Education should come from both sides of the coin, making sure that women know that it might not be that bad, or that it MIGHT be that bad. Educate them to try that there are a large variety of pain relief methods to try, from walking to epidurals, and what the risks and benefits of all of them are, THAT is the best option.
The problem with simple education on the risks and benefits is that it does not take into account the fact that, in most hospitals, in most families, making those choices is not easy. I have seen many women who understood the risks and did not want an epidural end up with one because their partner was beside himself panicking while she was screaming or because of a vaginal exam that told her she was not up to par. Educating women about what they will need to fight to avoid the epidural is one thing and he does yield some limited success (just look at all the women here who managed to get their natural birth in hospitals), the only way to make a true difference is to get rid of those obstacles. That does involve an entire paradigm shift for many care providers and institutions so instead we end up with people trying to minimize that "guilt" (which should be really be felt by those hospitals and not their patients) and grasping at statistical trickery to convince people that there really is no problem.
The fact that you make the assumption that I am talking about educating women on what they need to fight to avoid it, is part of the problem and part of where the guilt come from. The purpose of the education is to help women make choices, not automatically to avoid epidurals. Many women look at the risks and decide that the epidural is for them. And that's ok. But being told that the education is to help them avoid it certainly implies that they are not supposed to want it, hence where guilt comes from.
And once again, there's the assumption that a fight has to take place at all. If you go into any situation expecting to have to fight, you are probably going to get a fight. But if you go into the situation with an open mind, you are more likely to get your way without any opposition at all. It's been my experience on this board that a lot of folks here go into birth at a hospital expecting a fight and are looking for opposition that isn't necessarily there.
That was meant as " Educating women about how they will need to fight if they want to avoid the epidural..."
Every single woman I have met who went into the hospital without a resolved determination to fight for a natural birth ended up with an epidural. I even witnessed a doctor trying to hold down my sister as the baby was crowning to get the epidural in because she had a fast labour and it was a big race to get it done in time...
I have to be honest aside from own my first birth (no epidural btw) , where a doctor rolled her eyes at me then quickly gave me a through and through episiotomy that I was too exhausted to even know I HAD until I discovered stitche a few days later and asked my mom about it all because I was passing out between contractions and just didn't think I could go on anymore...I have NEVER seen this kind of lack of professionalism in a hospital setting (L&D or toherwise) directed at a patient
and frankly..having worked in emergency services for going on 10 years I've seen some very unprofessional things..but never anything that would involve restraint of a patient beyond a psych with a psychotic break..
I have witnessed healthcare professionals try to convince a patient they needed something (when they were genuinely concerned not financialy motivated) life saving but never for simple pain relief
you wanna suffer...go for it has always been the attitude I've seen.
but then again...epidural goes to the anesthesia department at every hospiatl here ...not L&D and definitely not the OB who generally has a two flat rates, one for cesarean, one for normal vaginal delivery and for all prenatal appointments (btw the difference between the rates at the practice I'm currently going to is $500 dollars..which is peanuts)
I feel an incredible amount of irrational guilt for having had two epidurals...my own PCP had a spinal headache from an epidural and has actually stated she'd rather go through natural childbirth rather than ever experience that again..this weighs heavily on me because I trust her judgement fairly implicitly..not to be confused with complacently, I question that Dr a lot because shes always made me feel her equal to her credit.
Ive had a full epidural and a walking epidural...I'd say that if I had been a first time mom I might not of figured out how to push with the full epidural...as it was I had to watch my abdomen for contractions to know when to so thats a strike against it for sure
..the walking epidural was pure heaven, for the first time I got to feel the baby's body move through my pelvis and understand what was going on...actively push while squatting, be alert, be happy..not want to kill the staff for imagined insults...and ENJOY my new baby
both of the epidural babies were much quicker labors and that really really helped me cope with caring for a newborn
by no stretch of the imagination am I saying everyone should get an epidural..but much like another hot topic among womens healthcare..
those that are against epidural give everyone else a sort of quiet crap to those that get them, like you didn't earn a special merit badge or something...but those that get them don't think everyone should
I think for every medical procedure including this one TRUE informed consent should be given and it rarely is honestly so that each woman can weigh the pros and cons