In Canada, the rate of epidural use is already very high, and rising. In 2010-2011, the rate of epidural before vaginal birth was 56.7% overall. This ranged from a low of 32.5% in BC to a high of 70.0% in Quebec (CIHI, 2012b). This is ON TOP OF all of the epidurals or spinal taps required before caesarean sections, which make up 26.9% of Canadian births in 2011 (CIHI, 2012).
If we add this together, an average of 83.6% of Canadian women in 2011 had an epidural, spinal block or general anesthesia while giving birth!
For me, this means it is very important for EVERY pregnant woman, especially young pregnant women, to learn about what epidurals are, and their consequences on your birth process.
WHAT IS AN EPIDURAL? An epidural is an injection of anesthetic through a small hole that inserts a hollow needle into the space around the spinal cord (see the picture, above). This effectively numbs the lower half of your body, so that you do not feel the pain of contractions in labor. If you want to watch a video of the technical aspects of getting an epidural, a video here can explain it. Unfortunately, while they do reduce pain, epidurals can have other side effects, such as reduce your ability to push your baby out and lengthening your labor, among others.
IS IT NECESSARY? Epidural anesthesia, except in c-sections where you are having surgery, are completely voluntary, though many doctors can make it seem like they are not! With epidural rates of over 90% in some hospitals, many nurses and doctors will think it odd if you don`t want one, and may keep asking you if you want one. While you have the right to have an epidural, you also have the right to say no, and to have your decision respected by your doctors and nurses! It is important to know this is a very `hot topic `and highly contentious issue. Many doctors say that if labor is very painful it can be hard for a woman to relax enough to dilate, and that epidurals can take away the pain allowing the patient to relax. Many midwives would reply that such doctors are just impatient and are not willing to give the pregnant woman the time and atmosphere she needs to relax naturally on her own.
HOW MANY WOMEN HAVE EPIDURALS? Although epidurals were only first successfully used in the early 1900s, and not popular until the 1970s (Silva, 2010), 86.9% of Canadian women now have epidurals, spinals or general anesthesia during birth (CIHI, 2012 and 2012b). This is absolutely phenomenal, considering that up until 90 years ago no women had epidurals during birth...they did not exist. For a good history of epidurals, see Marcus Silva's 2010 article here.
WHAT HAPPENS TO YOUR BODY AFTER AN EPIDURAL? One of the big changes once you have an epidural is that you will need continuous fetal monitoring, meaning that you must stay in your bed. This restriction of movement is very difficult for your body during labor, as the natural impulse for many women is to move around. Walking and standing and sitting can all help to put pressure from the baby`s head on your cervix, progressing you labor naturally, but with an epidural, your body will be very restricted in it`s movement due to fetal monitoring.
Today`s Parent magazine published an article that references a 2002 study published in American Journal of Obstetrics and Gynecology (click here). This study found that the length of the second stage of labor (pushing) is increased by 50% with an epidural. It also found that women with epidurals are twice as likely to need synthetic oxytocin (ie. pitocin) or other induction drugs to speed up their labor, compared to women without epidurals. Finally, it is 8-10 times more likely for a women with an epidural to have her baby extracted with forceps or a vacuum than if she had not had the epidural.
WHAT ARE COMMON BIRTH OUTCOMES AFTER EPIDURALS? Having an epidural can lengthen your labor, which could have no further consequences, and you could have a normal, pain-free vaginal birth. This longer labor, however, also can start a domino effect. It can increase the chances that the doctor, concerned for time, will use pitocin or other drugs to increase your contractions. This can put the fetus in distress, and could lead to c-section. I recommend reading the Today`s Parent article on epidurals (all 5 pages), and doing more research yourself. There are also emotional considerations, such as bonding with the baby, that I would encourage you to explore.
WHAT ARE THE ALTERNATIVES TO EPIDURALS? The biggest alternative to an epidural is to embrace the pain of labor, and to understand that it is part of a natural process that the female body is designed for. Read as many stories and talk to as many women as you can about their births...start to build a picture of birth that you can believe in. Contact a midwife in your area, for a discussion. Some of the best stories are written by women who have experienced more than one type of birth, as their opinions are often well-informed from more than one side.
For me, in doing all my research while pregnant, I developed a trust that my body (and a woman's body in general!) is good, capable, and designed to give birth to a baby. It was a process that I did not want to interfere with, because it was a process I respected as amazing, somewhat mystical, and beyond my control. And in the end...it was beyond my control. I just had to show up, stand by, trust my body, and witness the miracle of a human body birthing another human body, without the interruption of any drugs to kill sensations or hurry things up.
If we add this together, an average of 83.6% of Canadian women in 2011 had an epidural, spinal block or general anesthesia while giving birth!
For me, this means it is very important for EVERY pregnant woman, especially young pregnant women, to learn about what epidurals are, and their consequences on your birth process.
WHAT IS AN EPIDURAL? An epidural is an injection of anesthetic through a small hole that inserts a hollow needle into the space around the spinal cord (see the picture, above). This effectively numbs the lower half of your body, so that you do not feel the pain of contractions in labor. If you want to watch a video of the technical aspects of getting an epidural, a video here can explain it. Unfortunately, while they do reduce pain, epidurals can have other side effects, such as reduce your ability to push your baby out and lengthening your labor, among others.
IS IT NECESSARY? Epidural anesthesia, except in c-sections where you are having surgery, are completely voluntary, though many doctors can make it seem like they are not! With epidural rates of over 90% in some hospitals, many nurses and doctors will think it odd if you don`t want one, and may keep asking you if you want one. While you have the right to have an epidural, you also have the right to say no, and to have your decision respected by your doctors and nurses! It is important to know this is a very `hot topic `and highly contentious issue. Many doctors say that if labor is very painful it can be hard for a woman to relax enough to dilate, and that epidurals can take away the pain allowing the patient to relax. Many midwives would reply that such doctors are just impatient and are not willing to give the pregnant woman the time and atmosphere she needs to relax naturally on her own.
HOW MANY WOMEN HAVE EPIDURALS? Although epidurals were only first successfully used in the early 1900s, and not popular until the 1970s (Silva, 2010), 86.9% of Canadian women now have epidurals, spinals or general anesthesia during birth (CIHI, 2012 and 2012b). This is absolutely phenomenal, considering that up until 90 years ago no women had epidurals during birth...they did not exist. For a good history of epidurals, see Marcus Silva's 2010 article here.
WHAT HAPPENS TO YOUR BODY AFTER AN EPIDURAL? One of the big changes once you have an epidural is that you will need continuous fetal monitoring, meaning that you must stay in your bed. This restriction of movement is very difficult for your body during labor, as the natural impulse for many women is to move around. Walking and standing and sitting can all help to put pressure from the baby`s head on your cervix, progressing you labor naturally, but with an epidural, your body will be very restricted in it`s movement due to fetal monitoring.
Today`s Parent magazine published an article that references a 2002 study published in American Journal of Obstetrics and Gynecology (click here). This study found that the length of the second stage of labor (pushing) is increased by 50% with an epidural. It also found that women with epidurals are twice as likely to need synthetic oxytocin (ie. pitocin) or other induction drugs to speed up their labor, compared to women without epidurals. Finally, it is 8-10 times more likely for a women with an epidural to have her baby extracted with forceps or a vacuum than if she had not had the epidural.
WHAT ARE COMMON BIRTH OUTCOMES AFTER EPIDURALS? Having an epidural can lengthen your labor, which could have no further consequences, and you could have a normal, pain-free vaginal birth. This longer labor, however, also can start a domino effect. It can increase the chances that the doctor, concerned for time, will use pitocin or other drugs to increase your contractions. This can put the fetus in distress, and could lead to c-section. I recommend reading the Today`s Parent article on epidurals (all 5 pages), and doing more research yourself. There are also emotional considerations, such as bonding with the baby, that I would encourage you to explore.
WHAT ARE THE ALTERNATIVES TO EPIDURALS? The biggest alternative to an epidural is to embrace the pain of labor, and to understand that it is part of a natural process that the female body is designed for. Read as many stories and talk to as many women as you can about their births...start to build a picture of birth that you can believe in. Contact a midwife in your area, for a discussion. Some of the best stories are written by women who have experienced more than one type of birth, as their opinions are often well-informed from more than one side.
For me, in doing all my research while pregnant, I developed a trust that my body (and a woman's body in general!) is good, capable, and designed to give birth to a baby. It was a process that I did not want to interfere with, because it was a process I respected as amazing, somewhat mystical, and beyond my control. And in the end...it was beyond my control. I just had to show up, stand by, trust my body, and witness the miracle of a human body birthing another human body, without the interruption of any drugs to kill sensations or hurry things up.