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Open Thread: Why I Do or Don't Think that Epidurals Are Bad

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After this comment thread, which is deteriorating rapidly, and this thread, which is an interesting exchange of diverse opinions, I am left shocked by the intensity of concern that the woman who recently broadcast her birth got an epidural.

Many feel that it was disappointing that a woman who wanted an unmedicated birth, (presumably) didn’t hear encouraging words from her midwife in transition, letting her know that she was so close and that she could do it. Many feel that her team let her down. Based on the woman’s comments after her birth, she wished that her midwife had told her she was eight centimeters before offering an epidural, then followed that statement with something to the extent of “but I needed it.”



This is a semi-open thread. You can say whatever you want anonymously here, provided you are civil to other commenters. If you would prefer to discuss this in Facebook, that would be fine.


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Reader Comments (30)

I will start off by saying that I did not like my epidural one bit. It made me feel helpless, powerless, and trapped. And it ultimately led to my Cesarean because I could not push out a posterior baby through my legitimately narrow pelvis when I was flat on my back. I, too, had no support from my attendants for a natural birth, even though that was what I wanted. After 40 hours of labor, I caved.

But I will never, ever damn another woman for getting one. I distinctly remember one point during my second birth where I was thinking, "If I was in the hospital, I would soooo be begging for drugs right now." Fortunately, there were no drugs to be had, and I reaped the reward of an oxytocin-induced painfree birth (after a very painful and intense labor).

Ideally all women would be strong enough to make it through birth without turning to an epidural. But we are not ideal and neither is birth. When the maternity care system is as broken as it is, how can we blame women for wanting to shut off the pain, when there is often nothing else they can turn to? Brought up by mothers who proclaim birth as the most hellish thing they ever survived, and spending their pregnancies watching tripe like A Baby Story, what should we expect? Let's rail against the system that encourages detachment from birth, not the women who choose or are blindsided into it.

November 7, 2009 | Unregistered CommenterJill

I didn't know much about what was going on until I saw your post on facebook and tuned in around the time she got her epi. I must admit I was surprised that a woman with a midwife and doula wasn't more supported. I mean, if a person hires a midwife and doula, isn't that a pretty big indicator that going natural is important to her? Otherwise she would have just gotten an OB, right? Am I missing something? Encouragement and support are so important in those intense moments, but it was like they basically just said "You're right, you CAN'T do it", and caved. Women in transition often express they feel they "can't" do it, but those feelings are natural, and in that state of mind, they just need to hear some positive words and get re-focused.

I do think epidurals have a place. Especially for women who are uneducated about birth and go into panic mode over pain, etc. Their fear is of course going to make their labor more difficult. Ideally, ALL women would trust their bodies, and understand the natural process of birth, but that is not the case. A clueless fearful woman would possibly be traumatized by natural birth and hate the experience, instead of enjoying and being uplifted by it. In a perfect world, everyone would know the real risks of epidurals, and the very possible cascade of interventions that may follow, but that just isn't the case.

But this woman... to have a midwife and doula, she must have known something to make those choices! She must have had a desire to go naturally. And for her "support" team to fail her like that was difficult to see. I know she could have done it, she was so close, and things were uncomplicated. I don't want her to feel bad about her experience by any means. But I hope that she is someday able to step back from this, look at it and say "Hey guys, next time I have a baby and am feeling a little out of my mind as all women do in transition, could you please have some more freaking balls and be there for me so I can have the experience that my baby and I deserve?!"

November 7, 2009 | Unregistered CommenterRMB

During my first labor the epi was placed to low, and it didn't work at all while they were hitting me with pit. I felt like they were peeling the skin off of my entire body. I was being forcibly pinned down as I writhed in excruciating agony for hours. They ended up giving me another dose that did nothing, and then they re-placed the epi. I got 2 more doses. It trapped my baby in the birth canal for 2 complete hours and the ob cut me a whole so large that he was up to his elbows with 3 different sized vacuums. My baby was near death. It was beyond belief, and totally traumatizing. Now nearly 5 years later, I have pinched nerves (damage) in my spine at that point. I can't sit down with out going really slow, and I have to be careful when I pick up my children, or stand, or roll over in bed. Lots of time the nerves just pinches right there, and I scream and fall over in paralyzed pain. I can't move either leg. I have to struggle to find a position to get into that will release it, and usually I need help. Yay for epidurals, yah right! I have had a natural labor and birth since then, and it was NOTHING compared to the pain of the pit with the epi.

November 7, 2009 | Unregistered CommenterNikki

What bothers me is that the pros and cons are usually about how the mom feels and needs. What about the baby? Before making the choice to have an epidural, ask about the known ways it could harm your baby. It's something that saddens me; in all this debating about our bodies, we sometimes forget that it needs to be more about the life we're bringing into the world and how something like an epidural will harm them, over what we want for ourselves.
Are there cases where an epidural is the right choice? Sure, but far to often I see women making excuses to make things easier on themselves. And not once do I hear them weigh how it will affect their baby. We’re told throughout an entire pregnancy that even taking Tylenol poses a risk. But now it’s OK to have hardcore painkillers to birth? There are so many other options to make labor more manageable. I’m sorry, but so rarely do I see it as justifiable. I truly feel that once you’ve made a choice to have a child, your comfort is secondary to what’s in your child’s best interest. And while it’s super important to have a supportive team, ultimately the responsibility lies with the birthing mother and the father.
I could go on and on, but I’ll leave it at that.

November 7, 2009 | Unregistered CommenterCristina

I have to say I'm very disturbed about all the judgments that were being made about her choices. It's her birth & her choice how to birth. It's a VERY slippery slope when we start telling women what they should/should not be allowed to do with their births. The VBAC-lash is proof. I am a doula and childbirth educator, and contrary to what some believe, women don't always want an unmedicated birth when they hire a doula. I've been hired for many, many, many, births, where they thought they might (or knew they did) want pain meds in labor. They wanted the consistent support of someone at their side on their side. I was not there to judge, but support their decisions.

As someone who had not planned on a hospital birth, nor epidural, I do not like that people potentially judge me for the decisions I had to make during labor. Not every birth is easy, or uncomplicated. I had planned a homebirth. I had a doula, her apprentice, my midwife and her student, plus my husband as support. I went into labor at 41weeks 4 days. After having contractions 3-5 min apart, 45 sec - 2 min long for 44 hours, I finally transferred to a hospital, where after several more hours decided to get an epidural. Was that my plan, no. Was it needed, yes. Was I happy, no - I cried and cried, as my team of women told me I had tried *everything*, I had done *everything* and now I was suffering needlessly. I was terrified to get one, sure I would be the statistic that becomes paralyzed or have some awful side-effect. Luckily it went fine. Long story short - at 42 weeks my son was born by cesarean, with his cord tightly wrapped around his neck; he had been unable to descend. He did not get to be skin to skin with me, nor did he get to nurse within the first hour - yet he is a wonderfully, healthy, emotionally-healthy, sweet little boy who did nurse like a champ.

I really wish women could just support other women, holding them up, instead of talking them down. We women need to stick together! :)

November 7, 2009 | Unregistered CommenterCRP

For me, it's not about whether or not the epidural is fundamentally right or wrong, it's about the situation. I normally don't speak in generalizations about women who get epidurals because I don't have the privilege of being there in that moment with the woman. We can argue the pros and cons of epidurals all day long, for both mother and baby, but in the end that old cliche still rings true: Until you walk a mile in my shoes.... And we can never really do that can we. No one can be me. No one could know what 6 hours of pitocin induced contractions one after another with no break, a doctor who keeps trying to get you laying on your back, and the horrible sting of antibiotics going in your arm feels like to ME. Not to mention all the psychological elements in place, my views on birth, my ideals, my fears, my anxiety etc. I went through that, and still I had no epidural, but I wouldn't fault the woman who does. What bothers me, and will always bother me is those who seek to remove the choice of a non-medicated birth from women. Those who make that goal hell. Those who pretend to have a woman's best interest in mind. Those who say there is scientific reason for interventions when there are none and those who seek to remove all autonomous thought and experiences from the birth.

Now in the case of Lyn, I did make a judgment regarding the epidural she received. And I will say that my judgment was based on the notion (which may or may not be true) that she desired a natural birth. And I stand by the judgment, not that she made the wrong choice, because I just can' t see myself having the right to say that, but that she wasn't supported, in the end, on the choice to have a natural birth. There was nothing done in that moment to help her achieve this. I know it may sound silly, but I did get emotionally investing in what I was seeing, partly because birth is just so emotional, but also because I saw a woman giving birth for the first time. She was working so hard, so well, so focused and then it just stopped (until it was time to push, which was great for me to watch too). It stopped and with the way things were going it more than likely didn't have to. I felt let down for her.

November 7, 2009 | Unregistered CommenterPatrice

I didn't get to see the birth (which sucks, and I'm grumbly about that), so I can't say anything specific about the birth or the attitudes/actions of the labor support staff - but I do want to say something about the comment if a person hires a midwife and doula, isn't that a pretty big indicator that going natural is important to her?

My DONA birth doulas training taught me that I'm hired by a client to help her achieve the kind of birth she wants. That doesn't mean that, universally, people hire doulas to ensure an unmedicated birth. One of my local doulas says there have been times when she's seen an epidural make a positive change for a woman in labor, give her back confidence when she feels eroded by pain and exertion, confidence that she could not achieve otherwise. And I've been an asset to a client who's had an epidural and needed positioning help for second stage.

Doulas can assist in many different ways depending on the needs of the mother and her family. There is a place for doulas at the side of mothers who are having interventions as well as mothers who are seeking an unmedicated birth experience. When I'm asked about the benefits and drawbacks of intervention, I give my clients the most complete, research-based information possible so that they may make the best decision for themselves. It may be that the midwife and doula had already spoken with this mom long before labor began about the pros and cons of epidurals.

November 7, 2009 | Unregistered Commentera newbie doula

I was happy with my epi with my first birth, but it was because my husband wasn't able to be there to support me (the timing was horrible, he had to be taking the bar exam on the same day I went into labor, there was no other choice) so my doula and my sister in law were my support team at a hospital with something like a 90% epi rate. I also had an OB group who weren't cut-happy persay, but they were very pain-relief-happy. So, I got the epi at like 9cm and I wavered back and forth for a long time about whether I was disappointed with myself or not. But then I realized the true reason I got it - I had gotten to 9cm without needing to vocalize through contractions and was starting to feel out of control. And without my husband and with my SIL there, I couldn't do that. I emotionally couldn't let go enough to feel ok with being as primal as I needed to be. I chalk it up to just bad luck - if she hadn't come on her due date, my husband would have been there, and it would have been ok with me to give in to the primal part. The biggest thing that sucked was a 2nd degree tear and coached pushing.

With my 2nd birth, I did hypnobirthing and had a bigger baby (the 1st was 9 lbs 1 oz and the 2nd was 10 lbs 6 oz), but had no epi and no tearing (my husband compared it to how ballplayers who get cortizone shots to play through an injury often injure themselves worse b/c they can't feel what is happening to their body). I was far happier with that birth, and needed the ability to move around given that he had mild shoulder dystocia and I had to use different positions.

But even with the natural 2nd one, I can't hate my first epi. I needed it. Not for pain, but for emotional comfort.

November 8, 2009 | Unregistered CommenterLeah

I birthed my son in a birth centre. I'm not sure if you have those in the USA, but here in the UK they're midwife-led units which to me felt a lot like being at home. There are no doctors at all. The centre I birthed in had no men working in it. There are no C-sections, no epidurals, no forceps or ventouse. The strongest painkiller they can give you is pethidine, and at least in my centre they allowed me to birth exactly how I wanted to. I know that some birth centres here are attached to hospitals, and they can be a little too eager to ship you off to the maternity ward because you're having 'failure to progress' but the centre I birthed in was situated in a hospital which had only geriatric wards. The nearest place with OB doctors and surgeons was a good half hour to forty-five minutes' drive away.

I recall that about an hour before I started pushing, I was begging them to bundle me into an ambulance, take me to St Mary's (the hospital I just mentioned) and give me an epidural. The midwives explained that that was a long journey and a lot of effort when I didn't have long to go now, and they were really supportive. I do know though, that had I been in a hospital where an epidural was readily available, I'd have taken it. Looking back I'm glad it wasn't available, but having been there I can totally understand why some women choose the epidural.

November 8, 2009 | Unregistered CommenterAnji

Amen to CRP. What I'm getting from these comments is that a lot of you are theoretically for informed consent, but really only if they consent to the same things you would.

I'm not going to justify my Bradley-classed, midwife-assisted decision to have an epidural placed. I'll just tell you it seemed like the right thing to do at the time, and it's not because I was unaware of the risks, ignorant about birth, scared, or unsupported. And it worked fine as pain-relief. Did a cascade of interventions lead to my section? Maybe, or maybe the fact that she was so stuck and destined for a section lead to the long, difficult labor that would lead me to have interventions.

It's just not a black and white thing. In a perfect world, maybe I could have birthed my daughter naturally. Or maybe not. But it certainly does not help matters to imply that anyone who gets an epi is ignorant or does not sufficiently trust her perfect woman-body.

November 8, 2009 | Unregistered CommenterKaren
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