By Donna Balo, CNM, ARNP, MS
A woman learns about her powerful and amazing body during pregnancy, labor and birth. Importantly, women experience the wonder, exhilaration and accomplishment of birth when they are not numbed to the laboring and birthing sensation.
For most women, labor is incredibly hard work, but the pain of labor has value for both the woman and her infant. Natural childbirth facilitates labor both psychologically and physiologically. Adrenalines and endorphins are released to help her cope with labor, while exuding the exhilaration of a job well done.
Throughout history and in most countries, a woman actively labors and births. Listening to her body, she will walk, rest, toilet, bathe, eat, and drink. Loved ones will rally around to assist and encourage her. So, why as a society today, do we cheer and celebrate athletes in their physical abilities, yet blunt the appreciation of a woman’s ability to birth?
Just as the media depicts birth as anything but a normal, natural and healthy process that women’s bodies were designed for, so in recent years has the popularity of the epidural become a common means to escape the pain of labor and birth. Although not everyone gets the relief they desire from an epidural, most women feel little or no pain. Anything that is so powerful that it takes away the body’s perception of pain is too powerful not to have side effects. Serious complications such as neurological injury or life threatening complications are rare, but other side effects are common.
An epidural can give rise to a cascade of other interventions, like a domino-type effect, as it interferes with the birth process. Routinely with an epidural, a laboring woman must lie in bed, have an IV, blood pressure and oxygen monitor, and a catheter in her bladder. Continuous monitoring of the baby’s heart rate is required because epidurals can lower blood pressure resulting in a drop in blood (and oxygen) flow to the baby; therefore, intravenous medicine is used to counteract this side effect.
In addition, an epidural often means a longer labor and then a different medication, called Pitocin, is administered to speed up contractions. Many women develop an unexplained temperature after an epidural resulting in a course of antibiotics not only for the woman (and therefore the baby) but also requiring the baby to have a work-up including a blood draw, IV antibiotics, a longer hospital stay, and sometimes a lumbar puncture. In addition, with an epidural the baby doesn’t have the benefit of mom’s muscles working at full capacity aligning the infant into the best position for birth. Thus, there is an increased likelihood of an operative delivery: forceps, vacuum extraction or cesarean delivery.
Furthermore, although it is not well understood it is well documented that after an epidural, it may take a baby days or weeks to breastfeed well.
Epidurals can be a useful tool and are medically necessary for some women, but there are also serious complications. Epidurals are one of many options for labor and birth. Before making a personal decision it makes sense for women to carefully weigh the risks and benefits of epidural use.
Donna Balo is a CNM whose expertise stems from working in many different types of facilities, including an independent, midwife-owned practice, a non-profit CNM practice, and a number of hospital-owned and MD-owned practices. For almost two decades, Donna has been developing and facilitating classes in early pregnancy, childbirth preparation, sibling preparation and parenting. She is also a frequent speaker on preventative health and has published numerous articles for local publications. Donna currently practices at Advanced Women's Health Specialists. In addition, she is an adjunct OB Clinical Instructor at Daytona Beach Community College and is the Florida representative for the American College of Nurse-Midwives for THRIVE (Teen Health Requires Interaction, Values & Education).
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