Why not have an epidural?



Epidural - yikes!


What I love about my friends is that they're not crunchy granola types who easily embrace things like "perineal massage" or "eating your placenta" or "natural birth." Which means I get a lot of practice justifying my own perspectives on epidurals, hospital births, and cesarean sections while trying not to come across like a condescending know-it-all. And the truth is, sometimes I totally lose the argument.

Take for instance a recent exchange with a good friend who had a c-section with her first birth and made it clear that under no circumstances would she ever attempt a drug-free labor. Her point: If labor is painful (yes) and there are strategies available to eliminate the pain (yes) and those strategies are not excessively harmful to mother or baby (yes), why on earth wouldn't I take advantage of it?

In other words, why not have an epidural?

Natural birthers cringe at such a proposition, but it's a legitimate question. These days, we just don't tolerate discomfort anymore.  When I have a headache, I take Excedrin. If my muscles are sore, I pop Advil. I wouldn't dream of having a cavity filled without novocaine. Modern medicine has given us women amazing ways to reduce pain, and we've readily taken advantage of them. Why suffer? (Unfortunately, this same logic doesn't apply to high heels - why do I still wear them? Why?!)

My instinctual response was to tell my friend that epidurals have awful side effects - that's why you shouldn't have one. But the reality is, if you look at the medical literature, epidurals aren't that bad. There's a chance you'll get a monster headache from leaking spinal fluid, but that only occurs in about 1% of women. There's a very good chance the epidural will slow your labor, especially the pushing stage - lots of studies showing this trend (read here and here) - and that a prolonged labor could lead to other interventions, like vacuum extraction, Pitocin, and forceps, which can result in poor outcomes.  But a major review of medical literature in 2011 found no difference in overall c-section rates or baby's health with or without epidural. It may cause some problems, but overall, you won't be unduly harmed. So if it makes you feel better, why not go for it?

(On a side note, I find it funny that women who won’t eat brie cheese, ingest a sip of wine, or take Advil during pregnancy are often the first ones to have analgesics shoved into their spinal column as soon as the first contraction hits.)

I couldn’t win the argument with my friend, because in the end, my reasons for going natural didn’t have anything to do with side effects, statistics, or medical studies.

We women who choose natural birth do so because we have infinite faith in our bodies to birth. Because we recognize that it’s about more than us.  Because we want to give our babies the best start in life, and we don’t need a long list of scientifically verified side effects to know that sticking a catheter in your spine absent medical necessity is probably not the best start. 

Yes, I take pain killers when I have a headache. But when it comes to birth, I’m willing to tough it out and have trust that my body and baby are working in awesome harmony. I may have to sacrifice a little bit of personal comfort to get that benefit, but that’s okay. Isn't that what motherhood is all about?