I recently came across a perfect example of sanctimommy literature. It’s a classic because the author has no idea what she is talking about (of course), deliberately makes a false analogy, is incredibly judgmental and is falling all over herself to demonstrate her natural mommy cred.
I’m referring to this piece: What if someone suggested morphine to help your newborn sleep? by Kristin Dibeh, who amazingly believes she is qualified to write about childbirth because she is a childbirth educator.
She starts with typical first world privilege and self-absorption:
I knew that birth was possible without drugs, and that if my baby sister can do it under the circumstances she was coping with, so can anyone.
Duh! Of course birth is possible without drugs. Who would think otherwise? 100% of women who existed prior to 1850 gave birth without pain relief, and around the world most women give birth without pain relief each and every day.
Kristen goes on to excoriate women who opt for epidurals during labor.
I knew that I wouldn’t use an Opiate or a Caine derived drug BEFORE I was pregnant, so it confused me as to why people would be so shocked by the idea of NOT using controlled substances when there was a baby inside me. It still confuses me, actually…
Her “confusion” might be cleared up if she learned something about physiology and pharmacology, but that’s obviously too much to ask, so let me make it simple.
There is nothing dangerous about medical use of opiates or ‘caine anesthetics. If Kristen wants to tolerate the pain of a broken bone or a 3rd degree burn without morphine, she’s welcome to do so. If she wants to tolerate the pain of a root canal without novocaine, she’s welcome to do so. But that doesn’t justify pretending that opiates or ‘caine local anesthetics are dangerous.
The same thing applies to pregnant women. Both opiates and ‘caine anesthetics are safe in pregnancy, too. There is no reason for a pregnant woman who breaks her leg or sustains a severe burn to forgo morphine, and there is no reason for a pregnant woman undergoing root canal to avoid novocaine.
These medications are also safe for babies. Were a baby to be experiencing severe pain (from surgery, for example) opiates are perfectly appropriate to treat that severe pain and local anesthetics are appropriate for local procedures that require pain relief.
In other words, physiology and pharmacology tells us that opiates and ‘caine anesthetics are safe for use in non-pregnant women, in pregnant women, and in babies. Hope that clears up the confusion.
Let’s address the deliberately misleading and outlandish analogies.
If you took your baby home and he or she appeared to be in pain, would you give the baby…would you even consider giving your baby the likes of morphine? epinephrine? fentanyl? stadol? bupivicaine? chloroprocaine? lidocaine? The are all in the class of Opiates or Caine derived drugs. Would you give them to your baby short of ABSOLUTE medical necessity once they are in your arms?
If my infant had severe pain, you bet I’d be giving him or her opiates or ‘caine anesthetics. You’d have to be a monster to refuse to treat severe pain in an infant.
And here’s a helpful hint: Treating severe pain IS an ABSOLUTE medical necessity. What other reason is there to use analgesics and anesthetics?
The above list of drugs are serious, you wouldn’t dream of giving it to your baby the day after your baby is born unless the risk of giving it, outweighed the risk of not giving it.
Wrong! I’m not sure what Kristen imagines the “risks” of not treating severe pain in infants to be, but we give babies (or anyone) pain medication not because the “risk” of leaving the pain untreated outweighs the “risk” of treating it. We give pain medication to relieve pain, PERIOD. We don’t encourage burn patients to do without morphine even though that’s what our ancestors did. We don’t encourage people to do without novocaine during dental work because that’s what are ancestors did. So why should we be wandering around berating women for having pain relief in labor, for no better reason than because our ancestors avoided it?
Of course, the santimommy heart of the piece is the title:
What if someone suggested morphine to help your newborn sleep?
Is anyone suggesting giving morphine to anyone who is not in pain? You wouldn’t give morphine as a sleep aid to ANYBODY, so why ask if you would give it to an infant? Because the question reinforces the sanctimommy self-satisfaction, which, of course, is what this piece is all about. Good mothers would never drug their infants to sleep with morphine so why would a “good mother” allow opiates injected into her epidural space to relieve your own agonizing pain? How about because one thing has nothing to do with the other?
Imagine if we asked sanctimommies:
Would you feed a newborn a kale smoothie the day after it was born?
Think about the risks of doing that, everything from aspiration to severe GI pain. So if you wouldn’t feed a newborn a kale smoothie, how can you justify drinking one while you are pregnant?
No doubt a sanctimommy, in her own defense, would point out that a pregnant woman drinking a kale smoothie is very different from a newborn drinking a kale smoothie; the mother digests and metabolizes the kale so the baby doesn’t have to do so; that the placenta is not a sieve so that the kale itself does not get into the baby’s bloodstream; and that the chemical components of the digested kale are safe for babies.
Guess what? The same principles apply to the opiates and ‘caine anesthetics in epidurals.
Let there be no mistake about the inevitable conclusion: the fact that a woman refuses an epidural does NOT make her a better mother than someone who has one. What determines the quality of a mother is how she raises the child, not what she does to treat severe pain while pregnant.
If you don’t want to have an epidural, don’t have an epidural. But if you think that marks you as a good mother, think again. It merely identifies you as a gullible consumer of natural childbirth propaganda.
I just want to point out that there are very legitimate reasons NOT to have an epidural during labor. I would never dream of criticizing another woman’s choice to have an epidural. I’m all for relieving unnecessary pain. However, sometimes reading your blog I feel criticized for choosing natural pain relief during labor. To make a long story short, I had an epidural with my first born and it was by far the worst part of the experience. It nearly killed me. My baby was perfectly fine even though he was stuck, but I had a terrible reaction to the opiates in the epi, and I don’t respond to ‘Caine medicines. I couldn’t even open my eyes to respond to the doctor showing me my beautiful new son. I couldn’t hold him for many hours after delivery because I was too out of it. I have no doubt it contributed to my crippling PPD. My point is, though epidurals are GENERALLY safe, there are real risks and if women decide they don’t want to make those risks for whatever reason, she shouldn’t be made to feel stupid for doing so. My family thought I was crazy to be hesitant to have one and they all breathed a sigh of relief when I gave in after 14 hours into an induction. They were so relieved when I turned grey and my blood pressure plummeted and I couldn’t even open my eyes to respond to anyone. Or when the doctors and nurses took perfect care of my perfect baby and failed to notice for a good 15 minutes that I was in trouble. I know I’m the exception. Most women have great experiences with epidurals. Just please acknowledge that the exception does exist.
For the record, my other two sons were born in the hospital, one with a CNM, one with a family doctor, both thankfully were textbook births and the pain was well controlled through accupressure and massage and I haven’t had a recurrence of PPD.
Why do you feel criticised? What about this piece undermines your choice? I really don’t understand.
“It merely identifies you as a gullible consumer of natural childbirth propaganda.” The word “gullible” is generally considered an insult.
I’m very sorry about your reaction to the epidural. I feel the same way about the Gardasil shot. Everyone kept telling me to get it and when I finally did, I was one of the very few women who had a severe reaction and almost died. Unfortunately, there are real risks to everything that we do…even walking outside in the morning. This article was simply showing the true facts about an epidural and defending women who make the choice to get one. It’s unfortunate that you feel criticized by this blog because it was in no way attacking you or anyone else who chooses natural birth.
Considering the amount of physiological and psychological distress pain causes, yes, I would definitely give my baby morphine.
Of course morphine and the like are dangerous. That’s why there’s such strict guidelines regarding its usage.
I really wish people would do more research before decrying the use of “harmful” medication, especially one so many people rely on for very good reason.
I agree with you one hundred percent, and know that I’m no less of a woman or a mother for having chosen to have an epidural. But seriously, painting every woman who chooses to have a natural childbirth as a ‘gullible consumer of natural childbirth propaganda’ is asinine. There are other reasons women choose not to have an epidural than just buying in to some fetishized notion of motherhood. Just because epidurals exist and are safe (not to mention AWESOME) doesn’t mean that we *have* to have them or that women who don’t utilize them are uneducated idiots. The discussion ought to encourage and allow women to make informed decisions without shaming their choices, as long as they know all the facts. Let’s just not drink any koolaid ever, you guys. No matter who offers it.
I am one who didn’t chose one, simply because I felt I wasn’t having pain enough for an epi. Stadol and Demoral (before I had a reaction to the Demoral) did enough for me, and sometimes I didn’t need that. I don’t count myself a special snowflake because of my choice.
The blog can still be seen here:
http://webcache.googleusercontent.com/search?q=cache%3Akind-birth.blogspot.com%2F2013%2F09%2Fwhat-if-someone-suggested-morphine-to.html&oq=cache%3Akind-birth.blogspot.com%2F2013%2F09%2Fwhat-if-someone-suggested-morphine-to.html&aqs=chrome..69i57j69i58.4029j0&sourceid=chrome&ie=UTF-8
I’ve been coming here for a while, and I just have to say: I adore you and LOVE your blog!!
Thanks!
I must be the worst of the worst then, as I stayed on strong opioids from pre-TTC through both pregnancies, got an epidural and fentanyl during labor, and both babies got morphine for a few weeks afterwards. Oh noes!
You know what? No one would ever know unless I told them. The NCBers see me nursing and wearing a wobbler (not an infant, not a toddler) and see my DS 3 riding his 2 wheeler, and think I am just like them. They often share their nasty opinions of others with me, because they look at my kids and I and assume we are NCB, AP, and anti vaxx. I love disabusing them of this idea.
End of story, guys. She deleted her post. I was wondering whether she would do so.
Anyone screen cap?
Because if she has a book out, she isn’t going to go away.
”What if someone suggested morphine to help your newborn sleep?”
My late father, born and raised in small-town Southern Italy, told the story of babies being given some sort of poppy extract, wrapped in cloth, to suck on. Herbal medicine, I guess.
And paregoric was legally sold over the counter in the US until 1970!
http://en.wikipedia.org/wiki/Paregoric
Its main ingredient was tincture of opium, and it was used for, among other things, quieting teething or colicky babies.
Got links for me, anyone? Cause I’m arguing with this chick now. She’s pulled the mayo clinic. I have to confess, this is not my normal topic for debate and I’m not very knowledgeable about it.
…links about what? Kale? Pain medication during pregnancy? During childbirth? During infancy? Later?
Links about the safety of epidural.
Check the Adequate Mother’s blog, she wrote a detailed post awhile back. She’s an anesthesiologist.
What subject, do her links go to the real mayo.edu website? There are lots of fake Mayo claims out there….ps used to work there
I had an epidural and a pregnancy full of kale smoothies! Do I get a prize?
“Expecting Kindness” or maybe her book should be “No Pain, No Gain”.
“Expecting Kindness” by Kristin Dibeh AVAILABLE NOW!
“Expecting Kindness”
My fledgling book, for sale now on http://www.createspace.com as well as http://www.amazon.com.
Is there a correlation between the number of candles surrounding the newborn and the I.Q. of the midwife?
http://www.upworthy.com/see-how-a-bunch-of-students-got-vaginas-banned-at-their-university
Er… what? I don’t understand what these students were complaining about or felt the need to prove. Perhaps they should’ve put pictures of yoni cupcakes instead.
I think most college students feel the need to prove something… I am inclined to think this was just their issue.
I think most college students feel the need to prove something… I am inclined to think this was just their issue.
I don’t get it. They wanted to dispel society’s idea of what a vagina looks like. Last time I checked half of society has one and I’m sure most of the other half has seen one before. What’s to dispel?
Exactly. Where the hell are all these airbrushed vaginas they keep complaining about?
Perhaps they are seeing a lot of them online and not a lot of them in real life..
Porn. Even if they don’t personally care for looking at porn, chances are their SO does.
Yeah, but it’s not the :”beauty of the vulva” that attracts guys to porn.
Some guys are extremely turned on by certain things, and repulsed by others. Including the appearance of the external female genitalia. Some are do not personally feel this way, but feel that they should feel that way and act upon it. Including the appearance of external female genitalia. Generalizing what and why ‘all men’ use porn is not going to yield applicable results. Some porn specializes in showing the INTERIOR female genitalia. Now just think about that for a second, and then think about whether male attraction to images of the vulva is really at all rare or odd.
For the love of god, I have seen young men argue fervently and publicly that their girlfriend’s (very large, supposedly natural) breasts were either A: sexy because they weren’t made of fat, but ‘healthy breast tissue’ instead, or that their girlfriend’s larger breasts disgusted them because they were made of fat rather than muscle. Imagine being the woman in question, and perhaps having your only cultural source about said breasts being the young man and their mutual friends. There is no bottom limit for physiological knowledge or preference.
And some men are attracted to big feet.
For pete’s sake, of course there is variation in what people find attractive, but it is absolutely a minor thing.
You talk about the extreme porn (inside shots) for example. Yes, it exists, but a) it’s actually not aesthetics, it is anything but, so doesn’t contradict my claim that guys don’t care about it, and b) it is absolutely rare. Contrast that to the explosion of “amateur” porn that exists, which is not about airbrushing at all.
Jeez, amateur porn is for the most part killing the porn industry. Fewer and fewer people are willing to pay to see models and actresses, and are perfectly happy watching home videos and digital camera shots. The subjects are not perfect in any way, but guys still flock to it in droves.
There’s enough women who find uncircumsized penises to be disgusting and ugly that it has become a cultural norm in many countries. Pretty sure the same can go for types of vulvas, even if many people aren’t actually all that personally particular about foreskins or labial symmetry. How big a deal is armpit hair, after all, when it comes to sex? Forearm hair? Leg hair? Not really, but you can still have entire countries that feel strongly one way or the other about it, and therefore a cultural expectation that your body match the accepted look.
‘Aesthetics’ can be a code word for healthy or normal, and porn is where people get the most images of explicitly naked genitalia. Aesthetics can also just be aesthetics. Porn is a crafted image, the genitals are chosen as much as faces, breasts, and limbs are. Do the faces of actors and actresses have nothing to do with how we view attractive facial features?
My ex used to love watching amateur porn, and I can say for sure that I never saw anybody in it who made me feel unattractive in comparison. 😉
I’m not sure I like their approach, but I do understand where they were coming from. I’ve worked with many young women who feel like their vulvas are ugly or abnormal because they are different colors or less symmetrical than the vulvas they see in porn, or even in the drawings in health class text books. The fact that vulvar cosmetic surgery exists is proof to me that our society has a false ideal of what a vulva should look like.
I’m not even sure if it’s a false ideal of what a vulva should look like. I think vulvas simply look like vulvas, and they are kind of ugly. In the same way eels and hairless cats are kind of ugly. It’s how they are supposed to look. But it’s not aesthetically appealing. Of course, I agree with Bofa that visual is probably the least important sense when dealing with a vulva. But there have been prior attempts at making vulvas and vaginas more “appealing” to other senses as well – douche, vaginal cleansing cloths, etc. I don’t think it’s just pornography that has caused women to think their vulvas need cosmetic surgery. I think in general our society expects a certain appearance from women, and anything that is wrinkly, saggy, weird colored, etc. doesn’t fit into that mold. So to that end, I think airbrushed pictures of models and ads for wrinkle creams are to blame in the same way that porn is to blame.
I think these days most young men have looked at hundreds belonging to porn actresses before they see one in person.
But is this driven by guys? See the post by (No longer) Pregnant Guest below, that talks about how WOMEN think their vulvas are ugly, and it is attributed to what WOMEN see, in porn or books.
I don’t know the origins of it, but as the textbook example of a guy who looked at hundreds of porn actresses before seeing one in person, my response is, huh? Not even on the radar.
On the list of things that guys care about, the “color” or “symmetry” of the vulva is pretty darn low on the list. Even from a sense perspective, it will rate below touch, smell, taste, and maybe even sound. And that is not even considering the fact that all of these factors are well below other considerations, such as accessibility.
You may be right, I don’t know. It takes all sorts. I’m sure most chaps aren’t that fussed about it but a few are and it only takes one unpleasant comment for some girls to develop a long term complex. I’ve heard several men, particularly my age (25) and younger, say some pretty horrid things (usually in pubs etc) about women they’ve bedded not being as, er, tidy as they would like. of course they are classless tools to speak so in public but hard to believe that even more eligible types don’t feel similarly. But come to think of it I’ve heard a lot more women make negative comments about themselves and I just assumed it was due to some crass comment but perhaps it wasn’t that at all. I suppose it isn’t strictly a modern problem..who was that art critic that wouldn’t consummate his marriage because his expectations of a Grecian statue appearance were not met
Sound? Lmao
You’re thinking of John Ruskin, who was probably attracted to prepubescent girls.
http://en.wikipedia.org/wiki/John_Ruskin#Sexuality
I heard a local (Australian) discussion on this on the way to work this morning. Women’s Health Victoria has developed a Labia Library to counter the increasing trend for women to get labioplasty.
I expect other posters are correct – that ”normal” has been skewed by images on on-line porn.
There are already large libraries of normal vulvas to look at, and a study that showing them to women who request labiaplasty doesn’t make them feel any better about their own.
BMJ article a few years ago…I think 2007 334;1090-1092.
I’ve had a cosmetic surgery (not on my labia) and I would agree that seeing pictures of other people’s variations of normal would not have convinced me not to do it. Neither did people telling me I looked fine the assuring me that what I wanted to have “fixed” was hardly noticeable. If the students want to take this up as a cause I don’t begrudge them that. I’m not sure it’s a cause I would put my time and energy into but, to each their own.
I’ve been thinking about this.
We can all see noses, all the time.
Rhinoplasty remains one of the most requested cosmetic surgeries, and the noses operated on are usually “normal” in size and shape when compared to the range of other noses out there.
Which is why I don’t think the answer to cosmetic labiaplasty (as opposed to corrective surgery of functional problems like Lisa Cybergirl’s friend) is to have pictures of lots of vulvas available for women to look at.
The issue is that the women don’t LIKE their vulvas the way they look, not that they think they have a uniquely horrible looking vulva. Saying “hey! Your vulva a variation of normal” doesn’t make them feel that their vulva is any prettier, any more than saying “hey, I know lots of people with noses like yours!” is the way to persuade someone not to get rhinoplasty.
The ethical question of whether the feeling that you have an “unpretty” vulva is best treated with cosmetic surgery is a different matter.
I too, like the authors of the first paper I linked to, have issues with a culture that says FGM is abhorrent, but removal of large parts of the clitoral hood or labia minora for cosmetic reasons is A-OK.
I didn’t get a chance to read the study but personaly, I don’t think it’s fair to equate FGM with cosmetic labiaplasty One is (from what I’ve heard) a forced or at least heavily coreced procedure that often happens to pre pubescent girls and greatly interferes with sexual function. The other is a procedure being chosen by adult women and while there are risks it could interfere with sexual function, these risks are mitigated and women can evaluate them for themselves. Even if the women choosing to have labiaplasty are bowing to societal pressure to have prettier vulvas it’s not quite the same as being forced. If there were some culture or religion that required 12 year old girls to undergo rhinoplasty to leave them looking like Micheal Jackson, I would be against that but, I still wouldn’t be against elective rhinoplasty for American women. I think I do undetstand your overall point though and would agree that ethically there can be a fine line. On the one hand if women choose to engage in any form of body modification they should have ownership of their body. On the other hand some modifications might be unethical and how much as a society should we condone and technology make possible? I went back and forth with ethical issues regarding my own surgery–was I giving in to pressure to look a certain way, was I setting a bad example for future daughters I may have? I’m sure some women wouldn’t agree with my reasoning but, I would do the surgery 10x over given how I struggled for so many years to like that part of myself (and I’m convinced in my case all other options were exhausted) and how happy I am with the results. I don’t know but, if my vulva were my area of concern, I may make the same choice.
Sorry my mistake the BMJ article was about FGM and labiaplasty being rather too similar for comfort.
Interesting stuff.
http://www.ioe.ac.uk/Study_Departments/SIG_Gender_SexCulture_Lei-Mei_Liao.pdf
http://www.ioe.ac.uk/Study_Departments/SIG_Gender_SexCulture_Lei-Mei_Liao.pdf
http://pubmedcentralcanada.ca/pmcc/articles/PMC3533050/pdf/bmjopen-2012-001908.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2084124/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020045/#__sec3title
Some women do have labiaplasty for functional rather than cosmetic reasons. A friend of mine was literally unable to wear pants without pain (and was often in pain anyway). Her surgery greatly improved her quality of life.
I come from a family for whom the ‘caine drugs are less than effective. When I had my BC implant put in for the first time, they needed to inject roughly 10ml into the surrounding tissue to get it fully numb. My arm took longer to heal from the added liquid than it did from the implant. When I needed it removed, we tried a longer wait time before my OB/GYN started the minor procedure. In the middle of the procedure, I found out that one of the nerves wasn’t quite as numb as I would have liked it. (I started getting pain between a 4-5 on the 10 point scale.) My doc offered to shoot me up with more ‘caine, but I honestly found the thought of having the implant half-in half-out of my arm much more disturbing than just finishing the procedure. The nurse and doctor finished up the procedure while asking me every few minutes if I wanted more pain medication. I focused on visualizing scenery from Yellowstone, breathing, and saying “Nah, I’m good” until I was all patched up and ready to roll.
Notice, though, that I don’t take my odd series of events and use them to pontificate that EVERYONE who undergoes minor surgery should be willing to deal with pain. That’s just stupid.
Wow! I have something similar – lidocaine doesn’t work properly for me either (neither do quite a few other things + I have stupid allergies). I love my current dentist because he was able to cut the pain of fillings by about two-thirds, gave me frequent rest periods, and took me seriously when I told him about my prior experiences.
Just out of curiousity, are you red-headed? I think there’s an association? Maybe.
Nope, though I probably carry the allele for it. There was a new (larger) study about anaethesia and red heads that disproves that link and points to a gender-based one, but since my google-fu is only turning up a news article about the study, I’d leave it as a maybe.
I do have a joint condition that appears to be linked to increased resistance to lidocaine, so I tend to blame that and the family history of resistance to drugs/alcohol for it.
Yeah, when I had a couple of stitches after the birth of my daughter I discovered that I do not go numb easily. After the third injection I just had it done on gas and air so I could get it over with. My mother told me afterward that she and my grandmother also have issues with those not working. Thanks Mom. She also apologised for not believing me when I said it still hurt when I had stitches in my thumb as a kid.
Same here! I was in my mid-20s before I realized that having a filling filled wasn’t supposed to start hurting halfway thru. On the plus side, by the time I’m finished driving home from the dentist, my face is no longer numb.
Who the hell uses morphine as a sleep aid? These dummies drive me nuts. I give babies morphine for pain all the time. It’s safe and effective.
I gave birth without an epidural because pain meds and anesthesia in the past has made me really sick and feel awful for days. My son’s heart rate started having issues when I started pushing and I had a vacuume extraction, episiotomy and a 3b tear all with only some lidocaine. The natural endorphins did “work” but they left me really jittery and weirded out. Fentynal and morphine leave me puking for days. Next time I might dicuss more pain relief options, any ideas on what drugs might be better for the puking and two day hangover?
Anesthesia consults are usually available for situations like this. I wouldn’t want to vomit for days either.
I think that epidurals are supposed to be better for those who have problems tolerating morphine and fentanyl. My mother cannot tolerate these either, and she has lots of problems with GA. She has been holding off on getting her knee replaced because she fears not having adequate pain control since she vomits uncontrollably from opioids as well. I have been encouraging her to have a frank conversation with her orthopedist and anesthesia, but thus far to no avail. I hope that you can find something that works.
My mom had an epidural during her knee replacement surgery. But they did take it out after a while, so for pain control post-op, obvs she’d have to come up with something else.
The part about putting anyone to sleep with morphine really made me laugh.
I wouldn’t feed a Kale smoothie to my worst enemy…unless that is what they wanted.
I have never had an epidural because I simply didn’t want it. Didn’t think I was a special snowflake because of it. When people gush “WHAT??? You DIDN’T have an EPIDURAL?” it just kind of shocks me. It is no big deal to me.
Pain relievers can be very helpful during labor. My first two deliveries were inductions due to pre-enclampsia. I was given Demerol with my first after laboring a while, fell asleep, and woke up with my baby crowning. Same thing with my second. I mean, what could be better? Falling asleep and waking up to a crowning baby?
The only down side was my babies were a little sleepier. They are alive and very well today.
Made me laugh too-if it relieves your pain so you CAN rest then it’s a plus but its not a sleep aid. Anyway, I have heard so many doulas and homebirth midwives suggest taking a couple Benadryl in early labor so a woman can be rested for the pushing part. So using Benadryl to sleep IS ok, but actually treating pain is BAD.
Because they can buy benadryl OTC silly, if they can’t prescribe it or administer it, then suddenly it’s not ok.
True! Same with the ginger bathes to slow labor or the “herbal induction pill” that midwives at the local birth center give patients (it’s supposedly from Europe).
I would have had the epidural if I was suffering badly but my contractions were only horrible for about 20 seconds and I had 2 minute breaks in between. None of those back to back contractions for me thank God. Also not keen on the idea of not being able to move/feel my legs as I used to get sleep paralysis in my teens and it terrified me. Never want to experience anything like that again. I had two half doses of nubain instead which I both loved and hated. First dose I had at about 5cm and it was lovely.. I only remember feeling silly, telling myself a joke and giggling myself to sleep. I asked for another dose right after doctor broke my water in anticipation of the pain getting really bad really fast and…nothing. It made no difference at all! Felt so cheated.
It is a gamble refusing the epidural.. pushing my son out hurt a lot more than I thought it would and it only took us five minutes and he was very small so I didn’t tear, I think I’d have been traumatised if it had taken the usual hour or two for first timers.
OT but not really, when my son was six he broke a tooth in the back of his mouth and until the dentist could see him the prescription for a opiate pain reliever was phoned into my local CVS.
Forgoing pain relief would have made an upsetting situation intolerable.
When she was 13 my daughter broke her lower arm(both bones) her fore arm looked like the letter L. The on-call orthopedist had to be called in to reduce the fracture and they put her on a morphine drip because he was going to be a while(bad traffic). I can just imagine what the wait would have been like with out pain meds. With them she was talking and even joking with the ER staff. It made a difficult situation a bit more bearable.
We just got intra-nasal Fentynal in my ED (have used it previously in other EDs). Works faster than Morphine and no need for an IV. Kids will go from screaming and crying (from broken bone pain AND being scared of shots) to ” I feel better. Thank you” I hate seeing kids in pain and anything I can do to alleviate it, I will.
Wish they would have had that for her, she hates needles, always has and the IV was not fun to have them put in but I have to say the ER staff were all lovely.
She was a bit loopy when we got her home but I will take loopy over screaming in pain any day.
We use nasal Fentanyl for kids too, and topical anesthetic cream for IVs (if there is time), and nitrous oxide (great when it works) – pain relief for kids is much more emphasised than it previously was.
But the woman in this post is not talking about health care, she’s talking about folklore.
Well, when I broke my foot, I went without pain relief (almost) all the way. I rock, your daughter sucks. That must be it, right? It can’t be that I broke my foot in a place where the pain was fairly tolerable, instead of somewhere where anyone would have howled in pain. Right. We are created all equal, so all fractures are created equal. The fact that I didn’t need pain relief automatically translates to “no one ever needs it because it’s unnatural’.
Sad thing is, there are idiots who migght actually believe it.
I walked around on a broken foot for a week before I realised it WAS broken! I win.
You don’t get medals for not taking pain relief, as I keep reminding patients who come to me complaining of pain, and then get offended when I suggest painkillers “because I’m not really a tablet person”.
So….you came complaining of pain, and expect me to wave a magic wand? ( not that I say that, of course).
Oh my, thank you, Dr Kitty! I am so glad that I wasn’t the only one who didn’t realize such a thing. When I broke my (other) foot 15 years ago, I figured that the swelling would just go down. There weren’t any bones cutting through the skin, so it couldn’t have been broken, right? I even traveled for 7 hours standing upright in the train. At the end of the journey, kind strangers dragged me out… to the cab and then, it turned out to the BROKEN elevator of my block of flats. 7 floors up on foot.
I sure could have used some painkillers when I was climbing those hellish stairs up.
I really can’t see what’s the bad side of relieving someone’s pain. Our revered ancestors would have KILLED for what we have now.
I apparently developed such tough calluses going barefoot for my whole childhood that I once had a several-centimeter shard of glass in my foot for several hours. I only noticed when I came home and it went clink clink on the kitchen floor.
I tumbled for 2 weeks on a broken hand without knowing it. I win!
I fractured my shin and didn’t realize it until I had a different injury and the doc thought I lied to him about never breaking anything before.
When I fractured my knee, the first couple days it didn’t hurt much, then the first x-ray missed the fracture. The ER wrapped it up in an ace bandage and told me I’d be fine. Between the delayed diagnosis and my drug allergies, I wound up with no pain relief at all other than ice packs. (It only really hurt for about 2 weeks, after that the pain was tolerable.) You know what I think about my “hardcore” experience?
It was fucking hell. I went to the ER in the first place because my pain was unbearable. I’m STILL pissed about the 2 weeks of agony. I could barely crutch from couch to bathroom, I couldn’t sit in a chair. I gave myself chillblains with the ice packs that were worse than any winter has ever caused, which meant shooting burning pain from the chillblains waking me up at night.
If I had it to do over again, I’d have thrown a fit in that hospital and refused to leave until I was appropriately splinted and medicated, negative x-ray or no.
Epinephrine is not in fact either an opiate or an anesthetic which has the syllable “caine” in its name [I don’t get this “caine derived” nonsense. What “caine”? As in “cane sugar” maybe? ] Medications which are chemically similar are often given somewhat similar names which distinguish them as being in the same family, but they aren’t derived necessarily from the same source or are the same chemically. Pork and steak are both kinds of meat, but not from the same source.
Epinephrine is another name for adrenalin; it is produced naturally in the body and has some very specific and important uses. Whether she likes it or not, Kristen is awash with epinephrine.
I think she gets confused either because it is added as a vasoconstrictor to LA to allow lower doses to be used, or because she’s thinking of amphetamines which are obviously not a good idea in pregnancy.
Either way, it is again all coming from the Chemical Dependency Counselling background rather than from any medical or pharmacological knowledge.
I’m glad I’m not the only one who caught that. Epinephrine in her med list made me laugh. Literally. The rest just made me role my eyes.
The NCB advocates have to come up with some reason to malign epidurals, and it seems there’s not much evidence to support their position. On The Bump and other pregnancy sites I see over and over “I don’t want an epidural because it could slow my labor and I’ll end up with a C-section.” Hell, even *I* was worried about that despite knowing that recent research didn’t show an association between the two. So if epidurals don’t slow labor and don’t increase the risk of a C-section then you have to find some other way to convince women not to get them. What better way than to insinuate or claim that they’re dangerous for babies or make them drowsier or inhibit breastfeeding or SOMETHING really terrible and awful.
They are really doing women a disservice by convincing them that safe, effective pain relief should be avoided during childbirth.
Sort of OT, I was just listening to a programme on BBC Radio 4 about Ada Lovelace.
As she lay dying fron uterine cancer, aged 36, an atheist, her mother Annabella withheld morphine until she converted back to Christianity.
It made me very sad to think of that, having to choose between your conscience and pain relief.
http://en.wikipedia.org/wiki/Ada_Lovelace
….
Because sure, that is exactly what God wants, right?
I would not have blamed her for lying just to get the drugs. I think I would. Then I think I would have kicked my mom out of the room.
Reading the entire piece the impression I get is that she has an earnest belief that narcotics are really, really bad.
So she trained to be a drugs dependency counsellor, but found that perhaps the actual reality of addiction is that just telling people drugs are bad for them doesn’t work so well. At least, that’s how I read “lacked the addiction necessary to actually have credibility in that field”.
So, she looked about for a field where she could use her skills (apparently consisting of repeating “drugs are bad!”). Presto chango instant NCB educator!
She seems to have conflated drug use with drug abuse.
Also, while 12 step programmes have sponsors, by no means is it obligatory to be in recovery yourself to provide recovery services (and, as far as physicians prescribing substitutes for heroin, having a history of substance misuse would be impossible).
Which is why I think that “I didn’t have credibility because I’m not in recovery” is perhaps not the full story of why she left that field.
Obligatory South Park quote 😉 “Drugs are bad, mmmkay?”
Ironically, her blog is titled “Kind Birth Services.”
I suppose we should be grateful she isn’t running “kind cancer services.”
By the way, anyone who would use the decorative “Sunshiney” font to “educate” folks deserves to be laughed out of the room.
I could *not* read that page with sleep-deprived eyes. Sounds more&more like a good outcome 🙂
Maybe she meant *Kind-of* Birth Services.
But don’t let confusion stop you from spouting off like you actually know something.
It’s like she doesn’t know the difference between crack and an epidural anesthetic. ‘Cause you know, all those crack heads are hooked up to epidurals…that’s how that little rhyme got started “step on a crack, break your mother’s back, right? Or maybe she think they are slipping thalidomide into those Zofran pills all those rotten mothers who are definitely going to get all high on epidurals during their labors are getting.
Bradley teachers call novocaine, et al “cocaine derived drugs” like they are actually made from cocaine. So that’s part of where it comes from.
That’s dumb. I would have gotten tossed out of class if I had ever heard something like that! Why do people feel the need to LIE like that?
I think for the most part, they are just passing on lies they have been told. It’s not like they are qualified to know better unfortunately.
True. I forget not everyone is a complete science nerd like me.
And not everyone cares if she gives accurate information. This woman is a doula; it’s not like she’s actually accountable for anything.
Cocaine soaked swabs work well for unstoppable nosebleeds…you can usually find some in the controlled drug cupboard of an ENT ward.
When I was 38.5 weeks pregnant, I was in an accident and suffered a compound arm fracture (and I milder foot break). They induced so I could more safely undergo arm surgery (ortho thought operating on someone that pregnant for 3 hours was risky), and I was loaded with morphine throughout labor. It was hilarious to me (later) that I could tell the morphine was wearing off when I felt the contraction pain – it was worse than the compound fracture.
Underlying all of this is the idea that labor pain isn’t “real” and deserving of relief. They would never make this argument about root canals, broken bones, etc.
That must have sucked royally. Recovering from two fractures and taking care of a newborn? You truly deserve a medal!
Thanks. It was bad for a few weeks, but I had lots of help (mother, MIL, husband on paternity leave, aunts), plus anti-depressants 🙂
I’m going to ask something that is none of my business.
Were you given the option of a CS (either GA or spinal) instead of the induced labour?
Because, if it were me, I think I’d have preferred to go to sleep and wake up four hours later with a baby and a fixed arm than what you experienced.
Of course, that may never have been on the table, or not something you would have been interested in even if it were.
I’m just being nosy, so don’t feel you need to answer.
Or maybe a brachial plexus block and some fetal heart rate monitoring…
I don’t really remember if they mentioned just doing a CS. However, I really wanted a vaginal birth (this blog has really helped get rid of the guilt and helped me understand why I thought that was so important), so I probably would have induced anyway. I ended up with an emergent CS, so in hindsight, just going for the CS would have been less traumatic and scary. I stayed awake for both surgeries because the idea of going under scared me. The arm surgery was actually pretty interesting to listen to. CS, not so much fun.
In that case, you deserve an extra BIG medal, because you got labour pains, CS recovery, a compound fracture and two regional blocks, which is more than anyone should have to have in one day.
Fair Play, and I appreciate your answer.
gahhh you were awake for the arm surgery? I broke my ankle last year in three places and snapped some tendons- no way could I have been awake for that (putting in a plate and screws). Respect!
I actually was offered the choice, opted for an epidural, but the anesthesiologist was unsuccessful, and Number One Son was born with GA for the C/S. Second birth, second attempt at epidural, which I didn’t want [I quite like going to sleep and waking up with a baby — a terrible admission for a licensed Lamaze instructor!], but it too didn’t work. By my third C/S, with my history, I got general anesthesia without any argument. But just recently, I had a hip replacement and had to fight for my general anesthesia, with several doctors issuing the direst warnings. Since I have had a ruptured intravertebral disc right at the level of epidural insertion ever since 1986, I managed to convince them, but it was tough. [My post-op course was completely uneventful, and the staff was amazed at how little pain medication I needed, btw.]
I took my son into a dentist who used general anesthesia. He needed dental work done and literally could not hold still enough to complete a cleaning let alone have a cavity filled.
The dentist observed him and had a brief chat with me about the risks of GA. I was entirely in agreement that GA was a serious step to take, but a needed one. Yes, of course we give our children pain relief and GA drugs when they are indicated.
She’s playing up the familiar narrative that birth is DIFFERENT, birth is an exception to all of the rules. Birth is the one time that we should embrace pain and refuse pain relief. There is an additional theme of “Won’t anyone think of the BABIES?”. Well, yes, we do think of the babies which is why the pain relief used either has no effect on the baby (epidural/spinal) or has a very short period of effect.
And no, birth is not different. It is unique, but it’s uniqueness does not make it transcend biochemistry, pharmacology, physiology and so on. A woman’s body works the same way during the process of birth as it does every other day of its life. A woman still feels pain. When tissues stretch, she feels it. When tissues tear she feels it. When a huge muscle rams the baby first against the cervix and then through the pelvis, she feels that.
If giving your baby (or your about to be born fetus) pain meds is bad, then shouldn’t an epidural, which allows for use of amounts of med so low that they’re virtually undetectable in the circulation, be a good thing?
“the chemical components of the digested kale are safe for babies.”
Wait, kale has chemicals in it??? Gamechanger!
ugh I am having memories of working at a burn ward, with little kids screaming stuff like “you hurted me!” 🙁 of course kids need pain relief. Your heart breaks when you see kids in pain. Its hard enough to watch a baby who is teething.
The burn ward is my worst nightmare. We ended up just in the regular pediatric unit for my daughter, thank God, but passing through the ward to the treatment room was more than enough. What awful, painful, terrifying injuries.
Kids in a burn ward…that would break my heart. 🙁 The pediatric oncology ward where I volunteered was difficult enough, but the burn ward. Seeing children you don’t know in pain breaks the heart even though they’re not yours.
I was able to sleep through most of my second labor thanks to an epidural. Does she think that I took it as a sleep aid rather than for pain relief? What a twit!
But why did you want to sleep during labour? RealMamas stay awake for 48 hrs of labour, if they have to.
It was the best sleep that I had in nearly two months.
So they can grunt and vocalize and have pics and video taken of themselves naked to be posted on YouTube. A peacefully resting woman in labor with the help of an epidural undermines their self imposed value system!
I still haven’t gotten over that woman by the stream crapping her baby out on the rocks.
It didn’t look more comfortable than being in a hospital bed
I hope none of them suddenly pooped, peed, or vomitted while ebeing filmed…
There was someone whose husband taped the popping part.
I remember reading somewhere about how they used to rub paregoric or whiskey on the gums of teething babies…this was back when the “Greatest Generation” were babies, and they turned out to be the “Greatest” so these sanctimommies clearly need to get schooled by some great-grandmas.
I know that my teething pain as an infant was treated with whiskey on the gums. I lived to tell about it.
Whisky on the gums or in the bottle is still the go to solution for a lot of Irish Grannies, along with Guinness to help post natal anaemia (which it doesn’t! Guinness is not a good source of iron).
We’re gently trying to suggest to patients that they should feel free to ignore their mothers’ alcohol related home remedies, at least when it comes to giving booze to infants and nursing mothers.
Do, however feel free to listen to granny if she tells you a rash looks like measles or a cough sounds like whooping cough-they’d good at recognising VPD that most of us haven’t seen much of recently.
“One of my classes was pharmacology. Classifications of drugs and how they affect the body.” Hate to break it to her, but she still doesn’t know crap about drugs, pharmacology or pharmacodynamics. What a twit.
Does she say if she passed the class?
Adrenaline (Epinephrine) is a catecholamine, not an amino-amide local anaesthetic, for a start.
Also, her education was for the express purpose of counselling people addicted to opioids, cocaine, alcohol, methamphetamine and benzodiazepines.
“Drugs are bad, mmmkay?”
Yeah…except when they aren’t.
Somebody whose whole perspective is about misuse and abuse of drugs and their negative effects isn’t exactly best placed to be able to judge when narcotics ARE appropriate.
There is a reason anaesthetists don’t ask a drug counsellor to sign off all orders of narcotics first.
You’re right. She most likely learned what I like to call “ideology-driven pharmacology,” which is just a fancier way to say “Drugs are bad, mmmkay?” I’ve had those classes myself… in my previous career I worked with at-risk youth and was a “Certified Prevention Professional.” We learned about drugs but only in the context of How Drugs Will Ruin Yer Life and Then You Die. That’s what sparked my interest in pharmacy. I liked learning about the drugs, and was less interested in learning the “prevention” part. So I became a pharmacist – everyone knows we just push drugs and want our patients to have All The Drugs.
When my baby got burned, I actually ran into the ER screaming, “someone get morphine, someone get morphine!” They did. We all felt much better.
Excellent breakdown of the kale analogy, by the way.
Good for you! You fought for your baby!
Well, I didn’t really have to fight; they weren’t going to deny it. Helping her pain was just my first priority, before I could concentrate on what they were telling me about the injury and the prognosis.
Poor little thing! I’m glad the morphine helped. I can’t imagine not wanting to relieve your child’s pain, no matter what the age. We gave our son gas drops from the get-go to help relieve gas pain, and once he was old enough I would use acetaminophen and ibuprofen for his teething pain. I read so many things suggesting other ways to “handle” teething pain, but when he’s crying from the pain and unable to sleep, it’s time for medicine!
Oh seriously…I met someone who had something against infant tylenol, yet was down with giving her baby Hyland’s teething tablets. When I asked what was in them, she said “They’re homeopathic!” That’s helpful. Several years later, turned out some lots had high doses of belladonna in them…sure death’ll cure the teething pain.
My 7 month old gets dosed with Tylenol on a semi regular basis. If he’s unhappy and can’t sleep and we’ve fed, changed, burped and snuggled, it’s time for the meds. He’s teething right now, so the bottle just lives on the (high) counter. I don’t get these people that have screaming, unhappy babies for days because some random Internet blogger says it’s bad
I looked them up online. They mainly have lactose – sweet, anyone?
I had a hard time buying it that miniscule doses of poison were going to be as instantly effective as everyone was telling me. Aren’t sugar cubes cheaper?
You have no idea how many kids I’ve seen who are sick and sore and miserable, sometimes for days, and the parents have given NOTHING for pain.
You know, because they “wanted you to see how bad she is doc” or the idea seemingly didn’t cross their minds that a child with a fever of 39C and pus running out of his ear might benefit from some ibuprofen.
So no, making your child’s pain relief a priority is, in my experience, already one step ahead of many people.
Pus running out of his ears? It is SO good that I am not a doctor. *gag*
Sure, acute otitis media, pus behind the eardrum builds up, under a lot of pressure, child screams from pain, eventually eardrum perforates, pain is better but pus and blood come out and parents panic.
Co Amoxiclav for a week, no swimming til the perf heals (2-4 weeks) and the parents get told that acute otitis media is extremely painful, and I give a script for ibuprofen and paracetamol and suggest they keep the medicine cabinet fully stocked in future.
The ones who deny their child pain relief so I can see how sick the kid “really is” get an altogether sterner lecture, which boils down to “why the needless cruelty folks, I would have been perfectly happy to take your word for it. Don’t ever do that again”.
I can kind of understand the ‘wanting the doctor to see it’ because I received a lecture from a triage nurse for not doing that.
One of my kids perforated her eardrum with a plastic paintbrush handle. We went straight to the ER, were seen quickly and she surprised two doctors by being cheerful and talkative with a very obvious hole. Advice being to have a few check-ups with our GP to be sure that it’s healing and bring her straight back to the ER if she developed a fever within 2 weeks. Which she did. I gave her some ibuprofen because I will not leave pain and a 39 degree fever untreated. It was down to 38 by the time the triage nurse saw us, copped a lecture for giving her the ibuprofen, and ended up waiting 7 or so hours to be seen even though it was quiet enough for the very obvious drugseekers to be seen. (When I say obvious, I mean they were on the phone and selling their drugs after being seen while on their way out of the waiting room.)
I was plesnately suprised when ER took my sons pinalodian cyst pain serisouly and put him on Vicodin. Same for broken arm. My younger son when he has Kawaski was on opiates Q 4 hours.
I second Dr. Kitty. Seriously, if your child had pain and/or fever, TREAT IT! Our triage is set up such that kids with fevers get Tylenol or Ibuprofen right then (often an hour before they see me). So I (hopefully) won’t even have to see your child in pain.
We were on vacation in NYC with our then-20 month old when she suddenly began saying, “Mummy, my ear” and clutching her right ear. Our insurance (we’re Canadian) meant we could take her anywhere, NY Presbyterian was closest, so we loaded her in the stroller and 15 minutes later, we were in the pediatric ER. She was seen pretty much right away and the first thing the NP did, after quickly verifying that she did, indeed, have an ear infection, was give her a good dose of ibuprofen. I was really impressed — first ever ER visit with our little one, and they treated her pain right away. Good stuff.
I understand how fever is natural, and that it is a fighting mechanism, so, on the whole, you don’t want to medicate just to reduce the fever.
However, I don’t let that stop us from giving some medicine to the kids if their fever makes them miserable, which it tends to do, at least with the older guy. We never need a thermometer with him, because he presents a fever about as obvious as you can get (actually, his fever leads to VERY hot hands and feet, so that’s what I check; if I grab his hand and it is burning hot, I check the other and a foot. If they are hot, he’s got a fever. The other thing is that a fever takes him out. He is miserable. However, ibuprofen works like a charm (not so much acetaminophen), and that brings him back to life.
The younger guy, however, doesn’t present so clearly. We’ve probably missed fevers on him, because he hasn’t acted all that sick.
Short answer: I agree on medication for pain relief, including misery. I feel so awful all the time when my kids are miserable, I’m glad we have things that help, because we are so helpless in so many ways.
…of course, she was also examined by another NP and a pediatrician, who also listened to her chest, and we were introduced to two more nurses, and a child life specialist, who gave my daughter her own personal DVD player, after asking us what she’d like to watch, (“Uh…Elmo?”)…and then a dose of Clavasomething or other, stronger than Amox…for which they billed our insurance company an outrageous amount, and we, as Canadians, were…more than a little surprised. 😉
You’d never take your 20 month old to the ER for an ear infection here in Ontario — walk-in clinic, wait an hour or more, see the NP, or see your own GP, if available. No pediatrician, no extra nurses, no child life specialist, no DVD player……………..the parking lot was filled with BMWs/Mercedes etc., but I digress…… 😉
I give my newborn gin to help him sleep. It works wonders. Sounds like Kristin Dibeh could use some, too.
I’m starting to wish I lived close to you so we could have parent-baby play group together.
I know – the ones here are either run by churches or NCT, neither of which are good fits for me.
How cool if there was a SkepticalOB-fan parent and toddler group.
All the kids would be vaccinated, no one would be trying to convert anyone to a religion or NCB and we could talk about fun stuff instead of how we gave birth or our parenting choices!
That would be fun. Not sure what I’m going to do when it’s time for baby playdates.
Baby playdates are to keep parents from going out of their heads – mine spent a ton of time at daycare, so I didn’t really see the need to book up our weekends with other babies.
Once they stop being babies, I need playdates even with daycare. You shouldn’t have trouble finding them. There are *tons* of dads out there who get shoved out the door with the kids sometime in the course of the weekend.
My middle child was teething, badly, when we had to take her with us to a wedding. [Back then, babysitters were almost unknown in Israel]. Well, she whined and whimpered and was really miserable, so I put a little brandy in her bottle with her milk, hoping she’d fall asleep.
In about 10 minutes, she was not only not asleep, she was the life of the party, grinning and cooing at everyone. In fact, she has hardly been as pleasant since [she’s 31 now].