epidurals.... do they increase the rate of c-sections...

[illinoismommy]

Maybe not? I thought they did but I went to try to search and found tons of stuff from 2005 that says this http://www.msnbc.msn.com/id/6980795/

I'm not planning to get an epidural, I was just wondering....

[famousmockngbrd]

So - am I understanding this correctly - *both* groups of women in the study received pain medication? And the c-section rates were 18% and 21%?

I don't even know where to begin, in my outraged response to this article. It is the epitome of bad science, and bad journalism. This in no way "debunks the notion about c-sections" being linked to early epidurals. :

[kJad29]

I would consider the source on this one. I was a doula for a client who was otherwise healthy and had a very uneventful pregnancy. Fast forward to the delivery room and the mom was doing well until the AROM at -2 station and 80%, the pitocin to "get things moving" (BTW I did warn the parents about this, but they wanted their baby NOW) and then the epidural, which led to a host of other interventions. When it was all done, she had a tube coming out of every oriface imaginable and baby's heartrate tanked after the epidural went on board. She ended up with an emergency c-section because the baby wasn't taking the contractions well. The AROM caused the cord to drop in it's face so there was a prolapsed cord basically. Also most of the women I know who had the epi ended up with c-sections and only ONE had a vaginal birth with forceps and attempted vacuum. I only know a couple of people who have had vaginal births with an epidural on board. I wouldn't trust this research. Let's remember that these are the same people who say that homebirth is dangerous.

[Emilie]

As for why the earlier research reached a different conclusion, it could be that some of the women had underlying problems — such as an unusually big baby — that can cause more pain, make women request early epidurals, and also require a C-section, researchers said.


wtf?

I do not know where to begin. horrible horrible horrible.

[rmzbm]

Originally Posted by famousmockngbrd

I don't even know where to begin, in my outraged response to this article. It is the epitome of bad science, and bad journalism. This in no way "debunks the notion about c-sections" being linked to early epidurals. :

:

[Lousli]

Maybe it isn't about epidurals or not epidurals in this study but later epidurals or earlier epidurals? I don't know, weird.

[arlecchina]

I found this bit amusing:

This study examined only first pregnancies, but C-sections are less frequent and therefore less of a worry in later pregnancies.


not what I hear from women trying hard for a VBAC and told they cant..

[milliegirl]

Interesting post. I think this article is completely misleading : . It is in no way comparing epidurals/medicated births vs. med-free births, but comes across as if the results are applicable to med-free births.

In this study, 728 women in first-time labor were divided into two groups. One group received the spinal shot and then got epidurals when the cervix was dilated to about 2 centimeters. The other group initially received pain-relieving medicine directly into their bloodstreams, and put off epidurals until 4 centimeters if they could tolerate the pain.

Can't answer your question, but I would like to see a study which directly compares the rate of c-sections in births w/ epidurals vs. totally med-free births. Call me paranoid, but does anyone else think that there are not so ethical motives for encouraging epis, such as more compliant patients and bigger bucks for the hospital?

[talk de jour]

if they could tolerate the pain.

:

[jeanine123]

As for why the earlier research reached a different conclusion, it could be that some of the women had underlying problems — such as an unusually big baby — that can cause more pain, make women request early epidurals, and also require a C-section, researchers said.

Oh what a load of bunk. Alex was "unusually big" (10lbs 10oz) and at no time did I ever feel the need to request an epidural or any other pain relief other than the nice big tub of warm water. He was a full 2.5lbs bigger than Connor was and with Connor the thought of using drugs did enter my mind during transition. Though I think a lot of that was due to being in the hospital, lying on my side while they were trying to insert the internal monitor that never worked anyway, while in transition. With Alex I was in the comfort of my own home, my midwives weren't calmly freaking and there weren't 20 people rushing into my room. Every day I am grateful that I was able to give birth at home so my poor baby didn't have to endure any of the typical hospital bull that happens to baby's of his size.

As for the article, the study it's based on is comparing women who get any early epi (I think 2-3cm) to women who get stadol or similar drugs early and an epi later if I remember correctly. Not exactly comparing an unmed drug free birth to a drugged one. One way or another an epi can lead to an increased risk for a c-sect.

[October16Mom]

Maybe the key is in the low-dose aspect? I just gave birth and had a really strong desire to have a med-free birth. However, I didn't dilate before I went into labor and spent 8 hours just getting to 2 cm. I tried every position and jacuzzi, birthing ball, etc. during those 8 hours. The baby was posterior, and I had horrific back labor. I did get an early epidural, probably close to 3 cm. I went to complete within a few hours of getting it. It was very low-dose. I could have upped it, but chose not to. I wanted just enough that I could cope, but not so much I couldn't feel anything. I was able to get up on my hands and knees to help gravity turn the baby. I still had a lot of pain with the epidural (especially in my lower back during transition), but I knew that I needed to feel as much as I could deal with. When the time came to push, the urge was immense. I felt like I had to push to take the pain away. I pushed in three different positions, managed to get the baby turned. The pushing was extremely hard work, and I was glad I had gotten a little relief so I could save up energy for that. The baby came out and was very alert and latched on like a little champ. I would still like to have a med-free birth in the future, but know I made the right decision for me at the moment. I think a lot of people think that the purpose of an epidural is a completely pain-free birth, and I think people should realize that even if they do feel like they need an epi keeping the dose as low as possible is going to be better for them and for the baby. Just my observation...everyone has their own decisions to make.

[faithinrosie223]

There are cases in which the epidural relaxes you and actually prevents a long drawn out labor, which can prevent a c section. I was induced with pitocin and had an epidural at 7 CM... two hours later with no pushing she was crowning and I didnt even know it... then was born on her own. I was a First time mom, with an induction, they ruptured my membranes, I had an epidural, and my labor was just over 4 hours from start to finish. I would do it again in a heart beat. I also had two doulas and a midwife, and was not required to adhere to strict hospital policy. That may have had some to do with my short labor... but The epidural really did it for me.

[JanetF]

http://www.healing-arts.org/mehl-madrona/mmepidural.htm
http://www.healing-arts.org/mehl-mad...ral.htm#study2

Overall complications rates for epidural anesthesia

1. Effects of epidurals on cesarean rate: read this at the link.

QLD Maternity Review 2005

http://www.health.qld.gov.au/publica...20caesarean%22

The notion of a cascade of interventions has been explored by research and is supported by perinatal data. Among women whose pregnancies were otherwise low risk [they mean one baby, head down, mother aged 20-35, no other problems] whose labour was induced in 2002, the incidence of caesarean birth was more than one and a half times higher than among women with low-risk pregnancies whose labour was not induced. Among women whose pregnancies were low-risk who had an epidural for pain relief, the incidence of caesarean birth was more than three times higher than among women with low-risk pregnancies who did not have an epidural for pain relief.

So, translated, get induced and have 1.5 times the chance of a c-sec that you otherwise would, have an epidural as well and more than treble that chance! Sheesh, scary!

[AllisonK]

The study they are talking about DID NOT compare unmedicated mothers to mothers who recieved an epidural!!!!! This was a study on whether having a epidural early in labor caused more cesareans than a later epidural.

I had a doula client who wanted an epidural, this was shortly after this study came out. The anestheiologist (sp?) actually came in and told her that there was a new study saying that epidurals do not increas your risk for cesarean. I could not believe it, I mean how much can you twist it around.