Yes, It Happens
It started off as a normal day on the labor and delivery floor where I was working as a nurse. I stood by the nurse's station, getting a report from the night nurse, who bounced up to me much too excited for someone who had been up for 24 hours straight.
"This patient is unreal!" she exclaimed. "She's 8 centimeters dilated and just laughing and talking like it's nothing in there. She's the easiest labor patient you'll ever have!"
Not believing it, I gathered up my supplies for the day and headed into the room to check out the situation for myself. Lo and behold, the patient really was at an 8 and she really was laughing and talking. She literally didn't make a change with contractions, other than barely breathing a little heavier during them.
"Wow," I said to the other nurse. "That is crazy! Good for her!"
Not everyone labors the same way
And so my day with my patient continued. When we had a chance to talk, I learned that she really was just one of those women naturally capable of coping with labor. She was very young, hadn't taken any childbirth classes, but knew that she did not want an epidural. Not only was she deathly afraid of needles, but she expressed an innate belief in herself to get through labor naturally.
"I know I can do this," she said to me solemnly.
And although she was doing it and doing it quite well, her labor stalled at around the 8 centimeter mark — she just didn't seem to be able to dilate past it. So when the doctor came in to the ward early in the afternoon to break her water, the young patient was very anxious. I updated the doctor on how the patient was doing, emphasizing that the patient was very adamant that she did not want an epidural.
When things aren't progressing
The patient found "checks" extremely painful and it took the doctor a few minutes to be able to break her water. By the time she was done, the patient was crying. The doctor mistook her tears for anxiety and suggested that an epidural might help calm her down.
The patient looked hesitant and continued to cry. The doctor again repeated her suggestion, fully convinced that what this patient really needed to get through was an easy fix: call anesthesia for an epidural, stat.
Does doctor always know best?
Honestly, the situation that unfolded was difficult. On one hand, both the doctor and I realized that for some women, choosing an epidural at this stage in labor really can help. I've seen many cases in which women, who were adamant that they didn't want the epidural, changed their minds and then loved the results; they were able to relax and labor progressed naturally and more quickly because their bodies weren't stiff and tense with the pain of contractions.
On the other hand, however, I had heard the patient express over and over to me that she really didn't want the epidural and I knew first and foremost, that it was my job to serve as an advocate for both the patient's baby and the patient. I had to let her choose the path that was best for her.
Patients and healthcare staff working together
That day, I learned that nurses and doctors can work with their patients to make sure their choices during birth are respected. That day, I was able to talk with the patient, calm her down, and figure out what she wanted — not what me or the doctor thought she should do.
It was an empowering and humbling experience to see this young woman fight for what she believed her body was capable of — and in the end, deliver a healthy baby boy.
Without an epidural.