Diane,
I cared for and supported a woman's choice to labour and birth her twins at
34 weeks, both cephalic, without an epidural despite the medical staff
ordering the epidural and the anaesthetist arriving to put it in. The
anaesthetist actually did take the time to talk and listen to the woman and
her partner and was respectful of their decision to wait and see if the
woman wanted one later on. The woman laboured and gave birth to both her
twins using nitrous, assisted by the midwife, with the supportive Doctor of
both the woman and midwife just watching the events unfold. It can be done.
We were fortunate that there were no problems arising with the second twin.
I seem to remember that there was the options of epidural on arrival,
placing the epidural catheter in place and later adminstering bolus doses if
an emergency arose with the second twin, but I can't remember about mention
of a test dose (hence the anaethestist was close by during the second stage
of labour) or have the epidural if and when the woman requested it. I hope
this helps.
kathy
----- Original Message -----
From: "Diane Gardner" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Sunday, November 16, 2003 6:13 PM
Subject: [ozmidwifery] Epidural


Hi all

I have a client, 42 y.o first time mum who is expecting twins. Her ob/gyn
has told her that he would like her to have and epidural anyway to prepare
her in case they have any trouble with the second twin being born. When she
asked the midwife at her antenatal class if they can just insert the needle
without giving her the actual medication she was told that it was either
give it or not prepare her for the epidural at all, no half way.

In your opinions is this correct or can they do all the prep and then
administer the drug if complications occur?

thanks in advance
Diane





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