Book (written by anesthesiologist) promotes epidurals for birth as soon labor starts – and suggests women who don’t take an epidural are foolish and may even cause harm to the baby. What time machine did I step into? Comparing the pain of childbirth to root canals and appendicitis? Am I back in the middle of the 20th century again? My memory is long, and the sell-job of epidurals and the put-down of “natural” childbirth has just donned new clothing.
Most bothersome about the reports from the baby-birthing industry is a lack of progress toward women owning it. Why can we not make bearing a child with as little intervention as possible the norm and not the butt of political ridicule from the “let’s save women from the burdens of women” camp. You see, when you relinquish all the uniqueness of the female of gender, you lose. Children lose. Family loses. Society loses.
I could do a lengthy academic paper, with pages of citations, on the effects of epidurals and analgesia on labor and breastfeeding. There would be studies that come down on different sides of the issue. Logic dictates, however, the fact that drugs that numb or depress the nervous system have negative effects on babies. Those drugs in anyone’s bloodstream, depress thought, breathing, can lower blood pressure and prolong labor. Babies don’t talk, so we can’t measure their thought, but when they aren’t very interested in breastfeeding the first day, we might surmise they are sleeping off the drugs. But forces with agendas can also determine study results. One fact is certain: all drugs carry side effects. It is a risk versus benefit decision. Always.
An unmedicated birth, when labor is uncomplicated, is within the capability of every healthy woman. This should be the default method – with other plans coming in as necessary. Instead, medical professionals present the contingencies as the norm and the unmedicated birth as the exception. The American College of Obstetricians and Gynecologists came out with a statement that no laboring woman should have to endure any pain.
“Labor causes severe pain for many women. There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor. Pain management should be provided whenever medically indicated.”
How confusing. What does that mean? Has a baby ever been born with no pain? No one should have to experience pain, but pain management should be provided “whenever medically indicated.” If labor is a normal physiological process, how can labor be a “medical indication?” How is a drug or intervention determined to be “safe?” For any individual mother and baby, the only way to determine safety is in retrospect – if there was no harm caused. Otherwise, there is a risk to every drug and every intervention.
ACOG has lumped in the pain of labor with the pain of surgery – or the pain of broken bones. I can tell you first hand that I would do all of my five labors – back to back – without drugs – rather than go through the pain of one traumatic shoulder dislocation. The two hours with my shoulder out of its socket is when I found out about real pain.
Each semester I give my students an assignment: Interview six women – three who had unmedicated births and three who had medication. The students then ask a series of questions about the mothers’ experiences, pain levels and attitudes. The students are always surprised when so many women who birthed unmedicated report birth as a less painful experience than those who had medication/epidurals. One midwife I worked with explained it thus: If you have pain medication, you get stuck in the pain you had right before you were medicated. The push-out is a big eraser, and you aren’t stuck with the pain.
I have witnessed motivated and prepared mothers in hospitals, determined to walk through the labor without drugs, falter under the parade of doctors and nurses, meds in hand, saying, “Honey, you REALLY don’t have to be in pain. You don’t have to PROVE anything.” Talk about demoralizing – the very people who are supposed to be your advocates and minions, undermining one of the most important events of your life.
Sadly, I have seen a laboring woman at seven centimeters who had said in Spanish, “No Drugs!” receive narcotics IV from a nurse (who knew better than the mother, of course) while the doctor stood between her legs lecturing the resident at his side – not even knowing her name. They wanted her to be quiet. Good Nurse stopped her voice with some morphine so Doctor would not be disturbed. Labor and birth are not quiet. I will never forget that scene.
What if we look at labor and delivery as an athletic event?
What if women conceptualized labor as a marathon, or mountain climb – worthy of their time and effort to prepare physically and mentally.
What if the mother put all of her efforts into learning about the labor marathon, training for the race and employing all of the techniques that will allow her to endure to the end?
What if accomplishing labor and birth through the body’s amazing capacity was the priority rather than calling for drugs to eliminate any discomfort that comes during the race.
What if we had a medical community committed to educating women toward natural birth, but also equipped to support them if it does not work out that way.
What if, at every doctor’s appointment, a mother receives education and messages about how well her body works and how it was likely to do a superb job when labor comes rather than shaming her selfish and silly desires to reject drugs.
Nine months is an adequate amount of time to learn about and train for labor and birth. While a marathon yields immense sense of accomplishment and maybe a ribbon or medal, the end point of labor is the biggest prize of all – a baby. And, as a bonus, the woman knows she trained, worked with the forces of her body and did not run away from the process. No one seeking marathon completion calls for a taxi at the starting line. She is anxious to apply training and knowledge to meet the biggest physical event of her life.
How can medical professionals responsibly practice in childbirth and neglect to guide the education of the mother on childbirth – unless they assume that she will be drugged and safely on the sidelines and therefore won’t need any education on how to “run the marathon.”
The pain of labor is informative. It tells you where you are. You get breaks from the forces of labor – which allows a woman to regroup for the next wave. Yes, during that last part will be tough, but generations of women have stayed the course and pushed through the burn of those last (centi)meters of the marathon.
What does an unmedicated birth provide to a woman? Power. Confidence. Strength. Knowledge. There are cases where medication assists a baby to be born safely. That is when we need medication. But uncomplicated birth? No. Mothers who encounter complications that necessitate drugs or surgical deliveries know they did their best and nature dictated a different course. They usually do not feel defeated if they know nature took the choice out of their hands.
Mothers will always do their best with the knowledge they have. If they choose medications and epidurals, they should be supported during the labor. No one can get inside another’s body or head. Women should be kind to other women. My primary concern is that mothers hear accurate information and receive greatest support from their medical professionals and encouragement towards the healthy body responses rather than a one-sided – don’t-you-worry-we’ll-take-care-of-you approach.
Respect mothers and give them the knowledge with which to make an informed choice.
Birth is holy – the mother is the center, father and friends there to protect her and the child – and to keep intruders at bay – no matter who they are.