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I’m glad I didn’t have an epidural

August 26, 2009

I gave birth to my first son in 1992. A lot has changed in those years, but a lot hasn’t, too. Now, 17 years is a long time to hold on to a birth story, and I didn’t keep a journal of experiences in those days so much as I kept a journal of emotions, so I know that during my pregnancy I was incredibly depressed. I was 21, for most of it, and had married that February and gotten pregnant on the honeymoon–the same honeymoon that we had to cut short because we found out my then-husband was losing his job. I spent the entire pregnancy on WIC, food stamps, and Medicaid. Thank you, taxpayers of Virginia.

I remember more about the birth itself the closer I get to my due date, now. I had been flirting with toxemia; my blood pressure and weight gain were the biggest concerns but I was starting to show protein in the urine. But I was already showing signs of effacement and dilation, so the doctor made a decision to go ahead and induce me the following Tuesday with an amniotomy.

I remember coming in on what felt to be the coldest day of the year. It was blustery as my then-husband dropped me off at the door; he parked, we went up together. I don’t recall checking in, but I do remember getting set up in the bed to be induced. The nurses started an IV. Ten minutes later, the doctor walked in, and asked why they had started an IV. They were visibly startled; I was just impressed. “I want to see how she does after we break her water. I have a feeling she won’t need Pit.”

I honestly can’t recall how insistent I was at that time for a low-intervention birth, but I must have made myself clear at some point. The amniotomy itself didn’t bother me; it struck me as a physical intervention rather than a chemical one. But what surprised me was what the doctor said upon examining me. “She’s already 3 centimeters. She’s having this baby today anyway.” I had been in labor all morning and not felt a thing–something that is common to my mother and my grandmother. He performed the amniotomy; I didn’t feel that either. By 10 a.m., labor was well established. “No need for Pit,” the doctor said again.

I called my mom. “You’ll have this baby by 1:30,” she said. We all had a laugh, but it turned out she’d be right–I was ready to start pushing around the time that everyone else was finishing up lunch. Suddenly, the entire world turned round: my eyes, my mouth, my soul was all formed into a perfect “O” shape–and everything I could see *felt* round. (I’m prone to synesthesia, so in hindsight that makes better sense than it did at the time.) The head was out, and the nurses were pleading with me to pant, because one of my son’s shoulders was hung up on my pelvic bone, a condition known clinically as shoulder dystocia. The doctor deftly worked him up, then down, then up, then down, rocking him past the barrier–and then my son came into the world, all 9 1/2 pounds of him.

One of the nurses who was helping me breastfeed made an offhand comment to me that has stayed with me ever since. “It’s a good thing you didn’t have an epidural,” she said. “Oh?” I replied, asking her to explain. I was 6 weeks past my 22nd birthday at the time, and didn’t have any more of an understanding of labor other than what I’d gotten from “What to Expect,” my childbirth education class, and my mother’s tales of carrying me and my brother. But I suppose I was influenced by my mother’s explanation of the difference between her birth with me, done under twilight, and with my brother, done completely natural. I showed up in five hours; my brother in 3. (We’re wondering, actually, whether I will have time to even get to the hospital at all, if I don’t know I’m in labor until I get to 5 cm and I roll through dilation half as quickly as I did with Elder Son.)

The nurse explained that she’d seen cases where an epidural actually caused a labor to drag on and on. “Your baby was so big, that it was a good thing you and all your muscles were fully present to work with your baby and your body to get him out. I think, if you’d had an epidural, you’d have wound up having a section.”

This made me curious, even then, about whether we should always trust in medication. Sometimes I think we’re taught to be afraid of the pain, so afraid that the epidural looks like an attractive option. So many women in my childbirthing ed class this time around have the attitude of “pass me an epidural as quick as you can!” And while I’m a huge advocate for allowing women to make their own choices about pain management in labor, there are times when I wish this aspect was made more clear to women. Interventions have a funny way of cascading. I feel like I’m lucky that my doctor was Pitocin-averse, at least in my case–because I’ve heard so many stories about how Pitocin creates unnaturally strong contractions that leaves a woman begging for epidural relief. Then, sometimes the epidural creates a difficult environment for pushing; other times, the pitocin makes it such that the oxytocin rush that I think I felt in that O-moment of birth never happens. Either way, it can lead to that nebulous diagnosis that scares me so much: failure to progress.

As if women didn’t have enough “fail” pressure in their lives, right?

So anyways, the point is: in 1992, I was told–after the fact–that having an epidural would have made my life more difficult. I’m glad I turned it down. And will do so again with this pregnancy, even though I’m 17 years older.

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6 Comments leave one →
  1. August 26, 2009 10:51 pm

    Your post gave me a lot to think about. Everyone has me so terrified of pain from childbirth I’ve been saying I’d take all the drugs I could get, but I expect a big baby. My hubby and I were both large. I think I need to do more thinking about this one.

  2. August 26, 2009 11:34 pm

    Thank you so much for posting this!! By the way, what is a PIT? šŸ™‚
    It’s so hard for me to figure out how to deliver just cause I haven’t *felt* it yet. Right now, I’m thinking that I will not have an epi early, but see how things go and certainly have them tell me how quickly things are going, if the pain is getting too bad. If the labor would be a few hours or so, I would hope that I could do it… but we’ll see how it feels! šŸ™‚
    Thanks so much for posting this – it really gives me a lot to think about!

  3. August 27, 2009 2:23 am

    I was planning on having an epidural as needed but I maybe I won’t have one. How long was the labor all together? Many props to you for doing it as naturally as possible. ā¤

  4. August 27, 2009 4:22 am

    MP – My labor was about 5 hours total–they broke my water a bit after 8 and K. was born before 1:30. My mother says this completely parallels her labor with me, though since it was done under twilight she doesn’t remember it very clearly.

    B&F – It did get pretty sharp and intense from about 5 cm on, but I will say that any of my gallbladder attacks hurt much worse and for much longer, and I managed most of those without pain meds too until I finally had the dern thing out!

    Kristine – I think one of the best books for understanding the relationship between fear and pain when it comes to labor is “Childbirth Without Fear” by Dick Grantly-Read. Look for the current edition, which isn’t heavily edited the way that older editions were. My father is a trained hypnotist, too, and was certified until his retirement; between him and my years as a Buddhist I’ve learned a lot about the mind-pain connection.

    Everyone: Like I said in my tweet, an epidural *is* the right choice for many women. But I think it’s important for women to understand both sides of it. And since I’m going to go through this again in November, for those of you that are due later I’ll be sure to talk about how it goes!

  5. August 27, 2009 5:09 am

    Thanks for the reply. I will check out the book. I’m also a practicing buddhist. Funny to run into you in the cyber momma to be world. I haven’t been practicing long. My husband is what is a “fortune baby.” We practice through SGI.

  6. Christine permalink
    August 29, 2009 4:35 am

    Helen, that is an impressive memory for 17 years!

    I agree with you – pain medication is important and necessary for some women. My main problem with pain meds in labor (epidural, spinal, analgesics, whatever) is that most women are not aware of the full range of risks associated with their use. Decisions in pregnancy and birth are a balance between benefits and risks. But in order to make that decision, you need the information. I’ve been present when lots of women have received their epidurals, and never once have I heard the anesthesiologist give the woman a full informed consent speech. Though rare, an epidural can lead to lifelong back pain, paralization, and even death. Much more common are severe itching, spinal headaches, malpresentation (baby isn’t facing in optimum direction), failure to progress, fever, and the cascade of interventions – pitocin, oxygen, distressed baby, forceps and/or vacuum use, and c-section.

    I’ve had 3 babies naturally (at home in the water) and loved it. LOVED it. I can’t wait to do it again. I wish more women could go into birth with less pressure to get drugs drugs drugs.

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