Wednesday, September 1, 2010

Stupid Epidurals

I could go on and on about epidurals and why I think they are silly and dangerous.  But I think this intervention really just speaks best for itself.  Once again, I could not make this stuff up. 

Here is a quote from Wikipedia about the most common drugs used in epidurals-
"For a prolonged effect, a continuous infusion of drugs may be employed. A common solution for epidural infusion in childbirth or for post-operative analgesia is 0.2% ropivacaine or 0.125% bupivacaine, with 2 μg/mL of fentanyl added. This solution is infused at a rate between 4 and 14 mL/hour, following a loading dose to initiate the nerve block."

And the package insert for bupivacaine:

"Local anesthetics rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity." 

YES folks- it crosses the placenta and don't ever let anybody tell you it doesn't.

"Maternal hypotension has resulted from regional anesthesia. Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient’s legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously and electronic fetal monitoring is highly advisable."

YES it can cause hypotension and YES you NEED to be continuously monitored because---IT IS DANGEROUS.

"Epidural, caudal, or pudendal anesthesia may alter the forces of parturition through changes in uterine contractility or maternal expulsive efforts. Epidural anesthesia has been reported to prolong the second stage of labor by removing the parturient’s reflex urge to bear down or by interfering with motor function. The use of obstetrical anesthesia may increase the need for forceps assistance."

YES- it is harder to push out your own baby when you can't feel a dang thing.


"Bupivacaine has been reported to be excreted in human milk suggesting that the nursing infant could be theoretically exposed to a dose of the drug. Because of the potential for serious adverse reactions in nursing infants from Bupivacaine, a decision should be made whether to discontinue nursing or not administer Bupivacaine, taking into account the importance of the drug to the mother."

Yes it comes out in your milk!

"Until further experience is gained in pediatric patients younger than 12 years, administration of Bupivacaine Hydrochloride in this age group is not recommended."

NO it is not recommended for children under the age of 12- what does this mean for babies?  Hmmm.....


Know the actual risks and benefits of your birth choices BEFORE you choose them. 

10 comments:

Melissa Neece said...

I had 30 hours of abdominal labor - then he turned around and I had 26 hours of back labor, before he turned around again right before I pushed him out. I had no pain drugs of any kind - just a lot of support. Having a great support team is key!

So, yeah, I have no patience with people who are in labor for only a few hours before they just "have to have" an epidural.

Handy tip: If you open your jaw (like when the ped tells a child to say Ahhh) and moan Ahhh, it can really help the contraction.

mamapoekie said...

Great article, putting it in next week's Sunday Surf.
I've written an article about epidurals being anti feminist once... boy, did that hit a nerve.
happy blogging

Sarah C said...

Thanks ladies-
mamapoekie- I would love to read it and link to it- and thanks for the sunday surfing! I didn't know what you were talking about at first!

Shanon Pruden said...

Thank you for this!

Matt and Heidi said...

I admittedly was a sheep during my first labor. I had PUPPPs really bad and allowed them to induce me even though earlier in my pregnancy I had said I didn't want to be induced and wanted to go as natural as possible. So of course DR. then broke my water, and I got the epidural because he said "you're probably going to need it later for the c-section anyway..." That pissed me off and I luckily didn't need one, but did get not one, but 2 episiotomies (sp?). Afterwards during recovery my back hurt worse from the epidural than my stiches did from him cutting me! Needless to say, i've done my homework now and next time around I'm having a homebirth.

Lucia said...

And you haven't even gotten into the breastfeeding ramifications of Fentanyl. It takes one month epidural medications to be processed by the baby and until the baby gets it out of their system they are unable to really "wake up" and nurse properly.

http://www.ncbi.nlm.nih.gov/pubmed/16306734

is a study showing women who got high dose fentanyl were much more likely to wean early because of difficulties with baby nursing. I got one with my first and it was awful. With my twins I got a spinal, and luckily they were out fast enough to not affect them as much (c-section) and then when I vbaced my last baby It was SO nice to go au naturale and boy was nursing easy!

Danie Nicole said...

You have no idea how sad this post makes me. I am so sad I didn't fight harder for the birth I wanted. I thought I was educated and really I wasn't. Inductions suck. Epidurals suck. Episiotomies suck. Ten long months to recover from a birth experience that still has me bitter. Next time will be different.

alicia duclos said...

I think that everyone needs to remember that everyone is different and what is right for you is not right for another. Doesn't make them less of a mother, less of a woman. I think if you want a drug free birth experince then you are awesome and I applaude you. But I think if any of us want an epidural then we are awesome and should be applauded as well. I had an epidural with my first born, but it didn't take, and I felt every contraction for all 48 hours of labor. I did have a great mid wife who massaged (ehem) and I didn't tear:) I also nursed for a year after he was born. With my second I had an epidural that worked, had a much shorter labor, and I felt when I had to push just fine. My labor was much easier and more enjoyable the second time for me. I don't feel one experince trumps another. None of us are here to judge other people on their choice of birthing options. That's up to God. I'll propbably get a boat load of flack for my comment, but just wanted to defend the mom's who are being almost villified here.

Brittney said...

I don't necessarily feel like "whats right for one may not be right for another" in this case. In saying that, I don't feel like woman are bad moms or anything, but I do think it is a less than good decision. Here is why: Just because it "isn't right for someone else" doesn't change the huge risk factors for them and their baby. That is not a relative risk based on how that person feels about natural birth. The truth and medical fact is that in healthy pregnant women natural birth IS SAFER. That in my opinion means that whats right for me is right for everyone else, so long as they are healthy and not in need of medical intervention. I hope this doesn't come across as judgy, I just don't understand how medical fact becomes a "whats right for you isn't right for me" thing. We should be spreading the word and letting moms know the true risks their choices entail so that they can make real educated decisions. If you don't know, how can you make a good choice? I believe if more women understood the possible damage they are cause, especially getting them early in labor, they would seek out better options BECAUSE THE RISKS APPLY TO US ALL.

Rebekah C said...

Once again, well said. I watched an epidural once...that was enough for me. No thanks.

LinkWithin

Related Posts with Thumbnails