Thursday, August 23, 2012

Labor & Delivery: Pain Medication vs Natural Birth

When it came time to make a decision in regards to pain medication options during labor and delivery, I decided to do my research. I found a ton of helpful websites, (listed at the end of this blog) as well as my book What to Expect When You're Expecting, but what I found most helpful was the experience of the women who had been there, done that. I decided that before I make this critical decision I needed to weigh the pros and cons and simply make a decision.

Pro's:
  • The obvious: pain relief. Let's be completely honest here, I've talked to hundreds of women and they all pretty much agree that it's the most intense pain they've ever had, so I'm not going to be naive in my belief of "being able to handle it." I'm nervous, apprehensive, a little scared, there's a feeling of dread... you name it, I'm experiencing it.
Con's:
  • Decreasing of my blood pressure, which affects the babies heart rate.
  • Possible difficulty breathing.
  • Increased possibility of ripping.
  • Severe headache possibilities
  • Not knowing when to push, therefore the need for forceps and suction might be necessary
  • Possible Nausea and/or dizziness
  • Decreased activity from baby after delivery.
  • Latching for breastfeeding becomes difficult for the baby right after birth because there's some medications that cause numbing
  • Slows down labor
  • In college I had a back injury: 2 slipped discs (L1 & L5) and it still occasionally happens. Because of this injury I'm also prone to back spasms. Thankfully, it doesn't happen very often because I've been proactive in stretching and strengthening my core. As long as I stay in shape, I'm good. However, I never know when it's going to happen, or what spurs it to happen again. The timing never makes sense. I can visit the chiropractor and two weeks later it'll happen again, or it could be 6 months! It can go out with something as simple as twisting just the right way, or picking up something wrong. It's so weird and frustrating! With the epidural placement being in the lower back I have to wonder whether this is a good idea or not....
  • "If you receive medication during labor and delivery, some of it will pass through the placenta and enter your baby's blood supply and tissues. The effect of the anesthesia in your body will wear off in a few hours, but it may take several weeks for all the drugs to be eliminated from your baby's immature system." (Eiger, M. & Olds, S. The Complete Book of Breast Feeding, Chapter 9, p.172) Eiger and Olds go on to talk about how medication has not been proven to have a long term effect on babies the short term effects are enough for me to be leery. "While this does not seem to have a permanent effect on full-size, full-term babies, it does affect their early activities, including their interest in nursing. Since the vigorous suckling of a hungry baby is vital for establishing an ample supply of milk in the mother, if your baby is sleepy and not interested in nursing, both you and she are at a definite disadvantage in building up your production of milk." Thankfully our hospital believes in skin to skin time where I will literally hold the baby for the first few hours of her life, feeding her, talking to her, cuddling with her. They won't weigh her, measure her, or take her from me until she is full and ready to be held and coddled. I'm SO EXCITED for this time with her!
  • "The use of epidural blocks, especially for mothers who plan to breastfeed, is controversial. Some research reports ineffective early suckling by infants whose mothers received epidural anesthesia, and other research shows no effects on these babies. ... problems with epidurals may include prolonged labor and a temporary lessening of the ability to nurse." (Eiger, M. & Olds, S. The Complete Book of Breast Feeding, Chapter 9, p.172)
  • "If you can avoid anesthesia during childbirth, you should." (Eiger, M. & Olds, S. The Complete Book of Breast Feeding, Chapter 9, p.172)
  • "You have to weigh the relative risks and benefits of pain relief." (Eiger, M. & Olds, S. The Complete Book of Breast Feeding, Chapter 9, p.173)
  • "Basically, whether you're pregnant or nursing, you should not take any drug unless you have a sound medical reason for it. This is the best course for both you and your baby. However, if there is some medical indication that a particular agent is important for your physical and emotional well-being, in most cases you can take it." (Eiger, M. & Olds, S. The Complete Book of Breast Feeding, Chapter 9, p.171)
  • One website made a very profound statement I can't get out of my head: Each pain medication has risks and benefits. So I have to ask myself, do the risks outweigh the benefits?
As I reread over the possible risks I feel like I'm being over critical, or a worry wart. It uses the same vocabulary over and over again: possible, possible, possible. So I may be that high percentage of women who experience no side effects. BUT what if I'm not? I'm most definitely not judging those women who have chosen pain medication, I just honestly don't think it's for me. What has influenced my decision the most is talking to other women. And the thing is, 100% of the women I talked to who did it naturally, say their experience was positive. It's 50-50 for women who decided to have pain medication.

My sister, a few friends from high school, and friends from college swear by the epidural. They went through the birth with few or zero glitches and side effects. However, I've talked to another woman who swears her negative experience was because of her epidural and is therefore doing a home birth with her second delivery. I have four more friends who did it naturally, as well as my mom (x3), who swear by it for many convincing reasons:
  1. The recovery is quicker.
  2. Ripping was minimal.
  3. They knew exactly when to push.
  4. They were lucid the entire time and was able to walk around.
  5. Millions, gazillions, and bazillions of women have done it before, so if they can, I can as well.
  6. God said there would be great pain with child birth. Deal with it or deal with the possible side effects.
  7. Hindsight, it doesn't last long. Yes, 20 hours (plus or minus) seems like FOREVER when you're going through excruciating pain, but they say it's something you forget as soon as you look into the face of your beautiful baby. I heard over and over again to keep my mind on the end result.

Lastly, I've been reading article after article stating that the death rate for women during or after child birth is higher in the United States than it is in many other countries. In fact, after reading this particular article: Too Many Women Dying in U.S. While Having Babies by Jennifer Block where I read the quote, "... the likelihood of a woman's dying in childbirth in the U.S. is five times as great as in Greece, four times as great as in Germany and three times as great as in Spain." One of the reasons mentioned was, "overuse of risky interventions like inducing labor and delivering via cesarean section." The major cause, that I read in other articles as well, was the increase in C-Sections. Still, I have to wonder how much of the rise is to blame because of our desire to go away from the natural delivery process God intended...? I don't really know if that's the case, but we are one of the only nations in the world that offers alternatives to the natural birthing process and highly encourage it. I really believe we try too hard to play God, rather than letting go of the fact that HE is in control. If you read from the beginning of time, God is most definitely in control of the pain women experience with childbirth, so pain during delivery was an expected fact of life. Why do we encourage going away from the natural process and instead encourage something that has possible, no matter how slight, of risks? (Don't get me wrong. I'm extremely grateful to be living in this medical day and age. The death rate has obviously, significantly decreased because of all our advances in medical science. I can't imagine giving birth "back in the day" and I'm so, so thankful for the nurses and doctor's who will be there to help and know what to do in an emergency. So unless an emergency does occur, I'm going to stay on the all natural course, letting them do their job in assisting me and monitoring baby and me.)

Based on the conversations I have with other women, the research I've done, and after talking it over with my doctor and husband, I'm going to do a natural birth. The only reason I have for getting an epidural is pain management and many women have shared occasions where the epidural was ineffective on one or both sides anyway. I look at my pro's vs con's and the con's far out weigh the pro's. Usually this makes my decision pretty easy, however, I'm nervous about the pain. Still, to me, my own pain relief seems pretty selfish when I think of all these possible side effects. It just doesn't seem worth the con's, so I have tell myself to suck it up, and -push- through it.

I've spent much time in prayer (plus I'm using the workouts provided on www.crossfitmom.com to build strength, God knows I'll need it!) over this decision and as you can see, I need all the encouragement I can get, because I'm, like I said before, nervous, apprehensive, scared... well, more like terrified. I walked out of the hospital doors after completing my birthing plan and filling out paper work suddenly feeling like this is all very, very real. So, unless there is an emergency situation, I'm trying natural and it's been my mind set since leaving yesterday. I told the RN, "I'd be lying to you if I said I wasn't nervous." She laughed and said she wouldn't expect anything less of me, gave me lots of pointers, and told me, "You can do this!" Then she actually told me she was proud of my decision! Yay! I know I can do this.

PLEASE PRAY FOR ME. (Note the slight hint of desperation in that request....)

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Websites:
A fellow blogger's advice that I found super helpful:

9 comments:

  1. Sara "Angel" VeselyAugust 23, 2012 at 8:16 AM

    I'm super excited you are going for a natural birth. I went into both deliveries with my kids expecting to do it all natural and ended up getting an epidural each time. My biggest advice would be to have a plan but be flexible. Things can change in a heartbeat and if you get really stuck that this is the only way to do it, you're going to get disapointed. Just pray on it and God will take care of you whether you get to do it naturally or not. I'm so excited for you! Congrats!

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  2. Having done it both ways, I'm excited you have chosen to go the natural route. My advice would be to do a Bradley class or a Lamaze. These will help you learn how to manage the pain through breathing. BIG help.

    Who knows for sure but with Lauren: induced and epidural. Her heart rate dropped and had to have a monitor on her head. She came out with breathing problems and had to have a short stay in the NICU. She had to have her stomach pumped the next morning. I had a visit to the ER and an additional hospital stay a week after she was born with blood pressure issues that wouldn't go away for months and months. I also had anxiety issues after she was born. Kate: Completely natural. She was fine. Mommy was fine.

    Like I said, who knows. There are some other factors that need to be considered in my births but it does make you go "hmmmm" doesn't it?

    It is so hard and if I had had a 20 hour labor with Kate, I can't say that I wouldn't have given in and gotten an epidural. My epidural with Lauren was perfect. I couldn't feel pain but I could feel her, when to push and people touching me. But, I am grateful I was able to have a natural labor. It truly is amazing to see how God has designed our bodies for this. I also am always amazed to see God's design in breastfeeding.

    Remember this if you make it through labor all natural, the pain relief is immediate once the baby is born. Work toward that. Hopefully that helps! ;) AND most of all, if you end up needing some meds, that is okay too. I'm happy with both of my birth experiences.

    Good Luck! Will be praying for you. It is pretty darn scary not gonna lie! You will do awesome!

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  3. It does make me "hmmmm" outloud. :) I'm so glad you shared your experiences. I do have a weakness/strength (it could go either way)... once I've made up my mind, I'm not very flexible. I don't think (unless there's an emergency) I will be here either. Especially because I told the nurses, don't give me the paper work, don't even talk to me about an epidural, talk to me about the natural pain coping techniques.

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  4. Good luck to you! I'll be enjoying my epidural ;) but the best advice I've heard about a natural birth plan is to go in without ANY thought of taking pain medication, no matter how bad. Seems that if you know it's an option, you'll end up using it. Also that if you do decide it's too much and you change your mind, wait X amount of time before asking for it, often women just need to collect themselves and realize they'll be just fine after all.

    Almost there!!

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    1. Jamie, that's so true! That's why I decided not to make it an option because I'm weak and I'll give in, LOL.

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  5. Went natural with Matthew until his heart rate wasn't rebounding and had to do urgent c-section. When I miscarried and delivered Thomas at 19 weeks I had 1 dose of Tylenol to ease some of the cramping but otherwise went natural and it was very rewarding not gonna lie it wasn't easy but not as bad as I had anticipated. Be flexible in case of emergency, and be prepared for that possibility. But I know you can do it. Loved the lamaze class we took, knowing how to focus on breathing and use my body/movement to cope with the pain was very helpful. Best of luck I know God will give you the strength to do it the way that is best for you and baby.

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  6. Nice blog!! I have the same feelings of nervousness of the unexpeted. I fully believe God created us to do this naturally. Also the baby is designed to come out. I am with midvives vrs. Doctors and all they can emphasize is how gravity is your friend. Lying down is the hardest way to deliver. I dont know if u have options where your delivering but if u do bring a big ball, enjoy a shower in the room, be "doggy style," squat, so many different positions. Do stretches that open your hips to position the baby in the best place. I have heard hiw a birthing pool is amazing, we recently found the only place in san diego that has birthing pools and allows u to deliver in them so made a switch of midwives this week. I am 34wks. How far along are you?? Ill keep you in my prayers. Speak life into the labor and when pain kicks in just think.of how close you are to holding the biggest blessing in your arms. I have Mr. Loftgaurd voice in my head from basketball doing suiced and those squat shuffles- " its all in your head. Your body can do it, get your mind in the same game." lol. Wierd i know. But blessings over this amazing oppurtunity life has brought for u and your husband!!

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  7. Awe Becky! I too have done very similar research lately! :) We are using a birthing center, not a hospital, so don't even have the option for pain medication but I still wanted to know what to expect in the rare chance we are transferred and need hospital care. I've been taking a lot of classes and have some great resources from our Doula if you need. Just let me know and hopefully you will be comforted to know you are not alone in your apprehension at this time. We are in it together! :)

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    1. I would LOVE whatever information you have. It's comforting knowing I'm not alone. We'll have to stay in touch.

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