or Connect
Mothering › Mothering Forums › Pregnancy and Birth › Birth and Beyond › Opinions please! Epidural & C section…
New Posts  All Forums:Forum Nav:

Opinions please! Epidural & C section… - Page 2

post #21 of 55
It might be appropriate to include the role of Pitocin in this discussion, because I think that Pit contractions are difficult to tolerate, which leads to an epidural.

But why the Pit in the first place?

How many mamas and babies laboring in hospitals aren't ripe yet?.....TONS....so labor is forced to progress with Pitocin.

Sometimes when inductions/augmentations fail, a cesarean is indicated ("failure to progress")....But maybe we can cite a group of women who, thanks to epidural pain relief, are able to continue tolerating Pitocin contractions and thus avoid a c-sec.

the 80% of women who get epidurals + the 66% of women who have a vaginal birth will mean that MOST women with epidurals DO have vaginal births, right? is that decent math?
post #22 of 55
I had an epidural. It was pulled out, to let me labor some without it, in the thinking that perhaps it was slowing labor. I labored longer, then I had the epidural replaced. So, I got 2 epidurals.

I did end up with Pitocin and a c-section. I also had a very alert baby, complete rooming-in of my baby, and an easy breastfeeding relationship.

Everything isn't always black and white. I really feel in my heart that my baby was not coming out of me in the normal way.
post #23 of 55
OK, maybe I'm just in a pissy mood but there are a couple of things that need to be cleared up.

1) An intervention free birth does not mean a vaginal birth. Intervention free means no pictocin, no epi, no internals, no EFM, no IV, no C/S. Having an epi means that there was an intervention.

2) Why, oh God, why are so many of the pp writing that " at so and so cm, I had an epi". WHY are you being checked internally???? Any doctor worth their weight will admit that dilation is NOT a measure of progress. All that does is set you on the Friedman Curve (1cm/hr) and if you are not "progressing" according to that standard deviation, then you are labelled "failure to progress" and further interventions (ie) C-sections are pushed!!!!

3) Why are so many of the pp going to the hospital so early???? It doesn't matter how many hours you have been in labor. If it did, I could shock the sh!t out of everyone and say that I was in labor for a MONTH with my last two as I was having prodomenal labor. I was probably walking around at 4-6cm dilated for that time too but that matters a whole pile of beans!!!

What does matter is what emotional signpost you are exhibiting. For crying out loud, stay at home for as long as you can because the sooner you get to the hospital, the sooner interventions and laying on you back happens!!!!

To prove my point, with my dd#2 born 3 months ago, 10 minutes before she was born, my contractions were 5-8 minutes apart, irregular and only 45-50 sec long. HOWEVER, this is the big HOWEVER, I was telling my husband, that I can't go on anymore, my legs were shaking and I was burping up lunch. Rationally, I said "I can't be in transition, my contractions are close enough or long enough...but physically, guess what....I waaasss!!!!
post #24 of 55
Quote:
Originally Posted by cdnmom View Post
OK, maybe I'm just in a pissy mood but there are a couple of things that need to be cleared up.

1) An intervention free birth does not mean a vaginal birth. Intervention free means no pictocin, no epi, no internals, no EFM, no IV, no C/S. Having an epi means that there was an intervention.

2) Why, oh God, why are so many of the pp writing that " at so and so cm, I had an epi". WHY are you being checked internally???? Any doctor worth their weight will admit that dilation is NOT a measure of progress. All that does is set you on the Friedman Curve (1cm/hr) and if you are not "progressing" according to that standard deviation, then you are labelled "failure to progress" and further interventions (ie) C-sections are pushed!!!!

3) Why are so many of the pp going to the hospital so early???? It doesn't matter how many hours you have been in labor. If it did, I could shock the sh!t out of everyone and say that I was in labor for a MONTH with my last two as I was having prodomenal labor. I was probably walking around at 4-6cm dilated for that time too but that matters a whole pile of beans!!!

What does matter is what emotional signpost you are exhibiting. For crying out loud, stay at home for as long as you can because the sooner you get to the hospital, the sooner interventions and laying on you back happens!!!!

To prove my point, with my dd#2 born 3 months ago, 10 minutes before she was born, my contractions were 5-8 minutes apart, irregular and only 45-50 sec long. HOWEVER, this is the big HOWEVER, I was telling my husband, that I can't go on anymore, my legs were shaking and I was burping up lunch. Rationally, I said "I can't be in transition, my contractions are close enough or long enough...but physically, guess what....I waaasss!!!!

I can only speak for myself but I didn't know about the risk internal exams carried when I had my dd. So that's how I know I was so many cm dialated when I had the epi.

Same for going to the hospital early. But then again I was induced so I was at the hospital from the start. Obviously hindsight is 20/20. I know a lot more now then I did back then about inductions, epidurals and other interventions. This time I hope to get to the hospital right around the time I feel the urge to push.
post #25 of 55
I'm pretty sure I've mentioned before; I went into labor during my grandfather-in-law's wake. I made it through the first wake and dinner before I made the decision to go to the hospital. I was having regular steady contractions and felt my labor progressing quite quickly, so I went in. I wanted to rest myself for the birth and take a nap or two, get out of the uncomfortable formal clothing I was in... all of this contributing to the decision to go to the hospital. Had I not gone in when I did, I wouldn't have gotten to rest as my body told me I needed to.

I know how dilated I was when I had my epi because they only checked me twice. I went from 3 cm to 7 in roughly 2 hours, and my contractions were getting stronger. I was told my labor was progressing too quickly for a "first timer", to which I replied that that was just tough because the baby was coming within an hour. I had my epi, took a 15 minute nap, and woke up to push.

I had a very pleasurable, memorable birth experience, but had I not gone in when I had, I know I simply would have been too physically exhausted to push. I needed that rest and napping that at that point, only the hospital could provide me. I needed to get myself away from the death and heartbreak I was surrounded by and be in my comfortable, peaceful birthing room with music playing and DH snoozing next to me. And that was my decision, one which I'm particularly pleased with, and refuse to feel bad, ignorant, stupid or mistaken about, despite who agrees with it or not.
post #26 of 55
Quote:
Originally Posted by Redifer View Post
I know how dilated I was when I had my epi because they only checked me twice. I went from 3 cm to 7 in roughly 2 hours, and my contractions were getting stronger. I was told my labor was progressing too quickly for a "first timer", to which I replied that that was just tough because the baby was coming within an hour. I had my epi, took a 15 minute nap, and woke up to push.
I think this detail from your story is interesting...I doula'd a woman who started to fall asleep before the pushing stage, the "rest and be thankful" phase of labor:

from http://www.birthingnaturally.net/birth/pushing.html
Quote:
Once you have hit transition, you will soon be upon the time when contractions spread out again. They generally move to about five minutes apart but they may stop completely. Many women experience what is known as a “rest and be thankful” stage. This occurs because once the baby passes through the cervix, the uterus may need to “catch up” to be snug against the baby, because the contractions will only move the baby when the uterus is snug against the baby.
I think it's interesting that intellectually, you knew you would need an oppertunity to rest from labor, before doing the work of pushing your baby out.

I wanted to share with the group that this wisdom is also shared by the body, too...though
Quote:
But this stage, although common, is largely unknown in the hospital, where it is rarely given time to occur naturally.
from http://www.birthpsychology.com/messages/push/push.html

Sometimes we might think that only drugs can offer salvation from the rigors of labor--but sometimes it is our own bodies that will provide the comfort.
post #27 of 55


As to why an epi is given at 7 cm, I'll never know why....you're almost there!!!
post #28 of 55
Does an epi “send” you closer to a C/S?
Does it help prevent a C/S?
Or does it have no affect on the outcome?
Or is it just a case by case basis?

All I can offer is my own anecdotal information, but I had 3 full-term deliveries, epidurals with all 3, and all were vaginal deliveries. With my oldest dd, I was actually begging for a C/S during labor (I had only researched very mainstream info at that time, never heard of MDC) and my OB was very emphatic that C/S should only be used in an emergent situation when vaginal birth was absolutely not possible (the mother or baby was in inherent risk). She personally has a very low C/S rate, I believe, compared to the other OBs in the practice. At no point in any of my labors/delivery was C/S mentioned by any hospital staff members. My 2nd dd had cord involvement (cord was trapped between her head and my pubic bone), and my ds was having decels that were not recovering (cord was wrapped, we discovered during birth). But she never mentioned C/S. I don't think that my epi's prevented C/S, either, because I think my body would have delivered my babies regardless- if I were somewhere that I couldnt' have gotten an epi, my babies would still have come out vaginally, I believe, just with a lot more pain. I do think that the epidurals, in each case (even though I had a very severe complication with my last one) helped me to relax and be more aware of my birth experience and I did enjoy the experiences a lot more after the epidurals kicked in. And I had very alert, great nursing babies with great Apgars, too. But that was a personal preference, not everyone feels that the pain relief gained by an epidural is a desirable outcome, kwim?

In my case, the epidurals didn't lead to C/S, but I do believe that, generally speaking, once you start interfearing with the natural birth process, you *generally* increase the chance that you will encounter more un-natural events, including C/S. A friend's DIL had a baby last week- water broke at home, no ctx, they started pitocin, baby's heartrate was irregular- bad recovery after decels, epidural at 1cm because mom couldn't tolerate the pitocin-induced ctx, 12 hrs with no dilation, C/S due to failure to progress and "big" baby. He was 7.5lbs and she's not a small woman : So in that case, I'd absolutely say that interventions including the epidural at 1cm (which prevented mom from walking, squatting, etc. to get ctx strong and regular, and help with dilation) caused her C/S. Not cut and dry, guaranteed black and white in every case, but generally speaking, I believe that interventions can lead to C/S.
post #29 of 55
I'd say case by case basis. I have heard of women who say it helped them relax when labor stalled. Great if that works for them. Problem is you don't always know if it's going to help or hinder (more likely to hinder I think). In my 1st labor, I got an epi after about 16 hours of posterior labor, thinking it might help me get past 6cm. It didn't. I found out later that epi's with a posterior baby is not a good idea. (hospital birth for posterior baby is not a good idea either!) Ended in a c/s for FTP. I think hospitals really push epi's for their own convenience (laboring moms who have epi's are easier to deal with).
post #30 of 55
Quote:
Originally Posted by alegna View Post
In *general* I would say that the epidural itself makes a c-section more likely AND it begins a cascade of interventions that can also lead to a c-section.

I would say it is almost unheard of for an epidural to prevent a c-section.

-Angela


Ditto
post #31 of 55
Quote:
Originally Posted by OnTheFence View Post
You know lets actually find out what the percentage of this is? I mean how more likely, because most the people I have known who got epidurals have had vaginal births. Also here is a pretty recent study on the subject that says that epidurals do not lead to more csections.
http://www.bmj.com/cgi/content/full/330/7488/383
I think you will also find that getting an epidural in the early stages of labor MAY increase a chance of surgical birth, but epidurals given later on (after 5-6cm) there really is no difference in outcome.

I think you'll find you've misread this particular study, and it really only finds little difference between recieving an epidural early or late, as has been pointed out. You're not the only one to be mislead by the title of this study, however, and it makes some of it's own conclusions entirely unrelated to what they examined. I think this article sorts out the confusion here well:

http://childbirthconnection.org/arti...k=10005&area=2

That addressed, I feel any birthing woman is entitled to the pain relief she feels is right for her. Everything in birthing (or parenting, or.. life,) is a risk/benefit analysis, and you have to make those for yourself with the information you have available. There's no wrong answer. Epidurals bring risk, obviously (and I would suspect increased c-section rate to be one of them, if very slight, as it overlaps with things like constant EFM,) and the question of whether the benefit is worth the risk is entirely personal. For me, the sense of being strapped down, scrutinized, and imprisoned (ie, physically unable to get up and walk away if I didn't care for how things were progressing,) that made that decision for me. Outside of that, I may have regarded substantial pain relief as being worth other risks like more difficulty breastfeeding, or a spinal headache. For another woman, my concerns would be inconsequential to her, and greater relaxation vs. a higher rate of other intervention might figure more substantially to her. Whatever a thoughtful woman decides is in her best interest is the choice I'm willing to be supportive of.
post #32 of 55
ITA w/ pps re: trusting our bodies, not worrying about # of hours in labor (how is this even calculated? I'm sure it's different for everyone), cm dilated, getting to hospital too early, etc. I did hypnobirthing but felt I found it too late in my pregnancy to switch providers or do homebirthing - which I wish I would have done anyway.
I personally think I was in labor for 24 hrs. during that time I: got an estimate on my car, went to work, went to chiro (lost some mucus plug), back to work, to ob's (asked me if I wanted to schedule induction day after my due date then found I was 2 cm), to lunch, to target, home to pack, to dinner w/ family, to parents' for dessert, then water broke & got to the hospital @ 7 cm 1.5 hrs before dd's birth.
I am somewhat disappointed w/ the expectations here are along the lines of - accept interventions or have an excruciating l & d. what about the possibility of a calm, gentle, maybe even comfortable or PAINLESS birth experience? I know it's possible. why can't we embrace that our bodies were built for birth and can do a perfecly wonderful job @ it?
I also experienced the "rest & be thankful" stage. I knew it was coming b/c my hb instructor told us that if I were to think I couldn't go any longer, then that meant I was almost there. JMO, this is the point when many women opt for the epi & think it gave them a much-needed break. however, as pp said, their body may have done this anyway w/o dangerous drugs, risking prolonged labor, c/s,etc.
hypnobirthing works! if you are pg, check it out! you won't be disappointed!
post #33 of 55
Quote:
Originally Posted by cdnmom View Post
As to why an epi is given at 7 cm, I'll never know why....you're almost there!!!
I had an epidural when I was 10cm dilated, but it was clear delivery wasn't happening anytime soon. I was exhausted, really felt that I needed to rest, and have no regrets.

As for the original poster's question, here's an interesting article addressing the question of epidurals and c-section rate:

http://www.pubmedcentral.nih.gov/art...?artid=1481670

Apparently, most of the controlled, randomized studies in which no difference in c-section rate was found between those who received epidurals and those who didn't assigned women to the epidural or non-epidural group after they were 4 cm dilated.

According to this article, administering an epidural before the active phase of labor doubles the c-section rate, but administering it later does not.
post #34 of 55
Quote:
Originally Posted by cdnmom View Post

As to why an epi is given at 7 cm, I'll never know why....you're almost there!!!
I stayed at 9.5 cm for 10 and a half hours, before I finally consented to a c-section!! I was 7 cm 8 hours prior to that. So, at 7 cm, I had 18.5 hours left to labor.

Everything is not black and white. 7 cm is not always close to delivery.
post #35 of 55
Quote:
Originally Posted by maxmama View Post
quote removed by moderator
with a cesarean rate of nearly(or are we there now?) 30% a majority of those are unecessary. there arent alot of things i can think of that are more violent than cutting someones baby out with no medical reason. while im glad your section was a great experience for you to say you find my account offensive and want me to stop saying it youre showing disrespect from the trauma i went through and the trauma of so many other women. youll find so many people willing to say cesareans are just a bucket of roses, that theyre no big deal even. i just cant do that.
if you have anything more to say to me lets take it to pms.
post #36 of 55
Quote:
Originally Posted by cdnmom View Post
2) Why, oh God, why are so many of the pp writing that " at so and so cm, I had an epi". WHY are you being checked internally???? Any doctor worth their weight will admit that dilation is NOT a measure of progress. All that does is set you on the Friedman Curve (1cm/hr) and if you are not "progressing" according to that standard deviation, then you are labelled "failure to progress" and further interventions (ie) C-sections are pushed!!!!

3) Why are so many of the pp going to the hospital so early???? It doesn't matter how many hours you have been in labor. If it did, I could shock the sh!t out of everyone and say that I was in labor for a MONTH with my last two as I was having prodomenal labor. I was probably walking around at 4-6cm dilated for that time too but that matters a whole pile of beans!!!

What does matter is what emotional signpost you are exhibiting. For crying out loud, stay at home for as long as you can because the sooner you get to the hospital, the sooner interventions and laying on you back happens!!!!
Because we don't know any better and that's what happens when you are in labour in this day and age and you are told to go to the hospital. What you're saying is totally true. Women aren't encouraged that they can do it.

Now I know... if I didn't go to the hospital when I was 1 cm dilated, even though my ctx were 5 mins apart for 3 hrs, I wouldn't have had to spend the night on a triage table. I wouldn't have been denied food and drink and been so exhausted that I asked for an epidural. I wouldn't have spent the rest of my labour laying around on my back. I wouldn't have had my water broken and pitocin administered. Luckily I pushed my baby out on my own and we had a wonderful bf relationship from the start.

It may be hard to believe, but I don't regret the birth I had. I'll definitely be doing it differently this time around though. You live and you learn.
post #37 of 55
Quote:
Originally Posted by OnTheFence View Post
You know lets actually find out what the percentage of this is? I mean how more likely, because most the people I have known who got epidurals have had vaginal births. Also here is a pretty recent study on the subject that says that epidurals do not lead to more csections.

http://www.bmj.com/cgi/content/full/330/7488/383
I'm still reading this thread, but just read this article. Wow. 21% of the women who got epidurals had c-births. That's still well above the WHO recommendations. There was a difference of 3% between the group with epis and the group that thought they got epis, but really didn't (ethical?) But, there's a confidence rating of 5%. So, that means the actual number in that one study is -2 to 8% increase in cesareans with women who get epidurals. An, 8% increase to have a c-birth by taking an epidural? Too much for me!

It's not really opinion but fact that most studies have found that epidurals increase amt of interventions (epi is technically an intervention, too), more assisted pushing and increased rate of c-birth, breastfeeding issues & breathing problem..

But, this is the thing that got me the most. The women in the study who asked for an epidural, some of them got the epidural, the others in the control group got a needle in their back and no pain medication delivered. I would be really upset if in labor I was asked to be part of a study, without reading that I may be denied pain medication when asked. It did make it clear that women were eventually given pain meds if they made a second request though.
post #38 of 55
Quote:
Originally Posted by cdnmom View Post
2) Why, oh God, why are so many of the pp writing that " at so and so cm, I had an epi". WHY are you being checked internally???? Any doctor worth their weight will admit that dilation is NOT a measure of progress. All that does is set you on the Friedman Curve (1cm/hr) and if you are not "progressing" according to that standard deviation, then you are labelled "failure to progress" and further interventions (ie) C-sections are pushed!!!!
For what it's worth, I actually found it helpful and reassuring to know how many cm dilated I was and how far my baby had descended. Having this information helped me to make the decisions that were right for me during labor.

I wasn't particularly concerned about any increased risk of infection due to internal exams, since my amniotic sac was still intact. And it's not as though my doctor went nuts with the exams -- I think I had two or three in the 10 hours I labored at the hospital. (Which you may think means I went in "too early," but honestly, I don't think there was any way to know at the time that my labor was going to take as long as it did. As I recall, at the time I went to the hospital, my contractions were 3 minutes apart and quite painful; they'd been less than five minutes apart for about 12 hours.)

Different things are right for different people.
post #39 of 55
As would be expected, this thread veered quickly from the original op's questions. Here are my experiences for your research, OP. I realize they may or may not be the norm.

I was induced with all 5 of my children at 41+ weeks (except one).
I had an epi and pit with all deliveries.
I had EFM with my 1st (done by a midwife, interestingly enough).
I had all of my babies vaginally; a section was never mentioned or brought up.
All of them were 9/10 Apgar (oh wait, one was 10/10).
Their weights were 8 1/2 lbs or over, except the one who was induced early (verrrrrry looooong story).
All had good latch and bf/ed/ing from 9 mos. to 15 mos. (and counting).

I don't have statistics or scientific studies, but this is my personal experience.
post #40 of 55
I beleive that anytime you introduce an intervention whether epidural, fetal monitoring,vag exam ect, you up you chances of a c-sect. The key word is "chances".

It is a case by case situation however we are not always looked at as unique individuals in a bureaucratic environment such as a hospital. Epidurals alone might not cause a particular problem in a prarticular case, but maybe the mama laying on her back with an IV would cause a problem. The epidural drug does enter the baby and what ever problems manifest from that alone is understated.

I very much agree that Epidurals are a tool. Tools can be misused. That doesn't make them intrinisically bad. The same goes for any intervention.

All interventions have a degree of personal interpretation by a medical staff member and that person might be wrong. Second opinions and self education and true informed consent are a must in order to lessen the chance of a c-section.
~Angela~ NAK
New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: Birth and Beyond
Mothering › Mothering Forums › Pregnancy and Birth › Birth and Beyond › Opinions please! Epidural & C section…