My lovely friend had her bub a while ago and she was sharing her birth story with me....she had spontaneous membrane rupture that wasn't followed by contractions - so was booked for induction - which was put off due to the hosptial being busy, twice. She was induced more than 48 hours later and due to infection risk, the staff was reluctant to do many internals (which is total opposite of what some insist and great).
Anyway, induction was mid morning and bub was posterior, she was given excercises, etc in an attempt to turn him but without sucess, but soldiered on as she was really wanting a natural birth.
By 5pm, midwives were advising her that she had a while to go and should consider the epi as she was very tired with no sleep for 2.5days. She agreed. Thing was, she wasn't checked even at that point - which I thought was pretty unusal, I thought a check prior to an epi was standard procedure. Bub was born at 7pm - so she felt she was most likely pretty close and felt like had they checked her, she probably could have held on for a bit longer.
I'm not sure about her being checked, but it is quite common, especially with a stalled and long labour, for a woman to receive an epi and for her body to dilate quite rapidly after that. Sometimes exhaustion will stop a woman from dilating and the epi can be the difference between a vaginal delivery and a csection, the fact that she birthed soon after her epi isn't necessarily an indication that she was close.
I thought they had to check as they don't give it before a certain dilation... or at least that was the case with my labour
My waters broke spontaneously and my dilation was slow - 1cm in 14hrs even though I was having 2-3min contractions for the majority of that time
I don't know if they usually would check but can say in my experience they were happy enough to give me an epi before my induction had commenced, and then when it was discovered it wasn't working to pull it all out and put it back in when I was only 1-2cm dilated. Once it took, I dilated very rapidly as well - DD was born less than an hour after the second epi.
Ausgirl, my knowledge is that you are correct and they will only give an epidural up to 8cm dilation.
Yes, generally, dilation would be checked prior to 'approval' of epidural or administration of intramuscular pain relief (most cases pethidine)... However, a skilled midwife that is working closely with a woman should be able to see signs of where her labour is at without checking cervial dilation and depending on your friends birth, it could be the case that contraction length, frequency, her response etc was considered well 'below' transition and therefore safe to give.
I think Kelly has an article about it but I can't for the life of me remember which one, so maybe I just read her post it in a thread (years ago however).
FWIW my dumbo mid with DS probably should have 'known' that even though I was still 'only' 7cm (after being that for 3hrs) the natural bearing down and already urge to push was a sure sign I was in transition and it was too late for an epidural...... the anaesthetist that walked in an hour later (8mins prior to DS being born) seemed to have more of an idea that I was about to expel a baby than she did.
Last edited by The[cookie]Doctor; September 28th, 2011 at 08:37 PM.
My understanding (which could be wrong) was not before 4cm, not after 8ish? Is your friend sure she wasn't checked at some point without really realising? I hardly remember being checked.
Last edited by PumpkinZulu; September 28th, 2011 at 08:33 PM.
No cervix check before Epi... normal?
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