Epidurals

To be honest Epidurals are my favorite pain relief choice of the medical sort. Are you shocked? Well, let me explain. The Epidural is not a narcotic, it does not end up in the baby’s blood, and if managed well it can be adjusted to wear off for the pushing stage of labor to allow the women more mobility to aid her baby at that stage. What’s the catch? The catch is babies whose mothers have had epidurals are less responsive after birth, more fatigued, less likely to breastfeed within the first twelve hours. Women who have epidurals have harder recoveries, more difficulty breastfeeding, and more often experience long term negatives effects from the epidural. In contrast natural birth babies are wide awake after birth and usually stay that way for some time, they are alert with their mothers, and ready to feed immediately. In fact, they have a totally different countenance then epidural babies. It's obvious that the difference is the epidural but why? What does the epidural do to babies if it doesn't "drug them"?

I believe that labor and birth is very difficult on an infant’s body, I believe they are affected by the intensity of it, and I believe that the longer the labor the more fatigued the infant and mother. Studies have shown that in non-medicated births labor time is reduced by at least 25%, this is mainly due to the many advantages of having the entirety of the mothers body engaged the work of labor. The epidural on the other hand renders the powers of a mother’s body useless to her infant and places the unnecessary hardship and stress on the infant during labor; after all they can still feel the pain unlike their mothers.

In an epidural birth the mother who feels no pain attempts none of the natural measure to relieve such pain, therefore as the uterus labors down often assisted by Pitocin to increase the strength of the contractions to speed the labor, the baby alone feels the pain of the labor which pain is significantly greater because no natural measures are taken to relieve it. To further complicate the birth process epidurals with render the mother immobile often lead to a slowing of the labor, which is then treated by the artificial augmentation labor contractions through the administration of Pitocin. Since the mother cannot feel the pain of the contractions it is generally viewed as “no problem” if the contractions are close and hard, in fact it is seen as a benefit of the epidural that the labor can be augmented to speed it up artificially.

Though it may be no problem for the mother it seems from the apparent difference between natural birth babies and epidural babies that it is a problem for the baby. Whether or not the mother feels the contractions they go on crashing down on the baby (who in many cases is without the cushion of the amniotic fluid because of the routine practice of rupturing the membranes early to speed the labor). I believe this is the reason why epidural babies are so exhausted when they are born and less interested in their mothers.

Mothers who are active in their labors are using every measure and tool available to them to speed their labors naturally and help their babies descend the birth canal safely. There are less presentation problems in natural labors due to the labor movement that helps babies get into the right position for birth. There are far less vac and forceps used at delivery because unmediated moms are more effective during the pushing stage, and there is far less fetal distress including respiratory distress postpartum. Only 10 to 14% of mothers who labor without drugs have c-sections, compared to 25 to 30% of epidural moms who end up on the c-sections table.

To add to the benefits of a natural labor there are significant postpartum advantages. Natural birth babies breastfeed earlier and natural birth moms report less breastfeeding problems in the months following labor then epidural moms. Many respected lactation experts believe that there is connection between the reported 60% of American moms reporting breastfeeding difficulties and the American epidural rate of 80% on average.

Early baby bonding is a sad casualty of the unusually high epidural rates in American hospitals. The connections between early bonding and natural birth are most the reason women who choose natural birth do so with such passion. In the long term there may be no measurable difference between the bonding of mothers and their children, but there is a stark difference between the two categories in those precious bonding hours just after birth when natural birth babies are awake and alert, ready to breastfeed, and natural birth mothers enjoy the added benefits of natural hormones that fuel their energy and interest as well.

Many modern women have been convinced that the sweaty exertions and primal sounds of naturally laboring mothers are evidence that natural birth is violent and hopeless. What they observe as painful and undesirable is in reality one of the most empowering, precious, and fulfilling experiences that life has to offer. As a doula I have come to love the sweaty smelly work of labor that transforms women into mothers and brings babies into the world in a truly gentle loving way. These mothers throw all their might, mind, and strength into labor and shield their infants from a greater portion of pain, by doing the essential work necessary to bring their babies into the world naturally. This is why natural birth in reality is the gentlest of births.

My Thoughts on Why Women Fail

Why do so many American women who "try" for a natural birth fail...only to be convinced that for them it is impossible? In my experience as a doula, women put far too little thought into it at the start...that there isn't enough "try" in their tepid desire. Though most women I come across seem interested in the subject of natural birth and even express a desire to have a natural childbirth, they don’t really want to bother reading a natural birth book or seek the right labor support. Usually they just go far enough to say, “I think I’ll try to go natural.” not realizing that it takes a full commitment and fervent desire to have a good natural birth.

This laissez faire approach to natural birth preparation might have worked long ago when it was a foregone conclusion that babies come into the world in only one way; when women were surrounded by women with extensive knowledge of natural birth capable of aiding them in the process, but today when almost everything women face in the hospital environment hinders the progression of natural birth, it is naive to think that they will be successful without a fervent commitment to natural birth.

Besides the lazy faire attitude of many women toward natural birth, women today face a challenge to their success that women in the past did not. The soft living of our modern age has become a pitfall that often leaves us unprepared to face the "labor" of birth because of the extraordinary exertions it requires. We have become too conditioned by the easy life, constantly having our basic needs meet with little effort.

Convenience and ease is standard in our world of prepared foods and eating out, high-tech appliances, and instant gratification. We have an easy pain free life and so naturally we expect and want a pain free labor (a paradox in itself, perhaps labor should get a new name). To me it is sad that we’ve been taken in by the pursuit of the easy way and the soft life, since “the most worthwhile things aren’t easy”. We are missing out on some of the most worthwhile experience in life when we avoid the difficult pursuits. This is definitely true with child birth.

Women who go into labor with a casual commitment to a natural childbirth rarely make it past six centimeters dilation before they decide they can’t do it. Most women I talk to these days simply tell me they tried and it was too hard. They've come to believe that women who are able to labor naturally simply must have better genetics and easier labors. They draw no connections between methods they used and the types of labor interventions they allowed and the fact that most natural birth mothers fervently reject such interventions as the only way to achieve their goal of "natural birth".

I do not want to marginalize legitimate birth complications which are real challenges for some women, but the statistics clearly show that these complications happen very rarely when labor is left alone and medical interventions are not used. Only 5% of normal healthy women who are supported by doulas or midwives and reject common medical interventions end up with cesarean births, startling when compared to the average rate of 30%.

The sad part about these common experiences is that most of them are avoidable with some preparation and good labor support. Women who think they are unable to have a successful natural childbirth would be wise to take an independent look at their labors and ask themselves what medical interventions were used prior to the problem that arose, and could the problem be caused by those unnecessary medical procedures. It is my experience that very often the emergency measure is needed because of the unnecessary medical procedure that preceded it.

A midwife (who provides continuous labor support) or a doula can do a lot to help a woman who has a history of large babies, lots of back labor, or long and difficult labors. Baby size is one of the most common "medical reasons" for routine inductions which are most often the cause of medically induced emergencies during labor and birth. As a doula I have seen women push for hours only to deliver a 6 pound baby, and another will push twice and a nearly 10 pound baby charges onto the scene. I have watched this phenomenon many times and it is my opinion that the traction that large babies have in the birth canal aids them in the birthing process as long as their mothers are using movement and gravity to help them along. Still baby size is one of the most common "medical reasons" for routine inductions which are most often the cause of medically induced emergencies during labor and birth.

The thing that most often contributes to long and difficult labors is the improper presentation of the infant, an obstacle often overcome by simple positions changes and movement during labor. Medical interventions become the common obstacles to the correction of the baby’s placement because they cause a woman to be held captive to her hospital bed stealing her mobility and therefore snatching from her the most effective means of bringing her baby into the world by the power of her own body.

Women who labor lying down and immobile are not only going to experience more pain, they will have longer labors and more difficulties at the pushing stage. This alone is the most common reason women fail in their pursuit of a natural birth, and one that is easily overcome by the presence of constant capable labor support.

Whatever the reason for the failure the tragedy is that many of these mothers who walked into the hospital hoping for a natural birth walk out disappointed in themselves, or worse, horrified that they ended up on the c-section table. It has been my experience that the vast majority of women are able to labor naturally and bring their babies into the world by their own power so long as they lean upon the support of women who have confidence in and knowledge of natural birth.