“Just get an epidural”

I’ve just read something that has made me rather frustrated, and as it is not the first time I’ve heard this sort of thing I thought it worth sharing my thoughts here. It was along the lines of:

“Suffering the pain of childbirth is pointless, so just get an epidural”.

Let me take a moment here to point out that I have zero problem with women choosing to labour and birth however they wish, so long as that choice is a fully informed one. (And by fully informed I do not mean just what the Drs will tell you, what your friends have told you, or what you’ve read in a magazine – or blog! – Do your own research, and don’t just read things that say what you want to hear, that is *not* the definition of informed). It’s all very well harping on about it being someone’s choice to do something, but again, unless that choice is a truly informed one, it is not truly a choice at all.  And that’s what it comes down to really. It’s just not as simple as choosing between “the agony of childbirth” and popping a baby out without feeling a thing. There are many more factors involved, and interventions are not without risk.

Needle
This kind of comment assumes that all women experience labour and birth in the same way, which they clearly do not. One person will have a different pain tolerance level to the next. We are all different. We cannot equate our own experiences of birth to someone else’s. Neither can we look at someone else in labour and say how they feel about it. This is something only the woman herself can judge. It also perpetuates the incredibly irritating idea that birth is always something horrific, to be feared and dreaded, that you *will* experience unbearable agony and should be very, very afraid. Saying that birth is excruciatingly painful is not helpful, yet it is often the overriding message we circulate about birth in our society. Just because one woman experienced it as such, does not mean the next woman will. Even one individual woman can experience two very different labours. How you experience labour is down to a lot of things – your own expectations (It is well known that fear greatly heightens perception of pain and if all you’ve been told is that it is awful, really what can you expect?), your previous experiences, how you have mentally and practically prepared for labour, your perceived level of control of the situation, your surroundings, who you have with you, how you are being treated. All of these things have a massive impact on how you feel and how things go. Birth is not just a mechanical process that will progress from A to B in X number of hours. It is as much a mental process as it is a physical one. All the right ingredients have to be in place for it to work smoothly and as it should. Imagine trying to make a baby with all the fear and scaremongering and interference that is involved in modern day birthing. It just wouldn’t happen would it? You need to be “in the mood”. All the same hormones and mental components needed to make a baby are needed to birth one. (Read more about hormones in labour here).

Epidurals significantly interfere with the hormones of labour and birth, turning it into a medically managed procedure rather than a physiological process. Perhaps if you don’t care, understand or believe that our bodies have evolved complex mechanisms and structures to grow and birth our babies perfectly well by themselves, then you won’t think twice about interfering with these processes, even with something so seemingly simple as an epidural (if inserting several inches of needle into your spine can ever be seen as simple). But there are consequences to messing with this process, some of which include slowing the progress of labour (yes, actually making it longer – for example with my first baby, as the epidural needle was going in I started to feel pushing urges, yet the epidural took effect, the pushing urge vanished and my baby wasn’t born for several more hours, during which he became distressed), interfering with hormones vital to the birthing process, increasing the likelihood of instrumental or surgical delivery, double the risk of hemorrhaging, reduced chances of successful breastfeeding, and a whole host of others which I won’t list for fear of being accused of a bias! Dr Sarah J Buckley has written a very informative article on epidural use, which is fully referenced and well worth reading if you wish to educate yourself further on the subject.

A woman who chooses not to have an epidural is not “choosing pain”. This is just as wrong and disempowering as saying a woman who chose to have an epidural took the easy way out. The suggestion that going through labour without drugs is “pointless” is dismissive of the incredible process of birth and the sometimes bloody hard work we go through to achieve it. It suggests that researched choices are invalid compared to medically directed ones. We all have our own individual circumstances and reasons for our choices, as long as these choices are fully informed, that is what matters.

It really annoys me that there is this idea that women who don’t have drugs in labour are somehow martyring themselves, or trying to be “better” than other women. It annoys me when women who have had epidurals act smugly towards the woman next to her who had a natural birth and made a lot of noise. For goodness sake people, since when was birth a competition? Similarly, someone like myself who believes that a natural physiological birth as nature intended is healthiest for most women and babies is not “judging” someone who has had a medically managed birth, nor am I trying to change anyone’s mind. All I am interested in is accurate information, knowing that everyone who needs to has access to it and the freedom to make their choices from an informed position. MidwifeThinking put it very well in her article “Judging Birth” which she summarised with the following:

“There is no correct way to birth, or to behave during birth. As women and mothers we are subjected to more than enough judgement from others and ourselves. Perhaps it is time to start nurturing and supporting ourselves and others instead.”

To conclude; I am not saying that birth is a breeze or that there is a right way to do it, as in the quote above. Just that there is more to it than projecting our own entirely valid experiences onto others, and suggesting how they should or shouldn’t do it based on these. We cannot truly advocate for women or for ourselves if our view is immovable or we willingly ignore facts that do not fit in with our ideas. Our experiences are what they are, but we need to remember that a huge number of things will affect our experiences of labour and birth. Epidurals, like all interventions should be weighed up benefits Vs risks, not handed out as standard without any consideration of these factors.

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