Epidurals and Education

Epidurals: Time to stop laboring over 'natural' childbirth.

I had intended to basically discuss the entire article, but I won't bore you completely!! Instead, I would like to talk about the importance of education when you are faced with any kind of medical decision.

I had my first child at the age of 18. Because of the social stigma that follows many young mothers, I was worried of what people thought of me. So I decided to educate myself on all things pregnancy, birth, breastfeeding and infant care. This is where a lot of "ME" is now rooted.

I was not the ideal patient, as I was still 18, my diet needed an overhaul, and I could have used more exercise but the morning sickness took it's toll. Finally at 23 weeks it let up.

Anyway that isn't what this is about. This is about the choice to educate myself on what was happening with me. I did more birth education than pregnancy education, since well, I was already pregnant, I needed to prepare for the finale.

One of the first things I educated myself on was the methods of pain relief used in labor. First up were the analgesics, the narcotics. They can be used almost any time during the labor. But the closer to birth, the less likely is is that they will be used because of the potential risk to the infant (breathing problems requiring oxygen and sometimes an antidote for the narcotic given). They can be given in half doses or full doses. They can benefit to give the mom that little break before she begins to push, and when it's over, she doesn't have to wait for an epidural to wear off, or the catheter to be removed from her back. I know I was never told that the medication would most definitely cross the placenta. Though, if you think about it, it's obvious. The medication is typically injected in to an IV line (provided you have an IV, if you don't, they'll probably start one just for this) and the IV line is going directly into your blood stream. Blood is obviously carried through out your body, and the placenta, is attached to the uterus, which also gets blood flow. So the medication, though filtered a bit through the placenta still manages to reach the baby. Which is why doctors won't want it administered too soon before delivery.

Another option is the use of Oxygen and gas for pain relief, however I have not seen this used, only heard anecdotal stories. I haven't even come across a decently written study synopsis of it yet. Looking forward to finding one some day. So, we move on. To the Epidural!!! dun dun duuuuunnn....

Now, I've had an epidural. And I hope to never have another one. I will never have another one for childbirth, because we're done having kids. But with the research I've done, it wouldn't be an option if we were still workin the baby factory.

Allow me to interject here, that every intervention that is practiced in labor rooms across the country have had their place at one time or another. But the blatant over use, that has made a lot of these interventions routine, or even policy is what scares me, and upsets me the most, but first I'd like to weigh in with my thoughts on epidurals.

The potential for serious side effects is huge. There is an entire laundry list of risks associated with it. Not the greatest list, but it will do. I am extremely tempted to discuss most of this list...the doula, childbirth educator and future midwife in me wants to tell you what she thinks about all of this..but I shall refrain. Unless there are questions, please tell me there are questions lol.

As I mentioned above, I've had an epidural. When I was 38 weeks and 5 days pregnant with my son, my labor was induced. It was a medical induction for pre-eclampsia or toxiema (I haven't read the wiki yet). My blood pressure baseline had been 120/70 and when I was admitted to the hospital was only about 140/80, but a few days prior was 150/110. And in labor after having been on pitocen for 6 hours, having my water broken for about 3 hours, my blood pressure had risen to a frightening 180/120. And according to my husband, that isn't where it topped out. It was at this point that I was talked into getting an epidural. "but it doesn't hurt! i don't want one!" I was being almost completely honest. Yes, it hurt. But it didn't hurt THAT bad to me. So, I gave consent for them to bring in the anaesthetist. When she arrived I began crying. I told her I didn't want the epidural, I wanted to be able to feel the birth of my child. She helped me out by giving me a 'light' epidural so I wasn't numb. Unfortunatly for her and all involved in talking me into it, I'd also mentioned that I wanted it shut off when it was time to push. Well, that time was when I lay down after having the epidural placed. So it went in, it went on, it went off. ha. The idea here was to play on one of the potential risks of hypotention, or low blood pressure.

The catheter remained in place for about 12 hours after he was born. I couldn't really feel the catheter, but there is a huge 'bandaid' stuck to your back holding the cath. in place. (no, they don't leave a needle in your back, it's plastic flexible tubing so that you can do things like roll on to your side, and 'curl up' to push.

Do I have a real point I can sum up, no not really, not today. Forgive me blog writing is new to me...it'll take some time. Basically what I'm saying about the epidural in general is that it has it's place. But in this article we're being told that it should be used with every birth. And that my friends is dangerous practice. If that was put into practice the c-section rate would skyrocket (as if it weren't high enough), the rate of sucessful breastfeeding would drop dramatically (due to the potential for a poor latch or weak suck from a newborn, and the potential for lack of emotional connection)

From the article" There is not other situation in medicine in which pain relief is routinely withheld"

This makes me want to scream. If given too early you can almost guarantee a STOP of labor progression in many mothers. You can nearly guarantee a 50%+ c/s rate or higher. If a mother is EDUCATED in her choices some, believe it or not actually CHOOSE to have an UN medicated birth.

These mothers will typically employ other methods of creating comfort. The atmosphere is one way to help your body relax. Keeping your mobility is quite important in the 'health' of your labor. The gravity helps keep the pressure from the baby applied to the cervix. The movement helps to ensure baby's position and the work your body does to move, helps keep the contractions moving along and productive. Using massage techniques a labor parter, husband, friend, mother, doula can help to ease some pain, and bring relief and comfort to the mother. Using mental techniques is also a great way to keep a healthy labor going on it's own, and keep the mother grounded enough and comfortable enough to actually enjoy it.

Another plus to an unmedicated birth, is when the baby is out, and the placenta is out, it's over. No waiting on meds to clear your body so you can move about, shower, potty. Ect.

The difference for me was another 24 hours in the hospital bed. If I hadn't had pre-eclampsia it would have been 10- 12 just waiting on the epidural crap to come out of my back. So, I birthed my son at 10 pm, and finally around 11 the following night I was getting up out of the bed for the first time. Nearly 4 years later, I birthed my daughter at home, obviously no medication was used. 1 hour after she was born, she'd had already nursed, and I was in the shower getting clean, and then going to (by choice) lay in my bed with my newborn and cuddle her.

Perhaps I should change the name from "the daily report" to "daily ramblings"