July 29, 2007
I had a patient last night come in, 1st baby, contracting every 3 minutes, dilated 3cm 100% effaced. She wanted to try without an epidural and thought that the birthing tub would be great. Call the on call doc, who is notorious for being an ass about pain control in labor, and he of course said no tub and to call back if she makes cervical change. Patient is very uncomfortable despite efflurage, birthing ball and rocking chair. Short time later, she's 4 cm. Call him back. Can she get in the tub? No. How about IV pain medication? No, but she can have an epidural if she's making good change. This doc usually gives IV pain meds, and there was NO reason why he wouldn't give it to this patient. Patient decides she'll get the epidural for some relief, even though all she wanted was something to take the edge off for a bit. After her epidural was placed, she asked me why he wouldn't allow her to get IV meds. I was professional, but I had to tell her that I had no idea. Maybe she would have gotten an epidural anyway, but now she'll always wonder if she would have been able to do it. I just don't understand what happened here. He has been frustrated with some staff for different things, some things that were out of everyone's control, but it isn't right to make the patients suffer for it. And that's how it seems to me. If anyone has any insight as to why, that would be great. Because none of us here can figure it out.