Thursday, May 19, 2011

The lowdown on "The Stuff"

In the doula world (or the midwifery world, or the childbirth education world) we present non-baised information about childbirth to our clients. All the options are laid out, and we support our clients 100% in their decisions.

We truly believe that birth can be transformative for a woman - it can increase self esteem, and can have lasting effects on confidence years down the road. We also believe that birth can be natural and normal, and that the pain you feel is not necessarily a bad thing.

On occasion, though, the drugs offered to women in childbirth can be a good thing. Even with a doula around, women can enter labour with significant fears/concerns that inhibit the cervix from dilating at a normal rate. This leads to exhaustion and discouragement, and sometimes the assistance of pain medications can help the Mom to relax and progress more quickly.

As well, some women are unable to handle the pain associated with childbirth. We teach our clients that the pain we feel in labour is NOT suffering - we have not been shot, or stabbed or involved in a horrific accident. In other words, there is no pychological trauma associated with the pain. Labour pains are welcome, because they deliver our baby! And who's not excited to see their baby?

Sometimes, though, pain can turn into suffering in labour - when a woman is no longer coping well she will become afraid, angry, or sad. If nothing is helping (comfort measures, a doula or partner's support) then often an epidural is the right choice. Women can alleviate their pain/suffering, and go on to have a normal vaginal birth.

Unfortunately, many women are not approaching the option of pain medication with enough information or thought. They see the epidural as their "saviour" and demand to have it right away. This is where doulas and childbirth educators need to take the lead, in informing first-timers about both the benefits and risks of an epidural. This will hopefully prevent some of the disappointment that women feel after their births have not gone according to plan.

I've already talked about the benefits of an epidural. It can alleviate suffering, as well as give women a much-needed rest when they have been labouring for a very long time. Listed below are some of the risks (there are more that the anesthesiologist will discuss with you at the time the epidural is administered). It's best to know the risks BEFORE you go into labour, as you won't be able to think clearly when you are in labour.

The following is what some childbirth educators call THE PACKAGE (all the things that will/might go along with an epidural)

  • Blood pressure cuff is on all the time (a lowered blood pressure is common after an epidural).
  • You are checked continually by nurses, so rest may be difficult
  • IV fluids will be administered
  • Pitocin drip (a synthetic form of your natural hormone), as labour contractions often slow down after an epidural
  • Swollen hands, feet and breasts is a side effect of the IV fluids and Pitocin. This can sometimes affect breastfeeding, as the baby may have trouble latching
  • Catheterization (it's hard to get up and pee when you can't feel your legs!). This can lead to infection.
  • Baby's heart rate may get a bit wonky, which will require you to change positions frequently
  • Vaccum or forceps assisted delivery if baby's heart rate does not recover
  • Cesarean (again, if heart rate is not doing well)
  • Epidural fever - Mom's temperature goes up, which could impact baby, which leads to invasive tests and procedures after birth
  • Some babies have trouble latching, and are irritable for several days after the birth
As I mentioned, all of these things may not happen to you, but there is a pretty good chance that some of them will.

So the moral of the story - do your research, and feel confident the this is the best choice for you!

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