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The Truth About Epidurals: 6 Myth-Busting Facts for Moms-to-Be

Are epidurals misunderstood? One doctor says, Yes! and offers these answers to common myths about epidurals. 

The Truth About Epidurals: 6 Myth-Busting Facts for Moms-to-Be 
Pain Meds vs. “All Natural”. Don’t Get Caught In The Mommy Wars Over Labor and Delivery. Get The Facts For Yourself.

By Monique Johnson 

I have always been amazed by the mommy wars between so-called “natural delivery” camp and those who took a little nip from the epidural tap. I support women for whatever delivery method they choose, but there is no ticker tape parade or extra apple sauce for suffering through labor in excruciating pain. Contrary to some heated mommy debaters, neither experience makes you more or less of a woman. Or a mom.

So we asked Dr. Gilbert Grant, an anesthesiologist at New York University Medical Center with over 30 years of experience, and author of the new book, Epidural Without Guilt: Childbirth Without Pain (Russell Hastings Press), to give our Mocha Manual readers the real deal on the myths and realities about epidurals to help remove the stigma and guilt over getting an epidural to ease the pain of delivery. Dr. Grant says many women don’t have enough information to make an informed choice regarding epidurals and he sheds light on six common myths: 

Myth: Epidurals slow down labor
Reality: Epidurals do not slow down labor. This is one of those myths that have a life of its own. Three of the last four studies of this issue published during the last six years show that epidurals and spinals given early on the course of labor (before the cervix is four centimeters dilated) actually speed up labor. The fourth study showed that there is no effect between giving the epidural early or late. Bottom line: there probably isn’t much of an effect of epidurals on the duration of labor – certainly no reason to believe that it slows things down.
 
Myth: It’s difficult to push if you have an epidural
Reality: With today’s “walking epidurals,” the mother-to-be is able to feel the pressure of the contraction but not the pain, so that she can push in relative comfort. By using patient-controlled epidural analgesia (PCEA), the laboring woman can push a button to give herself her own doses of epidural medication. This way, she is in control, and is able to “fine-tune” the degree of pain relief she wants.
 
Myth: Epidurals lead to c-sections
Reality:  Although epidurals are associated with cesareans, they do not cause them. What does this mean? It means that women who are more likely to need a cesarean, for example, if they have a large baby and a small pelvis, will also be more likely to get an epidural because they will be in a lot of pain. But the epidural itself is not the reason for the cesarean. This has been shown in many studies from all over the world.
 
Myth: Epidurals make it more difficult to breast-feed the newborn
Reality: They do not. In fact, I think the opposite is true. When a new mom is rested and pain-free after the delivery, they are more likely be able to fully concentrate on their newborn than if they were to be experiencing pain. If someone has a delivery that is associated with a lot of pain afterwards (e.g., a cesarean, or a difficult vaginal delivery that causes tearing of tissues of the vagina and perineum), post-partum epidural analgesia can relieve all of their pain without causing drowsiness – and enable the new mom to walk around effortlessly. On the other hand, a new mom experiencing moderate-to-severe pain after delivery may need to use a narcotic to relieve the pain. The narcotic will make the mom sleepy, make the baby sleepy (medication passed through the breast milk) and won’t even relieve the pain that well.
 
Myth : There is a window of time when an epidural can be given – not too early, not too late.
Reality: Epidurals can be given at any time, from zero centimeters cervical dilation all the way to ten centimeters. Unfortunately, this myth – which is still believed by many women and obstetric care providers – has resulted in considerable suffering for many women. Many women (and obstetric practitioners, for that matter) still believe that there is a window of time during which an epidural or spinal may be administered. The myth, which is more than 50 years old, is that if epidurals or spinals are given before 4 centimeters cervical dilation, they will slow down labor. In fact, recent studies have shown that if given early, epidurals and spinals can actually speed up labor. The bottom line: if a woman wants pain relief she should get it, regardless of her cervical dilation.
 
Myth: The pain of labor isn’t all that bad, and anyway, it’s only temporary
Reality: There can be long term psychological consequences of unrelieved pain. Many people have the attitude that pain is a just “natural” part of childbirth –something that should simply be accepted. The story goes something like this: Labor pain, although it may be quite severe, is at worst only a temporary nuisance. Tolerate it – it will pass.  After all, until modern times, before medications like morphine and procedures like epidurals were around, didn’t women always experience painful childbirth?  But it turns out that pain may have many harmful effects on the mother and even on the baby that can last long after delivery. Serious psychological illness such as post-partum depression and even post-traumatic stress disorder (PTSD) may be more likely to occur in women who experience painful labors and painful deliveries. And you may be less likely to come back for seconds or thirds.

Read Kimberly’s humorous take on labor and delivery with and without pain meds. http://thestir.cafemom.com/pregnancy/100641/labor_battles_theres_only_one 
And learn more about having a labor and delivery your way in The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins).

Comments
8 Responses to “The Truth About Epidurals: 6 Myth-Busting Facts for Moms-to-Be”
  1. Rita says:

    A serious discussion should mention: 1) epidural may not work, that is won’t provided any pain relief, but give you a muscle block that makes you unable to push-even if given by an experienced anestesiologist (personal experience, unfortunately).
    2) epidurals have complication and these are not rare! tremors (distressing again by personal experience),very low blood pressure (ditto) and fever, among others that are rarer and scarier.
    3) there are contraindications.

  2. Melissa says:

    I think this conversation would be more complete if it also mentions side effects that this doctor you interviewed KNOWS are possible. The main stream conversation already supports the epi and only recently has this trend of natural birth began to push back. I feel like this interview is trying to convince women that they should get drugs (hence the long term effects of pain that was mentioned, that’s a new one). But getting drugs is a hard argument in my book. Why in the world would someone WANT to put something foreign in their body (the epi) if they don’t need too?? That is my biggest problem with western medicine. Doctors are so quick to give us a drug to solve a problem that can be solved or coped with in the absence of drugs. And by the way, these drugs cost an arm and a leg! Its hard to believe a drug doctor isn’t biased when they make about 500,000 thousand dollars a year – that salary is only possible if the public is completely comfortable with drugs such as the epi.

  3. Lynn says:

    Excellent points Rita!! I do appreciate this doctor addressing some of the myths but having a natural labor can be just as, and often times, less dangerous than getting an epidural. To just speak of natural birth in the context of PTSD and post partum isn’t fair.

    Also, it is very misleading to refer to a mother who has just given birth with an epidural as “pain-free.”

    And you forgot to mention common side effects like severe back pain (that can last for years) as a result of an epidural.

    • ajay mehta says:

      Again it is to blame as post procedure something… not necessarily because of it , many have back aches even without the needle .Just normal pushing and contractions at time of delivery, these are tearing forces. will last a long time ,even imprinting on minds.

  4. LBC Doula says:

    This article is very silly and one- sided.These things are considered “myths” based on one Dr.’s opinion? Not to mention uninformative for Mom’s actually looking for an objective viewpoint. I agree with Rita, it is important to mention the possible risks as well as possible benefits. Complications and reactions are extremely common such as dropped blood pressure and fevers which can actually lead doctors to perform C-sections. It’s also important to remember you have to consider what the common practices are. For example, I have actually seen Mom’s get persuaded into an epidural because it was their “last chance”, and although they are available, I’ve honestly never seen anyone get a walking epidural. Very disappointed in this article.

  5. Jayne says:

    This is an amazingly unbalanced article about epidurals – and one that uses a very inappropriate argument that women who go “drug-free” are doing it for some sense of accolades & recognition by her peers (ticker tape parade.) Any doula will tell you that epidural frequently slows or stalls labor necessitating usage of Pitocin, and many OBs agree that early placement of epidural comes with higher risk of serious side-effects including maternal fever – which often leads to mother-baby separation as well as blood-pressure drop which can negatively impact that baby. Epidural makes it impossible to ambulate or even move on a birthing ball in order to help your baby descend into the pelvis – that’s what leads to more c-sections! It’s not the epidural itself, it’s the inability to move in labor that inhibits descent – that’s extremely obvious, but not mentioned anywhere. And even ACOG has acknowledged that the pushing stage is lengthened by at least an HOUR with epidural usage, and typically requires interventions like vacuum extraction and/or episiotomy. So, this story is simply full of holes – I hope any woman reading it will do more thorough research on her own.

  6. Kayla Tomlinson says:

    I have had three children and all of their births have been different. With all of my epidurals I have had issues but the first gave me PTSD. My anesthesiologist said during my epidural with a needle sticking out of my back that she was needed in surgery. She rushed it and ended up having to come back a second time where she proceeded to wiggle the needle around in my back. I suffered nerve damage that made me collapse every so often without warning. That labor lasted 40 hours. My doctor nearly had me in for emergency surgery, because I was weak. Sometimes you have to get the epidural without choosing to or not. I ended up pushing and my baby got stuck. My doctor had suction her out. Traumatic!!! I was so scared going into the second kids birth. I basically had plans for everyone… even the anesthesiologist. Made him promise not to leave me for surgery. Should have locked the door because a nurse rushed in trying to take him away. He cussed her out saying that he had a needle in my $#?+ing back and to get out. I cried because I was scared but he finished and left. He checked up on me as soon as he could and the epidural only took to one side of my body but luckily no more needles just adjustments to the medicine. I ended up in labor for 13 hours with this kiddo and she had to be suctioned out as well. The last kid I was not as scared going in but Leary. I managed my pain mentally and quietly until I told the nurse I was ready for the anesthesiologist. They tried to refuse but I said I was ready and they checked me and I was a 6 dilation. They try to avoid the anesthesiologist if possible especially if you don’t look like your in pain. I am quiet when I suffer but wanted to be able to converse with the anesthesiologist. I told her of all of my past troubles. She locked the door and walked me through everything, even when the tape on my back slipped and the sterile area was compromised, I was still scared but she did a great job. That birth was quick at 9 hours, no suction just pushed HARD because her heartbeat was faint. I am sharing this to say that it is a great idea to talk to the anesthesiologist before the epidural so they learn what you expect from them and slow them down. A lot of nurses look at the epidural as a non necessity so they forget the danger of being paralyzed. It’s scary but a lot of the time necessary so make sure you get time and consideration from your anesthesiologist.

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