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Childbirth

Share experiences and get support around labour, birth and recovery.

do epidurals affect the baby?

37 replies

micegg · 18/03/2008 17:01

For some reason I always thought they had little or no affect on the baby because they are sited into the mothers spine and I assumed they acted a bit like a local anaesthetic to the area. I just remember one of the MWs on the post natal ward commenting that they say epidurals dont affect the baby but they do when trying to work out why DD never latched on for breast feeding. Does anyone know the answer?

Thanks

OP posts:
Sabire · 19/03/2008 16:20

Second labours tend to be easier because they're shorter - both first and second stage.

My first labour involved and epidural. I don't think I would have had one had I had better care. I was left on my own for long periods of time, expected to lie on the bed and offered no emotional support at all.

My third labour was also massively long and painful, but I didn't have an epidural. It was easier for one reason alone: that I had brilliant care from an independent midwife and spent almost the entire labour at home.

It wasn't a less 'anxious' labour than my first. When I went into labour with my first I was classed as low risk - I'd had a healthy pregnancy and I had confidence in the birth process. By the time I was facing my third labour I had loads of anxieties: I'd become a high risk pregnancy because I'd be diagnosed with gestational diabetes. My second baby had weighed 11 lbs and had shoulder dystocia. I'd been told, after repeated scans that my third was also a massive baby (turned out to be much smaller in the end though - just 9lbs). So no - my third labour was easier than my first labour - I just got better care.

I recovered quicker from my third birth because I wasn't catheterised and immobile from the waist down for the first few hours of my child's life. I also didn't have terrible perineal damage, like I did after my first which ended in a forceps birth (something which may well have been a result of having had the epidural). Not forgetting the infection that I took home with me(possibly related to the many vaginal examinations I had to check my very slow progress once I'd had my epidural sited).

What part of my post would make people feel guilty? I'd really, really hope that anyone opting or thinking about opting for an epidural would know all the possible drawbacks - including all the possible side effects for the baby as well as for themselves. I had a bad experience with an epidural and DO think it affected the first few days of my baby's life, but I don't feel guilty AT ALL. Why would I? It wasn't my fault. I did the best I could in labour in very difficult circumstances.

I never said that epidurals are forced on people. I do think that women having difficult labours are sometimes left with no option but to have one, simply because they're not offered the alternative of intensive, skilled one to one care from a midwife who isn't stretched to the limit by caring for three or four women at once. In my view opting for an epidural when you're at the end of your tether and nobody's offering you any emotional support ISN'T a free, informed choice - you're cornered into it.

I'm glad you had good care and help with feeding, but sadly at our local hospital, although the individual midwives are brilliant it's often like the last day of the Somme on the labour ward - the staff are flying by the seat of their pants and women end up getting really, really cruddy care. Over 50% of breastfed babies get given formula in this hospital too - most within 12 hours of birth, basically because there aren't enough skilled staff to sit and patiently help a mother with a baby who is slow to latch on.

TotalChaos · 19/03/2008 16:24

Anagram - I agree about pethidine/diamorphine being promoted because of being easier/cheaper than epidural. I had the cascade of intervention following diamorphine - so it irritates me when epidurals are represented as being risky when diamorphine also carries risks.

pruners · 19/03/2008 17:10

Message withdrawn

Anagram · 19/03/2008 17:16

TotalChaos --

I went to a workshop at Queen Charlotte's last week (a highly regarded research hospital with a birth centre in London) and in the Q&A afterwards, the midwife basically confirmed what you said. They use Diamorphine (instead of Pethadine, which she said has caused a lot of problems) and still she was steering people away from the injection because of the risks. In her words, the epidural is a very good choice and often works "perfectly."

pruners · 19/03/2008 17:25

Message withdrawn

Anagram · 19/03/2008 17:30

pruners I gave birth to ds1 in the US. This was at a major hospital, university affiliated, very high tech but they also opened the first birthing centre in NYC. They even have birthing pools, which is almost unheard of in Manhattan. One can take one's pick at that hospital medicalized birth or not. Definitely no Entonox, though. Considered inappropriate and not safe.

I've had gas and air for dental work in the US, it's widely available for that, both for adults and children. For root canals, wisdom teeth and such, sure. Not in maternity wards, almost never.

chibi · 19/03/2008 17:31

In answer to Sabire's post -

I mostly agree with everything you have said, it is pretty much true.

However, in my own situation, it was only once I had the epidural that I was able to relax and dilate to 10cm after labouring for hours and making no progress.

I don't think that you can have a guarantee either way. There are some definite risks with using epidurals, but having said that they can be a godsend for some women and don't necessarily result in failure to bf etc.

I think you need to really be aware of what your options for pain relief are and to have good support during labour so that you can make an informed choice.

FWIW I would hope with my next birth to be able to do it naturally.

pruners · 19/03/2008 17:46

Message withdrawn

Bridie3 · 19/03/2008 17:53

Two epidurals. Two babies with 10s in all their A.scores. Both b/f until they were eight months.

Mintpurple · 19/03/2008 18:58

This is an interesting topic. Anecdotally, as a labour ward midwife, I have not found that an epidural will affect breastfeeding for the first feed, and I try to initiate a first feed within an hour or so of giving birth. An analysis of 21 studys involving 6600 women relating to epidural use by the Cochrane collective has found no effect on baby. Article can be seen here.
There is very little fentanyl used in the epidural, and although a tiny amount will get through to baby, I really dont believe that it is enough to make a difference. There are many other factors which are more likely to affect babys feeding, ranging from exhaustion in the mother, raised temperature, midwife apathy, use of instruments at delivery, mucousy baby etc etc....

As far as gas and air is concerned, it is known to reduce oxygen saturations in the blood while being used, but I cant find any evidence to say that it is actually 'harmful' per se. It does not seem to affect the babys welfare (if CTGs are used as an indicator of babies wellbeing).

I think if you can manage with no drugs, obviously that is the ideal, but in reality do what it takes to get you through labour, and if that is an epidural or diamorphine, then so be it, and dont feel guilty about it.

Anagram - choice of analgesia has nothing at all to do with cost. If you want an epidural you will get it. At the clinical level, it makes absolutely no difference to availability. Also most obstetric doctors are actually female now - although this is still not the case at consultant level.

Anagram · 19/03/2008 21:06

Pruners -- I may have the information tucked away in a file someplace, kept a lot of the literature they gave us in the ante-natal workshops. Including hand-outs from the birthing centre at that NYC hospital. Will post it if I find it. No one I know who has given birth in the US has had gas and air. The FDA has a website, btw, which may be helpful.

fabsmum · 20/03/2008 14:04

Mintpurple - I saw that abstract on Cochrane but was put out to see that all but one study compared outcomes for women who'd had an epidural with women who'd had opiates (or have I completely misread it? It says "all but one study compared epidural analgesia with opiates"). For me this makes the review a bit useless - that probably the bulk of the comparison group used opiates in labour.

What I'd really like to see would be a study comparing two low risk groups - one group who'd have a pre-planned epidural at between 3 and 5cm and the other who'd have continuous one to one care from an experienced midwife throughout and access to a birth pool. That'd really sort the wheat from the chaff!

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