On epidurals

I just found an interesting abstract on epidurals… I’d like to read the whole thing and may have to break down and buy the issue of Midwifery Today so that I can. It basically sums up epidurals as being given so much because a woman’s friends are doing it and likens anesthesiologists to drug pushers.

This year, about two million women will get an epidural legally, but hopefully not lethally, in the US. As a result, about eight of them will never walk unassisted again. In Westernized countries, roughly 50–70% of birthing women have epidurals for pain relief. Research on who gets an epidural and why draws a profile very similar to the people who were taking drugs in the ’70s. Most women are getting epidurals because their friends are doing it.(1) In a recent, large study of epidural users, the most often cited factor in deciding to have an epidural was having heard about positive experiences from friends and family. Having already had children and having fear of the side effects of an epidural each reduced the odds of choosing one by half. In other words, the older or wiser women get, the more they avoid the epidural trip. Overall, those who did not choose an epidural reported wanting to be in control and having more confidence in their ability to tolerate labor pain.(2)

Go here to read more of the abstract.

After having an epidural, I knew immediately I never wanted another. I didn’t appreciate not being able to feel anything at all during the experience. I did not like not being able to move. I didn’t like the feel of the nurse and my husband holding onto my legs in an effort to “help” me push the baby out. Above all, I didn’t care anything for the fact that, even since that epidural, I’ve had countless issues with my bladder. I would only learn after the fact that that’s a pretty common side effect of epidural.

Not to mention the obvious factors of risk to baby and the fact that, after a cesarean, it’s vitally important to not have an epidural because, in the rare event of a uterine rupture the woman will never know, thereby posing a much larger risk of death. Definitely a risk I do not care to take.

Birth plans

Now as many of you already know, I’ve had two VBACs. One was highly (unneccessarily) medicalized and the other was not. I much preferred my second VBAC (my third child) to the prior VBAC. With the second, I made up a birth plan but found out very quickly that there was no way it was going to be honored. With my second VBAC (third child), the CNMs that I chose for my care providers were welcoming of my birth plan. They went line by line and discussed it with me. They very much agreed, which really put me at ease.

I have learned that birth plans are frequently scoffed at by medical personnel – and some mothers as well – so much so that it leads me to believe that they are ignored more often than not. I also read a blog entry from The Feminist Breeder about birth plans being more than a “wish list”.Very interesting read.

I’m curious how many of you have had birth plans and whether they were honored or not. What is your take on birth plans? Do you think they are frivalous or necessary?

As an aside, I also thought I would share with you why I believe birth plans are so important (for me). When you have had a cesarean, you are at (slight) increased risk for uterine rupture. It’s my understanding that uterine rupture is extremely painful and you will know immediately that something is wrong – unless you have had an epidural because you won’t be able to feel if anything goes wrong. If uterine rupture is caught, it can be taken care of immediately. Unless, as previously mentioned, you don’t know it happened. At this point, a birth plan comes in because I stress that I don’t want any medical intervention unless medically necessary – there is an actual risk to baby or myself – because as most of us know, once one intervention happens, say pitocin to “rev up” contractions, it is much more likely for another, say an epidural because you can’t stand the pain of the contractions caused by the pitocin. So, for me, the safety of baby and mom are at risk if I do anything to cause an epidural to occur. That’s why I like my birth plan.

Hypnobabies!!

I just got my Hynpobabies Home Study Kit today. I bought it used off of another mama. I’m super excited – I’ve been wanting this for awhile now.

I sat down and listened to the first track on the first cd. I was seated on the couch and had my legs crossed at the ankles on the coffee table. I noticed that I felt an awareness of a heaviness and pressure in my feet and legs. After I was done with the track, and had shifted position, I noticed some pain in the foot that was underneath the other. I’m not sure if that means that I was doing it right?

I didn’t do so well at the visualization. I hope that will come with time. I also felt a little silly because, well, I was supposed to be visualizing my baby and I kept picturing this weird shrimp looking thing like I’ve seen in books.

My Birthing Library

I love to read. When I’m pregnant, I love to read about pregnancy and childbirth. I’m not sure why I read and reread anything I can get my hands on. I think it’s because it almost feels as though I’m doing something. If that makes sense.

My birthing library consists of the following books:

Ina May’s Guide to Childbirth    
The Birth Partner by Penny Simkin
Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block
Natural Childbirth the Bradley Way by Susan McCutcheon-Rosegg
Mothering Magazine’s Having a Baby, Naturally       
The Whole Pregnancy Handbook by Joel Evans

I also found this fantastic 14 page pamphlet for expectant fathers called Comfort in Labor. If yours doesn’t want to sit down and actually read a whole book, this may just be the way to go. It’s written by Penny Simkin, the same woman who wrote The Birth Partner. It basically crams a lot of stuff from the book down into easy-to-read 14 pages.  

I ordered a few more books off of Half.com for very cheap so I’ll probably be adding to the list as they come in. In the meantime, if you know of any that I don’t have listed, let me know!

Getting Carried Away

Sometimes I get a bit carried away. If you read my birth experiences posted on this site, you might begin to understand why.

The whole time I was pregnant with Ceili Fey, I sort of felt as though I was a vessel for a baby. I was all alone, save for my mother, who faithfully attended all of the appointments with me. The OB was very impersonal, spending little time with me. I was told that I would have to have a cesarean – due to some health issues – and that we should schedule a date. Looking back, and being a far more educated consumer, I now know that my cesarean was completely unnecessary. I. Did. Not. Have. To. Have. One. At the time, however, I believed that you just did everything the doctor said like a good little patient, regardless of how you felt about it, and get on with life.

My second pregnancy (Elias) was micromanaged as well. During this pregnancy, I began listening to that inner voice a little bit more, realizing that I was not happy with my care. Plain and simple, my gut told me so many things were just wrong. I actually went and spoke to another OB who I wish I would have switched to. Instead, I listened to Jon when he told me that it would be too much of an issue with the insurance if I switched so close to term. I wish I had just gone ahead. I wound up with an epidural that I did not want, in the lithotomy position that I did not want, and PTSD (Post Traumatic Stress Disorder) that I definitely did not want. Nothing was even remotely close to my birth plan. All in all, not a good experience.

My third pregnancy (Noah) I stayed away from OBs and, instead, went to a CNM (Certified Nurse Midwife). Her views on pregnancy more closely matched my own, namely that pregnancy is not a medical condition to be managed, but an normal everyday occurrence. I also labored at home for quite some time. Honestly, I stayed home a bit long. I realized afterward that the baby was about ready to crown before we ever left home. After Noah was born, I felt happy, peaceful, yet energized!! Going to sleep afterward was the last thing I wanted to do!! Everything played out pretty much to plan – yes, I had a birth plan!!

Of the three, my youngest child was the only real positive experience. It was the only time when I did not feel as though I had to shout to be heard – figuratively because we all know “good” patients don’t shout. It was the only time that I felt it was truly my experience, on my terms. The only experience where, afterward, I was happy.

So, yes, sometimes I may get a bit carried away. It comes from being tired of being treated like a patient, like a case study, like a textbook, like a number. It comes from wanting the medical profession to see that women can actually know their own bodies so intimately, much more so than any doctor ever could. It comes from wanting to be heard. It comes from wanting to be treated as a person, not as a potential lawsuit.