Wednesday, March 11, 2009

Question of the Day

A woman in Massachusetts was eight months pregnant when she gave very specific instructions to her OB. She told him that, since she had already delivered two children with the assistance of an epidural, she wanted her third baby to be born without the help of drugs. She wanted to truly experience a natural childbirth.

Her OB agreed and the countdown to the delivery began.

When the blessed event arrived, the mother labored through the pain until the time to push was almost upon her. Exhausted and in excruciating pain, she demanded an epidural because she could not continue. Unfortunately, the doctor told her it was entirely too late and that the best he could do for her would be a Valium mask to help her relax and get through.

She agreed and her healthy baby was quickly born without further incident.

Six weeks later, the woman returned for her post-partum follow-up and informed the doctor that she would be suing him. She had wanted a natural birth, he had not adhered to her wishes (despite agreeing in the throws of labor), and now he would have to answer to her lawyers.

When they went to court, she won.

He appealed, and he won.

It is now before the Massachusetts Supreme Court.

Who should win??


Julie Weaver said...

This was just an invitation for me, wasn't it?

First, although she said she did not want one before labor had started, she apparently had some form of birth plan in place. If this was something documented, she may actually have a case. However, we are taught that pain is whatever the patient states it is, and if she requested pain meds and it's documented, than the Dr. will win the case. If she wanted a totally natural unmedicated delivery, she should have gone to a birthing center and used a midwife or came with a doula to help her through the tough spots.

I have never used a valium mask on any patient, never actually heard of them. It sounds very uninvasive, but probably hazes the entire experience.

The Dr. could have done things a little differently and offered her a pudendal block. He may not have been skilled to give it as it is a blind procedure where by, just as the head is starting to crown, a nerve block is given intravaginally to the pudendal nerves on either side of the ischeal spines of the pelvis. The old docs are the best at doing this, and if this was a young guy, well, I can't say what he was or was not capable of. The block numbs the pelvis for delivery and most "natural" patients feel they had successful experience.

Now, as a patient that has delivered with and without pain relief, it sounds as if she made this decision toward the very end of the process. Many women loose it at about 8 centimeters, this is normal and if she had had a better support team with her, she might have been able to cope better. She should be suing her labor coach.

Love you!
Nurse Julie

Amy M. said...

Do you have to be in labor to get a valium mask? Can you (Nurse Julie) write me a script for one?
PS: Looking at the story without any expertise, I would have to go with the doc on this one. I personally begged for (and received)an epidural at one centimeter, so I may not be the best person to ask!

Anonymous said...

Having asked, demanded and screamed for meds and never received them for my delivery (I even said my father is a pharmacist he would give me some...I was possessed my demons at this point)...I would have to go with the doctor on this one. She asked for the meds in my opinion...god I am jealous that she got some relieve!