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Epidural or Bust?

“Talking to moms about their options for pain relief usually yields me very similar answers: I did my homework and I chose an epidural. My next question is always, what else did you consider? The vast majority say nothing.

So starts a great blog post by pregnancy and birth expert, Robin Elise Weiss. “This always leaves me feeling a bit puzzled – how can you make a choice if you only have one option?” she adds.

This is a great question. I think many pregnant women get the impression that if you don’t get the epidural, you’re going with… zilch. You’ll be totally left out to dry, writhing and miserable. Suffering.

In fact, women who opt not to have an epidural are sometimes accused of wanting to suffer–to show off, to be a martyr, to win a prize, etc. But in my experience women who labor without an epidural can do it not because they are tough or like to suffer but because they are, in fact, doing a ton to cope with the pain.

The epidural is really just one of many ways to cope in labor. But yet, as Weiss points out in her blog, there’s a pretty strong vibe out there in the prenatal world that it’s numb or nothing.

I think one reason for this is that many US hospitals don’t offer much in the way of pain coping support other than the epidural. So hospital staff and doctors actually talk to women as if it’s the epidural or suffer.

On the other hand, at places such as the Brooklyn Birthing Center, where there are no epidurals on offer, you won’t just find women squirming in agony on beds. They are up moving around, or in tubs. Labor assistants have been trained more with labor support than medication dispensing. They know massage and positions that can reduce pain. And there are midwives who have worked with women all through pregnancy, helping them feel more comfortable about this process so that fear doesn’t amp up whatever pain there is.

I’m not going to sugar-coat it, I’ve given birth with and without an epidural and in the birth where I used massage/water/vocalizing I was most certainly not numb me from the waist down like I was with an epidural. But the non-medical coping tools did make something that felt impossible, feel possible. I can’t say which birth was harder– they were such different experiences– but the epidural birth wasn’t necessarily easier. There are aches and pains that come with getting an epidural fever, being tethered to lots of machines, not being able to move around, pushing on your back…. I couldn’t feel a thing but I think it was harder on my body. Pros and cons.

My biggest complaint with the way birth typically goes down in the US is not that hospitals have epidurals, but that they have so few other options on the menu.

I believe women are well served to learn as many coping strategies as possible.  Even if you really want an epidural, knowing how birth works and how you can take the edge of the pain can help you through the earlier parts of labor. It really depends on the hospital, but in the major NYC institutions you’re going to need to BYO most if not all non-medical coping tools. It’s not impossible to and I’d argue that it’s worth it (which is part of why I teach childbirth preparation classes.)

If you’ve never given birth before, what’s your hope for managing pain? Do you get the sense that the epidural is the only *real* choice you have?
Ceridwen Morris (CCE) is  childbirth educator and the co-author of the pregnancy & birth book From The Hips. Follow her blogging on Facebook.

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