why are people so against epidurals

[porcamiseria]

I am just curious, as the general vibe here (MN) and with the NCT and some midwifes is they are a bad thing.

I had one as was induced and literally could not cope with pain. I wont go into the whole story but its the usual ventouse, stitches etc. But baby was healthy and fine

My point is for me the epi was a godsend and the intense pains were not bearable.

If it happens again, I will have an epi if I can't cope. am due August, so its pertinent for me

It upsets me rather this attitude that they are to be avoided, as if you DO have one some people might feel like a failure?

Zeb If you HAD read the all of the posts then you might have got your answer to 'why?'

Gibran Clearly you have never been to a NCT class. There are many things they can do to improve but you are quite out of touch with even the worst taught class. And you are wrong about homebirths being riskier than hospital births. They are not.

I went to NCT classes when I was pregnant with DD and also to a class at the active birth centre.

TBH I found the NCT class very mainstream looking objectively at all the options esp for pain relief. She did harp on about stuff like optimal foetal positioning, not rushing into hospital at first contraction and importance of being calm and composed (as opposed to out of control) but I thought that this was very fair and balanced. She did say that the downside of an epidural was being stuck on bed and in this position more likely to lead to episiotomy & instrumental delivery, but also said that the downside for G&A or TENS was that they might not give adequate pain relief.

The class at the active birth centre was obviously much more natural / active based but we knew that when we booked in for it - the difference between the two courses was striking.

'Personally, I think the NCT's approach to pain relief during childbirth borders on quasi-religious fanaticism. I cannot abide the attitude (perpetuated by some on MN as well, it has to be said) that a woman who gets through childbirth with a bit of chanting and maybe some paracetamol is somehow "better" than someone who has every kind of pain relief under the sun just to get through it.'

Personally never heard this view from the NCT....accept that some individuals might however have this view.

Childbirth is not a competition between mothers. However a mother should be able to feel positive about the birth experience she had no matter what that experience was so if someone feels proud that they gave birth with no pain relief fine. Equally if a mother had every intervention going and is equally proud of her experience fine. Unfortunately this is not always the case and to say the ends justify the means is trivialising the very horror some women experience which causes some mothers to commit suicide during the first 12 months after the birth of their baby.(Cemach Why Mothers Die).

AngryWasp - actually, yes, I attended an entire course of NCT classes. In fact, if the stories on here are anything to go by, our teacher was more moderate than most, in that she did at least discuss the various forms of analgesia, even if she did pepper that discussion with a fair few factual errors, and spice it up further with opinion presented as fact.

That's what I mean when I say it's quasi-religious - beliefs are presented as fact, and I feel that is dangerous when the people doing that presenting are being held out as experts and are preaching to novices.

That said, there were many other aspects of the NCT course that I thought were fantastic.

As for home-births vs hospital births, that's a whole other subject, but I didn't actually say that one was riskier than the other - I said that home-births have more associated risks, which is not the same thing (a birth itself will not be made more or less risky based on where it takes place - a birth just is, with whatever risks that particular birth happens to have). However, I'm afraid I'm not going to take your word over that of my paediatrician partner (and common sense). If a particular birth develops complications (and there is no robust evidence to suggest that such complications are more or less likely to take place at home or in hospital - in part because no controlled experiment is possible), those complications can be addressed with less risk in a hospital environment. To believe otherwise in the face of the balance of evidence and common sense is clearly your prerogative, but being dogmatic about it doesn't make you right.

Gibran, she didn't say that homebirth is riskier than hospital birth.

She said that homebirth carries bigger risks than epidurals - they may be less common but still bigger risks. I assume by that she means that an epidural might mean you end up with instruments, but a home birth might lead to a baby that doesn't make it if something very exceptional happens (e.g. cord prolapse).

THat's my understanding, anyway.

Sorry, that was addresse to amgrywasps, not Gibran!

Gibran, I was very ineloquently tryig to agree with you!

I'm not homebirth bashing btw, not at all, I respect that as a very valid choice, but every type of birth carries risks, no getting away from it.

Not wishing to get into any arguments here but seems to me that, given some comments here about the contents of its ante-natal classes in addition to the point in its aims ('of 1956' - but presumably not revised as they are still up there) regarding the desirability of home births, the NCT would do better, and avoid any charges of being misleading (and there do appear to be some posters on here who feel mislead, albeit others who don't) if it reverted to Natural Childbirth Trust. NB - That does not mean I have anything at all against a charity with such a name, I have nothing against home births either - I fully support a woman's right to choose. But, given its aims, I think that 'Natural', rather than the broader 'National' - which might be inferred as meaning speaking for all women and equally for all birth choices when clearly that does not represent the reality - would be more appropriate.

iamwhatiamwhatiam (I guess "iamwhatiam" was taken?!) - thanks, and no worries - in fact, I'd forgotten myself that I was originally comparing risks associated with home-births and epidurals, so thanks for pointing that out!

'If a particular birth develops complications (and there is no robust evidence to suggest that such complications are more or less likely to take place at home or in hospital - in part because no controlled experiment is possible), those complications can be addressed with less risk in a hospital environment.'

I suppose the crux here is how you think said 'complication' came about. I here lots of friends tell me they thank god they were in hospital because the baby got stuck, and would have been dangerous at home, but a further look into the way they laboured suggests if they hadn't have been labouring in the often hospital-preferred way, the baby wouldn't have got stuck.

'To believe otherwise in the face of the balance of evidence and common sense is clearly your prerogative, but being dogmatic about it doesn't make you right.'

kettle - pot. Common sense isn't a universal truth in any case and having a paed as a husband doesn't impress me either, not when talking about childbirth in any case.

But bell it's aims aren't to get women to have a natural birth, so that would be misleading.

LindenAvery - in many ways we seem to agree with each other - to each their own, horses for courses - pick your phrase, but the message is the same for me: no birthing "technique" is objectively better than any other, and nobody should be encouraged or discouraged either way without a genuine factual basis for that encouragement / discouragement (and even then that needs to be weighed against the pros and cons of other birthing "techniques").

I am not sure what you are trying to say with your last comment though...? Are you suggesting that a statistically significant greater proportion of mothers who had epidurals commit suicide in the first 12 months after childbirth than mothers who had no epidural? That's pretty left-field, if so, and I'd be interested to know your source (and how, if at all, any kind of causal link was established).

Doubtless birth is very traumatic, and more so for some women than for others, and perhaps in some cases that trauma is so overpowering that the plain memory of it drives some women to suicide (I guess anything is possible), and if that's the case then it's obviously awful - however, I didn't have it in mind when making my original comments, and in any case I honestly can't see how I'm supposed to have trivialised the (presumably rare) phenomenon of birth trauma-induced post-natal suicide...?

"As childbirth is not a disease it should take place in the home wherever possible"

A valid point of view. Taking into account a particular perspective on the matter. I support anyone's right to have that point of view. It happens not to be mine (family history - my mother nearly died in HB and her best friend did). Now of course we could sit here all evening (rather than making my varms' supper) and debate (politely!) who is right or wrong and how times have changed and whatever and I reiterate - I would always fully support your choice of a HB - always. But an organisation with that aim/statement/whatever doesn't represent my point of view and I suggest is more of a 'natural' than 'national' childbirth trust - and there's nothing wrong with that.

As I said, never went to NCT classes. Only contact in Oxford when with small baby, rang the local contact (ten yrs ago) to find out about mother and baby meets etc. She spent twenty minutes of (my paid for!) phone time railing against vaccinations - I really wasn't going to have mine vaccinated was I?? etc etc. Of course her viewpoint valid - but was it really appropriate to lecture a new mother in that way? Never went to a meet. Now, she was obviously one of those out of control 'lone guns' I should have maybe complained about, and not the official face of the organisation - but, just judging by the comments on here, there do seem to be an awful lot of em around in NCT classes etc (and this was their North Oxford rep, or one of them).

AngryWasp - are you suggesting that hospital births give rise to more complications? If so, what's your evidence (other than anecdotal)?

As for common sense not being a universal truth, you are, of course, absolutely right - but it's a fairly universal truth that most homes do not have life-saving medical equipment fitted as standard.

Anyway, this is all off-point.

i also hate people that say b4 they have eva had a child i will def not b having one! i have to laugh to myself and think we will c! i feel the choice is whatever u feel right 4 urself but u dont get a medal 4 doing it without!!

its a myth that back problems come from epid aswell as it the pregnancy that put the stain on u not an injection (apparently!)

AngryWasp - Oh, and paeds do attend childbirths, specifically the ones that are (or become) complicated, plus they see the aftermath of home-births that develop complications, so this (along with the fact that they are medically trained and aware of the latest science on teh subject) is still relevant, in spite of how unimpressed you are.

smallwhitecat - I think the original question was "why are people so against epidurals?", which is not the same thing as "why do some people think they are a bad idea?"

My secondary point was this: I cannot understand why some people are so disproportionately against epidurals when there are other, more risky things to worry about. That said, obviously it's a personal thing - which was my main point: when people being so against epidurals reaches the point that they feel justified in preaching that aversion to others, I feel justified in asking them to both back it with evidence and place it in context. Or just telling them to sod off and do what's right for them and let others do likewise.

Thank you for summing it up smallwhitecat.

I feel this discussion is going round in circles!

Bottom line is - epidurals carry certain risks, therefore some women decide to do everything possible to avoid them. Some women weigh up the risks and prefer to have an epidural. And some women have specific complications which leave them without the choice. (I did not have a choice to go without anaestetic with my csection with dc2. Well - I had a choice of epidural or general anaesthetic and opted for the safer of the two). With dcs 1 and 3, I had natural vaginal births because that was the safest option for those two particular births.

I think looking for deeper significance as to why women choose natural birth is way off the mark for most women. Maybe some are really keen to fully experience every sensation, but I honestly think for most, it's as simple as: look at the options, weigh up the risks, and unless you have complications, then choose what is right for you.

I am planning to have a natural birth-who knows things may change, the only reason being I'm so scared of needles I'd rather go through the pain! many a time a dentist has performed fillings and things without anestic because I won't do needles

smallwhitecate, I'm not the paediatrician, so I haven't read the journals - I just trust my OH, who has.

However, by way of example, James Drife, professor of obstetrics and gynaecology at Leeds General Infirmary (someone better qualified than me or anyone else posting on here, I'm guessing), apparently believes that home births are more than twice as likely to lead to foetal death than hospital birth; the same is not true of epidurals (i.e. an epidural does not double foetal mortality rates compared to no epidural).

But you miss my point: although you and others have poked me into defending my beliefs regarding home-births (and I suppose it was fair to challenge my assertion that these beliefs have a sounder factual basis than judging epidurals to be too risky), I really don't go around telling people that they shouldn't have home-births, yet it is somehow apparently acceptable for people to preach the no-epidural approach and then play the clinical risks card to try to back up that preaching. Preaching about something so obviously personal is bad; claiming to be doing so in the name of science is misguided and subverts scientific fact to serve the preacher's purpose.

Or do you disagree - do you think that it is acceptable for the epidural nay-sayers to distort the risks as they preach their gospel to others?

I have to say that I think a lot of people are so anti-epidural because they consider them cheating. Some kind of weird masochistic view that you don't deserve to be a mother if you haven't suffered the pain of labour. Wasn't there a male m/w preaching exactly that viewpoint last year sometime?

I know the vast majority of anti-epidural people on this thread are so because of the risks and nothing else. But there are some who believe that you're not a real woman unless you've done it all without drugs. Macho, misogynistic freaks that they are!

Everyone at my NCT class for DC1 had gone there primarily to meet people and have a group that they could have coffee with afterwards and talk obsessively about their birth stories, which seemed SO interesting at the time . (13 years on, I can't remember any details, who had an epidural, nor who breastfed...). Not because of the ethos of the classes.

I am pro medical births which I put down to being influenced by my own birth (super-emergency CS under general, would have died if not at hospital and no, I don't feel I missed out by being a C-Section baby). I feel MORE relaxed when medical professionals are near, just in case.

I have said on another thread that I would have liked advice on an 'active epidural birth'. It IS possible. With DC3 I sat on birthing ball throughout, despite mobile epidural/monitoring. No catheter, no stitches, no intervention, only low-level pain, massive high afterwards.

But at NCT class, both 13 years ago and at refresher, it was very much EITHER active OR epidural, which I don't think is helpful. If you expect 'epidural' to be 'inactive' it surely will. My strategy was to ask for one early and NOT collapse on the bed, feeling 'I've failed' but stay upright and enjoy the experience.

Just wanted to second what NorthLondon mum said - if you think the NCT is biased tawards natural birth you should try the Ative Birth Classes!! Then you would see some serious anti-intervention viewpoints . Which was fine by me, that's what I signed up for.

I think the difference maybe is that GPs etc advertise NCT classes nowadays to pretty much all pg women that enquire - primarily for being a good way to meet local famillies and get your maternity leave coffee mornings going - which they are of course. Maybe they should emphasis the pro-choice aspect of their classes as well.

Though as I say, the Active Birth Centre makes them look like the epidural fan club!

I think a good point was made about the way hospital births are managed being part of the problem, in general, in busy, under-resourced hospitals. My first baby got seriously stuck (shoulder dystocia) in the end. I had been forced into having continuous monitoring so was strapped and wired up (I didn't know, as most first time parents don't, that I could have refused). I was left alone for most of the labour, given no guidance on positions, breathing etc, no one checked the progress of the baby coming down, or his position to start with. I was in completely the wrong position (I think some positions most definitley do help babies come out easier). If I had had better birth management in the hospital would it still have hapenned? We will never know but I personally don't think so.