I heard secondhand that there was recently a big argument online
about epidurals. My understanding is that women who were pro-epidural
were piling on women who expressed misgivings about them. I didn't read
it, but it got me to thinking about epidurals.
I have
never had an epidural, but because of my labor history, I have never
felt like I should take a side in the argument. Due to the nature of
precipitous labor, epidurals are not really a reasonable option. I
suppose I could have had one the two times I was induced, but it seems
silly to stick a needle in my back to avoid an hour's worth of pain. I
did have a dose of the narcotic Stadol when Grace was born.
I despised it. It only made me incoherent and unable to cope with the
pain. And that's my entire experience of pain relief during labor.
I watch these arguments unfold feeling like I do not have a right to
voice an opinion. I feel like my experience is so outside the norm that
my opinion would only cause eyerolling or resentment because, really,
one hour labors aren't that bad. It is an unexpected tidal wave that
crashes on you all at once, but then it's done.
I am
inclined to say that I would never have an epidural. I don't generally
take medicine when sick anyway. I suffer through head colds and fever
and headaches and rarely take anything for it. This is just my nature to
think it isn't so bad, that it is almost over, that if I go to sleep it
will be better when I wake up. It isn't any long-developed character
trait in which to take pride. As I type this I remember that as I get
older, I have taken more ibuprofen for fever than I used to because I
ache when feverish now whereas I never did before. Knowing this
stubbornness about myself and apparent high tolerance for pain, I want
to say that if my labors were of average lengths, I still would not get
an epidural. The truth is that I have no idea what I would do if labor
lasted for eight hours.
I have mulled on it for awhile
and I have figured out why the topic of epidurals irritates me. The
reason I get annoyed with the blase approach to epidurals is two-fold.
First, they are not risk-free endeavors, but they are often presented as
the no-brainer response to labor. 'Why would you want to feel pain when
you could avoid it?' is the argument. But epidurals have drawbacks as
well as benefits. There are complications, side effects, and unintended
consequences from an epidural. Sometimes the benefit far outweighs the
risk (hello, c-section) and sometimes the risk isn't worth the benefit
(a one hour labor). I am not going to list all the possible reasons one
might want or need an epidural, but they exist, there are many, and it
is a blessing to have this kind of pain relief available. But to decline
an epidural does not mean that one is a glutton for pain. It could mean
only that for any particular woman, the benefit is not worth the risk.
The
second and major reason I get irritated with overwrought discussions
about epidurals is that American hospitals are run with epidurals being
the default treatment for labor. The standard hospital procedures for
childbirth in America require that women give birth in the most painful
positions possible. Women are immobilized and strapped to machines for
"safety." Safety from liability, mostly. They are poked and prodded and
subjected to painful exams which serve little purpose except to satisfy
the curiosity of the doctors and nurses. Women are routinely starved for
hours at a time on the very slight chance they will need general
anesthesia. They have their bag of waters habitually ruptured
artificially to "speed things up" which dials up the pain level
exponentially. Who is in such a rush besides the medical team? I suspect
most people would prefer a longer, less painful labor for themselves if
it was explained that the presence of an intact bag is a significant
cushion to the pain. Women are put into bed on their backs where they
have to fight against all the laws of gravity in order to deliver, but
the doctor has a convenient chair and easy view. They are habitually cut
to mitigate the problems borne of the ridiculous, yet expected birth
position, and have to deal with the consequent stitches for weeks.
Every
coping technique and mechanism is routinely stripped away from women at
their most vulnerable time and then the hospital asks, "Do you want an
epidural?" Only the most stubborn decline. Childbirth should not require
such stubbornness in order to have access to more humane birthing
practices. We accept all the fallout and complications from epidurals as
a normal consequence of childbirth, but it really isn't. We have a
culture that fears birth in large part due to the conditions we are
subject to while giving birth, but we don't recognize that the
conditions can be changed.
I have had
conversations, in the past, with women from Europe who thought the
childbirth scenes in American movies were a joke. Nobody could possibly
think the practices depicted were a good idea. Surely, it didn't happen
that way in real life. They were gobsmacked when I explained that, while
the movies were dramatized and somewhat absurd, the shell of the
procedures were the same: the positions, the counting, the confinement
in bed.
So while a skirmish in the Mommy Wars consists
of one group of women declaring their superiority in their all natural
childbirths, another group of women accusing the first group of being
masochists and perhaps insane, and the rest of us trying to find our
ways through the happy middle of those ideas, the medical community
skates along mostly unnoticed in their culpability for creating
conditions where such drastic pain relief is almost always required.
Childbirth
is painful. There are not many ways around that basic fact. If hospital
procedures were more humane, childbirth would still hurt. There still
would be a need for epidurals and pain relief in many cases. The use of
pain relief is not a failure on the part of the woman. But what could
change is the cultural expectation, borne of fear from real experiences,
that childbirth is so excruciating that the only reasonable response is
to be numb from the waist down.
2 comments:
I actually had an epidural for the first time ever with my fourth L&D back in February. I have a few friends who have had epidurals and absolutely loved them. I was not impressed by mine. It really didn't work that well, and for all the trouble it causes (staying in bed, being catheterized, slowing things down), I would say it was not worth it. I opted for it only because my labor was an all-nighter, and I'd been given pitocin to try to get my contractions to become stronger and more regular. Being exhausted in the middle of the night left me more afraid of the pain than I've ever been before. Having decent nursing care that helps keep you moving and managing pain is really important, and nearly impossible to find in a hospital setting. It shouldn't be that way.
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