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Epidural without guilt? - Page 5  

post #81 of 135



 

Quote:
Originally Posted by SGVaughn View Post



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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.



I think to some degree you're being dismissive ...and I support use of epidurals with informed consent (real, unbiased information). I for one have had a sense of guilt having had epidurals and agree that a standard "full epidural" vs a "walking epidural" are two different animals. I think laboring for some time without the epidural is beneficial in one aspect for experience but more importantly it is often hospital policy to keep a mother on a gurney/be with continuous monitoring (bp, ringer iv, 02 sat, fetal hr, possible catheterization) and of course for liability. This is not a good position to labor in for fetal descent, this doesn't help malpositioned babies get into a better position for all involved, this increases the risks for interventions.I think this practice needs some "tweaking" in order to really help reduce risks of epidurals leading to more caesareans, vacumn extraction, low forceps etc.

 

I will add a qualifier to that and say that I was very adamant in my second epidural birth (walking epidural) that I still be allowed to move around at will and whim and had none of the above problems/risks but the only reason I knew I could fight for this, and it was an argument, was because I am acutely aware of patient rights in my state having worked on the other side of things and being a particularly aggressive patient advocate.

 

 

I think more women need to know what their rights are and not be bullied by anyone and that this is really the core of the matter.I see over and over again on this board that women have grown to mistrust the medical community because of bad medical attention they have received. This to me is a huge problem for a variety of reasons not least of which childbirth where women are affraid even at a home birth to call someone in case of an emergency.

 

 I also am a vaguely offended that you would imply that women (especially on this board) can't possibly understand what statistics mean or how peer reviewed studies are conducted. This is naive on your part. There are quite a few nurses, doctors and midwives on this board let alone many other sciences (I'm neurobiology and paramedic sciences, my husband a chemical engineer). The M.D. isn't the only area of study that study these things/learn them in college and apply them in their daily working careers. Perhaps your own patients can't make rational informed choices and for that I'm truly sorry. Also I think you ignore where people might have other strengths that may or may not apply to the matter at hand. For instance in absolutely any medical emergency where there isn't a controlled enviroment I'd bet my home that I react better and more efficiently than you do..not that this applies here but hopefully you get my point.

 

 

 

It's very difficult for someone - whether a scientist, physician, physician-scientist, or (especially) a layperson to critically evaluate a study, peer-reviewed or not, in an area that is not their particular specialty. That's simply a statement of fact, not an indictment of the people on this board regardless of what their (or their spouses) educational backgrounds may be.

post #82 of 135

I agree that it is difficult if it is not your area of specialty but this is where medical professionals need to try and give some guidance and they more often than not don't, not truly.

I think giving all of the available information including information that may conflict with your own views is important.

I don't think doctors especially are very good at being very good guides to their patients with information and too often take on a sort of authoritarian role forgetting that they are simply being hired by the patient to do their job.

 

I'm lucky that my demographic is such where medical professionals seem to be keenly aware that they are the "hired help" and frequently work with very educated patients so they generally treat their patients as equals. You'll find that the climate on this online community is more often than not the opposite experience. If you took some time to really read some of these stories around here I think any person that knows and abides by medical ethics would be horrifed by what they read and you'd see why some people will respond to your proposition with pure venom and rightly so.

The problem is far larger than whether epidurals are okay or not.

post #83 of 135
Quote:
Originally Posted by SGVaughn View Post

I don't think doctors especially are very good at being very good guides to their patients with information and too often take on a sort of authoritarian role forgetting that they are simply being hired by the patient to do their job.



i'm trying to envision how the ideal OB would discuss epidurals with her patient. when i had questions with my first daughter, i simply asked my OB if she would use an epidural. she said she did not, but that was because 30 years ago, they were rather new. if she were to deliver today at her hospital, she said she would (her hospital placed thousands of epidurals per year, she said, and she knew they were very good at it). if i had wanted more information than that, i think it would have been ideal for her to point me to a book (which now she could!). but i don't think it'd work for her to suggest i hop on pub med and scan the literature myself. or take 2 hours to discuss the finer points of the literature with me herself.

 

i guess i just see the doctor's role here as giving patients the most up to date recommendations possible, and point them in the right direction if they want to know more, but not more than that. i fully expect that if i want to learn everything i can about a topic, i'll have to do that on my own. what is it that you think they should be doing differently?

post #84 of 135
Quote:
Originally Posted by SGVaughn View Post

I agree that it is difficult if it is not your area of specialty but this is where medical professionals need to try and give some guidance and they more often than not don't, not truly.

I think giving all of the available information including information that may conflict with your own views is important.

I don't think doctors especially are very good at being very good guides to their patients with information and too often take on a sort of authoritarian role forgetting that they are simply being hired by the patient to do their job.

 

I'm lucky that my demographic is such where medical professionals seem to be keenly aware that they are the "hired help" and frequently work with very educated patients so they generally treat their patients as equals. You'll find that the climate on this online community is more often than not the opposite experience. If you took some time to really read some of these stories around here I think any person that knows and abides by medical ethics would be horrifed by what they read and you'd see why some people will respond to your proposition with pure venom and rightly so.

The problem is far larger than whether epidurals are okay or not.

Very interesting post of yours...first of all thank you for agreeing with me that's it's difficult for non-specialists to critically interpret clinical studies. Not everyone on this board understands this. And I agree with you that all available information should be provided, even if it conflicts with one's views. It's a shame that you think so little of doctors. And it's a shame that you view doctors as "hired help." You see, the way I was raised, and the way I was trained, and the way I view my profession couldn't be more different than "hired help." Physicians are meant to care for their patients, to be selfless and compassionate, not to allow their own prejudices to come into play. Physicians are the ultimate patient advocate, assisting them to come to grips with very serious decisions, including those involving life and death. Next time you go to one of your "hired help" doctors, if they do a good job, at least consider giving them a good tip!  I’ll bet dollars to donuts that you’ve never tipped one of your “hired help” doctors. C’mon, now, be consistent!

 

post #85 of 135
Quote:
Originally Posted by majormajor View Post



Quote:
Originally Posted by SGVaughn View Post

I don't think doctors especially are very good at being very good guides to their patients with information and too often take on a sort of authoritarian role forgetting that they are simply being hired by the patient to do their job.



i'm trying to envision how the ideal OB would discuss epidurals with her patient. when i had questions with my first daughter, i simply asked my OB if she would use an epidural. she said she did not, but that was because 30 years ago, they were rather new. if she were to deliver today at her hospital, she said she would (her hospital placed thousands of epidurals per year, she said, and she knew they were very good at it). if i had wanted more information than that, i think it would have been ideal for her to point me to a book (which now she could!). but i don't think it'd work for her to suggest i hop on pub med and scan the literature myself. or take 2 hours to discuss the finer points of the literature with me herself.

 

i guess i just see the doctor's role here as giving patients the most up to date recommendations possible, and point them in the right direction if they want to know more, but not more than that. i fully expect that if i want to learn everything i can about a topic, i'll have to do that on my own. what is it that you think they should be doing differently?

I couldn't agree with you more. the reason I wrote my book is that there is no resource out there that covers the information I present. Moms-to-be (and obstetricians, midwives doulas, etc) need access to up-to-date information about state-of-the-art pain relief techniques. I have spent quite a lot of time over the course of my career following the literature. I have distilled it in my book and presented it in an easy-to-read format. I kept the references to a minimum so as not to impede the flow of the book, but there are quite a few that I have included. I suggested on this board that people can consult the studies themselves, but this was a suggestion for those people who have no intention of ever reading my book, and those people who are much to suspicious to ever trust anything that a physician tells them. Of course, the problem is that unless you are trained in a particular area, it's darn near impossible to interpret the literature accurately. The best solution to all this is to consult a number of sources that you consider to be trustworthy, and to discuss the issues with your physician or midwife (assuming you consider them to be trustworthy!).

 

I'd be very interested to hear the reactions of people on this board who have actually read my book. It would be a great jumping-off point for a (hopefully) enlightening discussion.

 

post #86 of 135

lol! now you know how I think! will the arrogance never stop!

 

thats not the point I was trying to make at all...at all at all

 

When I was applying to a physician's assistant program in connecticut my PCP was invaluable at helping me in my senior year get my course load finished up to be an exceptional applicant.

She also treats every member of my family for a variety of different things from my husbands epilepsy, to my thyroid cancer, to my youngest's well child check-ups. She knows I'm inquisitive and shares interesting patient stories with me without violating HIPPA (I do the same). Who by the way suggested I might want a home birth for my youngest based on her OWN horrible hospital birth experience that included a good deal of complications from an epidural! And as far as giving her a "tip" I treated and transported in her husband due to a horrible MVA.

 

My endocrinologist is very much the same in treating his patients like equals and really has some very interesting studies published in the New England Journal of Medicine on the effects of Vitamin D deficiency.

 

I have severe SPD and found a Dutch publication that goes against the grain of advice typically given in the United States for coping with it. My Obgyn practice (which is the largest in the state) requested I bring in a copy of the book so that they may order it themselves to help out other patients.

 

My point was, before you put your own projections into it, was that Dr's would be wise to remember they can be replaced and will find themselves without a viable practice if they're not careful. Here they have to worry about being sued over the slightest perceived injustice which I don't happen to agree with but it certaintly makes for a much more open line of communication between doctors and patients.

 

 

 

 

as for how a conversation should look between a doctor and a patient in regards to an epidural...the facts without bias should be layed out and this should be communicated well before labor begins in an ideal situation. The practice I have gone to this go around gave me as a new patient a new patient bag that included a good deal of information including peer reviewed studies and ranged from induction methods to hypnobabies class information.

 

Also, don't lecture me on compassion.Ive been a practicing medic for about ten years. I was also a combat medic in the war. I promise I've had to exude more compassion in those ten years then you'll ever have to in your life.

So try to do a little more comprehensive reading before you jump to assumptions please you seem a tad emotionally invested.

 

post #87 of 135

First of all, thank you for your service to our country. We are all deeply indebted to all our heroes and heroines who defend our liberty. And I mean this with all sincerity. Civilians living a comfortable life stateside don’t give nearly enough thought to our countrymen who defend us overseas in some horrible conditions and dangerous situations. But, I don’t recall lecturing you on compassion – because I did not do any such thing. Similarly, I would suggest that you not jump to any conclusions regarding the compassion to others I have shown in my life, or comparing it to the compassion you have shown. You don’t know me, so that’s just plain silly of you. In terms of being emotionally invested, if you mean my reaction to your likening of me and my fellow physicians to “hired hands,” well yes, I do suppose you struck a chord. I take my life’s work very seriously, and don’t appreciate having it demeaned. None of this is helpful in furthering the discussion of the choices that women have for childbirth pain relief. So let’s stick to the matter at hand, OK?

' """

post #88 of 135

Deal

post #89 of 135

http://www.theglobeandmail.com/life/the-hot-button/epidural-guilt-debate-over-pain-meds-back-in-the-limelight/article1904419/

 

 

Quote:
He even suggests that epidurals can be used as pain relief after birth and to ease painful breastfeeding

 

 

 

Quote:
A lively debate ensued in the comments section, with Dr. Grant explaining why he sees an epidural as a “wonderful alternative” to other post-partum pain meds. For painful breastfeeding, he suggests a dose (delivered by the new mom using the technique from the study above) just before a breastfeeding session

 

 

And there went any of this man's credibility in my eyes.  I have no intention of reading a book written by a man who doesn't have a fundamental enough understanding of the breastfeeding relationship to know that, done correctly, breastfeeding should never require pain medication.  We all know that painful breastfeeding sessions can easily and quickly be resolved with a change in technique.  The Best for Babes Foundation has accurately identified this book and his belief that an epidural can (should?) be used to relieve pain associated with breastfeeding as a "booby trap."

post #90 of 135

Charmie, I would agree with you that normally breastfeeding shouldn't need pain medication and certaintly I agree that an epidural in this instance is extreme..but before making a blanket statement please look into the effects of raynaud's phenomenon/syndrome on breastfeeding.

 

You do a great disservice to the women that truly can't breastfeed with such a broad satement. I myself did not know that there were so many potential variables that are truly insurmountable.

post #91 of 135
Quote:
Originally Posted by Charmie981 View Post

http://www.theglobeandmail.com/life/the-hot-button/epidural-guilt-debate-over-pain-meds-back-in-the-limelight/article1904419/

 

 

Quote:
He even suggests that epidurals can be used as pain relief after birth and to ease painful breastfeeding

 

 

 

Quote:
A lively debate ensued in the comments section, with Dr. Grant explaining why he sees an epidural as a “wonderful alternative” to other post-partum pain meds. For painful breastfeeding, he suggests a dose (delivered by the new mom using the technique from the study above) just before a breastfeeding session

 

 

And there went any of this man's credibility in my eyes.  I have no intention of reading a book written by a man who doesn't have a fundamental enough understanding of the breastfeeding relationship to know that, done correctly, breastfeeding should never require pain medication.  We all know that painful breastfeeding sessions can easily and quickly be resolved with a change in technique.  The Best for Babes Foundation has accurately identified this book and his belief that an epidural can (should?) be used to relieve pain associated with breastfeeding as a "booby trap."

 

 

"What could this man possibly know about breastfeeding? He doesn't even have breasts!" So by your logic, should male doctors ever have anything to do with "women" diseases? And should female doctors ever have anything to do with "man" diseases? I don't think you really mean this. But let me let you in on something that I've observed: The afterpains (i.e., uterine contractions that accompany breast-feeding due to the body's release of oxytocin (i.e., natural pitocin) that accompany breast-feeding can be painful, and they tend to worsen with each subsequent birth. I've met women who have told me the afterpains are so intense that they don’t want to breast-feed!  Now, if you can tell me how these women who have severe afterpains can breastfeed "correctly," I'd be very interested. You see, I'll tell them right away, so that the afterpains won't hurt anymore!

In the meantime, I will continue to provide my patients who suffer from severe afterpains with the option of using an ultra-low dose epidural on demand so that they can breastfeed in total comfort, while being wide-awake.

Think about what I’m saying here – epidurals can be used to ENCOURAGE breast-feeding. No wonder the “Best for Babes” foundation is opposed to the concept – it goes against everything they think they know to be true!  J

post #92 of 135

She actually didn't attack the idea of men knowing anything about breast feeding, she said "this man" not..."men"

 

 

after pain relief tinctures work exceptionally well for the pain of a post partum contracting uterus..I'm not even that crunchy and find it to be superior to most traditional medications

 

no drowsiness effect on babies either

post #93 of 135

I've followed this thread and I have to say, I don't think long-term guilt (as opposed to initial remorse that helps propel someone toward seeking more knowledge or changing future choices) is an effective emotion. If a woman wants to choose epidural for pain relief and she's been informed of the potential side-effects associated with them (and let's not fool ourselves, they do exist), she should be free to do so. I will say though, I believe that true guilt is intrinsically motivated, whether real or imagined, not externally. I refuse to be chastised for "making" other women feel guilty because of a personal belief that in most cases choosing epidural is one of the last things a woman should choose if she desires a successful vaginal birth with minimal tearing, without episiotomy, side effects, or without a higher likelihood of eventual c-section.

 

As an aside, I'll say that any doctor claiming childbirth is the worst pain "most" women will feel has obviously never had bad gall stones, a two- day migraine, broken an ankle in three places, or has had food poisoning. Childbirth was painful but I got a reward at the end and I would choose that pain over any of the aforementioned situations I know first-hand. In fact, my midwife (who had gall stones) said, oh if you've had gall bladder pain, childbirth is nothin'... she was right. lol.gif

 

However, it would be extremely bold to suggest that not being able to feel anything from the waist down in no way interferes with a normal laboring experience which was designed (by God, nature, evolution, whatever your brand of belief system) to serve a specific purpose (yes, even the pain serves a purpose). Sure, correlation doesn't equal causation but it's a pretty darn glaring coincidence that as the number of births being "managed" has risen, the amount of interventions has risen (including epidurals), that the amount of c-sections has risen... and yet our infant mortality rate remains one of the worst in the developed world. Like I said, pretty glaring coincidence unless we leap to believing women's bodies are suddenly broken and unable to carry out the task of the continuation of life as we know it without doctors "managing" them. As far as 'walking' epidurals, perhaps they are slightly better but to me the evidence of their safety is not enough for me to jump on the peace train. The burden is on the medical community to sell me on their safety if they're asking me to choose it, not the other way around.

 

To hold any credibility with me I would first have to believe that someone who has never experienced childbirth could be so personally invested in sparing women any pain in childbirth without personal or professional agenda of any kind save that one selfless desire -- while simultaneously ignoring not only the coincidences and anecdotes, but the facts that epidural does come with a measure of risk to a woman's birthing experience, health, and potentially, her baby's health.

 

...and I don't believe that. Sorry.

post #94 of 135

 

"To hold any credibility with me I would first have to believe that someone who has never experienced childbirth could be so personally invested in sparing women any pain in childbirth without personal or professional agenda of any kind save that one selfless desire -- while simultaneously ignoring not only the coincidences and anecdotes, but the facts that epidural does come with a measure of risk to a woman's birthing experience, health, and potentially, her baby's health.

 

...and I don't believe that. Sorry."

 

 

 

 

 

Wow....another "don't confuse the argument with facts" post......Anyone seriously interested in ascertaining scientifically valid conclusions should definitely ignore coincidences and anecdotes. They are MEANINGLESS in the context of a scientific discussion. Of course there are risks to epidurals – my point is that there are risks to NOT having them, too – risks for the mother and risks for the baby. Someone considering what type of pain relief, if any, to have for childbirth should consider the risks of using an epidural as well as the risks of avoiding one. I realize this isn’t much discussed. That’s precisely why I wrote my book. And you need more faith in human selflessness – way too much cynicism here!

post #95 of 135

And let me in on something I've observed (because contrary to what you seem to believe, you are not the only person in this thread who has witnessed births): I've seen a G10p8 in more pain after birth (WITHOUT having initiated BREASTFEEDING) than before take a dose of a traditional herbal tincture and proceed to nurse her baby in comfort.  No hospital, medication, narcotic or doctor necessary.

 

But of course, that's anecdotal.

 

Oh, wait, so is your story!  duh.gif

post #96 of 135

There are risks to women and babies if mothers don't have epidurals?

 

 

Okay, credibility has not only left the building, it has spontaneously combusted and is a raging inferno fueled solely by my disbelief that someone can make such an assertion with a straight face*.

 

*save for the benefit of epidural use in extremely rare and mitigating circumstances of which would not likely fill a Hallmark card much less an entire book. 

 

I have faith in human selflessness, just not in the human selflessness of someone trying to sell books singing the praises of a drug which inhibits the sensations and functions of a common yet extremely important (and yes, sometimes painful) human experience while simultaneously downplaying and denying the severity, frequency of side effects and the often unnecessary interventions that promoting such a drug in normal labors often cause.

 

post #97 of 135
Quote:
Originally Posted by Charmie981 View Post

And let me in on something I've observed (because contrary to what you seem to believe, you are not the only person in this thread who has witnessed births): I've seen a G10p8 in more pain after birth (WITHOUT having initiated BREASTFEEDING) than before take a dose of a traditional herbal tincture and proceed to nurse her baby in comfort.  No hospital, medication, narcotic or doctor necessary.

 

But of course, that's anecdotal.

 

Oh, wait, so is your story!  duh.gif

Well, you're right about one thing: the herbal tincture treatment you describe is certainly anecdotal, therefore, it's use has no scientific validity. Now, if there is a well-designed blinded randomized study comparing your herbal tincture to another treatment (or even placebo), then we could seriously discuss its merits - and maybe even counsel women to use it with a clear conscience. In the meantime, I’d continue to recommend non-steroidal anti-inflammatory drugs, opiates if needed, or an ultra-low dose epidural (my first choice for someone with a history of severe afterpains who has an epidural in place).

 

post #98 of 135


 

Quote:
Originally Posted by Tumble Bumbles View Post

There are risks to women and babies if mothers don't have epidurals?

 

 

Okay, credibility has not only left the building, it has spontaneously combusted and is a raging inferno fueled solely by my disbelief that someone can make such an assertion with a straight face*.

 

*save for the benefit of epidural use in extremely rare and mitigating circumstances of which would not likely fill a Hallmark card much less an entire book. 

 

I have faith in human selflessness, just not in the human selflessness of someone trying to sell books singing the praises of a drug which inhibits the sensations and functions of a common yet extremely important (and yes, sometimes painful) human experience while simultaneously downplaying and denying the severity, frequency of side effects and the often unnecessary interventions that promoting such a drug in normal labors often cause.

 



it's really unfair of you to dismiss the man's entire book without reading it.

 

look, if you believe in making fully informed decisions, you should be willing to acknowledge that epidurals can have benefits. for SOME women, they probably represent less risk than not having an epidural (my first labor, in my opinion, was exactly that situation. DD's heartrate looked terrible at 2 cm, but OB said she'd like to go for a vaginal delivery anyway, and only do a c/s if DD crashed and didn't recover. things weren't getting any better despite numerous position changes, so i got an epidural in anticipation of a crash c/s. and i did indeed end up with a crash c/s, which thanks to the epidural, i was awake for.)

 

post #99 of 135

I did state that in rare and extreme instances, an epidural can be of 'benefit'. Your situation was one where you made a choice with all the knowledge you had that you would likely have a c/s if the situation didn't resolve and you wanted to be awake for it. I take your experience at face value and if you say the epidural benefited you, it did. However, I do now have to completely dismiss your experience as anecdotal evidence as the good doctor has been very quick to do when anyone else cited anecdotal or personal experience contrary to what his book is promoting. Fair? thumb.gif

 

I acknowledged further up that if a woman feels it necessary and is aware of the risks, she should be free to choose epidural. What the doctor is asking though, is for me and other women to uphold epidural as an optimum choice during labor, regardless of circumstance (it seems so anyway) without acknowledging the very real risks associated with choosing it and the interventions that often follow that choice, in part directly due to lack of sensation epidural causes that most women need to retain in order to birth effectively and safely (feeling the pushing sensation, knowing instinctively when to change position, being physically able to change position etc).

 

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.

 

 

 

Quote:
Originally Posted by majormajor View Post


 

Quote:
Originally Posted by Tumble Bumbles View Post

There are risks to women and babies if mothers don't have epidurals?

 

 

Okay, credibility has not only left the building, it has spontaneously combusted and is a raging inferno fueled solely by my disbelief that someone can make such an assertion with a straight face*.

 

*save for the benefit of epidural use in extremely rare and mitigating circumstances of which would not likely fill a Hallmark card much less an entire book. 

 

I have faith in human selflessness, just not in the human selflessness of someone trying to sell books singing the praises of a drug which inhibits the sensations and functions of a common yet extremely important (and yes, sometimes painful) human experience while simultaneously downplaying and denying the severity, frequency of side effects and the often unnecessary interventions that promoting such a drug in normal labors often cause.

 



it's really unfair of you to dismiss the man's entire book without reading it.

 

look, if you believe in making fully informed decisions, you should be willing to acknowledge that epidurals can have benefits. for SOME women, they probably represent less risk than not having an epidural (my first labor, in my opinion, was exactly that situation. DD's heartrate looked terrible at 2 cm, but OB said she'd like to go for a vaginal delivery anyway, and only do a c/s if DD crashed and didn't recover. things weren't getting any better despite numerous position changes, so i got an epidural in anticipation of a crash c/s. and i did indeed end up with a crash c/s, which thanks to the epidural, i was awake for.)

 

post #100 of 135

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. 

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