Thursday, April 29, 2010

Because a couple of people asked and I didn't have an answer, and in case anyone else was wondering, and also in case I forget like I usually do,

What I want/need for my birthday:

a jump drive, preferably a big (storage-space-wise) one.
Glee soundtrack(s)
Rainbows (the flip flops. Leather, I think. Or hemp? I don't know. I've never owned any. I wear size 9 or so.)
castor oil
sunflower seed oil (same link)
a "tree kit" for hanging a camping hammock

That's all I can think of at the moment.

In other news, this is probably not stuff any of you guys particularly want to read about, but whatever. Don't if you don't want to. I am just so glad I found this website before (probably someday) having kids, because I have always been the "omg that will hurt do anything to kill the pain please" type person w/regards to having a kid.

To understand why there is now an epidemic of epidural block for normal labour pain, it is necessary to understand what happens to the woman before she is offered the epidural. The care she receives when she comes to the hospital to give birth markedly increases the pain she will have. Scientific evidence shows labour pain is significantly increased: by laboring in an unfamiliar place; by being surrounded with unfamiliar people; by having unfamiliar procedures done; by being left unattended during labour; by being put in a horizontal position and not allowed to freely walk about; by having the membranes artificially ruptured; by having induction or augmentation with drugs. So the woman comes into the hospital in labour, has a number of things done which all increase her pain, is then offered an epidural and is so grateful to the staff for the relief of the pain, much of which the staff created.


Why does epidural block lead to operative birth? Two reasons. First, with the woman already having lost all feeling from the waist down because of the epidural, the temptation is great for the doctor to go right ahead and carry out surgical procedures. The second reason is fundamental to the basic understanding of the birth process. The pain of labour is an essential component of normal labour as it stimulates the brain to release hormones which, in turn, stimulate the uterus to contract at normal levels of intensity and at normal intervals so that placental blood flow will be maintained and there will be no fetal hypoxia. This is a delicate feedback process. With an epidural block there is an interruption of this process leading to a slowing or cessation of normal labour. Attempts can be made to overcome this with more and more stimulation of the uterus with more and more doses of drugs such as oxytocin---a rather typical scenario found in high tech birth where one intervention requires another intervention to try to overcome the complications of the first intervention. Nevertheless the scientific evidence is clear---- even with such efforts to overcome the slowing of labour caused by epidural block, there is still a four times greater chance forceps or vacuum extraction will be necessary after epidural block and at least a two times greater chance caesarian section will be required. This is no surprise---this is the inevitable result of using an intervention, epidural, which essentially stops the birth process in its tracks. The only way an epidemic of epidural block for normal birth has been able to happen is because the procedure has been given a very 'hard sell' to women by doctors. The only way that so many women agree to an epidural for normal labour is if they are told it is 'safe'.


First, a procedure can hardly be called 'safe' when close to a quarter (23%) of women receiving epidural block have complications. The risks to the woman are many and serious, starting with the possibility the woman will die because of the epidural. The maternal death rate for women having epidural block for normal labour pain is three times higher than for women with normal labour not having the block. For every 500 epidurals performed there will be one case of temporary paralysis of the woman and the paralysis will be permanent in one of every half million epidurals. The woman has a fifteen to twenty percent chance of fever after receiving an epidural, necessitating a diagnostic evaluation for possible infection in the woman and baby which can sometimes be invasive such as requiring a spinal tap of the baby. Between fifteen and thirty five percent of women given an epidural will suffer from urinary retention after the birth.

How effective is epidural block in relieving pain? In around 10% of epidural blocks it doesn't work and there is no pain relief. Even when it works, around a third of women given an epidural will trade a few hours of pain-free labour for days or weeks of pain after the birth. Thirty to forty percent of women receiving an epidural during labour will have severe backs pain after the birth and 20% will still have back pain a year later.

A great deal of scientific research has shown that women receiving epidural block for normal labour pain will have a significantly longer second stage of labour. This, in turn, results in a four times greater risk of using forceps or vacuum extraction and at least a two times greater risk of caesarian section and these operative interventions during birth carry their own serious risks as well. While many women might be willing to take risks with their own bodies to gain pain relief, it is highly unlikely they are willing to put their babies at risk. One common complication in the woman after an epidural is started is sudden loss of blood pressure leading to a sharp drop in blood flow through the placenta to the fetus, resulting in mild to severe lack of oxygen to the fetus as shown on a fetal heart rate monitor. In another typical high-tech strategy of using a second intervention to try to stop the bad effects of the first intervention, doctors give the woman a great big dose of fluid through an IV to try to prevent the drop in blood pressure from the epidural but this does not always work. So lack of oxygen to the baby during the epidural remains a possibility and the American College of Obstetricians and Gynecologists reports that the electronic fetal heart monitor shows severe fetal hypoxia in eight to twelve percent of infants whose mother's are given an epidural block for normal labour pain.

There are other risks to the infant including some data suggesting poor neurological function at one month of age in some babies whose mothers had epidural block. More recent innovations in epidural block, such as changing the type of drugs used or the drug doses used or the 'walking epidural', do not eliminate these risks to the woman and her baby.

One reason for the epidemic of epidural in many countries is that women are not told the scientific facts about all of the risks to them and their babies when epidural block is used for normal labour pain. Indeed, at one meeting of obstetric anesthesiologists in the US, discussions were held on how to prevent any information on risks of epidural from reaching the public. The excuse used was the typical patronizing approach of some doctors: "We don't want to scare the ladies." It is absolutely essential that any women offered epidural must be told all the scientific facts about the risks before she gives informed consent to the procedure.

With all these risks of epidural block to woman and baby, why are doctors urging women to use it? Research shows that doctors prefer the woman to have an epidural because then she is quiet and compliant. Furthermore, it is the frequent use of epidural for normal labour which has created a new specialty, obstetric anesthesiology, which is highly lucrative and flourishing---witness that obstetric anesthesiology journals contain advertisements urging doctors to purchase private jet airplanes.

(More of the article and more articles related to parenting at


  1. I totally agree with the info in epidurals. It's pretty insane/ridiculous when you look at how people are made to give birth and what happens in the hospital. Blech.

    Would you be disappointed if you got stuff from the list rather than something cool and original? I know you have a list because it's stuff you *want* but at the same time I'll feel kind of lame. As long as you like it though, I don't really care if I feel lame or not, though, haha.

  2. Cool and original is okay too, esp since we often have similar tastes. I don't extend the "cool and original" seal of approval to everyone...

  3. >:D I can name a few people off the top of my head who definitely don't receive that seal.

  4. I found the article pieces to be quite interesting... though, I'm not really sure why I actually read it. Hopefully, this is something I will never have to experience personally (something about being the wrong sex?).

    The two comments I had though, were that the piece about it being easier for doctors sounded right (my mom has stories about having to fight to not have each of my younger sibs through c-section, simply because I had been, and it was easier for them to schedule it for the next ones), but more importantly that the way the article used 'scientific evidence' and 'scientifically' weren't very comforting - it read like they were using those words to add power to the arguments, which sometimes means the arguments themselves aren't convincing.

    I'm certainly not saying I disagree (as I said, it sounded about right, and I know nothing about this topic) but I do think that before this really mattered for anyone who read it, it'd probably be worth finding the sources for those pieces of evidence (just as with any other argument that matters and is pulling in 'scientific evidence' as their support). :-)

  5. Hey, yeah I agree about looking up sources--there are a lot listed at the end of the article, but I haven't read the whole thing so I haven't really looked at them. Also though, this is excerpted from a book, and the point of the book is (or seems to be) to point out the scientific basis (/bases), or lack thereof, for the way things are done and the way things maybe ought to be done.