I was drawn to the title, “Epidural Without Guilt.” Hey, who’s not for “without guilt?” You can pretty much slap those two words after anything and get an audience. (Formula Feeding Without Guilt, Natural Birth Without Guilt, Neglectful Parenting Without Guilt! It all sounds good “without guilt.”)
And when it comes with epidurals there can be real guilt. But using an epidural in labor is neither good nor bad, the sign of success or failure. Weighing the risks and benefits of an epidural, requires that you look at the situation in which it’s being used. (Last week I wrote about how much Helena Bonham Carter loved her epidurals in an effort to bring some epidural pride to the continuing online birthing conversation which can tend towards guilt-inducing polarizing debates: natural vs medical, etc.)
So I clicked over to Epiduralwithoutguilt.com— a web platform for a book with the same title– with an open mind.
But what I found was hardly an agenda-free, reassuring message. The author, Gilbert J Grant, M.D.–an obstetric anesthesiologist in New York City–makes many irresponsible claims about epidurals but perhaps his most outlandish suggestion for new moms is this:
“Find out if the hospital where you will be having your babygives you the option of receiving epidural medications after you deliver.”
I’ve joked that I want an epidural now– as the mother of unruly, school-aged children–more than I did during labor. But this guy is serious. He says it’ll help with after-pains and breastfeeding.
But postpartum pain– whether from a hard labor, an episiotomy or a c-section- is not a quick blast. The healing process takes days, not hours. Women who’ve had c-sections are given medication to help with pain and breastfeeding: pain can inhibit milk let down. But is body-numbing anesthesia necessary? Or advisable? For a new mother who wants to be responsive to her baby? Who needs to move around to help with the healing process?
The risks of an epidural go up the longer it’s in–after five hours the risk of getting an epidural fever go up, for example. I just can’t see how this could be advisable postpartum under any circumstances.
Gilbert makes other claims in an easy-to-read, bullet point format. I’ve made my comments in blue.
According to Gilbert, epidurals:
- Can speed up labor. Yes, this is true in SOME cases. But it can also slow down labor. It’s irresponsible to leave out one part of this story.
- Don’t increase the risk of cesarean. Early epidurals can increase the risk. Late ones can reduce it. Again, please tell the *whole* story. Context!
- May reduce the likelihood of postpartum depression. What?? Where is the data?
- Can help with breast-feeding. I’ve only read that an epidural “may” lead to a slightly sluggish initial breastfeeding. In fact, a new study JUST came out supporting this.
Look, I haven’t read his whole book. I’d actually be interested to see how he defends some of these points. But I think it’s really irresponsible to put up a website with these bullet points and no context. This is a one-sided story to say the very least.
If you want an epidural, learn the benefits and risks. Don’t feel guilty for making a choice that feels right to you. Take responsibility for what you want and what you do. Along these lines, feel free to ignore people who tell you only one side of the story. I’m all for without guilt, but I’m not for without facts.