Labor

Pain Management During Labor isn’t for Pansies: A Logical Look at the Epidrual Debate

I’ve had four babies, and it seems anytime I get towards the end of my pregnancy and the big L-day is near, people start talking about pain management during labor, epidurals being the most common conversation piece. The world of epidural opinions is pretty evenly divided into those that are pro-drugs and those that are anti-drugs with very little middle-grounders. Myself sitting on the pro-epidural side, I find the anti-epidural moms tend to be pushier. They seem to feel they are validated in their opinion in a you’re-putting-yourself-and-your-baby-in-danger sort of way, and somehow came to the conclusion that’s their business. I don’t think that’s fair or their business. I don’t think a new mother needs people making her feel like a bad mom for wanting pain relief during labor. More over, I don’t feel the anti-epidural debates are validated.

Let’s take a look at the anti-epidural debate one point at a time.

I can feel the beauty

The labor process is a beautiful thing everyone should experience.
A baby is a beautiful thing. The labor process is nasty, gooey, and most notably, really freakin’ painful. I don’t know why anyone in their right mind would want to feel that, and someone who has experienced it trying to convince someone it’s something beautiful that they need to experience, is just sadistic — and that’s coming from someone who has experienced it. It’s like saying, “here drive a nail through your palm, it’s beautiful.”

Women have been giving birth for hundreds of years without pain medication.
Yes, and you know what? Before we had things like anesthesia, people had limbs amputated without pain medication, too — for hundreds of years even. Are you going to tell a car accident victim who needs their leg removed that they shouldn’t use pain medication because for hundreds of years people didn’t? This “hundreds of years” argument is often brought up by the same women who quietly call those of us that don’t enjoy excruciating pain weak or wussies. You can reference that car accident victim again in that case.

Epidurals slow the labor process.
There was a time when this was believed to be fact. However, more recent studies on the subject have shown epidurals to have no effect on labor duration. Others have shown a marginal increase in labor time (less than 1 hour). Earlier studies indicated waiting until you are dilated to at least 4 cm would eliminate this concern. In short, studies have mixed results. The question is does the possible even marginally increased labor time shown in some studies hurt you or your baby? The answer is no.

not just a fashion statement…

You won’t be able to feel the contractions to push.
This may or may not be true. It really depends on how your body handles the epidural. Some women indeed have trouble feeling contractions, others don’t. This is irrelevant, however, because modern labors are monitored, meaning you can see when you’re having a contraction by watching a machine, you don’t need to feel them.

Epidurals are dangerous to mom and baby.
There is no scientific evidence to support this claim. Rates of C-section are not higher with epidurals. Apgar scores in babies that are delivered with an epidural are not lower. Mothers who received epidurals are not at a higher risk for depression or any other condition. Some women do report nausea, shivering, injection site pain, and difficulty urinating shortly after having an epidural, but you should hear what women without pain management during labor report. Other than that, about 1% of women experience extreme headaches as a result of procedure error—not the epidural itself. In very rare cases, like 1 in 80,000 to 230,000 rare, permanent nerve damage can occur.

In the end, much like with most choices as a parent, epidurals fall under the personal-preference category. Opting for an epidural for pain relief during labor does not mean you’re weak. It doesn’t pose notable risk to you or your baby. Personally, I’d say the few possible side effects do not outweigh the pain relief. I will have an epidural with my next baby as well, and it doesn’t make me a weaker woman or a bad mom.

Cervidil Induction: What’s it like?

They say pregnancy is supposed to be 40 weeks, but apparently my kids didn’t get the memo. Of four children, three were induced. Two for being overdue by more than two weeks, and one a bit early as a result of preclampsia. With my first labor induction I was given pitocin, and honestly, it sucked. The contractions were brutal in comparison to my one natural birth. So, when my midwife suggested trying cervidil induction on round 2, I was both very interested and very confused, because I’d never even heard of it, much less heard it as an option for induction. cervidil induction

What’s cervidil?

Good question, right? Cervidil is a medication that contains dinoprostone, a naturally occurring prostaglandin. Now if you recognize the word prostaglandin, that’s because sperm also contains prostaglandin in a natural form. This is one of the reasons sex naturally induces labor. Prostagladins don’t actually cause contractions like pitocin will. Instead, they cause the cervix to ripen aka dilate and efface. In some women, that ripening can bring on contractions and lead to labor. In others, cervidil just helps prepare the body for labor. Pitocin if you are unaware is a synthetic hormone that causes contractions to induce labor.

What’s a cervidil induction like?

For cervidil induction, a tampon like device is placed beside your cervix, which on the off chance you don’t know, is the connection between your vaginal canal and uterus. It has to open, or dilate and efface, or thin, during childbirth to let your baby out. For me at least, this wasn’t painful even having a posterior, L-shaped cervix. It could be compared to your average cervix check during pregnancy, but it does have to happen at a hospital.

Your health care provider just inserts the tampon-like device, and you lay around for awhile waiting. In my labor, within 30 minutes of insertion I was having rhythmic contractions, and within three hours my water broke. My baby was completely delivered four hours after insertion. I started off dilated to a 4 and 50% effaced, however. Cervidil may not progress labor so quickly in every situation. For instance, with my one early baby, I also requested cervidil before pitocin since it had worked so well for me previously. In that labor I hadn’t begun to efface at all, and was only dilated to about a 2. The cervidil still worked, but it took longer. I began having contractions the following morning after insertion, and did still have to have a bit of pitocin as my labor stalled before she made her exit. Which, side point, you can use cervidil and pitocin.

I still would recommend avoiding induction if possible, as due dates are so relative, but if you feel medically it’s best as I did, and you’ve extinguished safe, natural induction methods, I’d strongly recommend giving cervidil induction a go.