7.14.2012

why i'm the crazy one who said no to the epidural

I wrote this post a couple years ago. I've grown as a mother and changed as a woman and didn't like the "judge-y" tone this post had. So I changed it. I don't judge anyone for getting an epidural or birthing in a hospital or getting a c-section, planned or emergency. I love natural birth. It's a beautiful process and design, and with the right preparation and education, I believe many other women would love it as well. I believe birth and the attitude toward birth desperately needs to change in America -- not just in hospitals, but in out-of-hospital birth, as well. Below are reasons I chose not get an epidural, but I don't expect everyone to make this decision. Your birth, your body.

I first became interested in homebirth when I was fourteen and my mom gave birth to my sister without an epidural. I had never even imagined a natural, drug-free birth. I just assumed it was part of the birthing process - go to the hospital, get induced, get an epidural. It was the poor women in remote villages in third world countries who had to, unfortunately, give birth without pain meds.



My mom had an epidural with her first three kids. When she was giving birth to my sister Sky, her third, they administered too much and she could feel the numbness creeping up past her lungs and to her neck, and it became difficult for her to breathe. She decided that with the next baby, she would try a drug-free birth. However, by the time she was in active labor, she told the nurse to give her an epidural, but she had already progressed so far so fast there wasn't time.

She said she was amazed at how she felt afterward. The pain was gone instantaneously as Emma fully entered the world. She was able to get up and walk around immediately after the birth of baby and placenta, and she felt normal, even energized -- something she had never felt after giving birth. Emma was different than her other newborns. She was awake and very alert, not sleepy from the epidural. Some people may tell you that the epidural won't effect the baby, but think about it -- you are not even supposed to take aspirin and ibuprofen when you are pregnant! Everything that enters the mother's bloodstream passes the placenta and reaches the baby.

A few things can occur when an epidural is administered. Sometimes too much is given during the pushing process, and the woman can't push properly, because she can't feel what she's doing. This can lead to not being able to push enough, or push the right way, to get the baby out, but it could also cause the woman to push too hard (and not know it) which can cause pretty bad tearing. Sometimes, the baby isn't in an anterior, head-first position, and in order for the baby to be delivered vaginally, mom needs to switch pushing positions. This can't be done when the mother's lower body is numb from an epidural.

Most of the time, the epidural is taken off a bit when it's time to push, so the woman can actually feel what she's doing. This could make the pain worse, since many women on an epidural are also on pitocin. The epidural also blocks the natural endorphins from being given off by the brain to counteract with the pain of the contractions. The woman's body hasn't felt the pain of contractions, so her brain isn't even making the connection that her body is in labor.

Another thing that I find fascinating about these endorphins is that in a natural, drug-free labor, when a woman gives birth, she literally gets an emotional and sometimes physical high when she gives her last push and her child has finally entered into the world. It's one of the most beautiful things in the process of labor, like a reward for all the hard work her body has done for hours.

Ideally, an epidural is administered between 5-6 centimeters of dilation. If an epidural is administered too early, it can possibly slow labor down. This is when pitocin must be given. Pitocin causes a woman's contractions to be unnaturally long and hard (because there is a constant drip of pitocin going, instead of spurts of oxytocin, which happens during natural labor), which causes more intensity, which calls for more epidural, which calls for more pitocin, which calls for more epidural, and so on. The long and hard contractions caused by the pitocin can stress out the baby and even restrict blood flow. It is possible that this may lead to a cesarean section.

Sometimes holding off on an epidural is easier said than done. Very few hospitals are seeing women birth naturally, which means nurses and doctors simply are not used to a naturally birthing woman. Often a woman is pushed to have an epidural. They are our healthcare providers, and we trust them. But too often, an epidural slows down early labor and the natural progression a woman's body is accomplishing is interrupted.
Like I said, I do not judge a woman for taking advantage of an epidural. I mean, hello. I knew that if I birthed any kids in a hospital, I would be asking for that damn epidural already. What needs to change is making birth in hospital more friendly for the mothers who want to do it naturally, without having to fight tooth and nail to accomplish that.

And I think it goes without saying that the mother who births drug-free is not any stronger than the mother who chooses an epidural. Sometimes an epidural can be a good thing in labor, by relaxing the mother and helping her open. All in all, the risk of serious complications from an epidural is pretty low. The instance of baby death during a c-section is remarkably low. I chose drug-free birth for myself, mainly for experience, and after two births -- one that was calm & "easy," and one that was intense and painful -- I'll choose it again, if we have more children.

3 comments:

  1. w00t! great post! people very often like to gloss over the risks and negative effects of what happens in a hospital birth, and it's really nonsensical, as if women can't be trusted to make the smart decision about where to birth.

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  2. I agree--I have had 4 hospital births--two with Demarol, two with epidurals--and all of them with pitocin whether it was needed or not. One of my doctors just routinely administers pitocin with an epidural because of the tendency of the epidural to slow labor down. (He consequently missed the birth because it sped up an already quick labor) I have also had three planned homebirths. I had no idea how horrible pitocin induced contractions were. I thought I was a total wimp for not being able to make it through even a short labor without assistance. Good post!

    Merechel

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  3. My first baby was totally drug free. I begged for an epidural but she was coming too fast. I lived. I didn't think I would. :-)
    My second child was induced with pitocin. I was on it for more than twelve hours. I received an epidural sometime that afternoon so that I could rest. I did not feel any more contractions after that even tho they were off the charts.That evening the dr came in and I was dialated to a 2. She broke my water and went to get some dinner telling me it would be hours at least. 20 min later I was in agony and pulled my husband in reeeeeal close to tell him to get sombody in my room to up that epidural as I was in some serious pain. The nurses came in...checked me and screamed for the dr. My husband told me they were pinching my legs and my woman parts to test the epidural and I never felt them. But I DID feel that baby coming down. I had dilated from a 2 to a 10 and completely birthed my baby in 45 minutes. He came out with such a perfectly round head that nurses would come in my room to see what everyone had been talking about. (perfectly round because he was in the birth canal for like 10 minutes..ha)
    So after birthing it was hours before I could move my lower body. (yet in labor I had one leg up on a birth bar and heard the dr tell me to move it but I pretended to not hear her...funny what you can do on adrenalin) Then, for weeks I had pain and weakness at the very spot on my spine that you need to hold a sweet baby. I would bend to pick him up and feel like I was going to drop him as I straightened up. Then it would pass. Such a strange feeling. Oh, and a headache. 15 years later that spot still irks me.
    For me, an epidural did absolutely nothing for pain relief. It only caused problems. I felt everything about his entrance except the surge of endorphins.(like you mentioned) I went from feeling nothing to full on birth with no acclimation time. Would not recommend that.
    Now having had three more drug free I would never chose the drugs. Not worth it. Total lie as to their efficacy. At least for me.
    I hate it how many moms succumb to the chemical lies thinking that they can't "handle" drug free...for me drug free was so much better (and easier). To be aware is an amazing thing.

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