At the hospital, Linda is nine centimeters dilated by 10:04 a.m. "Another half hour or so," Dr. Scher predicts. He heads to the door and notices Linda's worried look. "I'm not going away!" he assures her.
He checks on Marcia in the next room. She's been suffering from elevated bile salts, a rare gall-bladder condition brought on by pregnancy that makes her feel itchy all the time. Though uncomfortable, it's not life-threatening. But Marcia has researched the condition online and found studies suggesting that it can cause stillbirth.
"Having a high-risk pregnancy does not mean that the delivery will be high-risk too," Dr. Scher says, trying to calm her. Though he appreciates when patients show interest in their own care, he's wary of medical information they cull from the Web -- while some is helpful, much of it is not. "People can get the wrong perspective on a condition, which causes them unnecessary worry," he says. Marcia is bearing the pain stoically, but Dr. Scher encourages her to get an epidural now. He explains that if the anesthesiologists are needed for cesareans and other emergencies, they may not be able to attend to her precisely when she needs them, and she could end up laboring in pain until one becomes available. Dr. Scher believes that suffering is not a necessary part of the birthing experience and counsels his patients that wanting pain relief is nothing to be ashamed of.
Dr. Scher says more than 80% of his first-time moms choose to have a "walking" epidural, in which a cocktail of pain medication is injected into the lower spine. Unlike paralyzing anesthesia, this medication masks pain but not feeling, so a woman can experience the sensations of childbirth without the agony. Though laboring mothers-to-be are technically able to walk around while on this medication, Mount Sinai does not permit them to do so, a practice that's followed by many hospitals for liability reasons.
"Linda says she can't wait!"