Bloom Birth

Hands and knees with an epidural?! YES!
I have supported clients who chose to have an epidural and were still able to move into positions that they wanted. Evidence supports this and your care staff should too.

Hands & Knees with an Epidural⁣
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During our Physiologic Birth Training for Nurses yesterday, a few nurses said that it is in their policy to not put a patient in hands & knees if they have an epidural. ⁣
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If this is your unit, here are some thoughts I have:⁣
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1. Look at the evidence on the policy. What are the resources they used?⁣
2. Talk to the anesthesia team with curiosity and ask “why?” Is it safety of the patient (risk of falling)? Is it so the epidural doesn’t travel up? Is it BP reasons? ⁣
3. Start addressing the concerns. If it’s for safety of the patient falling… what if there were 2 nurses there? What if there was a requirement that the patient was able to lift at least one leg? If it’s for dermatome levels what if you were checking them every 5 minutes? Same with BP?⁣
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Leading change on a unit can happen! We actually have an on-demand class in our store guiding you to do this 🎉🎉🎉😎 ⁣
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Nurses that put their patients in H&K with an epidural… do you leave the bedside, or do you hang out there during your intervention? How long are you usually suggest this position?⁣
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With the rise in inductions, I wonder how many women are being scared and robbed of their VBAC's? You have the right to refusal and evidence based care.

The often-cited uterine rupture rate after two cesareans of 0.9% – 1.8% is based on a 49% – 65% induction and augmentation rate. This is an important factor to consider anytime we discuss VBA2C.

As a result, it’s possible that the rate of uterine rupture during a spontaneous labor after two cesareans is lower than 0.9% – 1.8%. In fact, Macones revealed that of the 379 people who labored spontaneously, 3 had a uterine rupture for a rate of 0.8%.

Continue reading: https://vbacfacts.com/2021/12/15/vaginal-birth-after-two-cesareans-vba2c-evidence/ [LINK IN BIO]