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Ladybug118 10-22-2012 11:45 PM

Turning off epidural without consent?
Has anyone ever heard of the anesthesiologist turning off your epidural (before it is time to push) without discussing it with you first?

I had a posterior baby and was stuck at 9 cm for a long time. I had wanted a natural birth, but eventually gave in and got an epidural after about 33 hours. I felt totally devastated, but I was really exhausted by that point (I'd only had 2 hours of sleep before that since contractions started 6 mins apart at midnight) and really needed it.

As soon as we found out the baby was posterior (there were no signs of back labor), our doula was trying to get me into some positions to help the baby turn. There is a famous chart of safe laboring positions while on an epidural published by Penny Simkin (which was given to us by the hospital at the prenatal class) that we were following. Nothing out of the ordinary, just laying on my side with my lower arm behind me and upper leg in front of me...doula kept calling it a "Texas Twist" position but I think the Bradley Method calls it something different.

Anyway, the anesthesiologist came in, saw this, and went directly over to the machine and turned off my epidural. The only reason I knew what he was doing is that I asked him after he already did it. There was no discussion of my options, nothing to inform me of what was going on, not even looking me in the eyes or anything. After he had already turned it off, we tried to reason with him what we were trying to do. I was pretty out of it from exhaustion, but I definitely remember him clearly mispronouncing her name as "Penny Simpson" when he was trying to be condescending to our doula and saying "I know who Penny Simpson is, thank you very much".

He kept saying that the position I was in was somehow dangerous, and that is why he turned off the epidural, but I really think this was part of their tactics to get me to consent to a c-section (which I unfortunately eventually did...they really gave me no choice). I'm sure he must have known that as soon as I got the epidural, all of my natural endorphins went away so as soon as the epidural wore off it was going to hurt worse than before. And it did.

Anyway, has anyone ever heard of anything like this? I've heard of turning off the epidural when it is time to push, so you can feel when the contractions are and be able to push more effectively. I assume that in such a scenario the laboring mother would need to consent to this? That they wouldn't simply turn off her pain medication without asking? Or at least without discussing it with her first? But what about turning off the epidural before it is time to push? In my mind, this is considered cruel and unusual punishment. I understand that if I was really doing something potentially dangerous we would need to adjust my position to something safe, but wouldn't you think that this discussion would happen BEFORE turning it off? Or at least don't you think they should tell me what they were about to do and give me a shred of respect by looking me in the eye?

I am planning to file a formal complaint with the hospital, but I've been dealing with breastfeeding issues for the past month and haven't had time. I just don't know if this is a common thing or if I really did something wrong and he was right to do what he did or what. I'm still trying to make sense of everything that happened. Any thoughts?

Nickel+3 10-23-2012 12:13 AM

I'm so sorry this happened to you :hugs:

evasimone 10-23-2012 12:17 AM

Re: Turning off epidural without consent?
:hugs: I've never heard of that. Anyways if he felt it was unsafe he should have communicated to you that if you continued to use those positions he would have to turn it off. Turning it off without giving you the option of doing something different is just awful. Not to mention it sounds like you and your doula were using a safe position and he was just being a jerk.

I think you definitely should complain. Even if hospital policy is that you aren't allowed those positions they should have told you that you couldn't do them with an epidural and that if you wanted to do those positions they would have to turn it off. But it sounds like absolute BS to me.

Ellasundies 10-23-2012 03:22 AM

Re: Turning off epidural without consent?
You need to make a complaint to the hospital. IME however that won't necessarily do much. So if you want the problem taken seriously you also need to contact the state medical board. Make sure they know you feel it was done as a way to get you to consent to a csection. Taking pain meds away from someone who requested it should be cruel and unusual punishment.

kaia.aline 10-23-2012 04:08 AM

When I got to the hospital I already knew I would be requesting an epidural so I wasn't in any pain when I signed all one billion consent forms for it and I distinctly remember one of my forms saying that I couldn't labor in any other position with my epidural as it was considered a risk (I only remember bc I told my dh how stupid that was) so you may have signed something like that when you were so exhausted? I would ask to see your forms and if it's not anywhere on there complain to the hospital

Lammy 10-23-2012 05:36 AM

Re: Turning off epidural without consent?
I think that even if you signed a form saying that you would only labor in "allowed" positions while having an epidural you should still lodge a complaint with whomever you can. He should have told you what he was doing BEFORE he did it. Do you even know if he talked to your OB about what he was doing before he did it? I would think any decision made should have been discussed with you and your doctor before anything was done- and that includes any type of pain management you had asked for.

ETA: And when I say " do you even know..." that is not me being condescending to you at all. That is me being worried that he didn't even discuss turning off your epdiural with your doctor before he did it.

Ladybug118 10-23-2012 12:42 PM

Re: Turning off epidural without consent?
I doubt that the forms I signed said anything like that, since the hospital-sponsored classes were teaching these positions for an epidural, and both my husband and I read them pretty thoroughly before signing so I'm pretty sure one of us would've picked up on that. But yeah that's a good idea...I should check to make sure. I wouldn't be surprised if he did talk to the OB about it but not in my presence and not in a good way. Maybe it's me being paranoid, but after I declined the c section the first 2 times they were probably out there scheming about how to force me to comply. The OB said at one point that we were not complying with the hospital's standards of care, and that it was making them look bad. Say what?

seacat 10-23-2012 12:50 PM

Re: Turning off epidural without consent?
What a jerk. No, I'd file the complaint. I had the same labor set up you had for my first. OP baby, 30+ hours of unmedicated labor, exhausted, etc. I wound up consenting to a low dose Epi and we also used some of Penny Simkins recommended positions to get baby to come down even if he didn't turn. No one said anything to us. I'm so sorry.

RachelFlores 10-23-2012 01:00 PM

That sounds like a bad situation all together and I'm sorry you had to deal with it. In my experience the hospital version of "informed consent" is, "I'm going to do X." and then doing it unless you fight them. It sounds like you didn't even get that much. I don't know much about epidurals, but couldn't he have turned the medicine back on after you were back in a "safe" position? You should complain.

cdeweese 12-09-2012 09:40 PM

Re: Turning off epidural without consent?
I've had two posterior babies and was allowed to labor anyway I wanted as long as I was in bed after the epidural (so I wouldn't fall). That's crap and I'd go to the hospital with the info you received at the hospital-sponsored class and file a complaint.

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