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misc.kids.pregnancy Epidural Anesthesia FAQ


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Archive-name: misc-kids/pregnancy/anesthesia/epidural
Posting-Frequency: monthly
Expires: Fri, 18 Apr 1997 00:00:00 GMT
Last-Modified: 1996/05/19

See reader questions & answers on this topic! - Help others by sharing your knowledge
Epidural - Frequently Asked Questions

Questions about epidurals are possibly the most often asked questions
in misc.kids.pregnancy, so here is a compilation of research and
opinions from professionals and women who had epidurals during
childbirth - both good and bad experiences.  

Index

Introduction
The Epidural Procedure
Research
Stories From The 'Net
---------------------------------------------------------------------

From:      OtisSam@aol.com

This is a copy of a column I wrote for the newsletter for an
organization I work with ICAN-NYC (the international cesarean awareness
network). It is written for lay people. I probably forgot a few things,
but it is supposed to explain the risks of epidurals. Anyone who likes
it can use it in any way they consider appropriate. I tried to be
balanced and resonable (which is hard for me to do, since i really
can't stand the things, but women seem to love them)

Samantha McCormick, RN, SNM

Epidurals are becoming increasingly popular as a method of relieving
the pain of labor. Many women can not understand why a woman would
labor without one.  Many physicians love them because the laboring
woman is calm and quiet, easy to control. Many hospitals take advantage
of the docility of epiduralized women to increase the patient load of
nurses, who are freed up from their labor support responsibilities.
Walking down the hallways of a hospital that uses a lot of epidurals
can be an eerie experience. The labor floor is quiet and still. Women
watch television and talk on the phone as they await the birth of their
babies. Some of them even complain of boredom.

The clear benefit of epidurals is that they can totally relieve the
pain of labor. The procedure involves the placement of a needle into a
space in the back near the spinal cord. Local anesthetics and sometimes
narcotics can be instilled directly or, more commonly, a thin catheter
or tube is left in place and medication is given as needed. Usually,
the body from the middle of the abdomen down to the feet becomes numb.
The legs feel very heavy, and moving them without help or walking is
impossible. Many women no longer have any sense that they are in labor,
some continue to feel tightening of the stomach or mild pelvic
pressure. The pain block lasts around an hour, depending on the
strength of the labor and the womans tolerance for pain and what
anesthetics were used. If the catheter was left in place, as is
commonly done, a continuous infusion or repeated doses of the
medication can be given without having to repeat the insertion
procedure.

Use of an epidural is far safer than general anesthesia for both the
mother and baby, if cesarean section is indicated. For certain women
experiencing serious health problems, such as high blood pressure or
heart problems, the epidural can potentially prevent further illness or
death during labor.  However,  we must remember that there are several
drawbacks to this method of pain relief and there are some serious
potential health risks for the mother and baby. Epidurals, like any
medical tool, can be used wisely to positive effect or lead to serious
unintended results. They can sometimes signal the beginning of a
cascade of interventions that culminate in a cesarean section.

Epidurals do not always work as advertised. There can be difficulties
with placing it, leading to long and uncomfortable repeated attempts by
the anesthesiologist to insert the needle into the proper place. This
is more common in overweight women, because the physicians use bony
landmarks to find the proper spot for insertion. Once it is in place,
the pain block can be patchy, with numbness over most of the legs and
lower abdomen, hampered by the persistence of a small "window" of pain,
usually on one side of the abdomen. Or it might not work at all. Both
of these problems can usually be corrected by moving the catheter, if
that fails, a repeat of the insertion procedure is necessary.

A woman needs to have an IV in place before and for the duration of her
labor with the epidural. This is because one common side effect of the
medication is a drop in blood pressure, immediately after it is given.
This can lead to a drop in the blood flow to the baby and a drop in the
babys heart rate. IV fluids before and after the procedure, along with
medications to raise the blood pressure can usually correct the
problem. Procedures vary with institutions and providers, but usually
the baby's heart rate must be monitored continuously and the mother's
blood pressure checked periodically.  So now the woman who walked into
the room under her own power is unable to even turn over in bed without
help, has an IV in her arm, a belt around her belly with monitors and
cables to the fetal monitor, a catheter in her back that may run to a
medication pump, and sometimes a blood pressure cuff around her arm.
If the fetal heart rate looks troublesome, especially if it dropped
along with the woman's blood pressure, the attendant may want to attach
a more sensitive monitor to the baby's head. This would necessitate
breaking the bag of water, if it was not yet broken. The cable for the
monitor runs out the woman's vagina to the fetal monitoring unit. Also,
oxygen via a mask on the woman's face will commonly be used to bring
more oxygen to the baby.  Because of the numbness, many women are
unable to urinate until the epidural wears off. So, along with all the
other tubes and wires, she will need a catheter into the bladder to
empty her urine. This urine tube carries with it a risk of urinary
tract infection in the postpartum period. If narcotics are used, a
common side effect is intense itching, usually of the face and stomach.
Also it is not uncommon to shiver uncontrollably after receiving an
epidural. Some amount of back discomfort from bruising at the insertion
site is common for some days after birth.

Up to this point I have discussed the effects of the epidural that
could be termed merely annoying. In my experience, woman who really
want an epidural don't seem to mind all the tubes and wires or being
numb and detached from her labor. However, epidurals also have
potential effects that are more serious.

The most common, but still rare (about 1 out of a hundred) problem
occurs when the fluid space that surrounds the cord is punctured. This
is called a spinal puncture and can lead to an extremely debilitating
and painful headache within 24 hours. The anesthesiologist can usually
warn you if this has occurred and it is treatable. Very rarely there is
a problem with the insertion and medication is inadvertently injected
into the spinal space, resulting in a higher level of numbness. The
arms and muscles that control breathing may be affected. Artificial
respiration may be required until the effects of the medication have
worn off. If the medication is accidentally injected into a blood
vessel, seizures can result. These last two very rare problems are
medical emergencies and require skillful medical care and usually an
immediate cesarean section to deliver the baby, while the mother's
medical condition is stabilized.

A commonly acknowledged problem with the epidural is its effect on
labor. A woman who receives an epidural may increase her risk of
cesarean by as much as five times. This is not simply a problem with
the contractions slowing down, because contractions can be stimulated
with pitocin by IV. Many women who have epidurals need pitocin to
continue labor. Even with pitocin, a higher number of women cannot
birth their baby without the use of forceps, vacuum, or cesarean. The
numbness produced by the epidural makes it more difficult to push
effectively, prolonging this stage of labor, and exhausting the mother.
Many women are not aware of their contractions and need to be told when
to push. Allowing the epidural to wear off before beginning pushing can
prevent this to some extent, but not only is it often difficult for
women to handle the pain of contractions after being pain-free for so
long, but also the muscle weakness and leg heaviness seem to last
longer than the pain relief. Therefore, the woman is in pain and still
not necessarily able to push effectively.

A woman who receives an epidural is more likely to give birth by
cesarean because of failure to dilate. The hypothesized reason for this
is that the muscles of the pelvic floor relax and allow the baby to
assume a less optimal position. The baby's head then fails to apply
proper pressure to help the cervix to dilate. Also the baby can get
stuck in a position that makes it more difficult to fit down the birth
canal, such as posterior or "sunny side up".

The greatest risk of cesarean comes when the epidural is given in early
labor, before 5 centimeters, especially if the woman is having her
first vaginal birth. Also, if the baby is still high up in the pelvis
or in a posterior position when the epidural is given, the risk of
cesarean is elevated. If the baby is low down (called zero station)
when the epidural is given, the risk of cesarean may not be increased.

Effects have also been noted on the babies. Infants who are exposed to
epidurals can have behavior difficulties in the first days after birth.
They can be more irritable and hard to console and may be less
responsive. They can have difficulty coordinating their movements and
responding to reflexes, which can make early breast feeding difficult.
This has implications for successful establishment of breast feeding,
as early and frequent feeding is ideal to secure a proper milk supply.
Additionally, the bonding between parents and the baby can be
disturbed, which has potential life-long consequences for the
parent-child relationship.

These are the risks of epidurals that have been observed and reported
in the medical literature. They do not all happen to every woman who
has an epidural. We would not be using them if they caused such
horrible problems for all women. I have been with hundreds of women in
labor with epidurals.  Most of them were able to give birth vaginally
and did not appear to suffer major effects on their own or their baby's
health. However, I have personally observed all of the potential
complications described here, occasionally quite serious complications
have arisen.

The fact remains that a woman who wants to maximize her ability to
birth her baby vaginally, unassisted by forceps or vacuum, should
seriously consider and attempt all reasonable alternatives available to
her before requesting an epidural. A woman who has become educated
about pregnancy, childbirth, and breast feeding and has avoided all
potential harms to her child by eating properly and exercising during
her pregnancy may want to carefully consider the potential effects of
an epidural on her ability to successfully breast feed and bond with
her baby after birth.  Please don't write to me and tell me how you had
an epidural at 2 centimeters and you pushed for twenty minutes and
delivered the baby without an episiotomy and the baby latched on right
away and still nurses 10 times a day. I have seen it happen, too. As I
stated earlier, many women seem very satisfied with their experience
with epidurals. However, a discussion of epidurals is not complete
without serious consideration of the potential risks involved.
-----------------------------------------------------------------------

Found in Reader's Digest (May, 1996, page 111)
(as submitted to the September Mom's list...)

"Researchers at the University of Texas Southwestern Medical Center stuided
869 women giving birth at a Dallas hospital. Those who opted for epidural
analgesia - a procedure in which painkillers are injected into the space
around the spinal cord - reported significantly less pain than those who
received their medication intravenously. But the women in the epidural
group labored, on average, an extra 90 minutes; they were also more likely
to have a forceps delivery, and twice as likely to need a Caesarean. This
study adds to the mounting evidence suggesting that epidurals sometimes
change the course of a normal birth.

"'While epidural analgesia provides superior pain control, women need to be
aware that there are trade-offs,' says lead author Dr. Susan Ramin,
associate professor of obstetrics and gynecology. Instead of asking for an
epidural at labor's onset, a woman may first want to try an alternative
method of pain relief; an epidural can be started later if pain becomes too
great.

--HealthNews"
------------------------------------------------------------------------

How The Epidural Is Administered
--------------------------------

From: npardue@ezinfo.ucs.indiana.edu (naomi pardue)
Newsgroups: misc.kids.pregnancy

Since it happens behind you, I couldn't see, but basically, they stick
a big ol' needle in your back. The needle is used to put a catheter in
place. The drug is injected into the catheter.  The tube is taped in
place so you can move without dislodging it.  I don't know if you can
lie on your back, but you wouldn't want to anyway. (Not good for your
labor.) There are two ways of doing the epidural.  With a continuous
infusion it lasts until they turn it off. (I don't know how long it
takes to wear off once they stop.) Mine was a one shot deal.  (Repeated
once.) Each time, the significant relief lasted about 2 hours, then
gradually began to wear off. (The first time it wore off, I got another
dose.  The second time it was almost time to push anyway, so it was
allowed to wear off completely so I could push easily.)

I did not find the procedure painful. They give you a local anestetic
(basically a shot of novacaine) before putting the catheter in your
back, so all you feel is the initial needle prick. I know that some
people find it very painful though.
--------------------------------------------------------------------

From: pete@fred.net ()
Newsgroups: misc.kids.pregnancy

I had an epidural with my first pregnancy. It is funny, my childbirth
educator had three children and experienced both types of delivery,
natural and epidural. Of course, we were all pushing her for
information (we were scared to death, all of us were first timers) and
pinned her down as to her advice on what to do. She hesitated, but
said, "I think you might want an epidural with your first baby, then
since the second one comes sooner, you might want to try it natural."
We also had a woman have her baby early and come into our last class to
see us (she had actually had it the night before) and her first words
were, "Take the epidural!" Well, I'm no fool! When I got to 6 cm and
thought I'd scream if the pain got any harder I said shoot me up!

What happens is this: The anesthesiologist has you sit up and bend over
so he/she can look at your back. Mine gave me a numbing shot first. It
felt like a small sting. No big deal. The only thing I felt after that
was some pressure, when he put the epidural needle in. You do have to
be absoutely still when the needle goes in. He taped it flat on my back
and hooked me up to the machine. I felt nothing. It was recommended
that I stay on my side. The pain vanished and gave me some much needed
relief. I was in labor for 24 hours so I was really tired. The only
negative thing I can say about it is that I should've had it turned off
sooner. I felt SOOOO good that I couldn't feel to push correctly. Since
I'd been in labor so long, the doctor used the vacuum to help me out.

My daughter was born healthy and beautiful. My legs never felt numb or
anything, the pain was just gone. No headache or anything either. With
my next pregnancy, I decided I was "tough" so I tried natural
childbirth. I got stuck at 8 cm and thought I was going to lose my
mind. Believe me, those pains you feel at 5 or 6 cm. are NOTHING
compared to the ones at 8 or 9! The doctor thought I'd be stuck for a
while and gave me a shot of demerol right into my vein. (so it would be
gone by the time the baby came). Well, Steven was crowning within 5
minutes! The shot had apparently relaxed me and he just came sliding
out! That was not good. He was blue and not breathing (the demerol had
affected him, depressed his system) and he had to be resusitated. He
was and is fine, but had a hematoma (a blood filled bruise) on the side
of his head for a month from coming out of the birth canal so fast. He
was lop-sided. I'm trying for my third child. After having experienced
both ways, I'm definitely going for the epidural again. I respond
strongly to drugs anyway (I'm very sensitive) so I'm going to ask for
just enough of an epidural to take most of the edge off, either that or
turn it off a lot sooner. The thought of getting "stuck" again isn't
appealing! Everyone's different, I've had friends have their babies in
3 hours naturally with no problem, but for me, the epidural is the way
to go!

Jamie
--------------------------------------------------------------------

From: maria@empath.sep.bnl.gov (Maria Van Der Karr)
Newsgroups: misc.kids.pregnancy

Well, I had decided not to have pain medication during my induced
labor(pitocin and mag sulfate due to toxemia) until after 6 hours, I
couldn't take it any more.  I begged for that anesthesiologist to come
back and give me some relief!  So an hour later (an eternity!) he
showed up and made my husband leave while he did the procedure.  I
wasn't happy that hubby got kicked out, but it was policy at my
hospital.  I was out of it with the pain, but here is what I remember:
He gave me a local anesthetic so that I wouldn't feel the epidural
going in.  I couldn't see anything he was doing because it was all
happening to my back.  He put some kind of template on my back and told
me it was very important for me not to move so I concentrated on not
moving while the pain of the contractions was horrendous.  I felt some
pushing in my back, it was in, the med flowed and I could relax again
and began to feel a helluva lot better-you can lay on your back since
only a flexible tube carrying the medicine comes out from your back.
They put in a catheter, but you don't feel it either.  Taking out the
epidural was easy as well, since it only took a few seconds-I was
surprised.  After all the fear I had from reading about migraines and
my giving myself a hard time about wimping out to get the medicine, I
was sincerely glad that I did it.  I had a miserable birthing
experience (babies to the NICU, didn't see them for a couple of days
because I kept fainting) and found the epidural, ironically, to be one
of the few things that went right.
--------------------------------------------------------------------

From: robin@iglou.iglou.com (Robin Elise Seibert)

There are two main types of epidurals:  bolus (single shot that can be
repeated) and continuous.  Which one that is used depends on many
factors, including the doctors.

First thing they do is give you an IV and then give you 2 liters of
fluid (to try and help with the decreased bp, this also can slow labor
because it increases the blood volume and decreases the concentration
of oxytocin in your blood).  You then lie on your side, curled into a
ball.  They clean up with betadine (usually cold), numb your back
(personally, it only numbed the skin and wasn't worth it for me), then
they actually take a large needle and use it to insert a catheter in
your epidural space.  You are then given a test dose to see if you'll
have any reactions, then either a bolus or continuous epidural.

For the most part you are confined to your back or side from thereon out.

Yes, you HAVE to have an IV.  How long the anesthesia lasts is dependant 
upon the type, the drug, etc.  Continuous obviously lasts longer and can 
be refilled before the medication runs out.

You will lie on your back or propped on your side afterwards, it won't 
hurt it.  The catheter is very fine and small.

My epidural hurt immensely.  I had good pain relief, but the
administration was the most painful thing I have ever felt.  Everyone
is different here.  I guess the worst thing is the backaches that I
still have after 4 years.

Robin Elise Seibert, ICCE, CD, NACA
--------------------------------------------------------------------

Research on the Effects of Epidural
-----------------------------------

The summary to follow in this FAQ is from a book:  "Obstetric
Myths versus Research Realities" by Henci Goer, pub. Bergin & Garvey,
1995 ISBN 0-89789-427-8. (send me email if you want ordering info - I
love this book, but do not wish to abuse the net with advertisements!)

Ms. Goer has written medical pamphlets and magazine articles for 10
years, and is an ASPO (Lamaze) certified childbirth educator and labor
support person.  She has read through the literature, given overviews
and abstracts as well as the citations for those who wish to read the
original research.  She starts out with a section on how to understand
the statistics and read the literature with an eye to a well-designed
study.  The amount of work in this book could only be appreciated by
seeing it - I have included only a few of her citations and this is only
one of many topics covered...

Here is the summary from the section on epidurals:

Epidurals substantially increase the incidence of oxytocin augmentation,
instrumental delivery, and bladder catheterization. (21 studies cited)
[Saunders, NJ, et al. "Oxytocin infusion ... primiparous women using
epidural..."  BMJ 1989;299:1423-1426]

In first-time mothers, epidurals substantially increase the cesarean
rate for dystocia.  (12 studies cited)
[Thorp, JA, et al. "The effect of intrapartum epidural ..." Am J Ob Gyn,
1993;169(4):851-858]

Epidurals decrease the probability that a posterior or transverse baby
will rotate.  Oxytocin does not help. (7 studies)

Having an epidural at 5cm dilation or more eliminates both excess
posterior/transverse and cesarean excess cesarean for dystocia. (2 studies)

Epidurals may not relieve any pain or may not relieve all pain. (3 studies)

Innovations in procedure - lower dosages, continuous infusion, adding
a narcotic - have not decreased epidural related problems. (13 studies)
[Naulty, JS.  "Continuous infusions of local ..." (this is a literature
review) Int. Anes. Clin. 1990;28(1):17-24]

Delaying pushing until the head has descended to the perineum increases
the chances of spontaneous birth.  (a time delay of 1 hour is not really
delaying - it needs to be a positional not timed thing...) Evidence is
divided as to whether letting the epidural wear off before pushing
increases spontaneous delivery.  (4 studies)

Maternal complications of epidurals include:
[Uitvlugt, A.  "Managing complications of Epidural Analgesia"
International Anesthesia Clin. 1990;28(1):11-16]

	Maternal hypotension(5 studies).  This reduces uteroplacental
	blood supply and can cause fetal distress. (8 studies)

	Convulsions (4 studies)

	Respiratory paralysis (3 studies).

	Cardiac Arrest (6 studies)

	Allergic Shock (2 studies)

	Maternal nerve injury due to needle injury, poor positioning,
	forceps injury, infection, hematoma, or subarachnoid injection
	of chloroprocaine.  The last three usually cause permanent injury.
	(9 studies)

	Spinal headache (3 studies)

	Increased maternal core temperature.  (2 studies)

	Temporary urinary incontinence. (1 study)

	Long-term backache (weeks to years), headache, migranes, numbness,
	or tingling.  (2 studies)

Serious complications occur despite proper procedure and precautions.
The epinephrine test dose can cause complications. (12 studies)

Epidural anesthetics "get" to the baby. (5 studies)

Epidurals do not protect the fetus from distress.  In fact, they cause
abnormal fetal heart rate, sometimes severe, which may occur with or
independant of maternal blood pressure (11% - 43% depending on the
study and type of medication used - the 43% was found with Bupivacaine,
the most common drug for epidural.) (15 studies)
[Stavrou C, et al. "Prolonged fetal bradycardia during epidural analgesia"
S Afr Med J 1990;77:66-68]

Epidurals may cause neonatal jaundice. (2 studies)
[Clark, DA & Landaw, SA.  "Bupivacaine alters red blood cell ...
jaundice associated with maternal anesthesia"  Pediatr. Res. 1985;
19(4):341-343]

Epidurals may cause adverse neonatal behavioral and physical effects.
(these are both direct effects and indirect effects from the increased
rate of labor complications and interventions.)  The importance of this
is debated.  (4 studies)

Epidural anesthesia may relieve hypertension, but hypertensive women
are at particular risk of epidural-induced hypotension, which reduces
placental blood supply.  (2 studies)
----------------------------------------------------------------------

Warning:  My opinion follows!  I am a teacher of natural childbirth,
so I am biased against the ROUTINE use of epidurals...
Please Note:  My opinion ends after this short section - please don't
criticize me for the opinions of others!
--------------------

In my childbirth classes, I always say that in the cases of women who
have been in labor for days and are exhausted, epidural may allow them
the rest they need to avoid operative delivery.  Also, women who are
tense to the point of fighting their contractions may benefit from the
artificial relaxation of an epidural - these women are often those
who have taken no classes or inadequate classes (but not always!)...

I teach the Bradley Method(r), and we have an overall 86% unmedicated
rate.  This is not because we use scare tactics or only superwomen come
to our classes!  The techniques we use allow the majority of women to
work with their bodies to keep the pain to a level they can handle!  I
believe that any good childbirth educator teaching any reasonable
method can achieve the same result provided that they make no promises
that a particular breathing pattern WILL remove all the pain
(reasonable expectations), and that the class comes away feeling
confident that if they wish to avoid drugs in a normal labor and
delivery that they have the strength to do it.

Notice I said "normal" labor and delivery - I mean that any
intervention may make the pain too much to take, interventions such as
induction of labor, being forced to lie down, and being disturbed too
often (such as for vaginal exams...).

Epidural anesthesia does seem to be the safest for both mother and baby
if you have to have something, such as for a c-section!  It is
wonderful that in the case where a c-section is really necessary, that
we have a way for the mother to be awake for the birth of her baby.
She can participate as fully as possible in the birth if she has an
epidural rather than general anesthesia!

Things that can help you avoid drugs in labor:  a trained labor
assistant (doula),  hiring a midwife instead of an OB for low-risk
women, researching the safest place to have your baby (the best area
hospital, a birth center, or home - individuals need different
things!), and being involved enough in your own health care to read
everything you can about the process of pregnancy and birth!

Sure, get information from the net, and from classes, but read books
written by a variety of sources, and follow the medical literature as
much as you can!

-Sabrina (swnymph@fensende.com)
----------------------------------------------------------------------

Stories From The 'Net
---------------------

Following is some commentary on epidurals from the net.  It is both
positive and negative, whatever people send me is what gets in, I
have no stake in editing or only accepting information I agree with!
Please, no flames about this section - it is no longer my opinion...
The names have been stripped unless it was requested to leave them in.
----------------------------------------------------------------------

Sometime ago, there was a discussion about epidurals in this news
group.  Somebody gave me a rough time because I criticized the use of
epidurals, but I could not remember the exact citations of my studies.
They accused me of creating an "unnecessary panic."

Well, here is the info.

This comes from "A Good Birth, A Safe Birth" by Diana Korte and Roberta
Scaer.

"Here is what we do know about epidurals from the obstetrical
literature:

- For nearly all women, they obliterate the sensations of labor and
  delivery.  Occasionally the block is incomplete.

- Continuous electronic fetal monitoring is almost always used.

- An IV must be used.

- The woman must stay in bed, losing her ability to be active and
  limiting the positions she may assume.

- Pitocin is frequently given at the same time for slowed labors.

- They can lower the woman's blood pressure and put the woman and
  infant at risk.

- The relaxation of the woman's pelvic muscles that epidurals bring may
  prevent those muscles from assisting in the usual rotation of the
  fetus as it moves to a normal birth position.

- The urge and ability to push may be reduced or extinguished.

- They more than double the use of instrument delivery and more than
  triple the use of midforceps delivery because the baby has not
  rotated normally or the mother cannot push. (Kaminski, et al,
  "Obstetrics and Gynecology 69:770 [1987])

- The increase the cesarean liklihood due to "failure to progress" in
  women giving birth for the first time at least two to threefold;
  cesareans are at least 6 times more common for failure to progress in
  women giving birth for the 1st time if the epidural is given before 5
  cm of dilation and the woman's dilation is slower than average
  (Thorp, et al, presentation at 1989 "Birth" journal conferance).

- Failure to progress is the most common reason for a 1st-time cesarean.

- Persistent, chronic backache is significantly greater among women who
  have epidurals during labor (MacArthur et al, "British Medical
  Journal" 301:9-12 [1990]).

- Serious, nonfatal complications (cardiac arrest, spinal damage, toxic
  reactions, and prolonged severe headache) associated with epidural
  anesthesia occur in the range of 1 per 10,000 deliveries (Scott and
  Hibbard, "British Journal of Anesthesiology 64:537-41[1990]).

- Narcotics are now being given at the same time to strengthen its effect.

- Narcotics are known to cause breathing problems in infants when given
  within several hours of birth.

- All drugs cross the placenta and affect the baby.

- When the cord is cut, the infant is left with trace amounts of any
  drugs that were being given to the mother at the time of birth.

- The infant's immature organs must detoxify the drugs.

- The infant's immature brain can be affected by his mother's drug use
  during labor and delivery.

-------  End of quote.

They go on to admit that they do NOT know for sure the short and
long-term effects of epidurals on the infant.  But they quote several
interviews with delivery nurses who are sure that the babies look
woozier and do not suck as well when epidurals are used.

They also quote a few studies on the effects of drugs during
pregnancy.  Most notably...

  "Working with Sarah Broman, a psychologist at the National Institutes
  of Health, Brackbill analyzed data from a study of 53,000 women who
  gave birth at 12 different teaching hospitals between 1959 and 1966.
  Broman and Brackbill studied the data on the 3500 women in the
  project who were the healthiest and who had the most uncomplicated
  pregnancies, labors, and deliveries, trying to rule out the
  possibility that any results showing damage to babies would be due to
  complicated pregnancies or deliveries.  In this select, healthy
  group, they found that obstetrical drugs affect the children's
  behavior through at least 7 years of age.  Among the older children
  whose mothers had received drugs during labor and delivery, there
  were lower reading and spelling scores, and lower scores on a
  visual-monitor test."

The book cites many other instances where it definitely looks possible
that epidurals can cause brain damage.  So, to the guy who accused me
of "creating an irresponsible panic", read up.  It's not conclusive,
but it *might* be true, and it isn't just from idle yammering.

This book also includes a very good discussion of the economic
corruption that prompts hospitals to promote epidurals.  They discover
that unless they do a lot of them, they can't afford to keep their
anesthesiologists on staff.  They also make money doing them.  One case
cited interviews with nurses who were sharply criticized if they even
informed patients of the potential risks of epidurals, including one
nurse who was fired for this.  It is UNTRUE that epidural anesthesia
does not cross the placenta to the baby, an oft-touted belief that I
have seen in pamphlets and on this net.  It is not even clear that its
effects are any less than any of the common pain-killing narcotics given
during birth.
----------------------------------------------------------------------


My one critism is your reprinting of the data from (I believe) "A Good
Birth a Safe Birth" that found a connection between labor medication
and learning disabilities.  That study looked at children born in the
late '50's and early '60's. At that time medication was FAR heavier
than today. Women were routinely heavily doped during early labor, and
drugged into total unconciousness during delivery. The spinals that
were routinely given almost ALWAYS required forceps delivery. Things
today are very different, with drugs being used in much lower dosages
and most women able to push during their epidurals. If there is, in
fact a connection, it is almost certainly dose related, and the risks
from modern medications VERY slight.
----------------------------------------------------------------------

My sister had an epidural in her first labor (expensive female OB, big
NYC private hospital, unproductive labor for 12 hours (probably
prodromal in light of her subsequent labors), amniotomy, pitocin, and
something in the demoral family).  She had a strong reaction to the
epidural.  Her blood pressure plummeted and she stopped breathing.
They literally tore the baby out -- she couldn't have sex for six
months.

With her next two babies she went to a midwifery practice and stayed
home until in full-blown labor.  No medication, minimal tearing, no
problems.

I know lots of women who have had blissfully pain-free births thanks
to epidurals ("I wanted to name my baby after the anesthesiologist").
I always interpret this as meaning that they gambled and won.
----------------------------------------------------------------------

Informally, as a La Leche League leader I have found that a very high
percentage of moms who've had epidurals have very sleepy hard to nurse
newborns and this seems to last up to 4 weeks.  There is just not
enough hard research on it!!!  Also, I wonder what makes a woman wish
to be unable to FEEL, as in numbing one from the total experience.

I am unable to speak for La Leche League Int. but at the '94 Texas LLL
conference research into epidurals was mentioned as the #2 need as far
as unknown effects, first only AIDS & breastfeeding. 

The whole idea of numbing oneself is that these women and I have met
MANY is that they plan on getting an epidural as early in labor as
possible and not feel a thing and a catheter is yucky but that is the
ONLY side effect of epidural.  Drs and nurses will swear up and down
that an epidural is 100% safe and has no side effects and is not a drug
in that it won't reach the baby.  My question is why do so many women
not want to be in charge of their bodies/births/ babies' health???Ina
May Gaskin speaks of an epidural epidemic, and women here really buy
into it. 

My last baby was born at home and weighed 10# 6oz and let me tell you
that was incredible agony and I didn't think I could make it either.
But I did (4th baby and 10 hrs of intense pain including 4 hours at 8cm
with a swollen cervix, baby had 15 and 1/4 " head!)and now I know I can
do anything!
----------------------------------------------------------------------

My experience with an epidural was very positive.  It did slow down
labor, however, requiring the use of pitocin.  Once the the pitocin was
administered, labor went quite quickly.  The epidural did not inhibit
the baby's progress down the birth canal.  When it came time to push, I
could definitely feel enough to push, and could move my legs (although
they were numb.) I really don't feel like I missed out on the birth
experience; in fact, I think it made it more positive.  Rather than
focusing on the pain, I could focus on the arrival of my new daughter.

To my knowledge, neither the baby nor I suffered any adverse effects.
She was a vigorous nurser from the start, and not drowsy at all.
----------------------------------------------------------------------

I was on bedrest for the last 2 months of my pregnancy, so was unable
to complete natural childbirth classes, as we had hoped.  My labor was
induced with pit, but I went for 24 hours without dilating more than 2
cms.  At that time I began to experience severe back labor.  It was
determined that the baby was posterior.  After several hours of
increasing severity - I could no longer stand the pain and relented to
an epidural.

Once fully dilated, I pushed for 5 hours!!!  The baby did not turn -
and I had to be taken to the O.R. and prepped for a C-section.  At the
last second he was delivered via forceps and all was fine.  I must say
that I had nominal discomfort once the epidural was administered. But
what happened as a result could probably have been prevented if I had
not had the epidural.

I went home 24 hours later.  That evening I became incontinent of
urine.  This continued into the next morning and I contacted my
doctor.  I had to have a foley catheter inserted for 4 days.
Apparently all the pushing (all 5 hours worth) had taken its' toll on
my bladder muscles.  I am certain I could not have lasted 5 hours
without the epidural.  I would have felt what my body was telling me
and relented earlier.  But because I was not in pain - I continued to
try to push, push, push, hoping the baby would turn.  The result was
one exhausted new mom walking around the house with a new baby in one
arm and a foley bag in the other.  Not a pleasant sight.
----------------------------------------------------------------------


My son was induced after 8 days late.  No fetal distress but a sonogram
indicated dangerously little amniotic fluid.  So they induced and
monitored him carefully.

I didn't respond immediately to the pitocin, but when I did, all hell
broke loose.  Labor progressed very quickly (6 hours from onset of
first contraction until my son was delivered).  I handled the first 3
hours fine, but then I hurt bad.  I didn't think I could possibly be in
transition because I had been in labor for such a short time.  I was
afraid to ask for an epidural because I was sure I was only 2 cm
dialated and they would say it was too early.  I felt like I was being
a whimp - crapping out after only 3 hours.  But finally I had to ask
for help.  When they check I had gone from 0 - 5+ in those 3 hours and
he OKed the epidural.

Getting the epidural was essentially painless - just a little stick, no
big deal.  But it took much longer to kick in that I expected.  The
anesthesiologist had to return 3 times to inject more goop into the
catheter - I was just getting no relief at all.  He said that tall
women often take more goop and longer to get relief - something about
more Cerebral/Spinal fluid in a longer spine.  1 hour later I finally
was getting enough relief that I was semi-sane.  My OB appears and
wants to check my progress and I snapped at him, told him it had only
been an hour, I was only 5 cm an hour ago, and he was to leave me alone
and let me get a nap.  He checked me anyway.  10cm - time to push and I
am finally getting numb.  So 5 - 10 in the hour that I was waiting for
the epidural to take effect.

This sorta sucked.  I got no relief for the transition, but now it was
time to push and I was as numb as a doornob.  The labor nurse said that
lots of women have a hard time pushing when they are numb and they may
have to wait the 2 hours for the epidural to wear off before I could
really push the baby out.  Apparently this is why they try to time the
epidural to relieve the end of the labor but to have worn off by the
time you need to push.

Great labor nurse.  She explained how to push and I just had to do it
blind.  But I could.  She let me know when I was being effective and
when I wasn't.  David was watching the monitor (for both the baby's
heartbeat and the peak of the contraction) so he could help me with the
timing and we did great.  It still took 2 hours of pushing. (This was
my first baby).  By the end of it, I was starting to feel the
contractions, but didn't feel any pain in the perineum.  I was glad for
the relief, even if it came late.

Most importantly, Paul was perfect.  Screaming like hell as they
clamped his cord and just an active little kid.  He kept kicking the
nurse who was trying to get his footprint.

I had no negative aftereffects.  I didn't feel groggy from the epidural
or anything else.  We had no problems at all nursing.

All in all, I have no complaints about the epidural.  Wish it could
have taken effect earlier.  Im glad I could push in spite of it.  If
my next labor is really painful and I feel like I could use some help,
you can be sure I'll ask for an epidural.
----------------------------------------------------------------------

After  induced labour (2 weeks late, prostaglandin gel, waters broken
followed some hours later by pitocin drip), I found the pain too much
to cope with and I was tensing up too much for the contractions to be
productive. I received a low-dosage, continuous feed epidural which,
within 1.5 hours, reduced the pain to nil. This lasted about four hours
after which the epidural needle slipped out and the pain returned in
full force. It took about 2.5 hours of the labour from hell before they
realised what had happened. They reinserted the needle and the epidural
took effect again shortly before the baby got into distress and a
vacuum extraction ensued. I spent the next eight days in hospital with
repeated UTIs, but I don't know whether that was due to the size of the
baby, the swift extraction or the epidural.

After all that, what will I do next time? I'll try to go with a natural
labour - I'll be much more proactive against intervention / induction,
but if I feel I can't cope, I'll have an epidural again.
----------------------------------------------------------------------

My wife had a bad epidural experience.  We went to the hospital after
Peg had been in labor at home for about 6 hours.  They did an
ultrasound, and the baby was transverse breech.  They said she needed
an emergency C-section, which we agreed to, even though it was the LAST
thing we could have imagined.  They took her away to prep her.  I met
her in the operating room, and asked her how she felt.  She said it was
really wierd not feeling anything.  The baby was born, and I went out
with him while they stitched Peg up.

Eli was not nursing well at all, but he also had an infection from
inhaling meconium and was in NICU for a week, so we cannot directly
attribute his lack of nursing on the epidural.

Peg, on the other hand, was not feeling well the next day.  She had one
of those push-button medication devices for the pain.  She said the
C-section hurt, but she had a really bad headache.  The next day, the
headache was worse.  By the next day, she couldn't have any bright
lights, and had a severe headache.  The nurses and doctors said she was
just upset because the baby was in NICU, and sent her home.  We came
back to the hospital the next day because Peg now had literally
blinding headaches, and went into convulsions and vomited in NICU.
Another doctor came in, asked a few questions, and they realized she
had a dural tear from the needle.  They performed a blood patch, gave
her an IV, kept her a day, and she was fine.  We now know better.
----------------------------------------------------------------------


Ask the chiropractic mailing list about the dangers of epidurals.  You
will be amazed how many people have long term effects from them.

I have had about 10 women in my Bradley classes who have had their
epidurals go up and need some help with respiratory efforts and heart
also.  They certainly wanted to do natural childbirth next time
around.

Deb Phillips
Arkansas Licensed Midwife
----------------------------------------------------------------------

My positive experience with epidurals:

I had epidurals with the delivery of both of my children.  Both times,
I was grateful to have the epidural, since it made it possible for me
to endure the labor with minimal pain (I actually slept for 6 hours the
first time; second time it wasn't even that long :-) and save my
strength for the hard job -- pushing!!

My children did not have any negative side effects from the drugs, nor
did I.  Both children were healthy when born; good apgars, crying, etc.
and to this day they don't show any signs of brain damage either.
They've been developmentally normal (not geniuses but not delayed
either) and happy, sociable, healthy kids.  The only side effect I
noticed the second time around was that I was cold, but that wasn't a
problem.  And both baby and I had good stable, steady heartbeats the
whole time; no fetal distress.

I did encounter an administrative hassle at the hospital in both cases
-- they didn't have enough anesthesiologists on hand either time, so
there was a delay in getting the epidural when I wanted it (I waited as
long as I could, just to minimize the amount of time/drugs) -- about 1
hour longer than I wanted.  But once it was in, what relief!!  As I
mentioned, I was able to relax and sleep.

In both cases, pitocin was used to counteract the slowdown in labor due
to the epidural.  No problem, it didn't hurt me! :-)  I had a fairly
long labor the first time -- about 10 hours.  And delivery took 2-1/2
hours; just as I started getting tired, my daughter decided to come
out.  With my second, labor was about 4-1/2 hours and delivery was 9
minutes (!!!!).  So I don't feel the epidural had any effect on my
birthing process (good or bad).  When it came time for delivery, the
anesthesiologist cut back the amount of the epidural drug, so I could
feel the pushing and how it was affecting me and my baby.

If I were to get pregnant again, I'd do it the same way.
----------------------------------------------------------------------

My attitude going in was wait and see:  I'd prefer no medication, but I
realize that I am generally a wimp when it comes to pain, and looking
at the alternatives, epidurals are safer and have fewer side effects.

I was induced (overdue, degrading placenta), so some of the side issues
(I.V., fetal monitoring, pitocin, staying in bed) were already a fact
of my delivery.  Having started the induction 5pm the night before, and
having gotten little chance to sleep, and having slept poorly when
sleeping, I was very tired by the time my labor started progressing
(2pm).  The epidural at 4:30pm (and 3+cm) was wonderful.  It was an
ideal administration; I could feel my legs (and move one leg well, and
the other slightly), I could feel my perenium (sp?), and I could feel
the peaks of my contractions under my ribs.  Being able to rest, and be
aware of what was happening was wonderful.  Although I had been dealing
with the contractions, it took all of my concentration, and I barely
noticed other people in the room before the epidural.  With the
epidural I could pay more attention to what was happening because all
of my attention was not focused on dealing with the pain.  I had no ill
after effects, and the urinary catheter was not nearly as bad as I had
imagined.  Several people had advised me ahead of time that there was
no need to be a martyr, and there are no brownie points for pain. I
agree.

Having written this, it sounds appologetic, which is not my intent.  The
epidural was  .
----------------------------------------------------------------------

I had an epidural for Beans.  I would not have wanted to face a
c-section without one!  For a cesearian delivery, an epidural is
greatly preferable to general anesthesia.  I had no bad side effects;
Beans had no difficulty nursing, and was not jaundiced.  her apgars
were 7 and 9, typical of a Cesearian birth.

In the longer version, I'd say that my labor probably was delayed by
the epidural.  The dilation slowed, but then continued after they gave
me Pitocin.  In the end, I was 10 centimeters but her head simply
couldn't come down.  Once I had the c-section, the doctor said that had
she known how big the baby's head was, she would have not let me labor
so long.  She had completely undersestimated Sabina's head size.  I
guess I'd have to say that the epidural made the 24 hour labor
bearable, and I was very glad to havr had the c-section with epidural
as opposed to general anesthesia.

I hear what you're saying about the research being negative.  If we
lived in an ideal world, we would have no anesthesia during labor and
delivery, no episiotomies necessary, no one would drink coffee during
her pregnancy, you name it.  But sometimes difficult labor and
deliveries happen, and for me the epidural was a necessary evil.  I
would guess the literature finds epidurals to be better for the baby
than general anesthesia.

I had a terrible childbirth class (can you tell??) .  All it did was
tell us we were weakwilled and didn't care about our babies if we
considered anesthesia.  The possibility of c-scetions was barely
addressed.
----------------------------------------------------------------------

*The following is my response to a request for clarification...

> I have looked back in Henci's book, and there is indeed some
> incidence information.  The studies (which I only have the
> abstracts from, but which Henci believes are well-done, ie.
> that they used adequate controls, enough subjects, and reasonable
> methods) do not agree as to the incidence of side-effects...
> 
> One study found life-threatening but non-fatal complications in 1 of
> 14,000 cases and serious complications in 1 of 5,000 (1990).  Another
> found life threatening complications in 1 of 3,000 cases (1985).
> I can only assume that there have been some advances in the use
> of epidurals in that 5 years, or that one hospital had better
> anesthesiologists than the other - you are right, it really does
> vary by doctor!


> Henci points out that drugs have been taken off the market when
> the serious complications/adverse reactions are in the 1/1000
> to 1/30,000 range, yet epidural is touted as perfectly safe.

(from the person who sent me email)
As always, this is a risk benefit analysis; there is a lower tollerance
of side effects in drugs for minor illnesses as compared to drugs for
major illnesses.  Alternatives to epidurals are more dangerous...

> Anyway, I really want people to do lots of reading, and THINK
> before they decide.  I also want women to decide in labor what they
> can handle, not before!  (I know you did that!)

I think that a balanced presentation is important here so that people
really think about the options ahead of time instead of dismissing the use
of any drugs outright. 
----------------------------------------------------------------------

Although I had prepared for a drug-free birth using the Bradley method,
my son turned during early labor and became stuck in the transverse breech
position.  This necessitated a cesarian section.  With an epidural came
other nasty things I had hoped to avoid, such as IV, urinary catheter, 
continuous fetal monitoring, and confinement to bed.  At first the epidural
"took" on only one side, so the nurses kept turning me to try to get it to 
work on the other side.  There were hot spots where the epidural didn't 
work at all, and I could feel some of the cutting.  Later it took several 
hours for the numbness to wear off because they had given me a lot of
medication.  My baby had to go to the special care nursery for some oxygen
(not related to the epidural), and I couldn't see him until I got out of 
the recovery room.  I feel that the epidural and its effects were the 
worst part of the entire experience and would never choose to have one
unless there was no other way. 
----------------------------------------------------------------------

A couple comments from my epidural experience:

* I went through Lamaze with the intention of having a natural
childbirth, but my waters ruptured long before contractions started and
the contractions that finally occurred were very weak.  Because the
doctors felt that the baby had not completely descended (this was only
2 weeks before due date, but there was still some ballottement going
on) they felt it would be dangerous for me to be in positions other
than flat on my back. That let out most of the labor-inducing stuff I'd
learned in Lamaze.

My doctors were very sympathetic to my trying to do it without
medication and we agreed together to let my body work for itself for a
certain number of hours, at which point it would be necessary to speed
things up to avoid the risk of infection.

I got to that point with 0 contractions. At that point I agreed to
induce, and the induced contractions really hurt, especially since my
waters had broken already.

I ended up asking for an epidural--which DID NOT WORK. I had complete
relief from pain for 15 minutes, then something went wrong. The
anesthesiologist attempted 2 boluses, neither took. So I got through
the induced labor on my own, fully dilated, at which point they checked
the baby's head and found an extreme disproportion between him and me

Because the epidural hadn't worked, I went through a Caesarean with
general anesthesia. Not a pleasant experience.
----------------------------------------------------------------------

My oldest was born after about 16 TOTAL hours of labor (from first pain
I felt til he was here)  I had one injection of demoral early in my
labor to make my contractions more efficient (at about 7 hours into
labor) nothing after that.  The pain was excurciating but not to the
point that I was screaming at people and out of control.  Although my
husband is lucky he doesn't wear any jewelry or he would have a
premanent dent in his fingers from me squeezing them so hard :) I
pushed for 30 minutes and our son was born APGARs were great and he had
no trouble nursing at all.

My second was born after about 12 hours of labor, when I was dialated
to 8cm my doctor and labor nurse determined she was breech.  A quick
sono.  confirmed she was a frank breech and we decided to do a
C-section for safety sake.  So I had the epidural, although there were
no side effects for either of us, she also had high APGAR's and nursed
very well, the little piggy that she was :).  However, although I had
no problems with the epidural, I would not have another one, just
because I COULDN'T feel anything, and I disliked that more than the
pain.

My third was a VBAC born after 7 hours of labor (from first pain I felt
til she was born).  No drugs of ANY kind, about 4 pushes, no tears and
no episiotomy.  She also had very high APGAR's and was a good nurser.

I am expecting my 4th and the only reason that I can see I would have
an epidural would be if I have to have a C-section, and then I would
only allow MY doctor to administer it.

I know that this has gotten very wordy but with so much discussion
about the pros and cons, I thought I would relate my thoughts since I
have been down both roads.
----------------------------------------------------------------------

My labor was induced when Maura was 3 1/2 weeks late and the sono came
back with danger signs. Immediately I was stuck in bed with IVs for
pitocin and glucose. After 24 hours, I *finally* started getting
contractions.

By 30 hours, I was dilated 3 cm. I had been in bed the whole time
[other than walks to the bathroom] and had no food. The contractions
were so bad, I could barely stand them, and was screaming [normally I'm
not a vocal person]. After much agony, I went against my original plans
and requested an epidural.

The epidural took the edge off the contractions. It did *NOT* stop the
pain, even after several boosters. There was one breakthrough pain spot
in my right side which never stopped causing intense agony. However,
the use of the epidural made it possible for the doctor to increase the
pitocin dose a bit, and within 4 hours of the epidural starting, I was
pushing.

I did *not* have any difficulty pushing, and only had to push for 20
minutes total. No grogginess, no headaches, no fetal distress from the
epidural [all the distress she was in had started before the epidural
was put in].

When/if I have another child, I'm still planning to try to avoid the
epidural if possible, but IMO, it's worth having the epidural in order
to be able to have a vaginal delivery.
----------------------------------------------------------------------

I had planned on no drugs, but I knew since I had never been through
labor and delivery before I should keep an open mind. I generally have
a pretty high tolerance for pain, though, so I thought I would be able
to handle it. And, mostly, I was able to -- up until about 4 cm :)

My labor had started at 1:30 am on a Saturday, and most of the day the
contractions were manageable. About 6 pm they started to get
"uncomfortable" and by 9:00 I was on the phone to the hospital telling
them I WAS coming in, even though the contractions were still pretty
irregular (anywhere from 4-7 minutes apart). When I was examined I was
at about 4 cm, and was told to walk around for an hour. When I got back
I told the labor nurse immediately that I'd be interested in an
epidural. We had to wait for the doctor to examine me; he estimated me
to be at 6 cm and OK'd the epidural plus something IV in the meantime
to relax me (mostly it made me sleepy between contractions).

The anesthesiologist had just begun an epidural with another patient,
and was required to wait with her for 30 minutes after it was
administered. It seemed as though it took him forever to get there.
Then he asked me to sit up and bend over a bed tray (those things they
serve the hospital meals on) while he performed the epidural.  It was a
difficult task, since I seemed to be having one long contraction at
this point. He asked me to let him know when I wasn't having one, and I
just told him to go ahead because I couldn't tell where one ended and
the next one started.

It took about 20 minutes; I'm not sure why. My labor nurse started to
become a little concerned because the external monitor slipped when I
sat up and she hadn't been able to get a fetal heart rate the whole
time. Once I laid back down Katy's heartrate kept decelerating during
contractions (probably because the cord had slipped down beside her and
was being compressed).

After that, things happened pretty quickly. I think I probably was
close to 10 cm by the time the anesthesiologist came to administer the
epidural, because it took no time afterwards for Katy to be born. I
wish I would have had the presence of mind to ask for another check
right before he did it, because if I had known I was that close I
probably would have been able to forego it.

So, here we are, getting ready to deliver Katy, and he keeps checking
to see if the epidural has taken effect (brushing wet cotton balls on
my thighs, asking if I feel it, etc.) -- of all the tests he did, I
felt everyone. As far as I can remember, I never lost any sensation
anywhere (except in the perineum because of a pudendal block they did
for the episiotomy).

The following day I had a nasty headache, but it was a hot, fairly
humid day and I'm prone to sinus headaches, so I attributed it to
either the weather or to tension in my shoulders from the pushing.  I
tried to tough it out and, in retrospect, maybe should have asked for
some medication to help. But we went home on Monday with instructions
to call if the headache didn't get any better. It didn't.  I literally
was flat on my back in bed except for feeding Katy and going to the
bathroom. When I did go back on Tuesday, they performed what's called a
"blood patch," where they take blood from your arm and put it into the
epidural space to replace any spinal fluid that leaked. It helped
immediately, so I'm sure that's what the headache was from.

The one thing for which I am grateful concerning the whole experience
is that I KNOW I can make it all the way through labor (and maybe
delivery) at least without an epidural, since I essentially did it
before. I hope next time I can be a little more aware of what's going
on with my body so I can tell how close I am. I'm still not averse to
trying some other pain relief (i.e., TENS) but I'm positive I don't
want another epidural.
----------------------------------------------------------------------

My water broke at 10AM at home.  I called the Doctor, my husband and my
mother and went to the hospital at 10:30AM.  I had no contractions up
to this point and was put on Pitocin.  By 3PM I had reached my pain
threshold and asked for an epidural only to be told that I had not
progressed enough.  The pain of contractions was extremely intense.  I
had curled myself into a tight ball, closed my eyes, couldn't bear to
have anyone touch me and did everything I could to block out all
external stimuli.  Finally, at 5PM I got the epidural.  I became a real
person again.  I could unbend my body, hold my husband's hand, have
conversations.  I could rather enjoy this event.  I watched the monitor
for the baby's heart-beat and my contractions.  At 11PM, epidural was
allowed to wear off and when it came time to push, I had NO problem
identifying when a contraction was starting and how to push.  I pushed
for two hours but unfortunately, Katherine was facing forward instead
of spineward.  I had to have a C-section because she was stuck and in
distress by this time.  Luckily, I already had an epidural so they just
upped the dosage.

For me, the epidural was fabulous, wonderful and now that I'm pregnant
a second time, I'm definately going to ask for it again.

I thought I'd relate my epidural story of my firstborn.  I had the most 
wonderful birth experience.  I was very concerned about the pain of 
labor, and requested an epidural.  It was administered, and my beautiful 
new year's baby was born a few hours later.  It was a beautiful, 
painfree birth for everyone involved, and I have no birthing horror 
stories to relate (I can't tell you how many "I laid there for hours in 
agony" stories I had to suffer through during pregancy).  Not so for me!  
My daughter was born alert and happy, and I believe the lack of pain 
induced trauma in her mother resulted in a happy birth experience for 
her.
------------------------------------------------------------------------

My baby was a footling breech, I had a planned cesarean before I went
into labor.  I had a reaction to the epidural, I think it must have
affected my mind because I was horrified and freaking out, and then my
blood pressure dropped.

Luckily the anesthesiologist brought it back up again but I couldn't
stop feeling like I was freaking out.  The fact that ten minutes before
the cesarean they scared the heck out of me by telling me about the
risks of the epidural ie. paraplegia, death did not help the situation
either I'm sure.  Going into that cesarean I was so scared I felt like
a stone.  I could have really used some moral support during that
cesarean but I think they must have forgotten that I was awake instead
of asleep, so I felt like I was on my own.  In hindsight, the thing
that worries me the most is the reaction I had to the epidural and for
safety's sake I do not want another epidural with my next baby.
---------------------------------------------------------------------

I went into labor knowing I could do it without drugs (women in my
family have short and uncomplicated labors and births as a rule).  I
ended up having an epidural after 30 hours of labor when I stalled at 8
and was on pitocin for the second time. Because the baby was so low and
my contractions so strong, I could not quit pushing and was causing my
cervix to swell. Because of the excellent training from my Bradley
instructor, I knew at that point that I was going to have an epidural
and a vaginal birth or an epidural and a C-section.

It took 30 minutes to hydrate me and about 10 minutes to get the
epidural in. I got almost immediate relief and was able to rest, dilate
to 10, and give birth vaginally after 3 hours of pushing.

There were some after-effects (headaches, random tingling and shooting
pains, etc.). I also think that my son might have been less drowsy and
nursing might have gotten off to a better start if I not had an
epidural.

I think epidurals have their place, but would not recommend having one
unless you really need it. I'm not planning to have one with child
number 2.
------------------------------------------------------------------------
I had an epidural with my first (a c-section).  As the
anaesthesiologist was inserting a needle there was a loud popping
sound, and it felt as if something had broken off inside my back. (ed.
note: this is usually the needle passing through a tendon and is not a
sign that something is going wrong)

Of course I hit the roof.  He said "Don't move!" then leaned toward me
and quietly said "Did you hear a popping sound?".  I told him that I
had heard it, although to this day I am unsure of what exactly that
was.

They proceeded with the operation right through my cries that I could
feel everything they were doing.  I went into shock and needed oxygen.
As my daughter was being taken out, it felt like my epidural suddenly
"kicked in" and I felt paralyzed from the breasts down.  (ed. note
again:  this was an emergency cesarean and not the normal case!)

After that, everything was fine.  I will NEVER let anyone give me an
epidural again!!  With my second I got through labour -5 very easy
hours then my water broke at home.  Excruciating labour and back labour
hit half an hour after I got to the hospital (I went within an hour as
my water had broken), and continued for the next 12 hours.

At any hospital I've been to (I live in Canada) you have no choice of
an epidural during labor.  You just don't get one.  Nurses are also
pretty "sticky" on giving any other pain medication as well.  One of my
friends who also made it through a rough labour without drugs likened
it to riding a bike! <G>.  She said that while you are riding up a
steep hill that seems to have no end in sight, you are tired, in pain
and near tears but once you get to the top the immense feeling of
accomplishment and pride is fantastic.  If you just rode on a flat road
at a comfortable pace (taking the drugs/epidural) for the trip it just
wouldn't be the same.
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