While epidurals generally give excellent pain relief during birth, there are several disadvantages to getting one which can affect both mother and baby.
Epidurals have become just another part of childbirth. In the U.S., rates are around 60% in large hospitals [Anesthesiology, August 2006]. Yet even well-executed epidurals can have serious repercussions to both mother and baby, including drops in blood pressure, fetal distress, fever, and physical and behavioral effects in the newborn.
While a woman who is in unbearable pain may feel the risks are worthwhile, without proper information, women who are coping well may decide to get an epidural simply because it has been offered and they believe it is safe. It is a good idea for expectant mothers to educate themselves fully about this common but serious medical intervention so that an educated decison can be made.
Epidurals May or May Not Give Total Pain Relief
In most cases, epidurals completely eliminate the pain of labor while allowing the mother to remain awake and alert. For a woman who has had a long, difficult labor, the epidural can afford her some much-needed sleep as she prepares for the pushing stage. In some cases, an epidural can get a “stalled” labor moving again, perhaps by allowing a very tense mother to relax.
The epidural does not always, however, remove the intense pressure and sensation of pushing, which can be quite uncomfortable and overwhelming. The epidural may also give only “spotty” coverage, where one side of the body receives anesthetic while the other half does not or where coverage is otherwise incomplete.
Epidurals Often Lead to Additional Interventions
In her book TheThinking Woman’s Guide to a Better Birth [The Berkeley Publishing Group 1999], Henci Goer goes into detail about the very real consequences of this common pain management intervention.
Epidurals can increase risk of Caesarian section. Epidurals slow labor, which leads to increased Pitocin (intravenous oxytocin) and higher rates of episiotomy, forceps delivery, vacuum extraction and Caesarian section. Increased Pitocin can strengthen contractions to the point where they cause fetal distress. Episiotomies can affect sexual satisfaction and continence for life.
Epidurals require continual electronic fetal monitoring. This also has been shown to increase the odds of Caesarian section.
Epidurals can cause a drop in blood pressure. This can cause fetal distress, resulting in the need for an emergency C-section. The copious amounts of IV fluids given in the hopes of preventing this can cause swelling and more serious complications as well.
Post partum, epidurals can give mothers an excruciating “spinal headache.” This requires further treatment and interferes with breastfeeding and bonding with the newborn.
Epidurals confine a laboring woman to bed. Lying prone not only slows labor but can have psychological repercussions on her as well. What was at one point a natural event in which she was participating has now become a medical event over which she has little or no control.
The above complications are only the ones that can happen if the epidural goes well. An allergic reaction or an error in the placement of the needle can cause catastrophic results including respiratory paralysis and cardiac arrest, according to Goer in as many as 1 in 3,000 cases.
Epidural Effects on the Newborn
Because the medication does cross the placenta, studies have been done on the epidural’s effect on the newborn. According to a 1997 study by M. Walker in the Journal of Human Lactation, the lingering effects of epidural anesthesia on the newborn can cause difficulty suckling and sleepiness, both of which interfere with early breastfeeding.
Over time, epidurals can also cause maternal fever, which stresses the baby and may result in him being subjected to painful procedures such as blood tests and a spinal tap after birth to rule out infection.
While epidurals have their place and can help a mother who is struggling with a long, drawn-out, or extremely painful labor, the decision to have an epidural should be treated as seriously as any decision to begin a medication that has numerous and potentially serious consequences.
Epidurals can be quite effective at relieving labor pain, but they are a major medical intervention that leads to additional interventions, and women should have a complete understanding of what they entail before making a choice to have one. If a woman decides to labor without an epidural, she can prepare herself with more natural pain relief and comfort measures. A midwife or childbirth educator can assist her with her plans for an epidural-free labor and birth.
The copyright of the article Epidural Risks in Childbirth - Labour & Delivery is owned by Christy Swift. Permission to republish Epidural Risks in print or online must be granted by the author in writing.
Way to apply the scare tactic. Epidurals are very safe. Look up the
statistics...don't read websites that are trying to tell you medicated
birth makes you less of a mother.
Nov 27, 2008 6:10 PM
Guest :
Thank you for a very clear and factual report. Very helpful in making an
informed decision. P.S. hard as I looked I couldn't find any
insinuation about... "are trying to tell you medicated birth makes you
less of a mother".
Jan 13, 2009 11:54 AM
Guest :
I also urge people to look up the statistics instead of reading websites.
The C-section rate in America is over 30% - WELL beyond an acceptable
level. You will quickly find that epidurals are not safe and almost always
lead to additional interventions. If you can't work with a few hours of
pain to bring your child into the world, not only are you less of a mother,
you have no right being a parent at all. The amount of sacrifice being a
mother involves dwarfs the pain of childbirth. Women have had babies for a
very long time, do you really beleive you are any less capable of working
through pain then generations of women before you? And for first timer's -
it doesn't hurt as much as everyone tells you it does, if you can stay up
and walking around vs. strapped to a bed it is much more comfortable.
Jan 13, 2009 11:54 AM
Guest :
I also urge people to look up the statistics instead of reading websites.
The C-section rate in America is over 30% - WELL beyond an acceptable
level. You will quickly find that epidurals are not safe and almost always
lead to additional interventions. If you can't work with a few hours of
pain to bring your child into the world, not only are you less of a mother,
you have no right being a parent at all. The amount of sacrifice being a
mother involves dwarfs the pain of childbirth. Women have had babies for a
very long time, do you really beleive you are any less capable of working
through pain then generations of women before you? And for first timer's -
it doesn't hurt as much as everyone tells you it does, if you can stay up
and walking around vs. strapped to a bed it is much more comfortable.
Jan 14, 2009 1:46 PM
Guest :
I think this report makes some valid points but I did feel it was biased
against epidurals.The choice of whether or not to have an epidural should
be informed BUT it should be left to the woman in labour. The poster above
is wrong in stating that anyone is less of a mother for not coping with
labour pains drug-free. Women have had babies as long as we have been on
earth (not just a very long time) It's not that we are less capable of
coping with the pain, it is that we no longer have to. Your statements are
illogical. "And for first timer's - it doesn't hurt as much as
everyone tells you it does, if you can stay up and walking around vs.
strapped to a bed it is much more comfortable." Please, speak for
yourself. I did not find it more comfortable or less painful to walk
around. I found I became quite dizzy and sick from walking around. And out
of curiosity, why do you think you are qualified to tell every woman that
she has "no right being a parent at all" if she doesn't agree
with your opinion.
Mar 9, 2009 10:09 PM
Guest :
Wow I think it is sad and completely ridiculous that someone would say you
are less of a mother and have no right to have children just because you
have pain medication during childbirth. You have to do what is right for
you and discuss it with your doctor. Do not listen to what people like
that say. It is just an opinion and honestly opinions like that need to be
kept to themselves.
Mar 9, 2009 10:09 PM
Guest :
Wow I think it is sad and completely ridiculous that someone would say you
are less of a mother and have no right to have children just because you
have pain medication during childbirth. You have to do what is right for
you and discuss it with your doctor. Do not listen to what people like
that say. It is just an opinion and honestly opinions like that need to be
kept to themselves.
Mar 9, 2009 10:10 PM
Guest :
Wow I think it is sad and completely ridiculous that someone would say you
are less of a mother and have no right to have children just because you
have pain medication during childbirth. You have to do what is right for
you and discuss it with your doctor. Do not listen to what people like
that say. It is just an opinion and honestly opinions like that need to be
kept to themselves.
Apr 9, 2009 12:26 PM
Guest :
i agree with the last statement!! the person who said you should not be a
parent if you can't take the pain is probably a guy!! and this site was
supposed to be pros and cons..i only found cons which would mean this is a
site that endorses no medication during labor!! ladies look elsewhere for
better advice
May 25, 2009 12:38 AM
Guest :
I am a strong advocate of natural labor, but during my experience helping
woman birth, I have come to realize that some women simply need that extra
help. It depends on what the psychological well-being of each person is at
the time of birth. I think that epidural are more than often overused and
in many ways do take away a lot of the experience one can have. Labor is
painful, but can also be very rewarding in its own way if you chose to have
no medication. The accomplishment of not using anesthesia promotes the
release of natural endorphins for you and your baby. Educate yourself and
realize that only the last stage is the hardest and know that it is also
the shortest. In cases of long overwhelming labors, an epidural may be
best to give mom a break. But remember that relaxing (as much as possible),
support, and FREQUENTLY MOVING, are some ways to speed labor. Don't lay
there like a stiff block. If walking is too painful, sit, bounce on a ball,
turn from side to side every 30 minutes or more (no less), get on hands and
knees. Simply LISTEN TO YOUR BODY. AND very importantly but not least,
HAVE ONLY PEOPLE THAT YOU FEEL COMFORTABLE WITH THERE. Oh, and don't
insist on getting induced if your simply tired. Chances are you will be
begging for an epidural, and your chances of needing a C-Section increase.
Most importantly know what you want your birth to be like, but be ready for
the unexpected. Aslo, keep in mind, labor is painful for you and your baby.
An epidural goes into the epidural space. It is NOT systemic (goes
throughout all body). It is confined to blocking nerve endings in the
epidural space. What does this mean? You are relieved of pain, but your
baby is getting no pain relief. So ladies, save it as a last option.
