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Epidural without guilt? - Page 6  

post #101 of 135

"I don't feel it prudent to read books in their entirety to complete dismiss them  ..."

 

I LOVE it! "in their entirety" Gimme a break! You didn't read ONE PAGE of my book, yet you dismiss the entire book because you're unwilling to open your mind to ideas that don't validate your pre-existing strong beliefs. You've completely mischaracterized my book, but it would be bizarre if you had  characterized it correctly, considering you haven't read it.  There is a big advantage to having strong beliefs that you don't allowed to be questioned - you don't have to think!

post #102 of 135
Quote:
Originally Posted by Mama Metis View Post

There are certainly valid reasons a woman might choose an epidural, and many women who benefit immensely from them. However:

 

1) It is pretty disingenuous to imply that there are no adverse outcomes associated with epidurals. To name a few: longer second stage, increased need for augmentation, urinary retention, fever, and reduced mobility during and after birth. (See the Cochrane review on this topic, which I think Dr. Grant's colleague will agree is scientifically rigorous.) If he or she is feeling honest, I'm sure s/he will also admit that there is not yet scientific consensus on whether epidurals increase the risk of cesarean, and that this relationship is most likely context-specific. More research is needed.

 

2) Honestly, I question the usefulness of this publication to society. Epidurals are the norm and the expectation for laboring women in the US. Only about 14% of mothers report birthing without one (see Listening to Mothers Survey.) I'm a bit skeptical of this guilt complex that Dr. Grant feels is so pervasive. Women can and do experience labor in many ways, and they deserve to have choices in how they engage with the experience. I'm not sure efforts to further whittle down the 14% are a societal good, nor will they do anything to improve the options that are available to women. 

 

1) Excuse me, but i don't recall anyone in this discussion ever implying that there are no adverse outcomes associated with epidurals. Am I missing something? Actually, if you were to bother reading my book, you'd find an entire chapter on their risks. So who is being disingenuous here?

2) I'm interested that you honestly question the usefulness of this publication to society. Considering that you've never read this publication, I find your honest questioning rather amusing.

post #103 of 135

I think it sounds like a good read and I'd like to borrow a copy from my library. 

post #104 of 135

1) Excuse me, but i don't recall anyone in this discussion ever implying that there are no adverse outcomes associated with epidurals. Am I missing something? Actually, if you were to bother reading my book, you'd find an entire chapter on their risks. So who is being disingenuous here?

2) I'm interested that you honestly question the usefulness of this publication to society. Considering that you've never read this publication, I find your honest questioning rather amusing.


An ENTIRE chapter on risks in a whole book about how epidurals need to be given to every one preemptively before they feel pain? 

 

As I was catching up with this a few pages back, I was going to ask if you also wanted to start giving epidurals for afterpains. That would have been my attempt at reductio ad absurdum. I guess I need to find a more absurd example... do you also advocate for some sort of modern day twilight sleep?

post #105 of 135

Actually, I said:

 

Quote:

 

I don't feel it prudent to read books in their entirety to complete dismiss them if I feel secure I have gotten the overall premise and disagree with the fundamental foundation of belief that supports the "research" and subsequent opinion therein. Books by The Pearls, Dobson, Ferber come to mind as well as Supernanny, etc. When the entire premise of a book begins with the assertion (whether stated or implied) that epidural is optimum in labor over being able to feel the sensations of labor... I am not interested in the rest, because I don't agree one iota. I believe it is an available choice for women who choose it and it should stay that way for those women, but I don't believe it's optimum in the vast majority of cases and I believe it's even harmful in many.

 

 Are you denying that you feel epidural is optimum in labor and the benefits outweigh any risks?

 

Personal attacks to my character aside (which are against the User Agreement if you'd like to take a peek at that), are you not accusing me of the very thing you've done this entire thread, which is dismissing every opinion/experience and even cited study that conflicts with your book because you're unwilling to open your mind to ideas that don't validate your pre-existing strong beliefs that epidural is a fabulous, relatively risk-free choice that may be actually (to quote you) unhealthy and pose risks to women who don't use them?

 

Accusing someone of not wanting to "have to think" is rich coming from someone who promotes drugs for women in labor who don't want to have to feel.

 

Quote:
Originally Posted by DrGilbert Grant View Post

"I don't feel it prudent to read books in their entirety to complete dismiss them  ..."

 

I LOVE it! "in their entirety" Gimme a break! You didn't read ONE PAGE of my book, yet you dismiss the entire book because you're unwilling to open your mind to ideas that don't validate your pre-existing strong beliefs. You've completely mischaracterized my book, but it would be bizarre if you had  characterized it correctly, considering you haven't read it.  There is a big advantage to having strong beliefs that you don't allowed to be questioned - you don't have to think!

post #106 of 135


 

Quote:
Originally Posted by DrGilbert Grant View Post



Quote:
Originally Posted by happysmileylady View Post

 

Quote:
  I suggest that women who want an epidural get it BEFORE the pain becomes severe. 

 This is something I am curious about.

 

I have taken lots of pain meds in my time.  I have had 7 teeth pulled, 3 root canals and countless other dental issues, requiring some form of narcotic pain relief either before or after, not to mention pain meds for afterbirth pains.  In addition, I get migraines and take meds for that, after having tried out several different options.

 

And in reading up on all the stuff I have taken (got any questions about vicoden, hydrocodone or vicoprophen?:-) )  something that is discussed quite a bit is that it's best to take the pain meds before the pain gets severe.  That pain meds work best on the pain the earlier you take them. 

 

Is this something that's true for epiduals as well?  An epidural is a different kind of pain killer, right? 

 

 There are different types of medication that can be administered in an epidural. But your thoughts are exactly right. It's definitely better to take pain relievers BEOFRE the pain begins. When's the last time time you were at the dentist and told the her/him to start drilling for a while before giving you the local? Let me guess: Never? Becuase that would be plain silly! But women in labor do that all the time. I'm not talking about those women that don't want any medications and are committed to a "natural birth." I'm talking about women who think theat they want an epidural, or are sure that they want an epidural, but they wait until the pain becomes excruciating before they get it. It makes absolutely no sense. But this is standard practice. I'm trying to explain that it shouldn't be. If you want pain relief for labor, why suffer at all? As I point out in my book, pain itself has a lot of really bad effects for the mother and the baby. In general, for various reasons, you're exactly right - it's better to tak pain meds before the pain becomes severe.


Not to sidetrack things too much, but it's actually not silly.  I have a very skilled dentist who has done fillings on both myself and my daughter with no anesthesia.  He gives me nitrous oxide because the sound of the drilling makes me so tense it is hard for him to do his work, but my daughter doesn't even need that.  He isn't afraid of anesthesia, and is a board certified anesthesiologist.  He just prefers to reserve it for when patients actually need it, which he has found to be far less frequently than they think they do. 

post #107 of 135




 



Quote:

Originally Posted by DrGilbert Grant View Post






I don't find my statement hilarious or tragic. It's merely a statement of fact. For most women, labor is the most severe pain they will experience in their lives. That is a scientific fact. It's not an opinion. Sure, for some women, the pain of labor and delivery isn't so bad. As I mention in my book, some women actually enjoy it to such a degree that they achieve orgasm at the moment of delivery. But facts are facts: for MOST women, labor is the most severe pain that they will ever experience. If a woman doesn't want pain relief, either because her labor doesn't hurt or because she would rather have the "full experience," more power to her! But for the overwhelming majority of women who experience excruciating pain during labor and delivery, of course I think they should have the right to have their pain relieved. I'm a physician. It's my duty to care for people. Of course what I propose is quite commonsensical: I suggest that women who want an epidural get it BEFORE the pain becomes severe. Why suffer needlessly?



 







Is there a citation to support that in your book?  Because I know it is not true for me nor for a number of women I know.  Maybe a lot of women have never had a serious injury or other significant medical situation at the time that this evaluation is made.  I don't know.  I am simply amazed by that statement.  (Breaking my foot hurt a lot more.  Setting my broken foot hurt 5x more!)

post #108 of 135

I think there is some confusion with terms in this thread.

I dont think epidurals CAUSE cesarian sections but they certainly create symptoms that may lead to a cesarian section.

 

I will have to read the bok but to say not having an epidural can be harmful is an overstatement and recommending pain relief for breastfeeding is unproductive, because it doesnt solve the real issue behind why breastfeeding would be painful. And I have Doctor Jack Newman breastfeeding expert who would back me up on that one.

post #109 of 135
Quote:
Originally Posted by starrlamia View Post

I will have to read the bok but to say not having an epidural can be harmful is an overstatement and recommending pain relief for breastfeeding is unproductive, because it doesnt solve the real issue behind why breastfeeding would be painful. And I have Doctor Jack Newman breastfeeding expert who would back me up on that one.

 

I believe the Doctor is talking about epidurals for afterpains rather than nipple pain.  Afterpains are no big deal, just a bit uncomfortable, to some women but can be absolutely excrutiating to others, and are much worse during breastfeeding as the hormones released make the uterus contract.  

post #110 of 135

Yay, lucky me, one more source to deconstruct for my MA thesis. Thanks, doc.

post #111 of 135


 

Quote:
Originally Posted by DrGilbert Grant View Post

For most women, labor is the most severe pain they will experience in their lives. That is a scientific fact. It's not an opinion. Sure, for some women, the pain of labor and delivery isn't so bad. As I mention in my book, some women actually enjoy it to such a degree that they achieve orgasm at the moment of delivery. But facts are facts: for MOST women, labor is the most severe pain that they will ever experience. If a woman doesn't want pain relief, either because her labor doesn't hurt or because she would rather have the "full experience," more power to her! But for the overwhelming majority of women who experience excruciating pain during labor and delivery, of course I think they should have the right to have their pain relieved. I'm a physician. It's my duty to care for people. Of course what I propose is quite commonsensical: I suggest that women who want an epidural get it BEFORE the pain becomes severe. Why suffer needlessly?

Where in there did I "claim" that the majority of women want pain relief"? My point is simply that the pain of childbirth is the most severe pain that most women ever experience in their entire lives. If you ask a whole bunch of women who've had a whole lot of life experiences what the worst pain they ever experienced was, most of them will tell you it was childbirth. Nothing anecdotal about this. Just facts. If you want to read the science behind this, look at Dr. Melzack's work.

Cultural aspects of pain in childbirth? Forget about my thoughts - just look at the facts: In cultures simce the beginning of recorded history, we know that chilbirth hurt. It's always hurt. It's mentioned in the Bible, it's mentioned in literature from cultures throught the world. It appears in drawings and art throughout the ages. Childbirth hurts.

Facts 

 

Well, unless you can quantify these "scientific facts" in a  scientific manner, (e.g. research, survey), they remain mere anecdotes.

 

My second point I say with all due respect.  The rhetorical question of "Why suffer needlessly?" can only come from a man or a woman who's never had a baby.  Extremely caring and well-intentioned men can come to the simplistic conclusion of, "It hurts.  So let's make it not hurt." 

 

But bearing a baby, from the laboring woman's woman's standpoint, is a lot more psychologically complex.  The pain of passing a kidney stone is a pain that you simply can't wait to get over with.  The pain of bearing a baby is simultaneously coupled with excitement, an awareness that I'm closer and closer to holding and loving on my sweet baby.  It's actually quite motivating in a way that numbness can't be.  

 

That's not to say that I don't support (or even partly empathize) with the woman who chooses an epidural.  But even the Good Book that you're quoting (so far as we know!) was authored by men.  winky.gif 

 

Finally....guilt-free?  As Tumble Bumble stated (albeit in different words) we're each responsible for our own emotions.  No one person can make another person feel guilty.  In fact, I'll venture so far as to say that is it combative and accusatory to state or imply that somebody is making somebody else feel guilty.  In short, whether consciously or not, it is a way of picking a fight.

 

The Mommy War of yesteryear (although it still lingers, unfortunately irked.gif) was working outside the home v. staying at home with the children.  The latest Mommy War that's unfolding is hospital/epidural v. out-of-hospital/natural.  And I'm sorry to say that along with news media,  I largely fault some physicians for fanning those flames.  It is a travesty to pit women against each other for something as intimate and personal as their birthing choices.  And it is an equal travesty when women choose to participate. 

post #112 of 135
Quote:
Originally Posted by kama'aina mama View Post


 


Is there a citation to support that in your book?  Because I know it is not true for me nor for a number of women I know.  Maybe a lot of women have never had a serious injury or other significant medical situation at the time that this evaluation is made.  I don't know.  I am simply amazed by that statement.  (Breaking my foot hurt a lot more.  Setting my broken foot hurt 5x more!)

 

I have to think you're in the minority.  Child birth was absolutely excrutiating for me.  I did it w/o an epidural, but it was the most painful thing I've ever felt.  (And yes, I broke my foot as a kid and then played soccer on it - it hurt, but not like birth!  I also broke a toe in high school, that I never got set b/c I didn't want to miss out on the rest of my crew season.  I've pulled more muscles than I can count, had stitches a few times, etc.)  ALL of that pales in comparison to child birth.  Childbirth was TONS more painful.  Next time, I'm going to try hypno-babies or something like that to see if it helps. 
 

post #113 of 135

I would suggest that this discussion might of gone a lot better on a site such as babycenter or the likes rather than MDC where the focus is on all natural everything. I think that for the most part this type of book will not ever be well received in this community because its not what this community stands for.

 

 

My own views on childbirth and a lot of parenting actually fit better with the above mentioned site, but I find the participants of MDC to be a better informed crowd that fits better with my views on naturapathic and herbal methods so I pop in from time to time. I'm fortunate to have mainstream medical practitioners that don't always think traditional western medicine is best.

 

 

As an unrelated note a friend of mine is doing her PHD based on how yoga helps lower blood sugars in type I diabetics and heart patients that traditional medicine has failed and she has carefully laid out double blind studies that are really ineresting. I do think a lot of things really are mind over matter.

post #114 of 135

 

Interestng thread. I started out reading thoroughly for the first couple of pages and skimmed through to the end. I have no interest in contributing to the debate about the risks (or not) of epidurals vs natural birth. I commend Dr. Grant for offering information and inspiring discussion on the topic, since I believe women are entitled to hear all views and to make an informed choice. (I also congratulate him for sticking with this discussion thread as it has heated up). I will offer my own anecdote about the guilt associated with the choice, though.

 

I have had 2 children, the first with epidural and the second without. They were both born in a leading teaching hospital in North America, recognized for its maternal and infant health programs. There was absolutely NO pressure from the health professionals to get an epidural. It was entirely my choice. I opted with the first, and was later very grateful that I had, since he was posterior facing. It was a tough birth for both of us and the epidural eased it somewhat (not completely though - it didn't "take" entirely). My second L&D was fairly quick and so I didn't have an epidural.

 

I have degrees in science and health care, was working in a hospital at the time of my deliveries and researched my optons before I gave birth. I understood the associated risks, and made a completely informed choice about the epidural. I am comfortable with my decision. Despite that confidence, I have encountered people who have worked hard to convince me that it was a bad choice and my birthing experience with the epidural was somehow "inferior". Some of these people are as "mainstream" as you can imagine, but on the topic of childbirth they are fervent advocates of natural delivery. With their fanatical devotion, they have been dismissive of any supportive discussion for pain relief during the birth process and derogatory toward any woman who opts to avail herself of it. Interestingly, a quite a few of them have been lawyers (both male and female).

 

I can understand how some women, confronting this kind of attitude, would feel a lot of guilt about their choice despite any personal beliefs that they made a good decision at the time. I have been gobsmacked to hear that I was less of a woman and a mother because I didn't fully experience the pains of childbirth and I unnecessarily risked harming my baby.

 

I'll also point out that this attitude isn't really something recent, as some posters have suggested.  My son is 18 y.o. next month, and I heard lots of arguments against epidurals for years before he was born.

 

 

 

post #115 of 135

Just a reminder, folks, to please - even in disagreement - keep the thread respectful.  I believe this is a conversation that can be had, but only if people remain respectful.  Have another look at your posts and reread them.  Make sure you are being, at the very least, civil, and are not violating the User Agreement. If your posts aren't being civil, then please edit.

 

Thanks.

 

smile.gif

post #116 of 135

Fair enough, I'm willing to read the book. I suppose that's the main purpose of your efforts in posting here. winky.gif But if you don't actually oppose either of my two points below, then I really have difficulty imagining the book will be very enlightening. Epidurals are somewhat risky, and yet are almost universally accepted by laboring women in the US. Where's the story?

 

Thanks for taking the time to post here, regardless. Whether you're a grad student trying to make a buck (been there) or an employee of the publishing company doing a less-than-popular job (been there too) it's not exactly fulfilling work to post on a board that is pretty fundamentally opposed to this kind of message. 

 

Quote:


Originally Posted by DrGilbert Grant View Post



Quote:
Originally Posted by Mama Metis View Post

There are certainly valid reasons a woman might choose an epidural, and many women who benefit immensely from them. However:

 

1) It is pretty disingenuous to imply that there are no adverse outcomes associated with epidurals. To name a few: longer second stage, increased need for augmentation, urinary retention, fever, and reduced mobility during and after birth. (See the Cochrane review on this topic, which I think Dr. Grant's colleague will agree is scientifically rigorous.) If he or she is feeling honest, I'm sure s/he will also admit that there is not yet scientific consensus on whether epidurals increase the risk of cesarean, and that this relationship is most likely context-specific. More research is needed.

 

2) Honestly, I question the usefulness of this publication to society. Epidurals are the norm and the expectation for laboring women in the US. Only about 14% of mothers report birthing without one (see Listening to Mothers Survey.) I'm a bit skeptical of this guilt complex that Dr. Grant feels is so pervasive. Women can and do experience labor in many ways, and they deserve to have choices in how they engage with the experience. I'm not sure efforts to further whittle down the 14% are a societal good, nor will they do anything to improve the options that are available to women. 

 

1) Excuse me, but i don't recall anyone in this discussion ever implying that there are no adverse outcomes associated with epidurals. Am I missing something? Actually, if you were to bother reading my book, you'd find an entire chapter on their risks. So who is being disingenuous here?

2) I'm interested that you honestly question the usefulness of this publication to society. Considering that you've never read this publication, I find your honest questioning rather amusing.

post #117 of 135
Quote:
Originally Posted by Mama Metis View Post

Fair enough, I'm willing to read the book. I suppose that's the main purpose of your efforts in posting here. winky.gif But if you don't actually oppose either of my two points below, then I really have difficulty imagining the book will be very enlightening. Epidurals are somewhat risky, and yet are almost universally accepted by laboring women in the US. Where's the story?

 

Thanks for taking the time to post here, regardless. Whether you're a grad student trying to make a buck (been there) or an employee of the publishing company doing a less-than-popular job (been there too) it's not exactly fulfilling work to post on a board that is pretty fundamentally opposed to this kind of message. 

 

 


Bolding is mine I think that statement is an unfair characterization of everyone who subscribes to MDC and one of the many ideas which infuriates me about the tunnel vision of the "natural" birthing community.  I do not consider myself fundamentally opposed to the idea of epidurals because as noted in many posts - they do serve a purpose and are an option and should be available to women if they so choose.  Again every laboring woman has the option to choose what level of risk they are comfortable in accepting in their lives.

 

To say, or preach there is a "right" way to give birth or imply some one is less of a woman for making a choice regarding pain-relief in a very personal time in their life is a terrible & hostile message we as a birth professionals community  are imposing upon our clients.

post #118 of 135


Bolding is mine I think that statement is an unfair characterization of everyone who subscribes to MDC and one of the many ideas which infuriates me about the tunnel vision of the "natural" birthing community.  I do not consider myself fundamentally opposed to the idea of epidurals because as noted in many posts - they do serve a purpose and are an option and should be available to women if they so choose.  Again every laboring woman has the option to choose what level of risk they are comfortable in accepting in their lives.

 

To say, or preach there is a "right" way to give birth or imply some one is less of a woman for making a choice regarding pain-relief in a very personal time in their life is a terrible & hostile message we as a birth professionals community  are imposing upon our clients.



Who here is claiming some universal opposition to epidurals or that the option should be taken away? 

 

I think this comment is a prime example of how people project their own fears and insecurities on others. When someone says they think natural birth should be encouraged and supported in our society and that intervention rates are too high, it does not mean that they are attacking women who chose otherwise. No one ever implies that anyone is less of a woman (whatever that means) for getting an epidural. Imagining such implications come from the observer's mind only.

post #119 of 135

I will put the book on my reading list. I will probably get to it this summer. It's available right now right?

 

I'm just going to throw my own experiences out there. I was a Doula for a short time, about 3 years. I only worked in 2 hospitals (I'm rural). Both hospitals constantly asked the moms if they wanted the Epidural, even those who said don't ask me. They were pretty pushy about it, and some were up front saying it makes it easier for them to have the mom on an Epidural. I had the Epidural with my first birth. It was horrible and I had a lot of complications after that, and my OBGYN who had been practicing for 25 years said that those complications were likely due to the Epidural and lack of getting out of bed (which I was not able to do). I had my second birth at home, with no pain medications. It was a lot better, and it wasn't painful. Yes, some women will have horrible pain in labor, but not all. Pain is different for everyone. If I was stuck in a hospital bed with my second child it would have been painful, but because I was walking and moving and working with  my body it wasn't painful. I'm a Childbirth Educator so I feel it is my duty to read all the latest books, and give out accurate information based on unbiased research (can be hard to find sometimes, but for the most part I can get access to it). I have no stance on the Epidural really. It has risks just like with anything, and each woman has to evaluate those risks and decide if it is something they are ok with. I prefer not to have any medications at all, because for me childbirth is not painful. It's not even in my top 5, and probably not in my top 10 (but I haven't had that many painful experiences, so I don't think I have 10). As for guilt. Guilt is an emotion which can come after anything. I did feel guilty for having the epidural. I was very disconnected once I recieved it and I had a horrible time bonding. My son needed to be on oxygen after birth so I didn't get to hold him for some time afterwords. The OBGYN told me that the Epidural made my son drowsy and he was having a hard time breathing. I still feel guilty from time to time when I think about it, but it's a part of life, and it's ok to feel guilty.

post #120 of 135

n/m - I am choosing to no longer engage in this forum or discussion.

 

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