,
that's an informed decision.
Another misc.kids reader had some questions as a follow-up to that:
To what extent can/should the woman make a
drugs/no-drugs decision prior to labor, and to what extent is it out of her
hands once the labor starts?
I had a chart of attitude levels that I found really interesting. I
don't think I have it anymore, but the basic idea was that people went from "I
want to feel no pain at all" (totally unrealistic) to "I don't want any pain
medication even if I need a c-section (totally unrealistic).
I think women have an attitude going into labor that affects whether
they ask for pain medication. I talked to Dean and Marjorie (our doula)
about it, and they both knew I wanted to avoid medication, and we talked about
what we would do if I thought I wanted it. We said we would set goals for
how much longer I would wait, and then if I still wanted it, we would get it.
For women who have natural (non-induced) labors, Marjorie said this often worked
quite well. Waiting 15 minutes might mean that the woman moved into the
pushing stage, for example, and forgo medication altogether.
Is it truly the woman's decision, or can the doctor (or
midwife) overrule her?
I don't know. I suspect in a life/death situation the dr might be able
to overrule, but I'm not even sure about that. A medical practitioner
might strongly suggest, though, and for many women that would be enough to push
her in the direction they want.
By the way, having a doula gave me incredible support, which meant I didn't
have to rely on the nurse who just happened to be on duty. Instead, I had
someone with me who knew what was going on, and I knew wanted me to have the
kind of labor I wanted (that I didn't get it was due to my medical problems).
To what extent is a woman capable of making such
decisions during labor? (Is the pain incapacitating? sometimes? often?)
Was the pain incapacitating? It was pretty bad. But, I
want to stress that I had an induced labor and had my bag of water broken at
about 2 centimeters.
I don't know how capable of making decisions I was, but I was able to
introduce myself to the OB on call and tell him that I didn't want an episiotomy
(which I ended up needing). I was able to calmly tell my husband how
to put a pillow under my knees. I was able to decide I was going to use a
hemorrhoid suppository whether the nurse thought I should or not. I was
able to decide that a catheter before delivery was a good idea.
I think a lot depends on the personality of the woman. I'm pretty
strong-willed, and was able to make decisions. Another woman might be
different.
              
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