Epidurals don't affect the baby?

[Elphaba]

That is what my SIL's doctor/hospital told her. They said that the drugs have no effect on the baby because they don't enter the bloodstream.

I was like, "Of course the epidural affects the baby, that's why so many have problems nursing."

But I need to know for sure. What's the word, ladies?

[kama'aina mama]

Yes, yes, yes! The epidural reaches the baby. Easy thing to do at almost any library or pharmacy. Look up Lidocaine. It is an analgesic sometimes used for epidurals. (Keep in mind of course, epidural is the name of a procedure that delivers drugs... there are a variety of drugs administered this way.) Under Lidocaine look up the precautions and warnings. Somewhere in there it specifically says 'When used as an epidural watch out for fetal overdose.' Why would you have to worry about the fetus at all if the drug doesn't reach them?

There was actually a study conducted in the late 60's (I believe) that I will find for you in the morning... using fetal scalp blood samples they found the drug administered to the mother by epidural in the babies bloodstream less than five minutes after the drug was given.

I am continually shocked that doctors lie in such a bold faced fashion to their patients.

[Elphaba]

thanks chica! I just found 2 articles on Mothering that show how quickly the drugs get to the baby and how long they stay in their immature systems.

What a dumba$$ doctor eh?

I understand my SIL being scared and deciding she wants drugs, but she HAS to know that the baby is going to feel them, too. No one should make a decision with blatantly false information.

[kama'aina mama]

Oh... another thing or two: Are you familiar with the blood/brain barrier? It is a special filter that makes it very hard for drugs to get into your brain. When they want to use chemotherapy for brain tumors they have to go through all kinds of wild procedures to even get the drugs into the brain. You aren't born with this barrier. So a drug dosage that won't reach your brain and won't harm you at all may very well enter your fetus/newborns brain and cause damage. Also, when the baby is still inside and on the umbilical s/he is using your waste systems... your liver is filtering their blood, your kidneys are processing their urine, etc. After the baby is born they are left with an adult size dosage of drugs in their system and only their wee tiny still learning the ropes organs to filter them out.

[stayinghome]

effects of epidural block as per "Medications used during Labor and Birth"

baby: "Low maternal blood pressure and fever can lead to fetal heart rate changes and lack or ozygen; subtle changes in reflexes, including suckling and breathing; fussiness;... observation in nursery if mother had fever in labor; septic workup, antibiotics, and 48 hours in special care nursery for observation for signs of infection if mother had fever (a common side effect in mothers who recieve epidural) in labor."

That's not to mention the side effects of pitocin, c-section, forceps, and vaccum extraction that also tend to be more common during epidurals.

[stafl]

She could ask her doctor for the patient info sheet on any drugs they want to give during labor. Even the drug manufacturers admit to risks affecting both mother and baby.

[cottonwood]

On A Baby Story (TLC) I saw a doctor tell a woman that the epidural is "completely safe".

[crazy_eights]

Originally posted by kama'aina mama
I am continually shocked that doctors lie in such a bold faced fashion to their patients.

I don't think that most OB's are bold faced liars. I think most of them believe it. Truely.

The drug used in epidurals is bupivicaine (trade name, marcain). A more recent technique that most women get for epidurals uses this drug in combination with a small does of narcotic (usually fentanyl or sufenta). This combination allows them to use a much smaller dose of the bupivicaine while still getting good pain relief. If you have seen women on "A Baby Story" that could move their legs, get up on hands and knees, could feel to push with an epidural - they had this technique. Now compared to, say an injection of demerol, the drugs "hardly affect the baby". And doctors argue about if they affect them at all. For instance, many anesthesiologist disagree with the study that shows nursing problems/groggy babies after epidurals - and have other studies that back them up. Most also will show you research that shows that they don't affect c/sec rates either.

I personally think there are many other problems with epidurals- malpositioned babies, causing temps in labor, do increase c/sec esp. in first time moms. I'm not arguing for their routine use, just trying to show how the medical folks think.

[crazy_eights]

FOund this info on the two drugs used in epidurals. I'm showing it to show how little of the medication is used or even available to cross the placenta: "The two most common medications used are Bupivicaine (Marcaine) . 0625% - .5% and Fentanyl. Bupivicaine (an amide local anesthetic) is used because of it’s rapid onset and longer duration of anesthesia. It is also highly protein bound (95%), making only 5% available for placental transfer. Fentanyl is a short-acting narcotic (analog of morphine), that is 80 to 100 times more potent than morphine. It is used as a supplement to the Bupivicaine in labor epidurals.

[PapayaVagina]

This is such a sore spot for me.

I was at a birth once where the doc (who, I swear, was called in from a golf game and came in wearing his full on tacky golf outfit) told the mom that there were "absolutely no risks whatsoever". Interesting that he said that to her bc I watched him draw up a syringe of Epi just before he gave it to her "just in case" (I wonder, just in case of what?) IMMEDIATELY after the epidural was placed and she laid down the baby's heart rate dropped to 50 and she started feeling dizzy. I think that they did end up giving her the shot and then bc she quickly dilated they did a vaccuum extractor on her. NO side effects my @$*#&!!

What I tell people all the time when we talked about epidurals is that I've been to quite a few births in the hospital but not a ton and I've seen A LOT of side effects, what does that tell you about the incidence of them? I've seen extreme itching, the epidurals not work at all or have really spotty coverage(on several women), major decels in the baby's heart rates, increased need for vaccuum extractions, lots of tearing that I always wonder if it would have been there had it not been for the epidural, increased use of antibiotics, and almost always augmented with Pitocin.

I think there's a mix of lying and truly believing what they say. Truly, their insurance companies don't ALLOW them to be honest and give full informed choice and I seriously don't think that most of them are smart enough to realize that the side effects that they're seeing are connected to the interventions that they use. They continue to believe that they're things that just normally "pop up" during labor which intensifies the fear, which leads to more interventions, which leads to more side effects, which leads to more fear..........

[MelKnee]

When I was in labor with my first ds at 24 wks, the OB told me I couldn't have an epi because it would kill my baby. Yes, my baby was fragile. But, doesn't that imply that the epi DOES reach the baby?
I didn't want one anyway, but how can he tell me that when they claim the epi doesn't affect fullterm babies.
They need to get their facts straight. Do they really think that mothers don't share information?

[Greaseball]

I think we are so used to seeing limp, floppy babies that cry miserably at birth that we don't think it could be abnormal.

I was born awake, looking around, and not crying. My brother was born asleep. I'm sure if we had been born in hospitals the doctor would have thought there was something wrong with us and given us low apgar scores, maybe even upended and slapped us.

[PurpleBasil]

This is such an interesting thread - thank you all!

Elphaba, I'm betting this won't be the last lie you learn of through your SIL's birth. It sure can't go up from here. I'll keep my fingers crossed though.

Can't think about the babies receiving the drugs like this - hurts my heart too much.

[Elphaba]

I just want her to have all the information she deserves. She has pretty much no choices in her care, as they live in a rural area and she is not a homebirth candidate -- not for health reasons but for emotional/mental reasons. She's very comfortable with a medical model of care, whereas I am not, so I really try to not push my views on her but rather prod her into questioning and researching for herself. She just doesn't have a lot of time to do that since she is also a full-time grad student and has an internship, and those activities all take place about 4-5 hours from their home.

I had an epidural, but I knew it wasn't the best thing for the baby. I had planned a Bradley birth, but it didn't work out. I certainly didn't go into it thinking that drugs would have no effect on the baby, and I want her to have the same chance to make informed consent, or to at least stay home a LONG time! :LOL

[Greaseball]

Some people don't even consider the epidural to be "drugs." I ask them if they're going to have drugs during labor and they say "No, just the epidural.":

[PurpleBasil]

Wow, Greaseball, that would be funny if it weren't so tragic.

Cheese and Rice.

[crazy_eights]

Originally posted by Greaseball
I think we are so used to seeing limp, floppy babies that cry miserably at birth that we don't think it could be abnormal.

I was born awake, looking around, and not crying. My brother was born asleep. I'm sure if we had been born in hospitals the doctor would have thought there was something wrong with us and given us low apgar scores, maybe even upended and slapped us.

I'm an L&D nurse. I've worked at hospital as an RN and been doula at birth center and homebirths. Limp, floppy babies are rare everywhere. Even with routine use of epidurals. Seriously.

See my post above. I think there is plenty wrong with routine use of epidurals. But let's not resort to scare tactics and misinformation in our quest to promote natural childbirth. In the end it will come back to bite "the movement" (the natural childbirth one) in the butt.

[Greaseball]

Mom2six - What do you see as the most common problem babies have as a result of epidurals?

[Mothra]

Originally posted by Greaseball
Some people don't even consider the epidural to be "drugs." I ask them if they're going to have drugs during labor and they say "No, just the epidural.":

I heard that recently, too. I asked a new mother if she had any drugs during labor and she said no, then went on to talk about how wonderful the epidural was. She actually had NO IDEA that there were drugs in the epidural. She thought that the procedure itself provided the pain relief, like acupuncture or something, and that the fluid going in was just saline or something. I know ya'll are probably thinking that she was just an idiot, but she really isn't. This girl was young, but no younger than I was when I had my first. She had no Internet access during her pregnancy, no friends who had babies, and no support from her family who stopped talking to her when she found out she was pregnant. She, like most young women, knew NOTHING about pregnancy and childbirth. It broke my heart to see the look on her face when she realized that she had not, in fact, experienced a drug-free birth.

[crazy_eights]

Originally posted by Greaseball
Mom2six - What do you see as the most common problem babies have as a result of epidurals?

Poor positioning resulting in c/sec, maternal temp, which can result in a septic work-up for baby - though we no longer do LP's (spinal taps) for them - and baby might have to stay in the special care nursery, if the baby is on the large side, esp. if it's the mother's first baby - c/sec for "CPD" which is usually caused by the fact that we can't get strong enough contractions even with the almost routine added pitocin augmentation to counter the epidural weakening the contractions. Then again, epidurals slow down labor too, so it might just be "failure to wait" with a large baby not "failure to progress". Vacuums and forceps. I know there are some studies that show that epidurals effect nursing, but that would be a hard call for me to make. Most babies latch on with a short period after birth. My guess would be that it depends on how long the mom had an epidural and I think the effects are fairly subtle.