Comfortably Numb: The Perspective on epidurals

Originally appeared on salon.com . Written in cooperation with The Perspective

 *Updated 2021

If you are one of the planet’s 2 billion mothers, you’re most likely aware that the pain of labor is every bit as dramatic as seen on TV. Given the (literally) gut-wrenching pain of childbirth, it’s hardly surprising that between 60-70% of American moms seek epidurals to ease the pains of labor and delivery. While women are increasingly taking advantage of epidurals, natural birthing movements are pushing back against the trend, citing unwanted side effects and maternal dissatisfaction as leading reasons to reject the treatments.

Below, we’ll discuss three reasons why epidurals are the bees’ knees, and three reasons why moms should leave childbirth to the birds and the bees.

 

Pass the Ether (Pro-Epidurals)

 

Safe, efficient, and even necessary

Gone are the days of lying with frozen legs in front of the obstetrician. Today’s epidurals are high-tech, low-dose, and focused on helping moms achieve maximum control and participation in their deliveries.  Epidurals pose no adverse effects to fetal health, and severe side effects for mothers are uncommon. Moreover, in cases where mothers are affected by complex heart disease or a bad airway (as is common with obese patients), having an epidural early on in labor can help to control blood pressure and heart rate, and ultimately safeguards mothers against serious complications that can arise during delivery.

 

It’s ok to pass on pain

Yes, childbirth is natural, but it is also extremely painful. Just as we would not expect a person to undergo an operation without some kind of pain killer, neither should mothers in labor be expected to simply suffer through birthing pains. In prolonged labors, epidurals are particularly helpful in ensuring the delivery’s success, as they can provide exhausted mothers a reprieve from intense physical pain that enables them to rest and carry out the birth.

 

Happy mommy, happy baby

Childbirth is a traumatic event for the body. The cervix dilates to the size of a grapefruit, the perineum usually tears. Indeed, the body-bending process is so jarring that a full quarter of new mothers walk away from childbirth with one or more PTSD symptoms. The pain caused by contractions raises blood pressure, stokes anxiety and can lead to stress-ridden birth experiences and an increased likelihood of post-partum depression. Epidurals offer women not only an escape from pain but also afford her the opportunity to regain valuable emotional clarity, empowering her to be a mentally and physically active agent in her child’s birth.

Pass on the Ether (Against Epidurals)

 

Longer road to victory

Anyone who has experienced active birth knows that all births last approximately an eternity. And, if you’ve taken an epidural, your birth will take forever plus an extra half hour. This is because pain relievers reduce or suppress the production of endorphins, a key hormone in advancing labor. High-dose epidurals have been found to increase the time spent in the second stage of labor by 15-20 minutes. They have also been found to cause a substantial increase in the likelihood of needing delivery interventions with a vacuum or forceps.

 

Unwelcome side-effects

Just as with all medications, some people will experience side effects. The side effects that can accompany any kind of general anesthetic treatment, including epidurals, range from itchy skin and day-long headaches to temporary or even permanent nerve damage, and, in exceedingly rare cases, even death. But undoubtedly, the least welcome side effect of an epidural is when it takes no effect at all. Five percent of women report their epidurals had no effect on their pain. While instances of side effects are decidedly rare, expecting mothers should weigh the risks, and even the possibility of ineffectiveness, into their decision.

 

We used to get along fine without them

That’s right. Human females survived the ills of childbirth for nearly 200,000 years before epidurals exploded into maternity wards in the 1970s. For epochs, people have relied upon natural pain management methods for labor pains – techniques which are just as effective today. Pain management is not only about easing pain but providing emotional comfort. The presence of encouraging family members, a skilled midwife or a doula can deliver emotional support that is proven to mitigate discomfort during labor. Breathing exercises, massage, and warm water are also all tried and true methods used to manage birthing pains today, and are even utilized in hospitals. Pain relief doesn’t need to be high-tech or all-encompassing to effectively aid mothers through labor and delivery. After all, birth is the miracle of life, and you might experience much less of the magic if you are sedated or numb.

 

The Bottom Line: Expectant mothers have a bevy of valid reasons for opting for an epidural during labor, and equally valid reasons for deciding to forgo it. Where do you stand? Is it best to keep the anesthesiologist on speed dial, or never bother calling her at all?

 

Special thanks to M. James Lozada, DO, who clarified some aspects of epidural treatments.

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