epidurals...

In ,
Beach mum wrote:

*"Vicky Bilaniuk" wrote
* Heh heh, he also described what it should *feel* like. He said that the
* drug they use to numb the skin hurts the most, and it hurts less than
* the contractions you feel at 6cm. Everything else should only feel like
* a pushing sensation.
*
*I can't help you as I had natural childbirth the first time. However, what I
*can tell you is that 'what it feels like at 6cm' is nonsense. What it feels
*like to you will be totally different than what it feels like to the next
*person.

Seriously. I don't think I was AT 6 cm long enough during my unmedicated
delivery to have any idea what it specifically felt like. I was approx. 3
cm dilated on arrival at the hospital at about 10 pm, at 11:25 pm I lost
my cool and begged for drugs, they checked me, said I was at 6 and could
have drugs, my water broke with the next contraction after the nurse who
checked me left the room, which Michael said happened at 11:40 pm, and
then, well, Naomi's time of birth was 11:50 pm. So I apparently dilated at
least 4 cm in 20 minutes. No wonder I wanted drugs (which I never did get,
thank goodness ).

--
hillary israeli vmd http://www.hillary.net
"uber vaccae in quattuor partes divisum est."
not-so-newly minted veterinarian-at-large

Beach mum wrote:
"Vicky Bilaniuk" wrote
Heh heh, he also described what it should *feel* like. He said
that the drug they use to numb the skin hurts the most, and it
hurts less than
the contractions you feel at 6cm. Everything else should only
feel like a pushing sensation.

I can't help you as I had natural childbirth the first time.
However, what I can tell you is that 'what it feels like at 6cm' is
nonsense. What it feels like to you will be totally different than
what it feels like to the next person.

Indeed. With my third, I was at 5-6 cm when I arrived at the hospital to be
induced by AROM. I wasn't in labor at all at almost 6cm. I was still at
about 6cm when checked a little less than three hours after my waters were
broken, at which point I was in pretty intense labor. My son was born a
little less than an hour later. So, at least in my case, being a 6cm and how
my labor felt had little in common.

I guess my point is that his description of how much it will hurt is
completely useless unless he's describing an analogy to his own
labor (oops, totally useless).

LOL!
--
Be well, Barbara
Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7)

This week's suggested Bush/Cheney campaign bumper sticker:
"Leave no billionaire behind."

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

This is a genuine question, but I will probably be shot down in flames and
branded a 'typical bloke' - May I ask why so many women are against an
epidural?

My fiance is due in December and we haven't found anything out about
epidurals, other than it is an injection that takes the pain away for a
while.

Its a poor comparison, but if I have a headache, I take something to numb
the pain, or if I am at the dentist having a tooth out, I get an injection
to kill the pain, so why not take something to reduce the pain of labour and
make the whole thing easier? Is an epidural risky for some reason - if yes,
why?

Thanks



"Vicky Bilaniuk" wrote in message
news
So, we visited an anesthesiologist today. It was interesting. He was
very nice and answered all of my questions. Unfortunately, if I choose
to go with an epidural, it will mean a transfer of care (although my
main midwife will stay with me - I just won't get the second midwife as
a backup), an IV, monitors, and a sudden implementation of a no food
policy (although I can drink as much as I want, and I can drink anything
I want, apparently, although I imagine that booze is excluded. ...so I'm
wondering if a breakfast shake will be acceptable, heh heh). He showed
me the needle and the catheter and he told me all about how it goes in,
what they do if it doesn't work, and so on. I was quite impressed. I'm
still terrified of it and I still have no idea what I really want to do
(I have always said that I want to *try* for an unmedicated birth, but
I've always kept the door open for a change of plans). He said that
they usually like to administer the drugs at 6cm. If I decide that I
want an epidural, they can put the catheter in at any time, and then
when the right time comes, a nurse can administer the drugs. He also
gave me all sorts of statistics regarding possible problems.

I'm soooooooooooooooo undecided! I mean, I have NO IDEA at all what to
do. I asked DH what he would do if he were in my shoes, and he sounds
just as undecided. He said "I would think it over and talk to the
midwife." I laughed, because I've been thinking it over for months and
I *have* talked to the midwife. ;-) In other words, *he* hasn't
thought about it much, heh heh.

Oh yeah and there should be no problems with my spinal curvature and
arthritis. He said that the kind of curvature I seem to have in my
lower back is OK.

Heh heh, he also described what it should *feel* like. He said that the
drug they use to numb the skin hurts the most, and it hurts less than
the contractions you feel at 6cm. Everything else should only feel like
a pushing sensation.

He also told me about his own wife's experiences. He said that she had
one for her first baby, but not for the others (IIRC he said they have
3). He said that first timers usually benefit a lot from an epidural,
but that those on their second or more usually don't benefit as much (I
thought that was interesting).

Sigh... No clue what to do. Epidurals definitely gross me out, though.

Gareth Tuckwell wrote:

This is a genuine question, but I will probably be shot down in flames and
branded a 'typical bloke' - May I ask why so many women are against an
epidural?

Because it increases certain risks for mother and baby.
Epidural anesthesia is usually very effective (though not always--
about 10 percent of the time the anesthesia is incomplete),
and serious complications are fortunately rare, but there are
occasional serious (even life threatening) complications, and
there are more common complications that, while not serious,
are still things some women prefer to avoid. Here is a summary
of some potential complications you will find if you do some
research:

- When too large a dose is used, or when it sinks down into
the sacral region too early, it can increase the risk of
malpresentation (because the perineal muscles become too
relaxed to help with normal flexion and rotation of the
baby's head). One study found a statistically significant
increase in c-section for dystocia with an epidural, even
after a great many potentially confounding factors were
accounted for.
- Epidurals can affect the efficacy of contractions,
increasing the need for labor augmentation or c-section.
It can decrease or eliminate the urge to push. (Labor
augmentation and c-section both have significant risks.)
It can also lead to an increased need for instrumental
(forceps or vacuum) deliveries, which also have risks.
- A *very* common complication of epidurals is significant
low blood pressure. Hypotension occurs in almost 1/3
of labors with epidurals. Because of this, IV fluids are
given prior to the epidural in order to try to avoid this
complication. Serious hypotension is dangerous for the
baby.
- Epidurals can increase symptoms of fetal distress (fetal
heart rate decelerations, lowered fetal blood pH). In
a healthy baby, this may not cause obvious problems, but
if a baby is compromised in some way (which may not be
known in advance), it can be a real problem.
- Around 1 percent of the time, the anesthetic can get
introduced into the bloodstream instead of being
confined to the epidural space. This can cause twitching,
convulsions, or loss of consciousness.
- The catheter can be slightly misplaced (happens 1-6
percent of the time), which can cause trauma to blood
vessels or hemorrhages around the spinal column (more
rare), which can lead to persistent backaches or headaches
requiring medical intervention to avoid more serious
complications.
- The dura can be punctured (happens about 1.8 percent
of the time), which can lead to severe headaches.
- Infections can develop at the site of injection.
- Backaches can happen, with at least one study finding
long term backache (i.e., lasting for months) in 19
percent of women having epidurals.
- In very rare cases, epidurals can cause maternal heart
attacks or spinal cord ischemia.
- Epidurals can worsen asthma symptoms.
- When combined with prostaglandins used to ripen the
cervix or induce labor, drug interactions can create
a situation where the usual methods of treating low
blood pressure don't work.
- Epidurals can interact with other illnesses (e.g., some
women with migraines find that they worsen after an
epidural).
- Another very common complication of epidurals is maternal
fever. Although the fever is rarely high enough to cause
problems per se, there is no way to distinguish an epidural-
induced fever from a fever resulting from some other problem.
Therefore, it is more likely that the baby will have to endure
a sepsis workup after birth, and may have effects on the
mother's labor as well.
- In very rare cases, epidurals can cause respiratory arrest.
Occasionally, even if the mother is *able* to breathe, she
feels as if she can't. Sometimes tilting the mother's
upper body lower than the rest of her body helps with this.
- In rare cases, epidurals can cause other neurological
problems (some persistent).
- Epidurals caues nausea in 20-30 percent of women and
vomiting in 3-7 percent.
- Some women have allergic reactions to the drugs in the
epidural.
- In very rare cases, epidurals can cause maternal bradycardia
or even cardiac arrest.
- Most women with an epidural will have urinary retention and
require a catheter. This can cause bladder dysfunction
after birth--occasionally this persists.
- Epidurals can cause uncontrollable shivering.
- Can increase the risk of having an episiotomy.
- Can cause drowsiness at birth or a poor sucking reflex in
the baby (making it difficult to establish breastfeeding).
- Can cause poor muscle tone in the baby shortly after birth.

My fiance is due in December and we haven't found anything out about
epidurals, other than it is an injection that takes the pain away for a
while.

It is a catheter inserted into the spinal column,
into which narcotics and anesthetics are injected.

All in all, while epidurals are often very
effective, there are possible risks and some of them
are serious. Epidurals can also lead to other interventions
which have their own risks (including episiotomies, instrumental
deliveries, labor augmentation, and c-section).

Personally, I would much rather just deal with
labor pain than incur those risks. I would rather be
able to move around and work with my body to give birth.
I would rather be able to adopt an upright or hands and
knees position if necessary to birth a larger baby (lying
on one's back or semi-sitting significantly reduces the
size of the opening the baby has to fit through).
I would rather increase my odds of getting through labor
with an intact perineum. Others may feel differently and
may feel that the pain relief is worth accepting the
potential risks, especially considering that most women
get good pain relief and avoid the most serious complications.
Everyone can certainly have their own perspectives on the
risk/benefit tradeoff. I just personally felt that I
was more comfortable being in control and able to move.
I had great support from my midwives and family and did
not feel that the pain I experienced required an epidural.
I've had three unmedicated labors (45 hours, 2.5 hours, and
5 hours) and have never had any significant perineal
trauma and have birthed at least one big baby with a very
big head. I was very pleased with how things happened
for me, but of course your mileage may vary.

Best wishes,
Ericka

Beach mum wrote:

"Vicky Bilaniuk" wrote
Heh heh, he also described what it should *feel* like. He said that the
drug they use to numb the skin hurts the most, and it hurts less than
the contractions you feel at 6cm. Everything else should only feel like
a pushing sensation.

I can't help you as I had natural childbirth the first time. However, what I
can tell you is that 'what it feels like at 6cm' is nonsense. What it feels
like to you will be totally different than what it feels like to the next
person.




Exactly. And some women have 2 hour labors while others
labor 24 or 36 hours.

Make the decision that's right for YOU at the time.

gloria p

Gareth Tuckwell wrote:
This is a genuine question, but I will probably be shot down in
flames and branded a 'typical bloke' - May I ask why so many women
are against an epidural?

Actually, not many women *are* against epidurals. The vast majority of
American women giving birth today have one (the figure hovers around 80%
nationwide, I believe, with some hospitals having epidural rates as high as
95%). The women on this newsgroup are far from representative of women as a
whole.

Purely from an anecdotal point of view (Ericka's given the medical
statistics and reasons some women don't want to have them), I had an
epidural with my first birth and, although I was grateful for the pain
relief at the time, it resulted in me being unable to push effectively (a
common problem with epidurals) and that led to an episiotomy and a vacuum
assisted birth. Neither of those are desirable, IMO. I also couldn't stand
for about 2 hours after the epidural was turned off and couldn't walk for 4
hours. And I had a really nasty sore spot in my back where the epidural was
inserted for about 2 weeks after my child was born. All in all, I just found
that the pain relief benefit wasn't worth the costs, and gave birth two more
times without any pain medication with excellent results.
--
Be well, Barbara
Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7)

This week's suggested Bush/Cheney campaign bumper sticker:
"Leave no billionaire behind."

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

Ericka Kammerer wrote:

What more do you need to know? Must you decide
this in advance for some reason?

I'm the kind of person who likes to go into things with a fully detailed
plan. This is the reason why I'm so freaked out about labour; I can't
fully plan it out. ;-( All I can do is come up with contingencies,
which is why I'm examining all of my options. Grrrr... ;-) I would
*like* to put my finger on something and say "Yes, THIS is what I'll do,
no matter what." I'm finding it hard to do that, though, because of the
whole problem with not having even the slightest clue how labour will go.

If I could only decide one way or the other on epidurals, then it would
make things a wee bit easier. If I decide I want one, then they can
prepare me for it right from the start. The backup midwife will know
not to show up, the OB might get a chance to show up and examine me
before the going gets tough, they'll probably start the IV early, and so
on, and if it's late at night, they can get the anesthesiologist out at
a half decent hour rather than right at the last minute (meaning that
the anesthesiologist will hopefully be there at the right time rather
than having to make me wait up to an hour). If I decide *not* to have
an epidural, then I can put it out of my mind and focus on other pain
relief techniques, and I'll be able to have food while in the hospital.
Obviously, it would be to my advantage to make a decision before
labour starts, or at least very early on in the game once it does start.

Jody Pellerin wrote:

Try for the unmediated birth but if you can't handle the pain or just don't
want to, then get it. That's the philosophy I went into my labor with. I got
the epidural and don't regret it at all. I was at 6cm when I got mine and
couldn't handle the pain any longer. So I got it. It was great actually.
Mine worked very fast and very well. When I was in pain, food didn't cross
my mind. Maybe you'll be lucky and the labor won't bother you. If so, you're
all set. But don't be afraid of the epidural.
I felt so good from the epidural after birth that I could walk around but
felt no pain. I got in the shower and my feet felt like they just got the
best massage in my life. I felt so good. It also helped with the pain of the
lacerations for a while afterwards too. I got a really good epidural
Thanks to my wonderful epidural, I'm not scared to have another child. I
loved it.

Hmmm, thanks for sharing. It seems like for *most* women, epidurals are
really great. I have heard of a few bad things, but really the vast
majority seem to really like them.

Nikki wrote:

Vicky Bilaniuk wrote:


I'm soooooooooooooooo undecided!


No your not!! :-) You've decided to have an unmedicated birth and
researched epidurals in case you change your mind. Sounds like a fine plan.
So, now all you need to do is start lining up all your support and tactics
for the unmedicated birth. Proceed with your thought out and planned
unmedicated labor and if you change your mind half way through - you will
feel comfortable making the decision for an epidural at that time because
you've already thoroughly checked it out.

You don't have to decide yes/no about an epidural *now*. It is probably
foolish to do so.

So, relax ;-D.

Relax? I'm sorry, but I don't think I have that word in my vocabulary. ;-)

T Flynn wrote:

-- As for the food question, many hospital-related births don't allow food
after being admitted, so if you've got the slightest chance, GET FOOD ON
THE WAY IN AND EAT IT BEFORE ADMISSION. Short of knowing that you're in

Thanks for the advice.

I mentioned food because if you go with an unmedicated birth, apparently
our hospital doesn't care if you eat. However, I was told very
specifically yesterday that if I get an epidural, they won't allow food.
Now, I don't see how they can physically stop me ;-) but I don't want
to make anyone's life miserable, including mine. I will probably bring
in good protein drinks. ;-) They said I could drink anything I wanted,
afterall, ahem... I also tried to pick up some gel packs (I think
they're called that, but I forget) for the big day, but I only know one
place that sells them and unfortunately they stopped selling them. If
you don't know, these gel packs are basically just big doses of sugar
and some ions, packaged in a tasty little treat - intended for athletes,
but definitely *not* a solid food of any sort; it's basically gatorade
with gelatin. Heh, anyone know where I can buy these in Peterborough,
Ontario, or Toronto, or anywhere in between those two cities?

the middle of an extremely tough labor and the discomfort is making you
nauseous,

I am definitely not a puker, so I don't think I'll need to worry about that.

-- For an epidural, you need to be able to lie on your side. This may
sound minor, but my hips went out of whack shortly before labor and I was
extremely uncomfortable in any position but my back on the hospital bed.

I haven't been able to lie on my back for months, due to hip pain. My
sides are the only way to go (actually, more like half side half
stomach, as much as the stomach will allow). I hate it, actually, but
it's all I can manage.