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?

Have not read the whole thread. Personally, I did not want an epidural, purely because the prospect of not being able to feel anything from the waist down terrified me. More than giving birth. Unfortunately, first time round, I had to have one after giving birth, and the not being able to feel my legs was as horrible as I thought it would be, but I had to have it, and therefore no problem. If I had been in excessive pain, I am sure I would have had it no problem either. Second time round not required but again intension not to have an epidural for the same reasons as above.

porcamiseria I'm glad yours went well. Mine very nearly caused me to be permanently disabled. Whenever I hear of someone having one I do not judge them - I simply feel relieved that they got through it without experiencing what I did. I am in the "to be avoided" camp, but simply because of the risks, NOT because I think less of anyone who makes that choice. Indeed, with an induction, IME, it can be closer to a necessity than a choice.

OK, I don't understand. I was just googling epidurals and came across a paper about third/fourth degree perineal tears. www.informaworld.com/smpp/content~content=a909312828&db=all

Which said epidurals help to prevent these severe tears, not cause them.

This actually makes total sense to me as I was able to slow down at the crowning stage far better when I had an epidural and wasn't in agony/desperate to get the baby out. But all I've ever been told is that you will tear worse with an epidural.

From the paper:

'However, induction of labour (OR: 0.71), use of medio-lateral episiotomy (OR: 0.35), epidural analgesia (OR: 0.88) and instrumental delivery of occipitoanterior position (OR: 0.77) reduced the risk of severe perineal tear.'

I was never told this at any class. It's only one paper but if true I think it's quite a consideration on the pro-epidural side!

Hi, for me the word epidural is my most hated word in the English language. My 1st baby was prosterior, so very very painful, but I was managing until the epidural which meant I had to lie on my back, the very worst position for a posterior birth. The epidural dulled the contractions but my babies head lying on my sacrum was agony, agony, agony. For nine solid hours I flipped, and twisted, and watched the hands on the hospital clock move slowly.

It made no sense, the doctors just assumed my baby would turn, but how when I was stuck on my back. Impossible. It was a nightmare.

My second baby was in the best position and came very fast, at home, I managed the contractions fine, had gas and air for 5 or 10 mins at the end when the ambulance team arrived. It was a scary because it was so sudden but blissful birth, no stitches.

I would never had an epidural again.

I had an epi with dc1 - was resited 3 times and didn't work - the consultant who came in from home to try for the third time said I had funny vertebrae which might have accounted for the difficulty so didn't bother trying for the fourth time - I had a R sided back to back baby and a numb left leg and had to lie on my back - I don't think epis are for me but don't think any less of anyone for him an epi was a good thing - will admit to being a bit jealous as in 6 weeks i'm doing it with dc3 and would like all the options to be there

(had easy normal, g&a birth for dc2 which was great and very, very lucky not some evidence of me being a higher form of life)

I think there are two parts to this.

The first part is the mental/spiritual side of giving birth. Some people care about this. Some people don't. This has a lot to do with attitudes towards pain and feelings around birth. I actually think pain can be very positive, like climbing a mountain. But I can understand why others don't share that feeling. So that side is very subjective. That's where all the platitudes about medals and feeling proud or not feeling like a real woman or whatever come out. Labour pain is hell. You have to find a way to cope with it. If the epidural is the only way, then it's the only way. No-one else is going to judge you.

The other part though is the medical effects of epidural. Yes, they can leave you paralysed. Yes, a friend of mine came very close to death following a blood pressure crash. It's very, very, very rare for something to go so seriously wrong, but it happens. More commonly, the effect of the epidural on lowering the maternal blood pressure can theoretically affect the oxygen flow to the baby. I believe this is being researched currently to see how significant this is. Very commonly, epidurals can lead to unwanted interventions, caesareans and instrumental deliveries. (See my earlier link for some evidence, more is available)

I do think the attitude of 'Go for the drugs! Why put yourself through it! Get an epidural in the car park!' is a bit irresponsible because it implies that these potentially very serious side effects are as minor as taking a paracetamol which simply isn't true. In a certain California hospital I was working with, women were given epidurals at 10cm for 'customer satisfaction' purposes because they had gone into hospital expecting an epidural.

Yes, if you want and need an epidural, have one, but do look into other methods for coping with pain. It's not all birthing candles and peppermint foot lotion. Doulas, water and TENS for example can have very significant effects on pain for many women and make labour pain more manageable.

I don't get it either - why be in pain when a nice doctor can give you an injection to make the pain go away???
They know now that the risk with epidurals is so low.
I think the NCT is a great orgainisation, it would be even better if it stopped harping on about "natural birth". We should be harping on about choice.

I just loved my epidural...I had twins last year....and it was heaven - in terms of pain I have had worse days at the dentist - its was an elective c section - nothing could persuade me to push - not that smug woman running my NCT class...likewise my yoga teacher (childless may I add)......or any one else for that matter - I was as calm as you like and my babes came out looking fab....they are very peaceful babies...the min I knew I was having twins I thought - oh good now I can ask for an epidural - any other form of giving birth seems barbaric to me....oh and by the way the scar is fine....

I am a childless midwife, so have often wondered what women mean when they say they "needed" a epidural to "cope". Or say things like "I couldn't have coped without one" or "the only way for me to cope was with an epi". What does that mean? What do they think would have happened if an epidural wasn't available? What would have happened if they were "unable to cope"?

HarderToKidnap become to weak and exhausted to push at stage two maybe?
That does happen. And babies are born with serious problems as a result.

HTK, this isn't going to make me popular on this thread but I chose a home birth for my last baby and my mindset was very different. I knew that drugs weren't available (not even g&a over here) and that changed how I perceived the pain and that I /must/ cope.

Labour pain is real and very intense, but it is not just something which is being done to a woman uncontrollably. There is heavy interaction of mind and body which is actually measurable in terms of hormones. Learning techniques such as hypnobirthing can make a big difference both physically and mentally, raising relaxation and in turn oxytocin levels and endorphin levels so that contractions are more manageable.

It's very hard to talk about this because it's easy to be accused of belittling women's pain. No-one would deny how horrendous labour pain can be. But with the right support and circumstances, it is manageable. It has to be, otherwise in pre-epidural days, no-one would have had more than one baby.

I understand what you mean Carmen. And totally agree with your previous post too.

Actually looking over this thread again, it seems a lot of the emotional'beating up' about epidurals is coming from either the woman herself (there have been a number of posts where the woman has said she feels she's 'failed' - not anyone else) OR there are anecdotes about dreadful NCT teachers who give women grief about epidurals (why do people pay for these classes if they're so bad?).

I don't see judgement coming from other mothers. And I certainly don't see smugness. it does seem, however, increasing impossible to describe your own natural birth experience and say that you feel really good about it and how you coped, without being sniped at by someone who thinks it can't possibly have been as painful as theirs

Carmen this is not an attack on you or your birth. Well done for having a positive experience, really! I don't see why having an intervention free natural birth should make you unpopular as it is ideal isn't it!

but I just wanted to say that if your baby HAD been in the position mine was in, NO amount of mind over matter would have got it out safely without interventions

That's not to say that if my baby was in the same position as yours I would have copes as well as you did, who knows? maybe I wouldn't

but there IS more to it than PMA and pain thresholds etc. So it can be frustrating when people who had a complication free birth say it was ALL down to mind over matter, I see natural drug free labors as 50% PMA and 50% luck. some people don't have the PMA so despite having the luck of everything else being normal, might choose to have interventions - but that only accounts for SOME of the non-natural births, for those of us without the luck aspect, no amount of PMA will do it!

So y'see I didn't have interventions because I had less will to do it naturally than others, or a lower pain threshold or whatever. I had one for lots of other reasons that WERE outside my control. I had all sorts of complications. I had a high fever, the baby's heart rate needed monitoring, the baby's head was stuck in my pelvis and had to eventually be cork-screwed out by surgeons etc. NOBODY could have 'chosen' to have my birth naturally and still have a living baby and mother at the end of it

Its lovely to hear about how your labour went well, but don't say that its managable in all cases because its simply not - there's more to it. And those who had the PMA but not the luck dont like to be bunched in with those who had the luck but not the PMA if that makes sense?

'And those who had the PMA but not the luck dont like to be bunched in with those who had the luck but not the PMA if that makes sense? '

SalBySea - doesn't your last sentence show exactly the kind of judgement you're accusing other people of?

You are saying that people who had the 'positive mental attitude' and 'were prepared to try to do it naturally' but were unlucky should somehow be compartmentalised, and regarded differently to those who had a potentially straightforward birth but didn't have the right mindset to cope with it naturally?

You are making that distinction, having accused other people of being judgemental!

violethill
its lovely to hear about peoples experiences of natural births as long as it stays about their experience
its at the end when some woman who had natural births start generalizing by saying things like "its all about mind over matter" or "its everybodies choice whether to go natural or not" that it becomes offensive

If its worded in that "I managed with lots of will power and mind over matter" thats fine and interesting and lovely to hear
but "its manageable (in general) if you have a positive mental attitude" can be offensive and damaging

does that make sense?

I do understand though that mums do sometimes out martyr each other. I sometimes feel uncomfortable talking about BFing around mothers who tried really hard to BF but failed and will play it down a bit

violethill maybe, I WILL think about what you said

but I think it is fair to say that while some women will choose to have interventions (and that is fine and totally their choice and what they need to do to have a positive birth), others have interventions but it wasn't a choice and to be told that you could have done it with PMA (which I have done in RL) is very frustrating because its NOT TRUE (not necessarily because to chose it would be wrong)

Does saying "I didn't choose to have interventions and don't want people telling me I did" really equal "I just those who chose interventions"???

on reflection, I really don't think so! I just don't like being called a liar when I'm not

But why make the distinction then?

As far as I'm concerned, I had the births I had. It doesn't matter to me what other women have.

It just seems strange to say that you're not being judgemental, but then add a disclaimer saying 'as long as you don't lump me in with all those women who chose lots of pain relief'.

obv meant "judge those with intervention" not "just"

and

I have had it DONE to me in RL, I didn't do it!

its late

as it happens I think those who do choose interventions have a type of PMA and strength to do so, so that they have a good birth for THEM, just a different kind of PMA than is described in natural births.

Just because its not true

It is not my reality

And to bunch everyone who had interventions into a category of "women who chose to handle pain with medical intervention rather than mind over matter" is like saying that the kind of birth that I had did not exist. I just DO NOT FALL INTO THAT CATEGORY

I just don't

I don't want to be called icelandic either, doesn't mean I'm judging people who ARE icelandic, I'm just not one of them and I want to say I am what I am without being contradicted and told I'm icelandic really

Thats as deep as it goes for me as I was open minded going into labour, but for some who really buy into the NCT thing of "you can choose your birth", and who become fixated on having a natural birth and then had that choice taken away from them for medical reasons and HAD to have interventions, the "bunching" in can be damaging as it can make them feel that if they'd just wanted it more.........

boils down to this violet hill, you say YOU dont judge, but I'm sure you don't want to be told that you've only had elective CSs when you didn't?

Same for me. I want to be able to talk about what I DID have without being contradicted and told I had something different (i.e. a chosen non natural birth when I had a non natural birth for life or death reasons)

that's all not a judgement on the categories I DONT fall into

Fair enough, but I still don't really get it, and it seems to me a very strange attitude, which starts from a mindset of having a 'heirarchy' of birth experiences, or otherwise, why would it matter?

You seem to have an issue with women saying 'I had a natural birth', even though they are just describing what they had. I like to be able to say 'I had a natural drug free birth' without being contradicted, or told I'm smug, or told that in having that experience I must somehow be judging other mothers who didn't. There;s been a lot of that on this thread.

SalBySea... It's not all about mind over matter. I wouldn't say that. Some people do have an appalling hand dealt to them with birth. No, the pain isn't always manageable but in the majority of cases with a normal labour it can be made less overwhelming without epidurals by giving the mother control over her birth experience and access to the comfort measures she needs.

There are such a huge amount of factors that play a part in birth so I do get frustrated with the 'birth is a random lottery' spiel I see so often here.

Some people sneeze out their babies. Some people have a baby that is stuck fast. Most are somewhere in between and their situation, mindset, support, environment, cultural expectations, pain relief methods, anxiety levels etc. can swing the difference between a vaginal delivery and an EMCS. (In addition to my home birth, I've had one EMCS after three days of 'stuck' baby... and one posterior baby delivered sunny side up.)

The problem is many women perceive this as blame. You didn't do anything wrong if you had a 'negative' attitude. You weren't weak or unwomanly if you were overwhelmed with pain. These thoughts are really irrational but common. Things weren't what you wanted. No-one is going to judge you and no, there are no medals.

If I blame anyone, I blame the midwives/doctors who view women as machinery rather than spiritual, emotional and individual beings.

A hospital video I saw recently suggested natural birth was 'unrealistic'.

So often (for example), I hear women say their babies were stuck and yet they never even got off the bed and walked or got upright. The pelvis outlet expands by almost a quarter in a squatting position. I suspect my first birth /might/ have gone differently if I had been encouraged to move as I was in my last birth with a similarly sized and also apparently stuck baby. Who knows?

Carmen - interesting post.

In my first antenatal group (NCT!!) there were 8 mothers. Only two of us chose to deliver our babies at the local MLU; 6 chose to go to the big hospital (even though we were all fortunate in having straightforward pregnancies and had the option of MLU).

The two of us in the MLU had natural births. Out of the other 6, five had epidurals; one of those ended in a CSection and two had forceps.

Now, there are two ways of looking at it. Either by some incredible fluke, the two of us who delivered at the MLU were the only ones who could ever have had a natural birth, so gosh, wasn't it a stroke of luck that we went to the right place for it, and the 5 who ended up with interventions were jolly lucky that they booked into the hospital.

OR.... the fact that the two of us in the MLU had access to better midwife care, encouragement to stay active etc etc meant that we achieved what possibly most of the others could have done.

I firmly believe the second scenario.

Yes, there are always some situations where intervention is unavoidable. (My dc2 for example. CSection saved her life). But most births have the potential to be non-medicalised, and with the right support, can be that way.

Violet, this is absolutely true. In studies comparing low risk women, those who planned a hospital birth were far more likely to deliver by caesarean. Most home birth IMs have very low caesarean rates.

The reasons behind this are complicated but it is definitely not a fluke.