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From: smith_bp101 on 16 May 2007 16:45
What is the cut off point for an epidural? I seem to be getting
conflicting answers. Some say 6cm, others say 7, some 8. Does the
anethesiologist make that decision?

Also, on average how long is transistion labor? How much worse is it
than active?

From: Anne Rogers on 16 May 2007 17:17
> What is the cut off point for an epidural? I seem to be getting
> conflicting answers. Some say 6cm, others say 7, some 8. Does the
> anethesiologist make that decision?
>
> Also, on average how long is transistion labor? How much worse is it
> than active?

there really is no cut off point, it's not like pethidine or other narcotics
where it gets through to the baby in moderate quantities and there is a risk
of supression of breathing when it's born.

I have heard of people being given them at fully dilated, you'd have to not
have an urge to push though, otherwise there is no way you'd be still enough
to get it in.

Many people will say you are too late when you are showing clear signs of
transition simply because although transition is hard, it is a normal place
to cry out for help and usually if you've got that far, you can manage and
it's a shame to give in for what is a reasonably short time - but really
that should be the women's decision.

If the anethesiologist is called, as long as they can get it in, they will,
they are unlikely to make judgements about progress, that will be the nurse,
midwife or doctor prior to calling them.

I think you'll just have to call the hospital, or your OB or something to
find out what is local policy.

Anne


From: Larry Mcmahan on 16 May 2007 17:20
In article <1179348312.097709.13130(a)q23g2000hsg.googlegroups.com>,
smith_bp101(a)hotmail.com says...
> What is the cut off point for an epidural? I seem to be getting
> conflicting answers. Some say 6cm, others say 7, some 8. Does the
> anethesiologist make that decision?
>
> Also, on average how long is transistion labor? How much worse is it
> than active?
>
>
Transition, whenever that is.

In truth, you should be trying to avoid the epidural in the first place,
although many can not because of unhelpful hospital protocols. And I
don't mean being brave or suffering, but learning some alternative pain
management techniques.

The benefit is that both you and the baby are alert sooner after the
birth, and some difficulties related to the epidural are less likely to
happen.

Good luck,
Larry
From: Anne Rogers on 16 May 2007 18:01
> Transition, whenever that is.

I'm afraid this is not correct Larry, I don't think anyone has every come up
with anything convincing about giving them at some points being worse than
any others and as the insertion is very similar to that of a spinal for a
c-section, they can be done at any point, think of all the women who have
c-sections at fully dilated?

Personally I have had them in transition, first time no one realised it was
transition and I think if they had, they wouldn't have given it to me, 2nd
time, though it was for various reasons a decision that had been made prior
to labour, that I was to have an epidural as soon as possible, the midwives
did not call for it, they never said it was too late, but they were doing
the "you don't need it dear" thing. Thankfully it was then ordered by a
doctor, it was still about 4hrs to delivery at that stage and it was very
necessary.

Anne


From: Ericka Kammerer on 16 May 2007 20:40
smith_bp101(a)hotmail.com wrote:
> What is the cut off point for an epidural? I seem to be getting
> conflicting answers. Some say 6cm, others say 7, some 8. Does the
> anethesiologist make that decision?

Yep. There really isn't a hard and fast cutoff.
It all depends on the situation.

> Also, on average how long is transistion labor? How much worse is it
> than active?

There isn't any real answer to those questions.
Transition can be anywhere from just a few minutes to
hours. For some it's quite a bit worse than earlier
labor, and for others it's not that much more intense.
There's a huge normal variability in labors, and even
when there are statistical trends, they don't really
have much of any predictive value for an individual
labor.

Best wishes,
Ericka
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