Friday, March 2, 2012

The Dreaded Epidural

When the topic of childbirth comes up in conversation, it seems everyone has an agenda. There are those who are absolutely dedicated to pain relief and ease for the mother, no matter the impact on the baby (which they see as negligible) or the length of time it will take the mother to recover. On the other side are the people who are virulently opposed to any kind of medical intervention. In the minds of those from the second camp, no matter how miserable the mother is during labor, they believe the mothers must be urged to give birth "naturally," as they call it. They speak of the impact of drugs on the health/recovery time of the baby and mother, but there is also a very strong theme running under their arguments, that an unmedicated birth is a badge of courage, a sign of the mother's strength or fortitude. I find this harsh, inflexible, unforgiving attitude cruel and ironically macho. Childbirth should be anything but macho, hey?

Yesterday I attended a birth. One of the nurses who is studying for her nurse/midwife degree said, "Women beg us all the time for epidurals, but of course we do everything we can to talk them out of it."

Really? A woman in labor is in such excruciating pain that she's BEGGING for help, yet the people there to allegedly smooth the process feel proud to say they always try to deny relief? It's kind of sadistic, if you ask me. I liked this nurse very much, but when she said that, there was definitely a smirk on her face. It's so weird!

Women who wish to work with midwives ordinarily hope or plan to give birth without medication. Once they're into it, though, if things turn out differently than they imagined, is it so awful to change direction, to opt for some assistance? I don't understand why. I wonder if the nurse with the anti-epidural attitude takes an aspirin when she has a headache. I bet she does! She insisted that the mother take ibuprofen for 24 hours after the birth because "it really helps." She also offered Percocet. It's OK to seek relief after birth, but not in the midst of it? Someone please explain this to me.

What was my agenda in my role as doula? My attention was solely focused on what the mother wanted or needed. I've attended births during which I had to advocate against medical intervention. Yesterday I had to advocate for the dreaded epidural. I say "dreaded" because midwives speak of this intervention as if it were the devil himself. In the case of the woman who gave birth yesterday, after more than 24 hours of hard labor, the epidural provided exactly what she needed. She was able to rest for awhile because of the epidural, after which she pushed her baby out. She worked hard, felt it, but wasn't out of her mind as most unmedicated women are at that moment. Is that awful? I thought it was great, and I welcomed her baby girl into this world with tears in my eyes.

Epidurals are not what they once were. Women who receive them can move their legs and definitely feel the contractions, the pushing, and the delivery of their babies. They feel pressure and sensation, but not pain. Is that a bad thing? Once upon a time they deadened the entire bottom half of the body, but not so any longer.

If the laboring mother is doing OK without the medication, then great - I'm all for it. But if they're ground down by pain and exhaustion, why oh why is it so bad to ask for some help?

As of yesterday I am officially retired from my role as doula. I have had many wonderful, amazing and miraculous experiences attending births. I wouldn't trade them for anything, but I've now completed that aspect of my professional life.

L'chaim! And shalom.


jeanette from everton terrace said...

My first thought was I wonder if that nurse has had ever given birth?

Reya Mellicker said...

The midwife proudly announced that her first labor lasted 36 hours. Talk about macho. At one point she said, "buck up" to the laboring mother. For heaven's sake!

Jo said...

Oh, how I wish we could provide a community where our daughters were raised watching women give birth, learning what happens, and helping to tend to them. I wish we could go back to the time when childbirth was family process supported by professionals, not a medical procedure with rigid protocols.

But I'm a hopeless romantic. We can't even manage to agree on reproductive health coverage for women.

Respect for the laboring mother's wishes and responding appropriately to her decisions, are the very least that we should expect from those attending the birth. So glad you were there for her.

Reya Mellicker said...

Thank you, Jo. You are SO right that girls would reallly get it if they could attend births. As you know I believe almost every part of our lives is overpathologized and I'm struck still by your comment that no mammal is ever moved during the process of labor and birth. When they are moved, they often abandon their litters. Yet we think it's a great idea to wait until we're in active, heavy duty labor, then drive across town to a hospital?? What the fuck is that all about, pardon my french!