Why So Many Women Are Taking The Epidural Trip

The Epidural Trip

[Reprinted with the explicit permission of the author, Cohain JS. In-links added by GreenMedInfo.com.

The Epidural Trip. Midwifery Today 2010:95:21-4, 65. © 2010 Midwifery Today]

Abstract: Two million American women will take an epidural trip this year during childbirth. In most cases, they’ll be ill–informed as to possible side effects or alternate methods of pain relief. In many ways, epidurals are the drug trip of the current generation. Similar to street drug pushers, most anesthesiologists in the delivery rooms maintain a low profile, avoid making eye contact and threaten to walk out if they don’t get total cooperation. Women get epidurals for one of the main reasons so many women smoked pot in the 1970s—their friends are doing it. This article examines why so many women in the Western world are compelled to take powerful drugs during their labor and exposes the risks epidurals pose to both mother and baby."

by Judy Slome Cohain, CNM

This year, about two million women will get an epidural legally, but hopefully not lethally, in the US. As a result, about eight of them will never walk unassisted again. In Westernized countries, roughly 50–70% of birthing women have epidurals for pain relief. Research on who gets an epidural and why draws a profile very similar to the people who were taking drugs in the ’70s. Most women are getting epidurals because their friends are doing it.(1) In a recent, large study of epidural users, the most often cited factor in deciding to have an epidural was having heard about positive experiences from friends and family. Having already had children and having fear of the side effects of an epidural each reduced the odds of choosing one by half. In other words, the older or wiser women get, the more they avoid the epidural trip. Overall, those who did not choose an epidural reported wanting to be in control and having more confidence in their ability to tolerate labor pain.(2)

The typical epidural is a combination of two powerful opiates: Fentanyl and Bupivacaine. Fentanyl has 80 times the potency (and side effects) of morphine. Bupivacaine has the ability to cause tingling around the mouth, tinnitus, tremors, dizziness, blurred vision, seizures, depression, loss of consciousness, respiratory depression and/or apnea. Bupivacaine has caused several deaths by cardiac arrest when an anesthesiologist accidently inserted the epidural analgesia into a vein instead of the epidural space in the spine.

Today, health authorities tout epidural analgesia as the safest, most effective method of pain relief available for childbirth. You could not pull that off on my generation. We lost enough creative artists—Janis Joplin, John Beluchi, Jim Morrison and Lenny Bruce to injectable pain killers. We are aware of the potential of painkillers that are injected into your body—let alone into the delicate spinal cord—by someone else. We know that epidurals do not compare in safety to asserting the power of mind over body, hypnosis or even group high. Those three involve no danger and are all as effective as epidural anesthesia. Pain, more than any other sense, is open to individual interpretation. This is particularly true when it comes to the pain of childbirth.

Watching a woman get an epidural reminds me of watching a teenager have a bad drug trip. Birth is not a terribly painful process in the comfort of home, although going to the hospital doubles it. At home, the part that hurts enough so that you can’t sleep through it typically lasts 2–12 hours, and even then, the pain is neither continuous nor pointless. Labor is a series of 30 seconds of pain followed by 2–, 3– or 4–minute intervals without pain. During that interval between pains, a woman can sleep, talk to friends, work, paint, cook, sing, read, do absolutely anything her imagination can dream up. She is in no pain.

The task of labor is to breathe and relax for 30 seconds of contraction. This can easily be accomplished by the most unimaginative person by walking slowly and counting 10 slow breathes. An imaginative person can connect to the place in her body where she can release her natural endorphins and get a natural high. She can surround herself with a few people who love her and get a contact group love surge. She can connect to her power or whatever power she wants to let flow through her—it’s much like the energy you get watching a great concert, or a shooting star, or a child take his first step.

As this energy flows through her she can imagine herself powerful and giving life force to others, praying for the health of sick people she may know. She can kneel down in soft, green grass and suck in nature’s bounties. It can be tiring, but the longest it will last at significant strength is 12 hours. If labor lasts longer than this, the contractions usually slow down and the woman can sleep a bit. If one needs pain relief to help release endorphins or sleep, three acetaminophen or acetaminophen with between 8 to 15 mg codeine work.  Most women who hear that Tylenol works in labor ask me why they don’t give it in the hospital. I tell them that I have absolutely no idea.

Walking through labor on her own path helps establish the type of self-confidence that is needed for mothering. You are upright and in your own home. No one is shaping your birth for you. You create your own reality. You find strength for the challenges of nursing and motherhood.

The biggest lesson I’ve learned from 25 years of assisting births is that there are no two people on earth alike. Each woman is a completely unique entity with different tastes, needs and desires. By enabling a woman to birth at home - or in any place she chooses—where she can find the position, place, smells, atmosphere and surroundings she needs to birth, she can birth practically without pain. I am not only referring to people who meditate and do hours of yoga every day. I’m talking about Mrs. Couch Potato, too. I could describe hundreds of women who did not feel much pain during birth.

Yesterday, I had just such a birth. When I arrived, she was in early labor, 12 hours after her water broke. We all agreed that perhaps she was stopping herself from going into strong labor for all kinds of psychological reasons. It was her third child. We all went to sleep for a couple of hours. When her husband woke me up two hours later, the mother seemed fully dilated, sitting on the toilet spraying herself with the water from the shower handle. The bathroom was covered with water and an inch or two of water covered the floor. Although it was her third vaginal birth, she said she did not believe in her ability to push.

She did not want to get in the bathtub, where I suggested she could be surrounded by water and have something to lean her back against. She did not want to go to her bedroom either. She decided to sit on the floor of her tiny bathroom leaning her head on the toilet seat, sitting in an inch of cold water. It didn’t seem comfortable to me, but it was for her. In fact, she said that in this position, the labor was painless. She said it then and she repeated it after the birth. She sat there for an hour, not pushing during contractions. During the hour, the fetal heart rate was reassuring and I told her so.

I occasionally whispered to her how great she was doing. Finally, she gave a very large, strong push and pushed the baby out. She said, afterwards, that for the first hour, she just didn’t realize, "It was up to me!" She said it was a lesson that applied to her life in general, not just birthing. This could have never been learned in a place where she could not direct and choose the path of her birth, i.e. sitting in an inch of cold water on the floor in no pain, learning the lessons of life. This kind of emotional growth does not take place under the influence of epidural anesthesia. You have to be in a position to make personal choices for yourself.

Epidural

How to Take an Epidural Trip

If women could take an epidural themselves, the FDA would make it illegal for women to do so, (probably using the same excuse they have used to ban other products that women can use themselves, for example  Epi-no to prevent perineal tears): i.e. it is deadly and lacks adequate research. Although the euphemism, "She took an epidural." is universally used, No woman can take an epidural. She has to be given it. She doesn’t get to administer the drug herself or choose the dose or the timing. The only active part of epidurals is agreeing to one and signing the triplicate, multi–colored consent forms.

The procedure is as follows

  First the current drug birth culture doubles the laboring woman’s pain by putting her in a $10,000 hospital bed with two sensors (each three inches in diameter and about the weight of a coffee cup) strapped tightly around her belly with wide, elastic belts. The continuous fetal monitor makes her constantly aware of being in a hospital and focuses her attention on the pain. She can’t turn, walk, or lie in a bath. There are two hospitals in Canada, though none in the US, that routinely use epidurals that permit walking and avoid some of the other "side effects" of epidurals, but most physicians and midwives have never seen it. 

 Then the woman has to have a two–inch long plastic cannula placed into a vein in her arm to really convince her that she’s being treated for a severe car accident or a ruptured appendix rather than the birth of her child. Then the authorities ask her in a sweet, kindly voice whether she is interested in an epidural. It will have no effect on the baby, they tell her. Any other pain relief will affect the baby, they tell her. It is true that for the purpose of anesthesia during cesarean, epidural anesthesia causes less respiratory depression of the baby than general anesthesia.

But extrapolating from the relative safety of its use for cesareans to stating that epidural is the safest anesthesia for vaginal birth has no basis. Not until long after she has verbally agreed to the epidural and the IV is loaded and the woman is beached in bed with her monitor, only then will a distant, impossible–to–track–down anesthesiologist appear. Like street drug pushers, the anesthesiologist often seems to makes him or herself scarce. For stories about this go to the website: www.MyOBsaidwhat.com. The comparison does not stop there.

Often the midwife, nurse or doctor will make it clear that there might be no anesthesiologist available for hours. The streets are dried up. When the anesthesiologist arrives, the woman is usually relieved by her luck that this hard–to–find anesthesiologist happened to have a minute to supply her. The doctor enters, picks up the chart, and with barely a glance at the woman, asks the same 10 questions that the woman has repeatedly answered since her arrival: allergies, general health, no previous surgeries, etc.

In the same monotonous tone, without ever making eye contact, the anesthesiologist pushes the consent form and pen into the woman’s lap, rattling off all the possible bad effects of epidural while the woman is sitting up on the bed, already in position to have the epidural, and often while having a contraction and unable to pay attention to what is being told to her. The anesthesiologist is reluctant to answer questions. In response to questions, there is usually a "I have better things to do" tone of discourse. The nurse is already gloved and masked, waiting to hand sterile objects to the anesthesiologist.

What a surprise that the woman in labor, who’s been waiting for her fix, says, "Why yes. Give me what you’ve got."

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epidural



I live in Sweden and I got an epidural when both of my children was born. The first one probably saved me from a c-section. I got it after 7  hours of incredible pain that started immediately after the water broke. I tried several kinds of other painkillers, inkluding acupuncture, warm water, Thylenol and Laughing gas - neither worked at all. The contractions were so severe and came every minute - I had no rest. And they did no work - I did not open up one inch. I had told them I did not want any epidural - but efter 7 hours of this torture I could no longer speak and the epidural was given in consent with my husband.

It was pure heaven! I did have to stay in bed for half an hour after it was given - after that I could get up, walk around (got an EDA or "stand-up" epidural), go to the bathroom, drink a little water (previously I had thrown up everything), and the "normal" contractions started immediately and I started to open up. I could parttake in the delivery and I enjoyed most of it.

I did get two more complications. - Suddenly my temperature was rising and probably I had got an infection. I was given antibiotics to protect my baby and the temperature fell again. I had no problems pushing when my daughter was born - I got very strong urges to push. But at the very end her shoulder got stuck and my baby broke her collarbone and I tore an artery and started bleeding. I had to be rushed to surgery. If I had had my baby at home I probably would have died.

When my second child was born I had hurt my back previously and was given an epidural before the contractions started - and they broke the water after that and induced labour chemically as well. This was an alternative to a c-section and it only took a few hours before my second daugher was born. It was very painful in spite of the epidural - the pain came from my back and did not ease between contractions. But I am very happy I was allowed that second epidural - much better than a planned c-section! My baby was very lively and hungry just after delivery and we had just that lovely time together that I missed so sorely when my first daughter was born.

epidural



I live in Sweden and I got an epidural when both of my children was born. The first one probably saved me from a c-section. I got it after 7  hours of incredible pain that started immediately after the water broke. I tried several kinds of other painkillers, inkluding acupuncture, warm water, Thylenol and Laughing gas - neither worked at all. The contractions were so severe and came every minute - I had no rest. And they did no work - I did not open up one inch. I had told them I did not want any epidural - but efter 7 hours of this torture I could no longer speak and the epidural was given in consent with my husband.

It was pure heaven! I did have to stay in bed for half an hour after it was given - after that I could get up, walk around (got an EDA or "stand-up" epidural), go to the bathroom, drink a little water (previously I had thrown up everything), and the "normal" contractions started immediately and I started to open up. I could parttake in the delivery and I enjoyed most of it.

I did get two more complications. - Suddenly my temperature was rising and probably I had got an infection. I was given antibiotics to protect my baby and the temperature fell again. I had no problems pushing when my daughter was born - I got very strong urges to push. But at the very end her shoulder got stuck and my baby broke her collarbone and I tore an artery and started bleeding. I had to be rushed to surgery. If I had had my baby at home I probably would have died.

When my second child was born I had hurt my back previously and was given an epidural before the contractions started - and they broke the water after that and induced labour chemically as well. This was an alternative to a c-section and it only took a few hours before my second daugher was born. It was very painful in spite of the epidural - the pain came from my back and did not ease between contractions. But I am very happy I was allowed that second epidural - much better than a planned c-section! My baby was very lively and hungry just after delivery and we had just that lovely time together that I missed so sorely when my first daughter was born.

Re: why so many ppl taking epidurals



Because in my opinion nursing staff offer it too soon.. and push for ppl to have no pain instead of letting things take their course :(

A Pain Free AMAZING Home Birth



   Maybe keeping active during pregnancy helped, maybe the fact that I am a runner who is used to pain and pushing past it to get to the finish or prize. My amazing little boy was born 1 day after due date on April 13, 2012 at home in a birthing pool. Maybe the fact that he had been so low for 3 weeks before his birth helped and being at 3 centimeters when labor began, who knows. I noticed my water leaking around 7 a.m, contractions began around 10:30 a.m and I immediatey went into active labor around noon. The midwife got there around 1:30 p.m, and her assistant soon followed. There was pain, I won't lie, but I understood what it was for and that it would not last forever, the hardest part was the painful pressure around my rectum but I dealt with it because I knew it had to be this way. I only asked my midwife once how much I was dilated, I had my watch on but never looked at it - I took each contraction as it came and enjoyed the resting breaks between, which really helped me. The involuntary pushes began around 4:10 p.m, like the involuntary need to throw up, you can't quite contro it  but you can help the as they come. I was feeling exhausted, and hoped it wouldn't be too much longer as I was worried that soon I woud be too exhausted to push anymore, my midwife told me to reach down and grab my son, he was born at 4:40 p.m. I will always remember that day, every moment, just about every contraction and most of all the moment I held him up and he looked at me, my heart melted and I knew I was in love and that I would do anything for this little boy.
  It amazes me how most women who could easily give birth at home listen to the crackpot words of doctors who only think of themselves: "you aren't dilated enough, you haven't dilated for hours", "your baby is too big", "the cord is wrapped around his/her neck", a baby doesn't begin to breath until air touches his/her cheeks . It is sad that women cannot trust their bodies to do what they were meant and made for, or they are too scared, or they will actually believe the crap coming from people who seem them as just a paycheck. They used to do breech births, even at hospitals but then insurance companies threatened not to back the up on their malpractice suits so the hospitals quit. The hospitals are controlled by insurance companies so believe whatever you want, it is severely sad though.
   Pain is a part of life, pain happens with lots of things you go through, and there is a reason for it. Nothing is worth more unless it comes at a cost like pain, giving birth is a privilege, not a right or entitlement. 

All 3 Natural births



A great read. At my most recent birth (My third and final) I had a professional photographer. I was worried that all of my pictures would be of me looked pained and miserable; shockingly, most of the pictures I have a smile or half smile on my face, even in the midst of a contraction. The joy of having my baby with only my husband and midwife (whom I have known my entire life) the only people present(save the photographer, whom I have known for about 15 years) allowed me to relax.

This is what birth should look like:

https://www.facebook.com/media/set/?set=a.534825174745.2030159.84401313&type=3&l=23a2557bc2
 
 
 
 
My first birth was a hospital, but delivered w/o any intervention. The entire time I felt like I needed to be on guard, I lied about how long I had been in labor, I lied about the last time I had eaten or drank; I didn't want them to push intervention and I would tell them what they wanted to hear. I did this to protect my birth plan and my baby. At home, I could be honest and open. I knew that my midwife cared about what was best for me and my baby. She was not in a hurry, never once mentioned a schedule, even though my second child's birth took over 30 hours from water breaking to birth.
My third child took about 8 hours but was born weighing 11.1 lbs and being nearly 24 inches tall. He was stuck and no matter how hard I was pushing, he wasn't budging. Looking back, I remember feeling a moment of fear that I would need to be transported. Instead, my midwife said encouraging words, my husband leaned forward and whispered "do it now." My body relaxed, my pelvic bone dislocated and our son was born moments later. My body knew what it needed to do, I just needed to allow it to do so.
The beauty of a midwife and homebirth is that from day one, she tells you you CAN do it, there isn't really another option. At a hospital, they start by asking if you WANT to do it. If you don't want to (and let's be honest- who does want to give birth to an 11 lb baby) they have a variety of options.You can even pick your child's birth date! However, I believe it takes away some of the magic of the experience.
 
I often reflect on how differently my births would have been, had I been ill-informed. All three of my children were "overdue." Hannah, now 7, was 12 days overdue ; Charlie, now 2, we didn't have a real due date for- per ultrasound he was 11 days overdue, per lmp he was 4 days before- but weighing in at 9lb 13 oz, I have my doubts about being early; and Will was 7 days past due date.
All three of my children were fantastic sleepers from the beginning, they were alert and wanting to nurse right from birth, they were healthy and gorgeous babies. But would my doctor have allowed the delivery of an 11 lb baby or a nearly 10 lb baby? I think not.
 
I am very passionate about making informed birth choices, even though we are done having children, I always try to share my knowledge with expectant moms (without being pushy). Usually, htey have no interest. They want a pain free delivery because it sounds appealing. Of course it does- but what are the long term effects? Do the benefits outweigh the risks? Your article provides a very detailed explanation- thank you.
 

Epidural helped me during my child birth.



I had my daughter, October 20th 2010, I was induced that morning at 9 o'clock in the morning with the nurses keeping a watchful eye on me, due to me being the only one on the delivering floor, they noticed that I was not dialating, I was stuck at 2 cm and going nowhere, my contraction were becoming so unberable they gave me the option of having an epidural admisnistered to me. I decided that I would get it done because the doctor had decided that with me not dialated she was going to book me for a c-section, so I figured by taking it that I would not have to endore the pain I was experiencing anymore. By the time the anesthesiologist got to me and admistered the epidural it was passed twelve o'clock. I immediately felt the relief and numbing all down my legs I felt no pain at all, which I was glad because I was no longer in pain for nothing since my body was not doing the work needed. Once I was completely relaxed and out of pain my body final stopped being stubborn and I was fully dialeted by 3pm and my beautiful girl was born at 3:45pm withought feeling a thing except for a lot of presure but no pain. It was a fairly easy delivery although we did have slight complications that I do not believe where due to the epidural. If it was not for the epidural I would of never experienced a natural birth. But now I find that I am suffering from cronic back pain which I was informed is due to the epidural, and since ready this article may also be the reason why my milk suply deminished and eventually stopped. I truely do not know if I would ever have another epidural done with my other pregnancy but I know that its thanks to it this time I had a natural painless birthing with little side effects. This article has made some things that I truly did not know clearer and made me consider not getting another one done. Thank you.

Natural = No Drugs



In response to the individual "epidural helped me during my childbirth", natural childbirth is childbirth without medical interventions, i.e., drugs. Your baby may have been delivered vaginally, rather than c-section, but not naturally. Women who avail themselves to natural childbirth education learn the risk v benefit of medical interventions and drugs.

RE- NATUREL=NO DRUGS



To the person that stateted Naturel= No drugs... I understand that because I had a epidural that it was not a hundred percent naturel but it was still a naturel birth, and like the other person that commented said people don't always need to be told that just cause you get stuff for the pain its not a naturel birth... yes it is and I am thankful that I had my daughter naturally and that the doctors knew what they where doing and what would be best for me and my child so we did not have to suffer through the pain, if it wasnt for it my daughter probably would not be here today, so maybe you should keep your comments like that to yourself. If I would of waited for the c-section my daughter would of died.

you can be right...



but does it always need to be said?  We can have compassion and be thankful help is there for the mothers that need it.  Not everyone is the same.

My Epidural Trip



This is just my personal perspective, I don't want to step on anybody's toes so I hope nobody takes it like that.

I planned to have a drug and intervention free birth in a birthing center with my first child. I did what I needed to do to prepare and I felt ready. On the day that I went into labor, I realized that childbirth was not exactly what I thought it would be. I had to be transferred to a hospital from the birthing center because my iron was too low to stay at the birthing center. They did not have the equipment there to give me a blood transfusion if I needed one, so they took me to a natural birth friendly hospital in the area while I was in transition. While I was transitioning I began having flashbacks from a sexual assualt that I survived years before. At that moment I felt that my birthing experience was being taken from me. The amazing and happy day that I had envisioned in my mind was slowly being turned into another traumatic experience. I decided to ask for an epidural, knowing that if the pain I was feeling was lessened, I might stop having flashbacks. I don't know how I know that, I think it was intuition.

When we arrived at the hospital I asked for the epidural. The nurses told me that there would be risks and told me briefly what they were, and I had to sign a waiver in order to get it. My signature looked crazy because I could barely hold the pen. It was a very simple and nearly painless experience. Unlike most hospitals nowadays, they allowed my husband to stay in the room with me and hold me while they did the epidural. They also told me that I would not feel the urge to push so they doctor would have to tell me when it was okay. That made me sad because I wanted to experience that on my own, but I decided that it was worth it because the flashbacks were so bad. I wanted them to end so I could concentrate not on the past, but on the future. On my baby.

Right after the epidural the nurse checked my cervix (she didn't check me when we first got to the hospital. The minute I was in the bed I asked for the epidural) and I was a 10. My flashbacks started to go away. My contractions did slow down a little bit. My water broke on its own while I was resting and talking to my husband. I was checked again after that and I was informed that my baby's head was stuck in a weird way under my pubic bone, and couldn't rotate its way out like it needed to, so I would have to push really hard when it came time. Because my contractions slowed down, I was able to rest for about two hours before I felt the urge to push. I really did feel the urge to push. All of the sudden I had this wave of adrenaline take over my body, and I felt like I needed to start pushing. I pushed for about two hours straight, doing very hard pushes the whole time. My baby was born without the use of forceps or a vaccuum, even though it is very common to use those if the baby gets stuck under the pubic bone. I honestly believe that if I had not had the epidural I would not have had the energy to push her out like I needed to. I would have been too exhausted from not having that break. I also think that there would have been a cloud over the day because of the flashbacks I was suffering from. In fact, if that flashbacks had gotten worse I don't know if I would have been able to focus well enough to push at all.

My baby was born VERY alert and awake. I don't believe the epidural affected like it does some babies because I got the epidural so late in my delivery. She scored 9/9 on both apgar tests. She was ready to nurse right away. She looked around the room a lot and recognized mine and my husband's voice. Maybe it did affect her, but it couldn't have done much because she was SO alert. Either way I am at peace about it because I did the best I knew how in the circumstances I was in.

I believe that pregnant women should definitely be informed of all the options available to them when it comes to giving birth. Women should know that if they choose an epidural there are possible risks. A lot of women don't realize what the risks are and they choose that route because they think that its perfectly safe. I think many would not do so if they knew what the risks were beforehand. I think that it should always be an option, because I believe that choice is important, but its not fair that a lot of women think that its the only method of pain relief during birth. I think that all drug free methods should be attempted first always.

Good common sense!



God bless you with full healing and a good future!

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