Negative effects from epidurals

[thesimplelife25]

Hi everyone! I am pretty new to the concept of natural childbirth. I have a VERY low pain tolerance, and so for a long time I thought I would not be able to get through labor without and epidural. However, reading the uplifting birth stories on this and other forums (as well as in mothering) has made me VERY interested. However, I have never been able to find any specific negative effects of having an epidural (both for mother and baby). Also are there any other pain relief methods that are not intrusive/harmful to the baby (what I guess I am looking for are both herbal/natural or mainstream medication or different anti-medication ways that you coped with the pain). Please don't flame me!!! I am just wanting to be the most informed I can be Hope this makes sense :

[DoomaYula]

There was just a thread on Birth Professionals about how epidurals DO affect babies: they often contain narcotic medications that pass through the bloodstream and are considered "Class C" medications for pregnant women (possibly harmful, do not use unless the benefit for mom outweighs the risk to the baby).

Personally, I can tell you that I experienced an epidural "window" with my twins; I had the epidural, and the pain vanished -- except for one spot on my leg, where it was all CONCENTRATED. It was actually more painful than laboring without an epi, and it was completely disconcerting -- I was expecting pain relief that I DID NOT RECEIVE! It was really traumatic. I've also experienced pain in my epidural site for years afterward. There is a lot of anecdotal evidence from moms who have had epidurals and experienced pain afterwards. There is the possibility of an epidural headache, which I've heard is really excrutiating. A friend of mine had to have a blood transfusion due to an epidural headache, about 2w post partum.

Dr. Sears explains how once you get an epidural, your options really become limited in what you can during labor and birth:

But because the lower half of your body can't move, you will need assistance changing positions. Since the sensation to empty your bladder is impaired, a nurse will insert a urinary catheter to take away urine. Because of the possibility of the epidural lowering your blood pressure, the nurse will monitor your blood pressure every two to five minute until it is stable, and then every fifteen minutes. To keep the pain relief even on both sides of your body, the nurse will turn you from side to side. To be sure baby is handling the epidural well, you will be hooked up to an electronic fetal monitor. You will also notice that the doctor or nurse periodically rubs the skin of your abdomen, checking to be sure the drug is giving you sufficient pain relief, but not ascending high enough to interfere with your breathing. Now comes the juggling act of getting you just enough anesthetic to give you pain relief and help you manage your labor, but not so much that it interferes with your labor.

So, basically, you're in bed hooked up to a zillion machines.

Also, epidurals (and other meds during labor) make babies sleepy and often affect the initial breastfeeding relationship. From Katy Lebbing, manager of the Center for Breastfeeding Info at LLL Int'l:

Research has shown that if an epidural is administered for more than 2 hours, you'll have latching problems. The longer the epidural is in, the more likely you are to have trouble. I once saw a woman who'd had an epidural in for 48 hours; her baby didn't latch on for 3 weeks.

Personally, as someone who has had an epi with one birth and not another (and planning a homebirth for this one, so no epi for me), I think it's really a psychological thing to get past. You just have to believe that you can labor and birth without an epidural, and you will.

hth!

[maxmama]

Epidurals are a tool. Like any tool, they can be over- or misused. This doesn't make them intrinsically bad.

Choosing an epidural does mean choosing many, many other interventions. Is it worth it sometimes? Of course. But sometimes not.

One very common immediate side effect of a block is a drop in BP, which can lead to decels for the baby. These are not necessarily problematic, but can unleash a whole other cascade of intervention.

On the other hand, I've seen them be an excellent help for survivors of sexual assault, for example, or for women who are "stuck" at 3 or 4 cm; a lot of times they will move quickly once they have a block. Could they have done it without the epidural? Of course. It's a tool, though.

[arlecchina]

well this article tells a lot of info about harm, it's not hard to find quite a few other studies on google. this one is very precise and gives sources, was written by a doc that worked for the WHO for 15 years if I recall correctly.

just from a personal aspect, I too had the problem of an epidural not "taking". I was numb on a sliver of my right side and nowhere else. I read then that it was rare but read since that it's somewhat common. you have to keep in mind that your ability to move and control your own environment, your level of fear and feelings of safety or lack thereof, will go leaps and bounds towards your pain level, you ability to deal with the pain, and etc.

If you are not induced and you're around good people especially if they let you in a tub (god, I hate to say "let", it nauseates me but I dont know you and how medical you are willing to let your birth be, at home, the hospital? so forgive me) you might find it isnt nearly so bad as you might think. warm water helps in almost all cases of pain.

induction almost always leads to epis which frequently lead to other interventions. I mention that only because induction is NOT natural labour and your pain will be far, far greater. so you might think you could take the pain of natural labour easily but I never yet knew anyone including me who managed through a complete induction and still managed to go without some attempt at pain relief. (I am sure there are women who have, my respect to them because I know what hell it is, although my epi did not take, I also admit freely that I gave up and asked for it, and I share the above poster's mention that you feel bad enough for giving in to what you did not want, just for the added problem of it not even working)

[CrunchyBikerMama]

I agree with a PP that if you are not induced and if you can move around (i.e., NOT confined to bed flat on your back), you can make it. I walked and rocked back and forth and squatted and did whatever felt right at the time, and I made it through without medication. It got extremely intense around the time when I was almost fully open and ready to push, but by then I was almost done. Also, don't forget that the body produces natural substances that alter your state of consciousness during intense labor. I had an awareness of what was going on around me, but I was in another world. It was an odd feeling but it made the time seem to go by quickly. I'm not sure the body does this if you introduce artifical oxytocin (as in an induction) and artifical painkillers (epi.)

[Full Heart]

One of the side effects is increasing the temp of the mother. This can look like a fever which will lead to other intervention such as Antibiotics, testing the baby and observation of the baby after birth, c/s and instrumental delivery, pit use, etc. http://www.transitiontoparenthood.co...ffects%202.htm That site states that basically the longer you have the epi the higher your temp goes.

As with any drug there are the potential for side effects. Asprin has side effects, injecting a narcotic into your spine? Absolutly there can be side effects. I don't think there is anything that isn't potentially harmful to the mother or baby.

[Emilie]

You can find lots of articles etc.
I had an epidural with ds( I could not imagine NOT having it at that time!!!!)
The biggest side effect for me that no one told me about( and this is all from what I can see- not all the other stuff)
was that my breasts filled with water ALOT and were very very puffy and I could barely nurse ds and it was hell for 6 weeks trying to get him to latch.
I had dd at home.
There are more reasons to have a natural birth than just the bad side effects of the epidural. It looks like you have time to discover them!
I reccomend Birthing From WIthin By Pam England.

Emilie

[artgoddess]

Epidurals can and most often do lead to other interventions. That said, I gave with the birth of my son and had an epidural after 30 hours of labor. he was born 4 hours later, and no further interventions were used. I walked from the L & D room on my own one hour after his birth. But now that I know I can go 30 hour pain relief free, I'm sure I can do even better the second time around.

[the_lissa]

A mothering article :
http://www.mothering.com/articles/pr...epidurals.html

Another thread:
http://www.mothering.com/discussions...d.php?t=616152

[EmmalinesMom]

Originally Posted by artgoddess

Epidurals can and most often do lead to other interventions.

That's what I was thinking too...that once you start in on interventions, it can become (though certainly not always) a slippery slope.

I have had one epidural birth, and one all natural birth. The recovery for me was much easier after the natural birth, even though the baby was a pound and a quarter heavier.

For pain relief, I changed positions a lot, used Bradley techniques, had someone apply pressure where I needed it, etc. Nothing took the pain away, but it was certainly more managable.

Have a wonderful birth, whatever you decide to do!

[meowee]

Prolonged lower back pain is the most common complaint-- I had an epi for my 5th child after 4 unmedicated birth, including a home waterbirth. My 4th birth was traumatically painful and I don't think I could ever give birth without the option of an epi again... but who knows. My suggestion is: listen to your instinct. I *knew* the moment I was pregnant with my 4th that something traumatizing would happen. Maybe my instinct was leading me towards pain relief. But if your instinct tells you that this will be a birth where you can cope with labor, listen to that.

Funny thing is, with the 5th, I'm sure I could have gotten though it without the epy, but psychologically I needed it, due to the trauma of what had happened to me. I had it for just the last hour of labor, and I had no complications other than the severe annoyance of being in a hospital and the residual back pain (mild, but it I hadn't expected it, it would have angered me) that disappeared for the most part after a year.

The worst thing you can do is get an epi the moment you go into labor... I think this is the cause of most complications. But it's a gamble because if you wait to long, they might not give it if you are too dilated. I got to the hospital at the absolute last possible point where they would have given it too me.

My baby wasn't sedated by the epi and continued to kick like a wild thing though all the contractions... she screamed and was alert the moment she was born, eyes wide open.

However being in the hospital is an awful thing when you are giving birth.... hospitals are places of sickness and death. But in my case the need outweighed the negatives, because I had been so traumatized by my 4th birth.

Listen to your instinct!!! It is there helping you, you just need to learn to hear it!

And one thing I learned is that you should never make a choice based on how people will think of you. There will be people who will say, "An epi is terrible, how could you do that to you baby???" and there will be people who say "You are insane not to have an epi."

The truth is... it is YOUR choice guided by your instinct! Ignore everyone except your own voice.

[Jimibell]

Also please remember that although it is your choice (as mentioned by meowee), your choice will affect not only you but your baby!!

I just learned recently that when you do the epi your body does not produce those lovely endorphins that it would normally produce which help you cope with the labor and birth sensations. This does not matter to you because the epi is there but it does matter to your baby who is also experiencing this (and will affect him/her for the rest of his/her life), but now without the benefit of the hormones that your body creates to help ease him/her through this transition into the world. Obviously this is very traumatic for the baby.....

check out this site dedicated to the baby's perspective, you know, the one who is being born, the one who is about to begin her/his life on earth.....why not make it a good one?
http://www.itsthebabysbirth.com/pare.../epidurals.htm

[RockStarMom]

Hi!
I, too, have a VERY low pain tolerance(I don't have ANY piercings because I'm afraid of the pain!), and I had a successful natural birth. I think the most important thing I did to prepare myself was to take a Bradley class- it was fabulous. I also highly recommend the book Birthing From Within. And, of course, don't give birth without a doula.
Best of luck!

[sarahn4639]

The biggest side effect for me that no one told me about( and this is all from what I can see- not all the other stuff)
was that my breasts filled with water ALOT and were very very puffy and I could barely nurse ds and it was hell for 6 weeks trying to get him to latch.

this is actually pretty common and not talked about! they pump the mom full of fluids to counter act the lowering of blood pressure from the epidural. breastfeeding can be challenging to get started.

also, GET A DOULA they have been scientifically proven to reduce epidurals and other interventions as well as c-sections by 50%!! The study is in the Doula Book. Sorry I don't have any links close. Someone else may. Good luck in what ever you decide. Epidurals are not evil and sometimes needed but i fully believe women can birth without them almost always. believe in yourself, take a good private class, get a doula, pick a supportive care provider (a midwife is a great option) and give it your best!

[musicmomto5]

I had a hospital birth with an epidural with my 1st dd. About a 1/2 hour after birth I had a spinal headache which led to a mini-stroke which lasted for 3 hours. It put me in the ICU for 3 days, under going millions of tests, separated from my baby. I was told by a top-notch neurologist not associated with the hospital to not have anything in my spine again, or it could lead to an actual stroke with serious lasting effects.

My next 2 births were wonderful homebirths. The one with an epidural was the painful one, btw.

This is a big issue for me now, even 11 yrs later, as I am pregnant with twins. I had a very tough time finding a physician willing to take me as a patient that would not have an epidural in place during labor.

[birthjunkie27]

How do you determine pain tolerance?

Regarding your statement about low pain tolerance, I often wonder how people gauge their "pain tolerance". I personally don't like pain (who does?) and I cry when I stub my toe or get a paper cut, but I really don't know if my tolerance is high or low. How do I know? I've given birth to a nearly 10lb baby, at home, with no drugs, and my friends call me "superwoman" or "amazon woman". That said, I didn't like the pain of childbirth, but I got through it (three times) and I LOVED my birth experiences. I guess the point that I'm trying to make is that even in people with so called "low" pain tolerance, it is very possible to make it through a drug free birth.

[Marlet]

Grrr! I had a long reply typed out and DH's computer logged me out of here!

I haven't read everyone's reply so I'll just share my experience.

I had an interthecal. Same drugs as an epidural just placed higher with an instant effect and shorter life span. You do need your water broken after getting it since it only lasts about three hours. They want to get you in and out.

By the time DD was born I had had the interthecal for all of 10-15 minutes. In that time:
I passed out
Needed to be woken up to push
Needed oxygen
Recieved two bags of medcine to bring my dangerously low blood pressure back to a safe level

DD was born floppy and purple, needed oxygen, and was so tired that she didn't even have enough energy to open her mouth to latch. The only reason she started to nurse was because a nurse helped me out by holding her mouth open and showed me how to express into her mouth. While I did that she tickled under her chin to stimulate DD's swallowing reflex.

We both just exsisted for about a day and a half. I was so out of that I passed in and out, had blurry vision (despite having brand new contacts in) and was dizzy. Both of us were extremely sluggish. So much so that co-cleeping was extremely unsafe for the first couple days.

The tricky thing about these drugs is they are based on weight. If you are off even by a couple pounds it can have reprucussions. In my case I was severely overdosed as was DD since they do cross to the baby. Yes these drugs have their place and can do some good but America over does everything, including this one. Very rarely will you find a women who was totally informed of her choice at the time she made it. It's usually due to a bad reaction that they start the research.

In my opinion the best pain relief is a good support person/system. Especially for first time moms. Find someone who can tell you to shut up and get a grip or whisper sweet things to you. Whatever you need to help you get through it find someone who can help. Someone other than your husband. Yes they can be a great source of support but (especially if it's a first time birth) they can get wrapped up in the birth and the emotions and movements from it just like you are. IMO it can be unfair to expect hem to keep their head on straight enough to not only be there but to be there as a support system.

I think the other thing is trsuting your gut and knowing your stuff. Yes it's helpful to read 700 pages of what worked for other women but that's what worked for them. If getting in the water doesn't work for you don't do it. I had read so many things about it being so heavenly that when it didn't work I was pissed! I told DH that everyone who had ever said it was good was a liar and just trying to be hippie like and natural minded. Turns out DD was face up (which I think was excaberated by the pain medicine....too speedy a birth plus being tired from the overdose she didn't have the time or energy to turn....which led to an episiotomy and the dr.'s finger prints on her head for two days) and water doesn't really work for face up babies. If it feels right to you go for it! I think that in the end is going to be your (and everyone else's) saving grace. If you need to do runners lungers by all means go for it!

As for natural minded relief the only ones I know of that come to mind are:
*Hypnobabies/meditation
*water
*moving/not being flat on your back
*low pitched moans (open mouth= open vagina= less tension and more effective contractions)
*sex/orgasm (you can read about it on Laura Shanley's site)
*massage

I'm sure there are more but tha'ts what comes to mind right off the bat.

[maxmama]

Originally Posted by OtherMother'n'Madre

Grrr! I had a long reply typed out and DH's computer logged me out of here!

I haven't read everyone's reply so I'll just share my experience.

I had an interthecal. Same drugs as an epidural just placed higher with an instant effect and shorter life span. You do need your water broken after getting it since it only lasts about three hours. They want to get you in and out.

An intrathecal isn't the same as an epidural, and isn't used in the US for labor/birth because of the significant risks of hypotension and fetal distress. Dosages are very different, effects can be very different, and the response hemodynamically is huge without vasopressors to counteract the BP drop. Epidurals have their issues, but I don't want to combine all regional anesthesia under one name.

[~Mamaterra~]

I posted this last week in response to a similar question...hope this helps.

I note that although most of the pp touch on the affects and epidural has on the baby, none really talk about the physiological effects.

As the epidural is given in the spinal column, the mother experiences localized effects from the narcotics. Unfortunately for the baby, these drugs pass through the placenta and are circulated causing a "systemic effect" meaning that it affects all of their systems.

Remember anything that deadens nerves will also affect neurons as structurally they are similar. As the babies brains and the connections that exist in them continue to form until 36 months, any drug that affects neurons on a cellular level will also have an effect on the formation of these synapses.


Remember the poison is in the dose....just because you may feel that the affect is minimal on you, your baby is forced to intake levels much higher than their immature systems can metabolize and not at a rate of normal infant metabolism....their heart rate and blood pressure is increased at the time of labour therefore this toxin is being circulated and recirculated many times faster than what is safe for a fetus. Additionally, size and gestational maturity affect the effects of this toxin on a fetuses system....I bet the docs/anethesiologists don't take the time to explain that one to you!!!!

One notable side effect is depressed breathing in the baby, as a result, the hospital will insist on electronic fetal monitoring of the baby. As EFM will show the natural heart rate fluctuations of the baby as contractions come and go, this is sometimes interpreted as "fetal distress". In combination with the side effect of the narcotic on the baby and the EFM, there is a higher incidence of C-sections as a result of epidurals.

Just an interesting FYI, the babys' immature liver cannot metabolize these narcotics as readily as the mothers liver. As a result, these drugs take a long time- sometimes days-to be cleared from the baby's body. These narcotics can interfere with the natural rooting that infants do for breastfeeding.

All of those in the "had an epi and baby nursed with no problems" are fortunate but should not ignore what physiologically happens to the baby when an opiate or narcotic is passed into their blood stream. Take a look at the most recent research on the subject.

A thorough review (Walker, M. Do labor medications affect breastfeeding? Journal of Human Lactation, 1997, Vol 13, No2, Pgs 131-7) of the effect of epidurals and narcotics on subsequent breastfeeding found that epidural drugs are present in the laboring mother's bloodstream, cross the placenta to the fetus and affect the baby's later behavior, often causing difficulty with latching on and "inefficient" sucking. These 'sleepy' babies may need more time to 'acquire efficient breastfeeding skills.

At the 1999 International La Leche League Conference, Jan Riordan, RN, MSN, EdD, IBCLC, and La Leche League Leader noted that babies seem to be having more trouble with early suckling, latching on to the breast, disorganized suckling, and sleepiness in the first days of life. Riordan's presentation looked at several studies showing the effects of medicated births on mother and baby. Riordan developed a study to focus on epidural anesthesia 's effect on the baby's suckling and the duration of breastfeeding. She explained the methodology of her study and its results. It clearly showed that medication during birth did negatively affect babies' suckling during the first 12 hours, and that combining medications increased the effect. Demerol was especially harmful to the baby's suckling ability

Again, anything that we ingest, inject, breathe or expose ourselves to as pregnant women, we pass on to our babies. Whether you think it has an effect or not, is irrelevant!!! You may not recognize the effect as you have nothing to compare how the child would have normally behaved without the narcotic in their system.

[applejuice]

cdnmom, you are right on.

Unfortunately, you are preaching to the choir here. I sincerely hope the medical profession takes note of the damage they have done to women over the last 40 years with spinals and epidurals.

Until that happens, the evidence is all "anecdotal" because the medical and pharmaceutical companies do not recognize that anything they do is damaging to their victims.

ETA I have long suspected that obstetrical analgesia and anesthesia is a cause for SIDS. This is particularly dangerous since all SIDS cases are treated as homocides whether you, the parent, are informed of this or not.