Why would anyone want to go through a natural childbirth today when just around the corner is a hospital that can offer an epidural?
Forty years ago, epidurals were just becoming the norm and most people thought they were a gift from heaven. Now that this much time has elapsed, there is significant research into the effects of epidurals. New findings have emerged that would warrant a thorough investigation by any couple before they decide if this form of pain relief is right for them. This would best be done well before the woman is due to go into labor.
Is Epidural Analgesia the Best Form of Pain Relief?
Here are some statistics taken from a well-known midwife, Ina May Gaskin. From her book, Ina May’s Guide to Childbirth,
“Epidural analgesia is a very effective form of pain relief, meaning that compared to a variety of other pharmacological and non-pharmacological methods, it provides generally consistent pain reduction. If there were no problems associated with epidural analgesia, almost everybody would want it. Unfortunately, though, associated with its use there are various undesirable effects, including:
• longer first stage labors
• longer second stage labors
• increased incidence of maternal fever directly caused by the epidural, which often leads to the use of antibiotics in both the laboring woman and her newborn
• increased rates of operative vaginal delivery (forceps and vacuum)
• increased perineal trauma with and without instrumental births – including severe tears into the rectum (3rd and 4th degree tears).
• a variety of complications such as a placement of an epidural too high on the spine (leading to breathing problems).
• failure of the epidural to provide any pain relief, or insufficient pain relief—requiring the continued use of other methods of pain relief
• increased need for a bladder catheter
• maternal hypotension leading to worrying fetal heart rate changes
• an increase in the likelihood of the need for a cesarean section – this last complication being the subject of great debate, which will be discussed further
“Of course, some of these problems may occur whether the epidural was or was not truly needed. And when an epidural is truly needed for pain relief or to solve a specific problem, it can dramatically change a situation for the better and can improve outcome. It is only when epidurals are used routinely, and especially very early in labor that these complications are more likely to occur.
Trading Birth Pain for Pain After the Birth
“Some women treat birth pain like something to run away from. They seek medication to remove the pain. What happens is they trade the birth pain for pain after the birth.
• Epidurals have 20% backache afterward
• IV site is sore as long as it is in
• Cesareans require urinary catheter which stays 24 hours
• Forceps or vacuum delivery causes injury
• Surgical drain is painful to remove 3 days after cesarean
• Intestinal gas from abdominal surgery is excruciating
• Post-surgery soreness
“All of these things affect the bonding between mother and baby. They also affect the mother’s ability to breastfeed her baby.
“Why not try a change of atmosphere, like moving around? Labor pain is clean. Once it is over, it’s over.
“In a comparison of U.S. women birthing in the hospital vs birthing at home, the hospital group rated birth pain significantly higher.
Here are some good reasons why birth pains seems less for women with home births.
1. They are less likely to be confined to bed during labor
2. They are not denied food and drink
3. They are more likely to have continuous help of someone they trust. (A factor shown to reduce pain.)
The normal creature comforts of everyday life- moving around freely, eating and drinking at will are just as compelling during labor” (Gaskin, 2003).
Water birth today
Interestingly, there is a lot that can be done to reduce labor pain naturally. This is one reason why water birth has become popular. Dr. Michel Odent , an obstetrician in France was the one who started the water birth movement, quite by accident. He tells how he has always wanted to make labor more comfortable for the woman. He was walking in the city one day and noticed an inflatable pool for children. He thought how nice that would be to offer a place for the woman to submerge in warm water. He bought one and took it to his clinic.
The first woman who tried it found much relief. When it was time to birth the baby, he encouraged her to get out of the pool and she refused. He delivered the baby under the water as there was nothing else he could do. Word spread like wild fire. The media sent the news all around the world and it was the women who took off with this new idea. Now water birth is a common feature in midwifery care. Some women say that it cuts the sensations of labor by half.
Other Pain Relief Options
Then there are the unmedicated pain relief options. These include walking, supported slow-dancing, massages, acupressure, breathing techniques, essential oils, counter pressure, TENS units, sterile water injections, straddling a chair in a warm shower soothing music, encouraging words, food and drink. The world opens up for the woman who has all of her faculties.
And when the baby is born, there have been no medications to dampen his alertness. He often cries very little. As soon as he is in the arms of his mother, he customarily quiets right down. The baby looks so peaceful. He often pinks in less than 2 minutes. He’s breathing alright, just not crying. Birth is a natural process.
Research Brings Knowledge
In summary, it would be wise for a couple anticipating their first birth to study out all of their options on the issue of pain relief. Once they make a decision of how they want to address this aspect of birth, they will have time to prepare well. They will be less likely to get surprised with a cesarean delivery and wondering how they could have avoided it. They will be much more likely to get the outcome they are seeking.
Gaskin, I. M. (2003). Ina May’s Guide to Childbirth.