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The Epidural Debate: Not So Bad, After All?

Do epidurals increase the risk of c-section? It's hard to say, according to one article.

Ah. Epidurals. Few topics get pregnant women as riled up as whether to numb or go ‘all-natural.’ Approximately 60 – 80% of American women opt for an epidural. But opponents of the procedure say it’s unnecessary and perhaps even dangerous for the mother and baby.

I know where I stand – firmly in the ‘all-natural’ camp, barring medical issues, because I want to be fully present in every way during birth. But heck… I’ll admit I’m tempted by the idea of an epidural.  The idea of not feeling every single centimeter of an eight pound baby squeezing out of my vagina sounds quite nice. That’s why I read The Truth About Epidurals:  Are They Really So Bad? with great interest.

Read my summary of the article – and one Babble blogger’s response – after the jump!

Melinda Wenner Moyer argues in her article that the concerns about epidurals from the all-natural birth camp are largely exaggerated.   Opponents argue that epidurals make it more difficult for the woman to push, extend the length of labor, increase the risk for a c-section, and even trigger breastfeeding complications.  The research, Moyer says, just doesn’t fully back up these claims.

Today’s epidurals contain less anesthetic and a very low dose of narcotics compared to epidurals used in the mid-1990s.  These newer epidurals have less of an impact on motor neurons.  In fact, one double-blind study compared women who received the modern epidural and women who only received a dose of narcotics – “women who had the epidurals were equally as able to lift their knees, wiggle their toes, and walk as those who” only had the narcotics.

Babble blogger Ceridwen recently responded to Moyer’s piece, pointing out that while moms may be able to lift their knees and wiggle their toes, the reality is that they’re not exactly roaming the hospital halls (as some all-natural mommas may be able to do to assist the labor process).  That’s because, once you get an epidural, you’re hooked up to a variety of monitoring machines.

Moyer argues that determining whether epidurals cause an increased need for c-sections is tricky – there are many confounding factors.  For example, women who request epidurals are more likely to have difficult labors or smaller pelvises, which increase the odds that they’ll need a c-section, anyway. The official position of the American Congress of Obstetricians and Gynecologists is that “the fear of unnecessary cesarean delivery should not influence the method of pain relief that women can choose during labor.”

One study mentioned by Moyer that I found very interesting relates to a 1999 experiment in Mexico. Half of the 129 women in the study randomly received an epidural; the other half randomly did not. The all-natural group dilated and delivered more quickly than the epidural group.  Only 9% of the epidural patients called labor “very painful,” while 100% of the all-natural patients did.

Moyer find research that contradicts most of the all-natural camp’s concerns over epidurals, including whether epidurals cause newborn drowsiness or trouble with breastfeeding, but concludes by saying that whether or not to get an epidural  should depend on the woman’s own unique birthing goals.

Read Moyer’s original article on Slate, and be sure to check out one Babble blogger’s response to the piece.

Photo credit: Bobjgalindo

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