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NPCER: is there a good medical reason to choose an unmedicated childbirth?
I know I could google for this, but I know you guys will know this and try to be less biased.
I heard something about smaller recovery time. Any truth to that?
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Re: NPCER: is there a good medical reason to choose an unmedicated childbirth?
Depends on the types of meds. There actually is a correlation with longer labor time with epidurals. Longer or stalled labor can increase the incidence of c/s, sometimes for good reason, sometimes for bureaucratic.
Or are you talking about medicated like pitocin?
Shorter, easier recovery
Less risk due to not getting an epidurl and more controlled pushing
I ended up having to have an epi after 22 hours of labor because P was posterior and they needed to give me pitocin. I only had one small tear, very few stitches and had a super fast recovery. The only pain I had was my tailbone from the way I was laying while pushing, but that went away by the time I was discharged from the hospital. I literally had zero peri/vag pain where I had stitches.
So while natural births tend to have quicker recoveries, so can medicated births. It all depends on your body.
It depends on the kind of medication / intervention in question and the specific labor / delivery circumstances.
Pitocin makes labor suck and increases your chance for a c-section so that is definitely a medication to avoid.
When they've done studies around epidurals it is tricky. Looking at recovery times for those who choose or don't choose an epidural runs into problems because you can't control for the factors that would lead one to choose it. One of the few that had a good control group was a study of a hospital that had not allowed epidurals and then did. The women previously hadn't been able to select that option. There was no increased rate of c-sections and there were actually slightly shorter labor times. That and some other studies suggest the higher c-section/complication/recovery time rates associated with epidurals are more effect than cause: if you are having the craptastic type of labor and delivery that is likely to go wrong, you are more likely to be in more pain and ask for pain relief.
As someone who had a 40 hour labor that included pitocin (the first 24 no epidural, then a failed epidural), and then a c-section and a craptastic recovery due to nerve damage during those three hours of failed pushing, I can believe it.
Oh yes, sorry. I meant pain meds, since I know pitocin is to speed along labor.
So assuming everything is pretty normal, I'm talking about med free in the epidural etc sense.
I've done both: a 25 hour labor with an epidural, pitocin, and an almost 8 pound baby, and a 3 hour med-free natural birth at home with an 11.5 pound baby. The med-free birth was significantly easier.
My understanding - based largely on information from my midwife and from the book 'Gentle Birth, Gentle Mothering,' an epidural prevents your body from experiencing the natural adrenaline rush it was designed to produce when you give birth. The author of the Gentle Birth book is an Australian doctor who birthed at home multiple times, and while parts of her book veer off into craziness (she had a lotus birth for one of her births), she does go into some really specific and interesting detail about the science behind why a med-free vaginal birth is so much better for the baby and the mother.
After I had my daughter in the hospital, I was exhausted, I could barely move, I felt drugged and dizzy. After I had my son at home, I got out of the bathtub, let the midwives check me for tearing, then hopped in the shower, took a shower, got dressed, and then everyone kept shoving me back into bed because I absolutely felt up to getting up and wandering around the house and playing with my daughter. I felt absolutely amazing. I told my husband that day that I totally understood why people bungee jumped or jumped out of planes, because the adrenaline rush I was on was pretty awesome.
I also recovered much faster from my second birth despite the baby's large size, and I had fewer issues getting him to latch on and breastfeed than I did with my daughter.
Meredith, 6-1-06 and Alex, 11-5-09
Here is a summary from the American Journal of Obstetrics and Gynecology (but unfortunately you need a subscription to access the whole article):
Epidurals are widely used for pain relief in labour. There are various types, but all involve an injection into the lower back. The review of trials showed that epidurals relieve pain better than other types of pain medication, but they can lead to more use of instruments to assist with the birth. There was no difference in caesarean delivery rates, long-term backache, or effects on the baby soon after birth. However, women who used epidurals were more likely to have a longer second stage of labour, need their labour contractions stimulated, experience very low blood pressure, be unable to move for a period of time after the birth, have problems passing urine, and suffer fever. Further research on reducing the adverse outcomes with epidurals would be helpful.
It is not mentioned in the synopsis but there is also a small risk of developing a monstrous headache due to problems with the initial insertion of the needle/tube. And of course, it is an injection so there is a risk for infection.
I wanted to go epi free for the following reasons:
- I heard it could stall labor.
- I heard it could affect the ability to bond or nurse the baby.
- I heard it could lead to a c-section.
- I heard it could affect your ability to push.
- I heard it would immobilize you.
- I heard it could affect recovery time.
I ended up with an epi because, OMG. But none of the above had any relevance to my delivery. The worst scare tactic is this inability to bond or nurse bullsh*t. That's just total hogwash. The moment they set her on me is like none other and I get teary thinking of it. Even though I wanted natural, I still had a great delivery because me and the baby both came out strong and and healthy.
I had an epi with my first, which was a Pit induction. I ended up with a c/s after two hours of pushing for failure to descend/OP baby. My OB at the time told me my pelvis was too small to fit a full term baby.
For my VBAC I wanted to go med-free because I hoped that being able to stay active would help my baby into the best position. Epidurals are associated with OP position. That may be because women with OP babies are more likely to ask for an epi, or because lying in bed promotes fetal malposition. I figured either way, I would avoid it if I could. I also wanted to be able to push in different positions to maximize the size of my pelvis or if one position did not seem to be working, and know I was pushing with all my ability (I was so numb the first time, I doubt I was pushing effectively). So those were my reasons. In the end I had a fast and pretty easy delivery with no epi and I liked feeling like I had more control over my body.
I see people on TB occasionally who cannot get an epi due to spinal issues or other reasons. Also epis overall do not increase c/s rates but getting one before 4 cm or so does increase c/s rates.
Iris Victoria {9.13.08} Augusto Morgan {4.30.11}
I had an epi (wanted to go med-free originally) with #1, unmedicated hospital birth with #2 and a homebirth with #3.
Everyone else covered my reasons for wanting to go med-free. My #1 reason was trying to do anything to avoid a c/s. I feel like the less intervention, the less likely a c/s is.
But honestly, I love the process of giving birth. I'm what you call a birth junkie. Despite the pain, I enjoy doing it naturally. I like being able to get up and walk shortly after the birth. My med-free recoveries were much easier than my epi one.
Good timing for this posts, friends!!
I am supposed to have a 'birth plan' according to the Bump. Well, I don't. BUT I would like to try med-free, so I'm considering hiring a doula to lower the risk of having meds (apparently they are pretty good at talking you out of them here).
THat being said, If the pain is unmanageable, bring on the epi. I'm sure at that point I won't care.
Here's my anecdote. Labor not progressing as quickly as they would have liked, so they started me on pitocin around midnight. Pitocin contrax SUCK ASS, so I got the epi, which required multiple touchings up plus a shot of whatever safe narcotic they give to ease my awful back labor (however, I also was confined to my bed). When the pain meds had worn off for the third time and seriously wondered what else they could do for me, it was thankfully time to push. LilShirley was out in ten minutes.
I admit I didn't feel the rush of bonding initially when they handed her to me (which wasn't right away, since she had meconium), which may have been due to the meds. However, we are bonded just fine now and we had no trouble breastfeeding.
I don't know how I'll proceed next time around.
No epi with either and babycopz was totally med free and breech.
Copzson was basically med free except for some demerol because it allowed me to sleep between contractions since I had been in labor forever.
I didn't see any difference between the two methods. Bonding wasn't an issue and neither was breastfeeding and I am a pretty fast healer so that never really bothered me either.
Please don't throw tomatoes at me...
If you want to go med-free at the hospital, get a doula. They are worth their weight in gold.
Agree. And also try to stay home as long as possible. This really to me was key to having a med-free hospital birth. My MWs encouraged it. Once you get to the hospital you are on their schedule and if you're not progressing they will push things that will make you go faster. Our doula labored with us at home until I said it was time to go to the hospital. I arrived at the hospital 9.5 centimeters so the epi ship had already passed.
Everyone listed my reasons already. To me it just boiled down to the fear of interventions leading to more interventions. Once I fully dilated my contractions weakened signficantly and I ended up pushing for 3+ hours. My MW told me that if I had had an epidural I would have had a c-section, so for me that justified my choice.
Off to the beach
DS 7/18/2010
Handy 2.0 Due Early August
2011/2012 Races
12/17/2011 Christmas Caper 10K
2/11/2012 Have a Heart 5K
3/17/2012 DC RNR Half Marathon
4/22/2012 10M Parkway Classic
10/28/2012 Marine Corps Marathon
This. I did hypnobabies and "trained" for 2 months. I didn't last without something to "take the edge off" but 10 minutes after they told me I was still only 1 cm (and I labored at home for a full 24 hours before we went to the hospital). Then when they talked to me about pitocin (and I knew it would make the pain worse), I refused it until I could get the epi. Everyone is different. I've always considered myself to have a high pain tolerance but OMG. I will say that there are issues with laboring med-free as well, pain has an impact on the body and that can also impact the baby (fetal decels for example). If you're in for a long labor, you can become exhausted faster and that also makes it difficult to push - that sometimes leads to a c-section.
When I went in (midnight Monday morning), they told me they didn't expect me to deliver until Wednesday. I had the epi and the pitocin and delivered that day at 3:45 pm. I had the epi at 4:00 am and it had worn off enough by the time I was ready to push that I wasn't in terrible pain, but I could feel my legs and I only pushed for about 17 minutes. I had no issues bonding with my son, there was no delay with my milk coming in. My best advice is if you want to go med-free and have planned for it - give it your best try but know that there is no shame in taking the epi. I give a lot of credit to women who can go med-free, but I don't think it's necessary to suffer either.
I'm pro whatever results in a healthy mom and healthy baby, I'm pro-vax, etc. I say that b/c I don't want to give the impression that I'm anti-medicine or anti-intervention.
Every intervention has possible side effects. You have to determine whether the potential side effects are worth the benefits of the intervention. For many women, the answer to that question when it comes to an epidural is HELL YES. For some, it's no.
When I had my colonoscopy, I was sedated the minimum amount that would let them maneuver the scope through my colon, I was awake totally for my wisdom teeth extraction, and I was totally awake for breast surgery (just had a local). It's a personal preference, I wasn't nervous about those things and the benefit of being zonked out on drugs for the procedures didn't outweigh the recovery period and likely nausea that would follow. For all of them, I was able to just basically sit up and go home and that was more important to me than being heavily sedated for the procedures. I know others feel differently, and that's their choice.
I'm not sure what I'd do if I ever labored, probably try to go without the epi but I'd take it if I needed it.
I think everyone has the "reasons" covered. Just wanted to add my story in case it makes a difference for you.
I wanted a natural birth. I labored for 17 hours unmedicated with my 1st, only to end up having a very necessary c-section. Because I was so tired and hadn't eaten in 24 hours, the epidural for the c-section had a BAD effect on me. I was shaking uncontrollably and felt like I was going to puke at any moment. I was dizzy and felt so out of sorts. The shaking made it hard for me to hold the baby after he came, which bummed me out. I wanted a natural birth but I certainly wouldn't have waited so long had I known what the effects were going to be. My doctor was very supportive of a natural birth. She even left for the day and came back to deliver my baby, but did sarcastically throw in that she knew about 5 hours earlier that I was going to have a c-section (my ob is very dry and sarcastic, which i love about her, so this was not a bad thing. the baby wasn't descending and even with meds, I was not dilating past 6). I appreciate the fact that she let me get to a point where I knew I did all I could and that neither of us jumped in to a c-section... but
When I was attempting a VBAC and labor was not progressing, I only waited 4 hours until I opted for the c-section. The epidural had a completely different effect. I was relaxed and pain free.
Anyway, I guess my point is we get really caught up on the idea of wanting something but one thing is for sure- babies don't always have the same plans we do. I now often say "my sons preferred extraction to birth" but they're both here and both perfect and I look back with no regrets except that I wish I hadn't been so hell bent on a natural experience the 1st time. I should have called it when I was not dilating after 10 hours in labor which, trust me, is long enough. If I had been moving forward, even slowly, it may have been different...
And that was a novel. Sorry!
And scene...
DD #1 passed away in January 2011 at 14 days old due to congenital heart disease
DD#2 lost in January 2012 at 23 weeks due to anhydramnios caused by a placental abruption
LG-Make sure you are set on going naturally if that is what you really want...if you leave yourself open to the possibility of an epidural, you're going to be more likely to go for it when the time comes and you're in a crapload of pain.
I think this is what happened for me at least.
There are so many factors in different births so, anecdotes are probably not that helpful, but here are mine!
The first one, I had a birth plan and was determined to go completely naturally. I ended up w/ fetal monitoring, an oxygen mask, and eventually getting prepped for an emergency c/s, which included an epidural and i think a little spinal block? I had been pushing for 2.5 hours. They also used forceps and I had an episiotomy. It took me weeks to recover and I had burst blood vessels all over my face for a few days. I was a mess.
This second time, DS came 6 weeks early and I hadn't gotten around to making a birth plan, so my resolve hadn't been set. I do feel like this time around was more painful. DH agreed that I looked like I was in more pain this time. I labored for a while w/ no meds until I couldnt' take it anymore and said eff it, give me the epidural NOW! haha It turned out to be the most wonderful birth experience. I was present and calm and was able to really enjoy the experience. I thought to ask for a mirror so i got to watch as he came out. The doctor suggested I was better able to push b/c I was much calmer. I had minimal tearing.I pushed twice, maybe 3 times, and he was out. Granted, he was a little smaller this time (5lbs 10 oz vs. 7lbs 6 oz) .The problems that I had were really bad/annoying shivering (forget the term-riders?) from the epi. I also had an inexplicable fever (maybe from the epi?) that meant i couldn't see DS on the NICU for 24 hours after my fever went down, which sucked. I felt great though, and required very quickly.
ETA: recovered, not required
I'm an example of the epidural speeding up labor. I had been laboring for 2 days (contractions 3-4 mins apart) and the hospital wouldn't admit me because I wasn't dilated (I wasn't dilating because I was exhausted). Finally my water broke, so I went back in and begged the nurse for any type of pain relief, since I had been in labor for 3 days by then with no sleep. I went from 1-9 in less than 2 hours because of the epidural. After that had nothing to do with the epidural. I ended up getting a c/s since I couldn't dilate past a 9, the baby was posterior, fever, and the list goes on. My recovery was very long because of the exhaustion of being in labor for so long.
My repeat c/s was a breeze. It was amazing being aware, and knowing what was going on. I was walking around the next day, and didn't have the exhaustion I experienced with my first.
Gas and air is the best option - out of your system in minutes, and no restriction of movement.
Narcotics only work about 50% of the time, and they get 100% passed on to the baby.
Epidurals restrict you movement, so if the baby's in a bad position you won't work them into a good one. It is hard to push effectively with an epidural. Having an epidural means you often get pitocin as well. Pitocin has it's own problems. You'll also get a lot of fluids by IV, which swell you and the baby up, meaning you get more engorged (engorgement is fluid in the spaces between milk ducts), your nipples are flatter and it's harder for the baby to latch (your breasts are as firm as a basketball). The baby's birthweight will be inflated and it will look like they've lost more weight than they have.
24 hours after my mega-drugged birth I felt like I'd been beaten up, swollen like a balloon, exhausted, felt bruised etc. 1 hour after my non-drugged birth I was feeling like I'd never been pregnant.
Reduces the chance of csection and tearing. That is why I originally wanted to give it a shot.
After experiencing the beginning of transition, there is no way in hell, lol. Its not worth it. (for me)
I liked the way my Bradley instructor put it.
Having a med-free/intervention-free birth carries the lowest possible risk. Each time you add a medication or intervention you get the risks associated with each of those, so your risk in general increases.
I had a med-free and generally pain free birth. I don't have a medicated birth to compare it to but other than pain from my tear I felt fine after (meaning I didn't have any muscle soreness, heck I wasn't even tired) and was home 4 hours after.
You never know, next time might not be as bad, or might be quicker.
A girl on my anniversary board had a spinal headache from her epidural. She had to go get the hole in her spinal column fixed a few days later, after having pretty much a constant migraine for the first few days of her child's life. *shudder*
40/112
I've had both; epi and med-free. Both good experiences. Both times up and walking within a very short period of time. Tearing both times. Nursed immediately after both times.
I felt better after my med-free birth but it was also my second time around, so the whole experience was easier to deal with.
I'd do med-free again. But I have no beef with my epi.
as soon as I got the epidural, my labor stalled. I needed oxygen a few times. it wasn't a huge deal, but you can see that the cascade of medical interventions can happen. also the numbness extended a touch upwards (my chest and lips). I was able to bond and BF just fine.
I would be willing to try it without meds next time