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Pages: 1 [2]   Go Down
Author Topic: Natural Birth vs. Epidural  (Read 22604 times)
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TmS
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« Reply #15 on: July 25, 2010, 01:39:59 PM »

Epidurals scare me - too many things that can go wrong.

Had a friend who couldn't walk for months after she had one. I've heard of women who couldn't breathe because it numbed up instead of down.

I went natural, no drugs. Yeah it hurt, it hurt a lot, but it's a pain that you know is going to go. Treat each contraction one at a time, rest in between and distract yourself when they are there. Eventually they will end, it definitely hurts less once the baby starts to come out and then it's over.

I did squat position, really helped my body kind of just did what it had to do, I don't think I could have done anything to stop it truth be told. Small tear and grazing caused a little discomfort for a week or so.

I was able then to breastfeed him before they did whatever else they did and i was walking around half an hour later



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kreena
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« Reply #16 on: July 26, 2010, 07:10:37 AM »

Hi Skylark,

    Thanks a lot for sharing the wonderful information.

    I knew very few of them. So we can say if everything goes
    fine for epidural then also it may have side effects.

   Yoga during pregnancy helps a lot.

   Here is one link which suggests some yoga exercises :   

   http://www.healthandyoga.com/html/pyogaex.html

   Please consult your doctor before following this as in some
   cases yoga or any kind of exercises are not recommended.
   Again breathing and pranayam will also helpful.

-- Kreena




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PY
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« Reply #17 on: July 26, 2010, 07:24:23 AM »

Thank you for all the info!! mellow

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susanschorn
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« Reply #18 on: July 28, 2010, 11:21:43 PM »

Even though the nurse (before my midwife arrived) continued to insist that I was crazy for not getting an epidural, I held held out and had my daughter naturally.  I am SO GLAD I did!  It was a wonderful experience!  You forget the pain when you see your incredibly allert, non-drugged baby. 
I will never have to wonder if the medication hurt her...

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SunshineMama
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« Reply #19 on: July 30, 2010, 03:14:12 AM »

What fantastic information.  I am so glad now that I didn't have an epi because I really didn't research it enough, just assumed there were no real issues since they are so common.



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Motherosette
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« Reply #20 on: August 03, 2010, 03:07:51 AM »

Thank you everyone for this posting, especially Skylark for the long, but well worth reading answers to all of our questions regarding "Natural Birth vs. Epidural.  I did make up my mind and said no epidural for just because they did not have it back in the days and women gave birth just fine.  I would like to experience everything that is supposed to be natural about birth; So nature birth is what I going after.  I just pray to Good that the labor takes little time and that it doesn't hurt as much..............Again thank you very much guys yes

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Skylark
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« Reply #21 on: August 03, 2010, 07:15:21 AM »

Motherosette, I am glad it was a help. I do want to give you an advice to take time and get ready for your labor and birth experience. It is easy to just "hope" it will go well, but while you can not possibly predict or change how your individual labor and birth will go, you can do something to make this experience good:

1. Take a good natural birth class, such as Bradley Natural Birth Class or a good course offered by midwife
2. Start early, preferably before your 28th week, practicing and doing relaxation exercises
3. Do your pregnancy exercises (pelvic rock, kegel, etc.)
4. Choose an out of hospital birth with midwife, if it is at all possible; if you can not do that then...
5. Have a trained doula to be with you and help you,  if you will be going to the hospital for your birth, she will help you to stay at home for as long as it is possible, help you through the hard times of labor and will be beside you in the hospital
6. Have a good diet now
7. Remember that during the labor you just need to relax ( that is your ally!) and let go, taking just one contraction at a time, the more relaxed you are, the easier it will be for the muscles to stretch and for your cervix to open, also the more relaxed you are the less pain you will experience
8 Try aquatherapy during labor ( shower, bath), and if you can try water birth ( it is amazing!!!)

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Motherosette
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« Reply #22 on: August 03, 2010, 10:07:16 AM »

Thank you.  I have to say that there is alot to consider, so far the only thing I have is a OBGY.  I can see I have alot to plan before the baby comes.  Again thank you for the help and I hope everything goes as smooth as yours. yes

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2010BEBES
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« Reply #23 on: August 04, 2010, 03:36:32 AM »

Skylark,

thank you for this valuable information.I will pass it to my daughter (she is in the 12th week) and am sure she will appreciate it.

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monika2001
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« Reply #24 on: September 14, 2010, 11:41:56 AM »

Greeting to all in this forum.

As the obstetric anaesthetist performing the epidurals, I feel responsibility to correct some Skylark statements and point out important evidence based facts currently available. 
In my five year practice, I have met a number of pregnant ladies, who initially refused an epidural (because somebody scared them off), but in agony they suddenly changed their mind and asked for the „last minute epidural“- which did not have enough time to work, thus was not reducing their labour pain. It is perfectly all right if you decide to go natural way, without epidural. For those who are easily coping with pain I would say this is the right way to go (I decided to have mine purely from the proffessional reasons). But there are some of us which are not as "resistant" and and labour makes them overstressed. This is the group I would highly recommend to have an epidural. Please, read this, judge responsively and decide early! It is nothing worse, than leave such a decission to be made in the last minute agony!!!! And believe me, if it was so dangerous, doctors would not be offering it to anyone (especially not to the pregnant!!! = two in one )  yes

These are my comments to some statements you found on the web:

„They are essentially paralyzed“ = not able to move with your limbs.
For the labour epidural, the very low concentration of local anaesthetic is used. This amount of anaesthetic does not cause paralysis. Patient is fully mobile and able to push. In my practice I leave my patients to walk with an epidural and they also can choose a position for labour (except for bath labour - with the risk of infecting the epidural). If Skylark had seen paralysed patient, it must have been either unprofessional labour epidural, or it was not an epidural for labour (it could have been the spinal or the epidural for caesarian section).

” With large doses the patient loses the desire and the ability to bear down and push. This results in an increased use of forceps and vacuum extractions over women having unmedicated deliveries.”
Epidural labor analgesia is not associated with increased rates of instrumented vaginal delivery for dystocia or cesarean delivery. Because epidural reduces agony (state when you are not able to cooperate), you are actually far more cooperative. In my up to date practice I have not seen a single women who lost desire and ability to bear down and push due to epidural analgesia. What we see far more often is exhausted women from long term agony, who does not have enough power to proceed or does not cooperate…the result is forceps or caesarian section.

“Fetal heart rate decelerations was reported as significant risk following the use of epidurals. Babies have higher chance to develop fetal distress after epidural anesthesia”.
The current evidence does not support that babies have higher chance to develop fetal distress after labour epidural analgesia. The opposite is true. Patient satisfaction and neonatal outcome are better after epidural than parenteral opioid analgesia.

The complications of the labour epidural are:
1. Hypotension
"occurs among almost one-third of patients with serious hypotension occurring about 12% of the time”.
Mild lowering of the blood pressure is more the normal side effect than the complication. It is due to reduction of the stress reaction – this effect is used with advantage for labour of mothers with heart or lung disease – to this group of the patients we strongly recommend to have an epidural analgesia for labour (or caesarian section). 
What is dangerous is only serious hypotension, especially if it lasts for a long time (it is number one medical priority to recognise it and immediatelly act - we have a number of drugs to conteract that). If the mother was not previously dehydrated or bleeding, serious hypotension should not happen. Both of above conditions should be identified by your doctor and treated far before considering an epidural.
“Maternal hypotension is a major risk for the baby”. 
No doubt, it is true. All the facts about oxygen and glucose you have studied are true as well. That is why it is dangerous to deliver outside the hospital. Main reason for serious hypotension is an excessive uncontrolled bleeding, not an epidural!!!

2. Inadequate pain relieve.
” The epidural is generally inadequate 7.1% of the time, leading to supplementation with intravenous pain medication 4.0% of the time and a general anesthetic 3.1% of the time (in one study)”
With 92,9% of success rate? I would say, it is generally adequate  smile .
Nothing in the world is 100%. The most frequent failure reason is subdural block (not exact position of the catheter, 1:1000)
The large part of inadequate epidurals are “last minute epidurals”, performed too late (up to 15 minutes prior to pushing phase), when there is no time for them to work. Epidural needs 10-15 minutes to start to work.
Having the general anaesthetic for labour is nonsence. You can only have the general anaesthetic for ceasarian section. If you end up having the caesarian, previous epidural is an advantage, because it can be used (with strong anaesthetic solution top up) for all procedure plus postoperative pain relieve. Spinal and epidural anaesthesia for cesarian section is current worldwide standard, because they have lower complication rate than general anaesthesia. General anaesthesia for caesarian is reserved for the emergency caesarian section, where there is no time to perform spinal or epidural.

3. Total spinal = ” When an epidural accidentally turns into a spinal anesthetic:”
1:5000 – 1:50 000. (Compare to: road traffic accident during next year = 1:8000, accidental death at home 1:11 000, death hang gliding per flight 1:80 000) Anyway, if it happens, it must be immediately recognized and appropriate action must be taken. All necessary equipment and personal should be available on place. With accurate treatment this transient state it is fully reversible. Reported deaths are due to inappropriate or late reactions of the incompetent staff.

4. “ Accidental injection of the anesthetic solution into the blood stream can occur and can cause the mother to twitch, have convulsions, or lose of consciousness…The chances of that is about 12-16 in every 1000...”
Toxicity of local anaesthetic (high levels of the drug in the blood) is one of the rare complications related to catheter misplacement. I would oppose the number 12-16 in 1000.
I have performed approx. 500 of labour epidurals and have not seen this complication yet. Anaesthetist is testing for the catheter tip position repeatedly several times during performing an epidural. When epidural works properly, we know that it is not inside the blood vessel. If overdose accidentally happens, we can now very efficiently deal with it. All the equipment and competent staff trained for this situation are present on place continuously.   

5. **” Trauma to blood vessels can occur as a result of epidural anesthesia. In one study, bleeding in the spinal column and unintentional placement of the catheter into an artery or vein occurred 0.67% of the time (67 women of every 1000 epidurals).The catheter actually escapes outside of where it is supposed to go 1 to 6% of the time.”
Yes, epidural hemorrhage is on the list as well. It is the risk you have take into account, however, number 67:1000 definitely does not correspond with reality. If you (or your family members) do not suffer from bleeding disorder, and you do not take an anticloting medication  (all of this will be checked), than the risk from epidural induced bleeding is minimal.
6 **” The actual dura may be punctured as a result of epidural anesthesia. Because of the large size of the needle used, severe headache may also result. Dural punctures have been found to occur about 1.8%”
That is true, that is the risk you have to take into account. We can treat this complication with „blood patch“. This helps to releave headache in 99% of the cases.

7 **”Backache after an epidural is a common complication. Back pain commonly occurs after epidural anesthesia (18.9% of the time).”
If you suffer for the back pain you will most likely have the back problems during the pregnancy and after the labour - with or without an epidural. I would not wonder, considering the extra weight you carry as a pregnant and limited mobility you have for long time. There is no evidence that epidural increase the likelihood of inducing new back pain. If you are back sufferers I would recommend gravi-Joga (personal experience  Wink ).

8**” Uterine contractions can become weaker and less frequent. An oxytocin infusion is then necessary to improve labor and produce good strength contractions Mothers having epidurals have longer labors and have a higher incidence of the use of syntetic oxytocin than mothers having non-medicated deliveries”.
Oxytocin is hormone which is normally produced by your brain during labour. It makes uterus to contract – you would not have a single contraction without it. Synthetic top-up is used routinely in obstetrics – actually I have to say, vast majority of patients ends up getting  it - during (to increase contractions) or after the labour (to help deliver placenta or to decrease bleeding).With epidural your labour might take longer (but without pain), but there is no evidence, that it decrease the amount of the endogenous oxytocin (the one released by the brain).


P.S.
To get the most valid of the information from web or medical journals, I strongly advice to sort the articles according to their level of evidence (metaanalysis is the one with very high level of evidence, because it joins results of all aviable studies on the topic): e.g.
Meta-analysis , Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor Stephen H. Halpern, MD; Barbara L. Leighton, MD; Arne Ohlsson, MD; Jon F. R. Barrett, MD; Amy Rice, MD , JAMA. 1998;280:2105-2110. Conclusions.— Epidural labor analgesia is not associated with increased rates of instrumented vaginal delivery for dystocia or cesarean delivery. Patients receiving epidural analgesia have longer labors. Patient satisfaction and neonatal outcome are better after epidural than parenteral opioid analgesia.


« Last Edit: September 16, 2010, 11:43:03 AM by monika2001 » Logged

heyblue41
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« Reply #25 on: September 30, 2010, 09:58:15 PM »

Skylark and monica, thanks for the great information!  There are always at least two side to every issue and you have both given great info.  I think what we should all remember is that no matter what side we are on, the best birth can only come from being well informed!  No matter what you chose, do your research.  Good luck!

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« Reply #26 on: October 02, 2010, 05:36:05 AM »

With my first pregnancy I wanted really badly to not get an epidural.  But, after like 20 hours of labor I gave in and got it, but even after 2 tries it only got rid of the pain in half my body!!!  My midwife suggested that next time I get something different, I don't remember what it was.  I'm pregnant again and I have no idea what I want to do.  I hope the same thing doesn't happen to anybody else!  It hurts!

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