“Give me the f*@k!n epidural!”
The above quote, to the best of my recollection, comes from the film The 40-Year Old Virgin, but it just as well could originate from any number of films involving birth and labor and the immediate need for some relief from the discomfort that so often accompanies this painful miracle. For the uninitiated, an epidural is an injection of a local anesthetic into the epidural space around the spinal chord to numb the pain and discomfort of labor and childbirth. There are two kinds of epidurals – conventional, which involves blocking all sensation from the waist down, and something called a “walking epidural” which uses a combination of local anesthetics and painkillers in a relatively low dosage. Many women who have experienced the joys and ardors of childbirth swear by the miracles of the epidural (more than 2/3 of mothers have submitted to epidurals), whereas others swear it off and contend that the administration of an epidural degrades the birth experience and endangers both mother and baby. Two camps, two distinct viewpoints, one objective – get the baby out safely.
While the pro-epidural camp includes most physicians, western medicine adherents, and mothers who are deathly afraid of pain, those who reject the practice include individuals who embrace a very natural childbirth, along with those who have considerable concerns about their safety. The administration of an epidural, in the opinion of many natural childbirth proponents, creates an escalating effect necessitating additional interventions and intrusions: IVs, catheters, blood pressure monitors, and electronic fetal monitors. All of which produce an unnatural experience and reinforce the over-medicalization of motherhood. However, a new look at the epidural procedure, by writer Melinda Wenner Moyer for Slate.com, provides a perspective that largely reinforces the usage of of epidurals. In an opinion piece that is sure to rile many who shun the procedure, Moyer makes a case for epidurals and claims that the concerns voiced by natural birthers are exaggerated. Some anesthesiologists have published books about why women should embrace epidurals, arguing that they might even be beneficial because they reduce the baby’s exposure to labor-pain-induced stress hormones.
While there exists a mountain of research and studies, a definitive answer as to whether epidurals pose a sizable risk to mothers and their babies seems elusive. Moyer admits as much, and speaks to the inherent difficulties in arriving at a conclusion:
“How can scientists tease out the cause-and-effect here? Ideally, they would split laboring women into two groups at random, giving one epidurals and the other no pain medication, and then watch what happens. But most doctors agree that it would be unethical to withhold medication from laboring women in the name of science.”
So the answer is likely no answer, other than to each his/her own and doing the research and honoring your own conviction are likely the best advise to follow. While epidurals do provide some much needed relief for mothers contending with the rigors of childbirth, as with any medical procedure or meddling, there exists a risk…even if it is a small one. What has been your experience with epidurals? Do you feel childbirth and epidurals go together like spring and flowers, of more like oil slicks and pristine beaches? Please share.