Sunday, July 1, 2012

Numbing Out vs Natural Birth

What you will hear from the pop culture herd: giving birth is a personal experience and the best path for you--natural or drugs--only you can determine.

If you don't subscribe to the cult of moral grayness that denies objective reality, there is only one choice and the thinking about it goes like this:
-Is it rational to not want to experience the pain of childbirth? Yes.
-Is it rational to sign up for an epidural unconsciously, without looking into the costs? No, unconsciousness is unacceptable.

Therefore, inform yourself by reading the following:

When you sign up for an epidural, you also sign up for an IV and a bag of fluids, a urinary catheter, a blood pressure cuff to tighten on your arm every 15 minutes or less and continuous fetal monitoring.

The forced fluids in the IV may cause your perineum to become engorged and not able to stretch so you will be at a higher risk for needing an episiotomy. The urinary catheters will put you at a higher risk of getting a UTI. The epidural itself will likely cause hypotention, a sudden drop in your blood pressure--hence the blood pressure cuff monitoring you. Your baby will also have to be monitored as a drop in your blood pressure decreases the amount of blood (and therefore oxygen) going to him/her which can lead to fetal distress.

Epidurals eliminate the normal hormone process of labor which will make your labor take three times longer than a natural birth. The epidural will slow down or stall your contractions. That is why most women who get an epidural will also require Pitocin. Common side effects of Pitocin include: nausea, vomiting, and much more painful contractions. Less common side effects include: rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue, blood clotting problems, changes in heart rate, cardiac arrhythmia, pooling of blood in the pelvis, postpartum hemorrhage and a ruptured uterus. Side effects for your baby include: bleeding in the eye, irregular or slow heartbeat, seizures, jaundice and low Apgar scores. Less common side effects for your baby include: brain damage, neonatal retinal hemorrhage and death.

Epidurals make pushing more difficult and increase the likelihood of forceps or vacuum delivery by 20-75%. Common side effects for the mother of a forceps delivery include: cuts and heavy bleeding. Common side effects for the baby include: heavy bruising. Less common side effects for the mother include: permanent loss of urinary and bowel control. Less common side effects for the baby include: broken bones, brain damage and death. Vacuum assisted deliveries are less risky for the mother but have common side effects for the baby that include: abrasions on the scalp, cephalohematoma (a collection of blood under the fibrous covering of the skull bone), jaundice and eye hemorrhage. Less common side-effects for the baby include: retinal hemorrhage, subgaleal hematoma(a collection of blood just under the scalp, injuring the underlying veins), intracranial hemorrhage and brain damage.

Epidurals increase the risk of a C-section by 25-50%. Some common C-section risks for the mother include: infection, heavy blood loss, blood clots in the legs or lungs, nausea, vomiting, severe headache, bowel problems, a recovery that takes three times longer than a vaginal birth and complications in later pregnancies (uterine rupture and placenta problems that cause severe bleeding after birth which may require a hysterectomy). C-section risks for the baby include: injury during the delivery, need for special care in the neonatal intensive care unit and immature lungs and breathing problems if the due date has been miscalculated.

If you just get the epidural (and manage to give birth without Pitocin, forceps, a vacuum assisted delivery a or a C-section) common side effects include: feeling like you are not able to breathe, uncontrollable shivering, ringing in your ears, itching around your face, neck and throat, nausea and vomiting. Epidurals also double your risk of hemorrhage.

Less common side effects of epidurals include: allergic shock, convulsions, respiratory paralysis, loss of bladder control for months, severe headache caused by leakage of spinal fluid that lasts for weeks and requires bed rest and a blood patch, epidural fever (which will result in your baby being sent to the neonatal intensive care unit), permanent nerve damage, brain damage, cardiac arrest and death.

Common side effects for your baby when you get an epidural include: respiratory depression, fetal malpositioning and an increased risk of jaundice. Your baby will be born drowsy and will exhibit the same drug toxicity symptoms as a baby born to a woman taking cocaine and opium.

The epidural-experience doesn't end with birth. For hours afterward the lower half of your body will be numb. You won't be able to walk and you might not be allowed to hold your baby. Later you might get tingling, shaky and numb sensations in your legs, a severe backache, soreness where the needle was inserted and urinary or fecal incontinence. You will heal more slowly than a woman who had an unmedicated birth.

Because the epidural prevented your body from releasing labor hormones, you may have trouble bonding with your newborn. You will have an increased risk of breast milk production problems and you will be at a greater risk for postpartum depression.

Because the epidural prevented your body from releasing labor hormones, your baby may have trouble latching on (which can lead to breastfeeding difficulties). Your baby may also have trouble bonding with you.

For up to six weeks after birth, a baby that was drugged (because you aren't just drugging yourself) will exhibit neurbobehavioral effects such as irritability, inconsolability and decreased ability to track an object visually or to shut out noises and light i.e. epidurals will make you are much more likely to have a crabby, difficult newborn.

To conclude, getting an epidural carries many serious health risks to you and your baby. It prevents you from experiencing a couple hours of intense pain in exchange for extra weeks of recovery (i.e. pain...) and over a month of caring for a miserable infant.

95% of unmedicated births have no scary side-effects. Less women tear. Tears are less bad. Babies are born wide awake. The wide awake babies nurse right away. Moms get hormone rushes that make them fall in love with their babies and prevent postpartum depression and hemorrhage. The babies get the hormone rushes and fall in love with their moms. Moms get hormones that make their milk come in. Moms heal faster... the list goes on. The 5% of natural births that have complications end up as vacuum/forceps/C-section births with all the risks listed above.

The medical establishment makes a lot of noise about breech babies but breech babies can be born naturally and easily--this is not a complication. Neither is the cord around the baby's neck--the baby is getting his air through that cord and does not need to breathe through his mouth until that cord is cut. Big babies are not a complication either.

For your entire life you have watched women pretend to give birth on television--they scream and it's horrible and doctors have to save the baby and then the mother. This is nothing like reality. The reality is: your baby is three to four times more likely to die if you give birth with a doctor at a hospital than with a midwife at home. Birth isn't a medical emergency. It's a natural process. Your body was made to do this. Your body evolved to be successful at this--that is why your genes were passed on.

Moreover, it is not rational to compromise the health and well-being of your body or your baby to avoid some perfectly natural pain. The average unmedicated birth is around five hours. What is five hours over the course of a lifetime?

A personal note: when I started researching this I was desperately hoping to find evidence that would free me from facing an unmedicated birth. I thought, "I'm so healthy! A little drugs every now and then aren't so bad, right?" Instead, I found no way to escape the reality that the best thing for the health and well-being of my body, my baby and our relationship was to take the pain.

When I decided that I was going to give birth with no medication, I cried. I was so afraid of how much it would hurt. Then someone said to me: "Why be so afraid of something you have never experienced? You know the fear of pain is always worse than the pain."

They were right. I had a natural birth, no drugs whatsoever. It took three hours. There were no tears or other complications. It hurt, but it was a fascinating life experience that I wouldn't give up.

The side effects of my natural birth have been:
-A certain fearlessness that comes with knowing pain is just pain. It isn't that scary after all.
-Intense admiration in my husband's eyes when we tell people about the birth of our son.
-A baby that was born wide awake and healthy with a perfect Apgar score, a baby that settled into life easily and comfortably, a baby that was never poked, prodded, stuck with needles or taken away from me and his dad, a baby that never got jaundice, baby acne or cradle cap, a baby that doesn't spit up. My baby is now five months old and has yet to catch a cold. He is that healthy, happy, glowing, beautiful example of life-thriving that every mother dreams of having. Everywhere I go people comment on how healthy, conscious and beautiful he is when they see him. My reward for all the hard work I put into the choices I make is that everyone tells me how "lucky" I am. Only the very few know it's not luck.

To be more informed about what kind of birth you think is rational:

The Business of Being Born: why the medical establishment wants you to have a medicated birth.

Birth: The Surprising History of How We Are Born: how the medical establishment took over birth. On a side note, the author totally neglects doing thorough research into current birth practices (like epidurals) but the rest of the book is awesome.

Baby Catcher: Chronicles of a Modern Midwife: an enjoyable and enlightening read. This book taught me how to think about birth and was instrumental for me when I went into labor i.e. it's possible my labor was only three hours long because of what I learned from this book.

How to Raise a Healthy Child in Spite of Your Doctor: This book won't just help you keep your kids healthy, it will teach you how to keep yourself healthy. See for yourself some mother and baby survival statistics when midwife births are compared to hospital births.

Sources I used in this post series (Trimester 1):
Weighing the Pros and Cons of the Epidural by Penny Simkin

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