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Going Epi-Free? - Page 3

post #41 of 80
"My mom had some pretty bad experiences twenty years ago. She said after those experiences, she decided to go natural on the last one because, "it just couldn't be worse than the epidural." (Well, she proclaimed to me that it was, and if she had to do it again she would go ahead with the epi.)"

Yeah, purely in terms of the amount of physical distress one must endure in the momnent, an epidural is less distressing than an unmedicated birth.

I have had three births - one at a birth center, one at home, one in a hospital with pitocin and an epi. None of my births were "bad." All three of my babies were healthy and pink and nursed right away.

Each birth was what I had decided I wanted, based on what I knew about my body and what was going on with my family at each point in time. That last birth, with the Pit and the epi, was a birth where I just had no interest in pain. I didn't have the time or emotional energy to put into getting over all that pain, and I had confidence that my uterus would do its job even with the drugs (I have 5-hour unmedicated labors).

BUT, this is your first birth, and if you decide that unmedicated/natural is what you want, then I think you'll be really happy with the experience. (Whereas, if you do it to please or impress your spouse or mother or whoever else, it's not so likely to turn out well). If you end up deciding to birth without meds, I urge you to do so out of a hospital. Hospitals are just not the ideal location to be private, get naked, work with the pain, and have an unimpeded natural birth. Even though I gave birth twice with very minimal interventions of any kind, I don't think that I could have pulled it off in the hospital environment.
post #42 of 80
Quote:
Originally Posted by micah_mae_ View Post
Epidural risks to baby:

* Fetal distress; abnormal fetal heart rate
True but temporary (it's a response to lowered blood pressure in the mom and evens out after half an hour or so AFAIK)

Quote:
* Drowsiness at birth; poor sucking reflex
* Poor muscle strength and tone in the first hours.
These are not supported by the literature as far as I know. Could you link some studies to back this up? I'd be curious to see.

Quote:
ETA: These are the reasons I wouldn't get one. But as long as it's an educated choice that's what matters. I don't think it benefits anyone to pretend there are no risks to baby though.
I think it's of benefit to have as close to a true picture of the situation as possible. Obviously you wouldn't want to paper over real risks but I also see a lot of non-fact-based scaremongering about epidurals and I don't think that's beneficial either.
post #43 of 80
Quote:
Originally Posted by mambera View Post
True but temporary (it's a response to lowered blood pressure in the mom and evens out after half an hour or so AFAIK)



These are not supported by the literature as far as I know. Could you link some studies to back this up? I'd be curious to see.



I think it's of benefit to have as close to a true picture of the situation as possible. Obviously you wouldn't want to paper over real risks but I also see a lot of non-fact-based scaremongering about epidurals and I don't think that's beneficial either.
Looks like it's mostly cited from websites like aafp.org and childbirth books..


Compiled using information from the following sources:

American Academy of Family Physicians, http://www.aafp.org

William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 19.

Mayo Clinic Guide To A Healthy Pregnancy Harms, Roger W., M.D., et al, Part 2.


39 Goer, Thinking Woman's Guide to a Better Birth, p. 133

40 Goer, Thinking Woman's Guide to a Better Birth, p. 270

41 Goer, Thinking Woman's Guide to a Better Birth, p. 270-271

42 http://www.ncbi.nlm.nih.gov/htbin-po...=6&db=m&Dopt=b

43 Goer, Thinking Woman's Guide to a Better Birth, p. 270-271

44 http://www.ncbi.nlm.nih.gov/htbin-po...=6&db=m&Dopt=b


I don't think it's scaremongering..if there's even a chance of a risk it's too much for some people. I'm extremely paranoid about my kids, especially while pregnant and it's just too much for me (and I'm sure I'm not alone).
post #44 of 80
Quote:
Originally Posted by mambera View Post
I'm not sure what risks you're referring to specifically but I agree there have been findings of prolonged second stage and somewhat higher risk of instrumental delivery (which may or may not be improved by the common practice of turning down the epidural for the delivery).

As gcgirl said, these are probably related to mom's reduced ability to move and feel what is happening.

However, a common fallacy I see on MDC is that epidurals raise Caesarean rates. The studies I have seen pretty consistently find that caesarean rates do not appear to be elevated by the use of epidural analgesia.

http://www.ncbi.nlm.nih.gov/pubmed/16235275
http://www.ncbi.nlm.nih.gov/pubmed/18044297
http://www.ncbi.nlm.nih.gov/pubmed/14695735
http://www.ncbi.nlm.nih.gov/pubmed/12005470


Another one I see circulating around here is that epidurals adversely affect neonatal alertness. This is also not supported by the available literature (actually one small study found better alertness in the epidural babies):

http://www.ncbi.nlm.nih.gov/pubmed/2718709


On balance I agree that the less intervention you have the easier the labor, delivery, and recovery are likely to be. But I don't agree that there is good evidence for adverse outcomes *for the baby* from an epidural. I think the benefits of skipping the epi mostly accrue to the mom so it really is a personal decision and one that should be made without mama-guilt.
Unless I am mistaken, those linked studies all seem to have been conducted by hospitals and by anesthesiology departments at medical schools- people who stand to financially benefit from continued and/or increased epi usage- certainly not an unbiased source.
post #45 of 80
I had my first son in the hospital with an epidural. I hated the epi. It worked for 45 minutes to allow me to sleep for a bit, but once it wore off it made me feel sick and I had back pain for almost a year, and then sporadic pain for months after that.

My second son was born a month ago, at home with no medications. It was painful and intense, but it didn't get painful or intense until I was in transition, and in the hospitals around here that is the cutoff point for medications. During the time of transition it felt like forever, but in retrospect, it only lasted about 2 hours. My recovery has been night and day from the first. First I couldn't walk or sit for 2 weeks. My second I was sitting and walking just a few hours later. I could also pee without any discomfort the day of birth. My first son was extremely sleepy after birth, I didn't see him awake until 2 days later. I couldnt' BF him, he wouldnt' wake up for it. DS2 was alert at birth and stayed alert for 5 hours, latch was great and BFing took place about 30 minutes afterwords.
post #46 of 80
Quote:
Originally Posted by micah_mae_ View Post
Looks like it's mostly cited from websites like aafp.org and childbirth books..
Those have to be getting the info from somewhere though?

Those links don't work.


Quote:
Originally Posted by laughingfox
Unless I am mistaken, those linked studies all seem to have been conducted by hospitals and by anesthesiology departments at medical schools- people who stand to financially benefit from continued and/or increased epi usage - certainly not an unbiased source.
Sure, since those are the people with the interest, resources, and expertise necessary to conduct such studies.

If you have other data to offer I'd love more information. However I don't think it's legitimate to dismiss all the available studies in favor of unsupported claims, just because you don't trust doctors. You can examine a study and assess its importance/relevance given whatever design flaws it has, but blanket rejection of all systematically gathered data is logical fallacy.
post #47 of 80
You may want to look into Hypnobabies. I had an epidural with my first baby and used hypnosis with my last four. I'm a pain WIMP and I hate pain, but I was able to give birth without pain meds thanks to the hypno-anesthesia skills I learned from Hypnobabies. With hypnosis I've been able to give birth comfortably (only pressure/tightening), which I liked better than an epidural (which was only painless after I got it and had other side effects that I didn't like). I loved my hypnosis births and would never choose to give birth without it in the future.
post #48 of 80
Take a good childbirth class. There are many to choose from and you can find the one that fits you best. Get your partner on board. If you're giving birth in a hospital, hire a doula. Seriously consider looking into homebirth, at least talking to some midwives. Giving birth without drugs in the hospital can be a huge challenge, because they simply aren't set up to support it. Giving birth without drugs at home is much easier and just as safe (I've had 2 babies, one hospital and one home, both in the water, no epidural either time).

I really recommend getting over your fears of the epidural. Fear of an epidural will not carry you through transition. You won't care anymore. I know from my first. I was giving birth without an epidural purely for reasons based on fear. I didn't want drugs in my baby. I didn't want a needle in my spine. When I hit transition not a one of those things mattered to me. All I wanted was to make it go away. I had a good midwife and a supportive husband and they got me through without it, but it was a close call. IMO decisions should not be based on fear.

With my 2nd, I had a much easier time. Being at home was part of it, but so was embracing the idea of natural birth for its own sake. There was no fear anymore, just knowing that natural birth had its own rewards. Fear only holds us back; we should try to be empowered instead.

Check out The Business of Being Born. There's a great segment in there that talks about natural birth having benefits beyond the mere avoidance of drugs. It's My Body, My Baby, My Birth is great too. You'll probably have to buy that one but it's only $12 or so.
post #49 of 80
Quote:
Originally Posted by mambera View Post
No, you are not. The epidural remains in the mother's epidural space. It does not enter her bloodstream and hence cannot be transmitted to the baby.
I've seen at least one to the contrary, that the drugs do enter the mother's blood stream just in smaller quantities than if they were put directly into it the way IV narcotics are. I'll have to see if I can find it.
post #50 of 80
Quote:
Originally Posted by mambera View Post
If you have other data to offer I'd love more information. However I don't think it's legitimate to dismiss all the available studies in favor of unsupported claims, just because you don't trust doctors. You can examine a study and assess its importance/relevance given whatever design flaws it has, but blanket rejection of all systematically gathered data is logical fallacy.
I'm skeptical of any study from anyone with a vested interest, doctor or not. That stance seems pretty logical to me.

I did examine the abstracts of those studies a little bit.

http://www.ncbi.nlm.nih.gov/pubmed/16235275
This one shows an increase in instrumental delivery, which is not without its own problems. I know you were just talking about c-sec rates, but the OP did want to know about other interventions, and there you have them.
Also, it's largely comparing epi vs. opioid.
I found it interesting that this study stated that it's purpose was to look for adverse effects, but they specifically did not look for severe or long-term adverse effects.

http://www.ncbi.nlm.nih.gov/pubmed/18044297
I don't know enough about Saudi birth practices to say how relevant that study is to me.
You can tell there's a difference in the way birth is handled in the society in which I live vs. the society in which the study was done in just by looking at the numbers: 106 people in the study got epidurals, 755 did not. Those are certainly not the numbers you'll find in a US hospital.
It also shows increase in instrumental delivery.

http://www.ncbi.nlm.nih.gov/pubmed/14695735
This study does show an increase in labor duration (which the OP wanted to know about) , and again an increase in instrumental deliveries. However, it's another one comparing epi vs. opioid, so it's not entirely relevant when one wants to compare c-section rates in epi births vs. drug-free births (which is what I assume the OP meant by "natural").

http://www.ncbi.nlm.nih.gov/pubmed/12005470
This study also shows a longer second stage for the epi moms, as well as more augmentation, increased likelihood of fever, and increased chances of urinary incontinence. However, again, it's comparing epis and opiods, not epis and drug-free.

http://www.ncbi.nlm.nih.gov/pubmed/2718709
This study is so statistically insignificant it hurts.
It compares a group of 15 babies with a group of 19.
I can conduct a larger "study" than that just by talking to a small group of friends.

Also of interest- the Cochrane study mentioned in the study in your first link was done at a hospital with a 12% c-section rate. That's far lower than national average, and it hurts the relevance of the study to have it done at a hospital where c-sections are already avoided more than is "normal".
That info comes from the text of this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1481670/, which showed that epidurals increased c-section rates more than any other factor.

You can find studies that say anything. That's the beauty of the internet, and of malleable statistics. It's also why I always consider the source.
post #51 of 80
When I gave birth to my son, I had to have an epidural for medical reasons. I knew this would be the case beforehand, and really grieved that I couldn't have an unmedicated birth and worried that my son would be affected and that we both would get caught up in a cascade of interventions. As it turned out, I was able to have a safe, peaceful, vaginal hospital birth and did feel labor & my son coming out, but with greatly decreased risk to myself and no pain. The recovery was also straightforward. I put in a lot of time up front with the HCPs (OB, anesthesiologist, midwife) and worked on being very clear about my wishes & needs and communicating well, and this made all the difference for me.

I tell my story not to argue for an epidural, but to say two things. First, just to say that if for whatever reason an epidural is needed or desirable, it is still possible that things will go well. Second, that getting whatever support you need to have whatever birth you need/want is super important. I was happy to read that you know in your heart what you want... best of luck in going for it!
post #52 of 80
While I was pregnant, I announced to any and everyone who would listen that I would not for any reason consider having an epidural in labor. I was convinced that I would never get an epidural, I was horrified at the idea of people actually electing for them. I was so upset by women in my (hospital-based) childbirth class who were making plans to bring video games to the hospital with them so they could play away the hours of (presumably drugged) labor. I was like, "you are going through one of the most intense and sacred transitions of your life, and you're going to play video games through it?" For me, the epidural represented all of our culture's most appalling techniques for avoiding encounter with the transcendent, the liminal and the transformative.

I had an epidural in labor.

Birth (and parenting too!) serves up a hefty slice of humble pie to us all.

Quote:
Originally Posted by dogretro View Post
Between pushes I was literally crying and begging my baby to please just come out already.
Me too! I kept saying, "let go, let go, let go," and the MW started getting concerned and asking all sorts of questions about my emotional state and was there something I needed to talk about. I just looked at her blankly for a minute until I realized why she was asking, and then I laughed out loud and said, "oh, I wasn't telling myself to let go, I was telling the baby to let go and come out already!"

Really, though, the pain of labor was never so bad that I felt I really couldn't handle it. It was the intense work of labor that finally overwhelmed me -- my body couldn't sustain it. I was in transition for a LONG time (about 10 hours), and I was vomiting a LOT, so I started to get dehydrated, which started to affect my energy levels too.

Quote:
Originally Posted by cristeen View Post
I was in labor for 5 days. I finally pushed him out the afternoon of the 5th day, in my bedroom, with no drugs whatsoever. ...if I had been in a hospital, I never would have been allowed to go 5 days (3 days with broken membranes). So for me, staying home was key.
5 days! You're the first person I've "met" who had a longer labor than me!!! I was in labor for three days, and ended up transferring for exhaustion. I'm sure that if I had planned a hospital birth, they would have interfered to 'hurry things up' long before I decided I needed intervention. When I got there, I told the doctor, "I just need an epidural and some rest." He said, "you're dilated too far for an epidural," and I said, "trust me, this is still going to take many more hours." Thank heaven he trusted my judgment on that! (It took 5 more hours before I was ready to push, and 4 more hours of pushing.) I am convinced that the epidural is what made it possible for me to rest, let my body relax and finish dilation, let the baby slowly move into the position she needed in order to be born. It slowed the whole process down, which is what I needed in order to have the strength to push her out.

All of that is to say -- in my case, I truly believe that the epidural was a reasonable intervention that made it possible for me to have a vaginal birth. If I had gone on with my endless transition without IV fluids or sleep for another 5 hours, I (or the baby) very likely would have crashed from exhaustion and dehydration and ended up with an emergency C-section.

However, everything that MegBoz says about epidurals is true:

Quote:
Originally Posted by MegBoz View Post
...not just the epidural catheter in my spine, but the resulting necessary blood pressure cuff around my arm, fetal monitor continuously around my belly, IV in my hand, and potential need for catheter in my urethrea to empty my bladder. EWWWWW! ... I was personally way more scared of being out of control of my own body, controlled by doctors & machines, & the whole medicalized experience, than I was of the natural pain of birth.
Me too!!! But in the end, because I was so aware of all of these "extra" things that came with the epi, none of them were actually too bad. Well, the catheter was gross. But besides some lingering back pain at the catheter site for several months, I had no other ill effects from any of these things. Thank heaven. Because I was prepared for it when I requested the epi, I didn't feel at all disempowered by all the medical stuff. (I did have some very sharp words with the resident who tried to put an internal fetal monitor into my baby's scalp without even asking me... and after that, they were careful not to do anything without getting my consent.) And since I was already so exhausted when I got to the hospital, I didn't even mind that I couldn't get up and walk around after the epi -- because I was too tired to feel that I could.

Quote:
Originally Posted by listipton View Post
I was not let in on the 'secret' about the epi.....If it's done 'right' you still 'feel' the end, just not the contractions. Instead of being able to work with your body, you're stuck in bed with your legs being pulled up, directed pushing and nurses and docs yelling at you because while you can feel the end result (and yes, it hurts), you can't feel WHEN to do the things they're telling you to do.
Yup. All of this is true. I hated it all. And the epi certainly slowed down my pushing stage because it interfered with effective pushing. But I don't think I could have done anything differently; even my HB MW thought the only way I was going to get baby under the pelvic bone was by pushing flat on my back. I tried some other pushing positions after they dialed down the epi, and none of them felt right to me -- the one that worked best with my body and my baby actually seems to have been this one. Of course, if I'd been at home and undeterred by cords and lines and tubes everywhere, I might have tried some other positions and found one that worked better, but as it was, this did eventually work. Thank heaven for my supportive, hands-off OB, who waited quietly through 4 hours of pushing while I worked to get the baby out. And, he never once gave me a hard time about "giving in" to the epidural -- he and I both knew that I wouldn't have asked for it if it weren't really necessary for me.

So my advice is this: plan not to get an epi, because you absolutely can do it -- labor pain is absolutely manageable without it. But don't make grand pronouncements about how you'd never get one, either, because you might just end up eating some good healthy servings of crow later.
post #53 of 80
Quote:
Originally Posted by laughingfox View Post
I'm skeptical of any study from anyone with a vested interest, doctor or not. That stance seems pretty logical to me.
Right, so it should apply equally to the more NCB-friendly providers. I'd say Goer and Gaskin have a 'vested interest' in promoting NCB, wouldn't you?

The fact is that everyone has a viewpoint, and there is no such thing as a study done by someone without one. If you reject all studies done by people with 'interests' you reject all the available data. (It's certainly appropriate to examine study particulars with a critical eye, but that's different from rejecting them out of hand because you think the authors are personally suspect.)


[start peripheral discussion of study particulars]
http://www.ncbi.nlm.nih.gov/pubmed/16235275
This one shows an increase in instrumental delivery,

Yup, as I noted in my post #32. The prolonged second stage and increased rate of instrumentation (something like a 1/3 increased risk) are relatively consistent findings.

I know you were just talking about c-sec rates
Indeed, because it's one I see talked about a lot on MDC and many posters seem to assume that it's true that epidurals raise section rates.

I found it interesting that this study stated that it's purpose was to look for adverse effects, but they specifically did not look for severe or long-term adverse effects.
OK, well if you have data to cite about those effects, again, I'd be interested. This study looks at short-term effects. The Cochrane review, for example, looked at long-term risk of backache. (They didn't find a difference.) What effects were you thinking of?

Also of interest- the Cochrane study mentioned in the study in your first link was done at a hospital with a 12% c-section rate.

Huh? Cochrane is an independent group that does systematic reviews of the literature. That review covered twenty-one studies involving 6664 women.
[/end peripheral discussion of study particulars]


Quote:
You can find studies that say anything. That's the beauty of the internet, and of malleable statistics. It's also why I always consider the source.
OK then, so when people are saying that epidurals raise section rates and cause drowsy babies they should easily be able to find citations to back up those claims, right? But I never see that done here.

By the way, from some of the things in your post it sounds like you think I'm saying an epidural birth is entirely equivalent to an unmedicated birth. Obviously that is not true. What I did say is that a large part of the difference arises from the mom's immobilization, and that overall the risk *to the baby* is rather small. (Yes there is an increase in instrumental delivery, rates of instrumental delivery range from 5-20% so a 1/3 increase takes you from, eg, a 10% chance to a 13% chance; you can make your own value judgement about the importance of that effect.)

I think there are good reasons to avoid epidurals (as I did in my birth) when possible, but I think most of the benefits of avoiding the epidural accrue to the mom (no need for directed pushing, easier recovery, etc.).

Overall I would say the 'guilt value' of epidurals among NCB advocates *hugely* outweighs their actual risks to the neonate.
post #54 of 80
I just want to say that this is a really GREAT thread for me to be reading as I am getting close to my baby's birth and preparing everyday for it. Thanks!
It's really nice and helpful to hear positive stories of women who were perhaps not so confident in their strength or pain-tolerance going through epi-free labour and birth and being so happy about it after all!
Quote:
Originally Posted by MegBoz View Post
My advice is to read "The Thinking Woman's Guide to a Better Birth" by Henci Goer.

Personally, I read "Thinking Woman's Guide" and decided that a medicalized birth is not for me! "I'll suck it up & deal with the pain." is what I thought.

& I was personally way more scared of being out of control of my own body, controlled by doctors & machines, & the whole medicalized experience, than I was of the natural pain of birth.
Yep, the "Thinking Woman's Guide" certainly hardened my resolve and gave me the facts to back up what I felt in my heart was right for me and my baby.
And I totally agree with some PPs who have said that an epidural is a lot scarier than the prospect of a natural birth! A needle...in my SPINE?!? Eek. Just the fact that the thought of that makes me shudder and my stomach turn, whereas the thought of a natural birth doesn't is a sign that I'm making the right choice for me.

Quote:
Originally Posted by Comtessa View Post

So my advice is this: plan not to get an epi, because you absolutely can do it -- labor pain is absolutely manageable without it. But don't make grand pronouncements about how you'd never get one, either, because you might just end up eating some good healthy servings of crow later.
Thanks for this reminder! I'm usually a really adamant person and I usually like to express my beliefs loud and clear (when the topics come up) to anyone who will listen. But I've been trying to be careful about this (having eaten humble pie more than enough times because of my loud-mouth disposition )- birth is a private thing and in our culture and society it seems complicated by so many factors. I do have strong beliefs about it, but unless someone asks me why I think my choice is right for ME, I'll keep 'em to myself. It's hard though when you mention your choices and it seems like there are so many people ready to tell you can't do it and why you'll fail. I wish THEY would keep their ideas about birth to themselves too.
post #55 of 80

I'm only posting to encourage Original poster to go epi free-NOT to debate!! 
I'll keep my response short and simple and based on personal experience only. MY reasoning and feeling towards having an epi: I'm a super tiny girl, not athletic or "in shape" what-so-ever. The most exercise I get is walking..that's it..lol! Pain tolerance is eh..I can deal with it if I HAVE to. The thought of giving birth is, of course, scary to anyone, especially for a first time mother like I (at the time) was. The thought of shoving a needle in my spine was even scarier to me. Not to mention the thought of my baby being medicated as well. Going through my whole entire pregnancy eating healthy, getting "exercise"..lol..and doing the right things only to, at the very last minute, shoot my child up with drugs, BECAUSE THAT'S BASICALLY WHAT YOUR DOING, to avoid going through pain just seemed a little selfish to me. So I decided, after much research and encouragement from ALL the women in my family who have all had med free births, to steer clear of ANY pain meds at all costs. My husband knew too that at my weakest point in labor to not let me cave in and get them.
Well, the time came to have our first born. I was in so much pain I thought it would never end. I asked the nurse to have something put in my i.v to take the edge off. She told me no..lol as did my husband. I pleaded, I cried, and the answer was still no (luckily I was dialating too quickly so either way it was a big fat NO!). I had to get through it without drugs..so that's EXACTLY what I did. Let me tell you it was the best experience of my life!! In the end my baby was born healthy and lively! I had the biggest rush of energy afterwards and felt amazing. Knowing that I just gave birth to an 8pd baby with no drugs was the best feeling i've ever had in my entire life. I felt like I was the strongest woman alive. When it came time to have my second, Same feeling, AMAZING!!!
The pain only lasts for so long and will eventually pass. The thought of knowing that I was strong enough to bring my children into this world on my own and drug-free, Is an indescribable feeling of pride and strength that will NEVER leave me! Not to mention the bragging rights I now have . In the hospital I was known as the "tiny patient who had a drug-free birth in 4 hrs (1 1/1hrs with my second). Even all the Dr.s and nurses were in awe ! Made me feel amazing and even prouder of the choice I made.
It will only be a matter of days (Hopefully!!) before I do it all over again. I actually look forward to this amazing experience that we call natural med-free childbirth! I can't wait 'till the day comes when I can say "Yep, these are my 3 babies and I brought them into the world without doping them up and as naturally as could possibly be!"
Whatever choice you decide on, I wish you a happy and healthy birth experience that you too will be proud of. We all know sometimes things can take a turn and birth plans don't always go the way we want or imagine them to be. In your case, I hope you get whatever type of birth it is you want for you and your LO!!


Edited by teenyxdoodlez - 12/6/11 at 11:50pm
post #56 of 80
Quote:
Originally Posted by mambera View Post

I think there are good reasons to avoid epidurals (as I did in my birth) when possible, but I think most of the benefits of avoiding the epidural accrue to the mom (no need for directed pushing, easier recovery, etc.).

Overall I would say the 'guilt value' of epidurals among NCB advocates *hugely* outweighs their actual risks to the neonate.
I agree with you. Deciding based on fear, guilt, or "the ewww factor" aren't scientific. I believe an epidural has risks. I don't think that means they are the wrong choice.

I've had 4 births. Two with epis and 2 without. My last baby was a homebirth and I am almost 99% sure I would have had an epidural had I been at the hospital. Even though I knew what I was getting into, I really though the pain would be less due to the great circumstances. I was seriously thinking about how to go to the hospital during the end of my labor. Pushing was no picnic, and while I only pushed for about 12 minutes, mw had to reach up in there and dislodge baby's shoulder. Not so pleasant.

I would not do things differently next time. Every other part of the birth was optimal: recovery, pp pain, etc.

I just think it's so hard to gauge another person's experience and make a decision for them based on one's own experience.

In a sense, I was waiting for those endorphins, the "buzz" or something, that never happened. I thought I'd be up and out of bed right away and back to normal in no time. I did okay, but I was wiped out and tired.

Like I said, things went great, but I believe this stuff is so individual. I get a bit annoyed when I hear the quotes of "It doesn't have to be painful" and "Just practice this technique and you won't feel a thing". I'm not saying it wasn't that way for those people, but they shouldn't assume it's the same for everyone and that others weren't prepared and therefore had pain.
post #57 of 80
Quote:
Originally Posted by mambera View Post
Right, so it should apply equally to the more NCB-friendly providers.
I never said they didn't. I said that I always consider the source. Always.
I never said that studies should be rejected based on the viewpoint of those conducting them, either, just that it should be taken into consideration.


[start peripheral discussion of study particulars]
OK, well if you have data to cite about those effects, again, I'd be interested. This study looks at short-term effects. The Cochrane review, for example, looked at long-term risk of backache. (They didn't find a difference.) What effects were you thinking of?
I wasn't commenting on existence or non-existence of any specific risks, just that they set out to look for problems, but then didn't bother looking for anything serious. It struck me as ironic, that's all.

Huh? Cochrane is an independent group that does systematic reviews of the literature. That review covered twenty-one studies involving 6664 women.
That was bad wording on my part.
The majority of the Cochrane study's info on those 6664 women came from a hospital with a 12% c-section rate. Another doctor looked at all the same studies involved, and came out with a drastically different conclusion. Did you follow the link?
I could be wrong, but this is probably the article people quote when they say epidural doubles the likelihood of c-section.
[/end peripheral discussion of study particulars]


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OK then, so when people are saying that epidurals raise section rates and cause drowsy babies they should easily be able to find citations to back up those claims, right? But I never see that done here.
I can't speak for anyone else, but I did already link to a citation on c-section rates.

Asking a couple dozen moms what their experiences are, or witnessing the birth of a couple dozen babies of friends and relatives will give you as large a population sample as the Finland study previously linked, even if it doesn't give you a source to cite. They may just be speaking from personal experience?
(Really, in making hospital-related birth decisions, I feel that asking around about your local hospitals is a much better way to go, especially if you know anyone who works/worked in L+D. It might not be quite as scientific, but taking the local hospital procedures, policies, staff, attitudes, etc. into account will give you a much better idea of what to expect than any national or international studies.)

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By the way, from some of the things in your post it sounds like you think I'm saying an epidural birth is entirely equivalent to an unmedicated birth. Obviously that is not true. What I did say is that a large part of the difference arises from the mom's immobilization, and that overall the risk *to the baby* is rather small. (Yes there is an increase in instrumental delivery, rates of instrumental delivery range from 5-20% so a 1/3 increase takes you from, eg, a 10% chance to a 13% chance; you can make your own value judgement about the importance of that effect.)

I think there are good reasons to avoid epidurals (as I did in my birth) when possible, but I think most of the benefits of avoiding the epidural accrue to the mom (no need for directed pushing, easier recovery, etc.).

Overall I would say the 'guilt value' of epidurals among NCB advocates *hugely* outweighs their actual risks to the neonate.
I wasn't assuming you were saying that there was no difference at all, or really arguing any specific point myself, just picking apart studies.
I agree with you (taking into account, of course, that "small" is relative), and I wholeheartedly agree that there's no need for guilting any mother for her birth choices, whether you have sources to cite or not. All that any mother can do is decide what's right for herself and her family, and making those decisions is hard enough without random strangers expecting you to justify yourself.

Besides, studies have shown that 94% of statistics are just made up anyway.
post #58 of 80
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Originally Posted by Sobranna View Post

1. I am terrified of the epidural.
I was/am too.

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2. I am a wimp. I'm not athletic, wouldn't really consider myself "in shape" (who really is after a month of m/s and fatigue??), and have never really accomplished anything physically hard (had to quit training for a half marathon because of shin splints, ugh!).
Same here.

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As I research I find my heart being pulled toward an intervention-free labor and birth. I am hoping you ladies can help me with your experiences and encouragement as well as any references and resources I can look up.
I had a pretty much pain free, medication free, intervention free vaginal birth in a hospital with my first child. My total labor was 6 hours long and parts of it were intense, and some parts were gross and/or uncomfortable, but the only times it really hurt were when I sat still for electronic fetal monitoring and listened to the nurses rather than my own body.

I had read the side-effects of epidurals beforehand. I had also read a lot of stories about women having medication free births. The potential complications (for ME) from an epidural scared me way, way more than the idea of painful contractions. I also read several books that talked about how contractions did not have to be inherently painful and the relationship between fear and tension and pain. So I went into birth with an understanding of the physiologic process behind contractions and the expectation that birth wouldn't hurt and a total fear of spinal headaches, plummeting blood pressure, and complications leading to c-section.

The books I read while pregnant that I found helpful were Ina May's Guide to Childbirth and Hypnobirthing.

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Also, what things did you do in the months leading up to delivery that you felt made your natural birth more "successful"?
I don't know that any of these things had a huge role in making my birth "successful," but they are all things that most women delivering in US hospitals don't do so maybe there's something to them:

-I didn't gain a huge amount of weight. 20-35 pounds depending on whether or not you count the weight I lost in the first trimester due to morning sickness. I also didn't begin pregnancy significantly overweight (150 lb. 5'5"). I think this might have made the later months of pregnancy physically easier.

-I walked a lot, partially because I wasn't driving the first part of my pregnancy. I didn't walk fast or competitively or anything... just a few miles a day most days. This is really the only regular "exercise" that I got btw.

-I drank a lot of water. Maybe 2-3 liters a day? I was already in the habit of drinking water before becoming pregnant.

-I ate a generally healthy, almost exclusively vegetarian diet fairly low in processed foods and virtually no "fast" or "junk" food. I did, however, frequently enjoy "unhealthy" things like cheese cake

-I only ate one dessert per day.

-I didn't eat for 2. I ate the equivalent of one extra snack per day about the same number of calories as a plain bagel.

-I got enough sleep.

-I drank a pregnancy tea containing red raspberry leaf in the third trimester.

-I was adjusted by a chiropractor once during the third trimester.

-I had a well informed, calm, and supportive birth partner... I think that this made the biggest difference overall.

-I discussed my preferences and expectations with my OB prior to labor and he was willing to support and advocate for them, despite not being terribly "crunchy" himself.

-I didn't go to the hospital until my contractions were 4-5 minutes apart and pretty regular/long... i.e. I wasn't very interested in talking during them. In my case this was after only 3 hours of contractions.

I don't think that any one of the above things really "made" my pregnancy/birth experience successful, but they all probably made it slightly more enjoyable in their own small way. This time I plan to: drink more raspberry leaf tea and I started earlier (because I like it and it makes me feel better NOW) and increase my flexibility and strength... I don't think the latter is necessary for an easy vaginal birth, but I think that it will help in the postpartum period.

I'm sorry if this is repetitive/irrelevant. I don't have time right now to read all of the replies or follow this thread. I did want to let you know though that an epidural free birth does not have to be painful and that you don't have to be a superwoman to accomplish this

Oh, and the biggest benefit to not having an epidural (all of my slightly obsessive fears about epis aside) is being able to move around during labor. If a contraction began to be at all painful I was able to pretty quickly switch to a different position so that by the end of the contraction I was not experiencing pain. I remember reading that this is the body's way of giving feedback to ensure that the baby is optimally positioned and able to descend.

ETA: I just had time to read some of the previous posts on this thread and I want to clarify that I'm not claiming "you must do these things to have a natural childbirth" or that "if you do these things your birth will not be painful." I was just trying to answer the OP's questions about what things I thought made my birth experience positive... not invalidate/contradict anyone else's experiences.
post #59 of 80
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Originally Posted by laughingfox View Post
I never said they didn't. I said that I always consider the source. Always.
I never said that studies should be rejected based on the viewpoint of those conducting them, either, just that it should be taken into consideration.
OK, agreed. And maybe I am a bit oversensitive about this because I really do feel like a lot of MDC posters will dismiss studies they don't agree with "because they were done by doctors" while applauding studies (no matter the source) that reach conclusions they like.


The majority of the Cochrane study's info on those 6664 women came from a hospital with a 12% c-section rate. Another doctor looked at all the same studies involved, and came out with a drastically different conclusion. Did you follow the link?
I could be wrong, but this is probably the article people quote when they say epidural doubles the likelihood of c-section.


Sorry, you're right - I didn't read the link the first time. Now that I have read it, I see that it says the reason the biggest Cochrane study didn't find a difference was because they never gave epis before 4 cm, and that when epis are given before 4 cm they really do increase the rate of c/s.

That's certainly a legitimate and important point. As far as I know (and my direct experience is limited to two hospitals), it's pretty standard practice to wait for 4 cm before giving the epi in order not to stall labor.

So while it certainly seems true that early epidurals can stall labor and result in increased rates of c/s, early epidurals are not AFAIK standard practice so it isn't really accurate to make blanket statements about increases in c/s rate based on what happens when you inappropriately give the epi too early.



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Really, in making hospital-related birth decisions, I feel that asking around about your local hospitals is a much better way to go, especially if you know anyone who works/worked in L+D. It might not be quite as scientific, but taking the local hospital procedures, policies, staff, attitudes, etc. into account will give you a much better idea of what to expect than any national or international studies.
ITA with this. I think a wise choice of HC provider is actually far more important for a good birth than anything else (like Bradley classes or whatever).
post #60 of 80
I haven't read all the replies. I had an unmedicated birth for very practical reasons. I believe that medication should be used when needed, so if I had really wanted an epidural I would have had one. But my labor was precipitous so they didn't offer me one. I have to say (at risk of getting flamed) I was kind of traumatized by the pain. My first thought was that I should have had pain relief. Now I am so glad that I had an unmedicated birth. I'm glad because there can be lasting side effects from epidurals. I know people who have dizzy spells, headaches and back pain from epidurals. These are people who've had epis for other surgeries, not just for labor. Of course a lot of people don't have any lasting side effects, but still I'm glad I don't have to deal with any of that.
That being said, I believe that epidurals can be very helpful for an exhausted mother. I know many women who weren't dilating through hours of excruciating labor and the minute they got the epidural they relaxed and dilated. What I object to is women being pressured into getting an epi, because it would be more convenient for the hospital staff.