the top 10 reasons to get an epidural July 27, 2007
Posted by guinever in : birth, birth story, epidural, health, labor, pregnancy , 4comments
I like to show this list to pregnant women so they have a chance to consider the side effects of an epidural before they’re actually in labor and wanting one. When a woman is in labor and overwhelmed with pain, she is not going to care about this list, not going to read it, she’ll just scribble her name on the dotted line and yell,
I don’t care! Just stick the needle in my back.
BUT if she reads this while still pregnant, long before labor begins, she’ll have time to consider the side effects and say,
You know what, I don’t want an epidural. I don’t have to get the epidural.
These reasons are taken from the release form that a woman must sign before getting an epidural (I got this form from a local hospital.) It is titled, “Authorization for the administration of epidural/spinal analgesia for pain relief in labor and delivery.”
- The epidural/spinal may not work and give partial relief (1 in 10).
- Dural puncture headache (1 in 40)
- Backache and/or leg pain (1 in 50)
- Significant decreases in blood pressure (1 in 50)
- Total spinal anesthesia ( 1 in 500)
- Toxic reaction (1 in 500) This may include a seizure, cardiac or respiratory arrest, or rarely, the possibility of death.
- Massive epidural/ spinal anesthesia (1 in 1000)
- Transient paralysis or nerve damage (1 in 1000)
- Permanent paralysis or nerve damage (1 in 5000). Other rare complications include infection, loss of epidural catheter in the epidural space, fetal distress, bleeding, or infection at the skin, subcutaneous tissue epidural or subarachnoid spaces, and possible death.
- I also realized that during the course of my labor, my labor may either speed up, stop, or slow down, which may make it necessary to have forceps or Cesarean delivery. As this may occur during the course of any labor patient, either with or without epidural/spinal analgesia, it is difficult to determine whether or not epidural/spinal analgesia has a bearing on these outcomes. But in any once patient, this may occur as a result of epidural/spinal analgesia.
You may be asking, but how can I get through labor? How can I handle the pain? The answer is preparation. Read all you can. Consider this list of books. Take an independent childbirth class (not associated with a hospital or doctor’s office). Read the birth stories below so you can be inspired and gain the confidence to birth your baby.
- diary of a primipara
- my second labor–a lot quicker than my first
- the labor that kept on stopping–my third birth
- born in our living room-the story of my fourth birth
- 12 days overdue, but who’s counting? the diary and birth story of my fifth baby.
For an in-depth look at the effect of epidurals, read this medical paper.
what is a birth doula and should I have one? July 12, 2007
Posted by guinever in : birth, doula, labor, midwifery, pregnancy , 1 comment so faryour questions answered about the purpose and value of labor support
What is a doula?
A doula is a trained birth professional who is knowledgeable about the progression of labor, pain management and coping techniques, and breastfeeding. She is familiar with your local hospital or birth center routines, medical terminology and procedures. She offers continuous support during labor and the immediate postpartum period.
What kind of support does the doula offer?
She offers physical, emotional and informational support. She will do her best to meet your needs during labor. Physical support during labor can include shoulder and foot rubs to help you relax, and counter pressure to help ease the pain of back labor. She can suggest position changes that will help your labor progress or ease your pain. She can go find more pillows or blankets, get you a cool wash cloth, re-fill your water cup or get your husband a cup of coffee.
Labor can be emotionally challenging especially if you are having your first baby. She can talk you through those really hard contractions. Labor can be especially difficult if you have a long labor or an unusually quick labor. Having an experienced woman there who you trust has a calming effect on both you and your husband. When you think you can’t possibly labor anymore and you want to give up, she’ll be beside you, the voice of experience, reminding you that you are doing it and that you’ll meet your baby soon.
Although not a medical practitioner, she is knowledgeable with medical terminology and procedures and can answer your questions or clarify something for you. When you’re in labor, you may be afraid of the unknown. A doula is there to reassure you that everything is alright. And if something isn’t progressing as it should, she’ll help to explain your options. If you have family members in the waiting room, your doula can give them periodic updates especially if you don’t want them in the labor and delivery room with you.
What are the benefits to hiring a doula?
The benefit is hiring someone who will always be with you. Nurses are busy and have many patients to help. Your midwife or doctor checks in with you only occasionally. Research indicates that when a doula is present, labors are shorter, less pain medication is requested, fewer births require forceps, vacuum extraction or cesarean. Additionally, more women breastfeed, and women are more satisfied with their birth.
What about my husband? He thinks he might want us to be alone during labor and birth. Will the doula take his place?
One of the best thing about having a doula at your birth is that she can help your husband help you if that’s what he wants to do. When hard labor kicks in and you start moaning, she can give him the thumbs up, letting him know that everything is ok. She can show him just the right place to do counter pressure on your back. A good doula stays in the background and jumps in when needed.
Understanding how labor progresses and knowing the physical changes that will take place, she anticipates your needs and is able to meet them. You don’t know how long your labor will be. Your husband may need to step out for a few minutes. With a doula there, you’ll never be alone, and if your husband never wants to leave your side, your doula can go get him coffee or dinner if necessary. It’s important that your husband meet your doula during one of your pre-natal meetings so the three of you can clarify what both their roles will be during birth.
What are the responsibilities of a doula?
A doula will be on call for you around your due date and come to your house or meet you at the hospital when you need her. She is available for phone support in those last days of pregnancy and in early labor. She stays with you during labor, birth and a few hours postpartum. She’ll come back and visit you in the first couple of days to answer any questions you might have about the birth. You’ll meet with her one last time after a few weeks postpartum.
What are some of the things a doula will not do?
A doula does not perform any clinical tasks including taking your temperature or blood pressure, monitoring your baby’s heart tones, or doing cervical checks. She also will not give you any medical advice or make decisions for you. A good doula will accept the kind of birth that you want and not try to force her own birth philosophy on you.
I’m planning on having an epidural. Could I still benefit from having a doula?
Absolutely. Even if you can’t feel the physical intensity of your labor that can often be overwhelming, you’ll still experience the intense emotional changes. Your doula can help put your mind at ease and of course she’ll be there after the birth to make sure breastfeeding gets off to a good start.
It turns out that I’m going to have a cesarean because my baby is breech (or some other reason.) Can a doula still help me?
A doula can be very helpful during surgery to help you stay calm. If your husband wants to go with the baby to the nursery after the birth, she can stay with you so you’re not alone during recovery. When you and baby are reunited, she can help you position the baby for breastfeeding. You won’t be very mobile so she can grab pillows for you and make sure you and baby are fully supported so you can nurse more easily.
Can a doula help me if I’m having a homebirth?
Of course! Most doulas love having the opportunity to attend homebirths. In addition to all the duties already discussed, your doula might cook breakfast or tend to your other children if needed (although if other children are there, you should have someone at your birth whose specific job is childcare). Just remember, a doula does not take the place of a medical care giver so you will need a midwife and, if applicable, her assistant there as well.
How can I find a doula?
You can find a doula through DONA International or by calling 1-888-788-3662. If you can’t find one in your area, ask around. Your friends, childbirth educator, doctor or midwife might also be able to recommend a doula.
It’s a good idea to talk to more than one potential doula so you can see the differences in philosophy and personality to find the best choice for your birth team. Your doula should meet with you a couple times during your pregnancy to discuss your expectations for birth and her role in it. These getting to know you sessions are crucial for her to be able to offer you the kind of labor support that you need.
Do you have another question that isn’t addressed here?
I am a birth doula in Lexington, KY.
