Reasons AGAINST having pain control during birth?

[fancyshmancy]

Hello ladies! I REALLY (REALLY!!!) would like to go natural for my first birth, but am also scared out of my mind! At times I think I can do it, and others, I think there is no way. I am just hoping you all could help me with some excellent reasons and/or articles as to why I SHOULD go natural and why I SHOULD NOT have any pain control. Any scary stories or excellent articles would be greatly appreciate it! Thanks~

 

[aliss]

Fancyschmancy,

I had G&A, morphine, and an epidural during my labour.

The G&A made me vomit/dizzy (but that's not a big deal - you can take the mask off and it has no effect on baby)

The morphine caused my baby's heart rate to drop twice

The epidural, combined with induction, slowed my labour down so badly that after a full day (my labour was 3 days), I was so exhausted from zero sleep that I lost the ability to push and he got trapped (shoulder dystocia) and his collarbone had to be intentionally fractured to pull him out. If she didn't break it, I would have had to have a zavanelli C-section which is when they shove the baby back up the birth canal (head already out) and then C-section. It has a 92% success rate, and 8% death rate. NOT good odds.

Yes, many women do fine with their epidural, but this is what can happen with excessive interventions (primarily induction and epidural). I won't even get into how hard it is to try and feed an infant with a fractured collarbone (you can't breastfeed without them screaming in pain, so they don't eat).

 

[NaturalMomma]

I had Nubain and Epidural with ds1. The Nubain made me feel like I was extremely drunk. I couldn't focus, couldn't close my eyes, couldnt' keep my head still, was getting a lot of motion sickness. It was horrible. The Epidural did take away the contractions for about 45 minutes. But the Epidural made me feel very disconnected to everything, baby came out needing oxygen (which my Doctor told me is a side affect, eventhough many sources try to say it's not), I still have backaches from the injection site and it's been almost 4 years.

 

[Ouverture]

Having yet to experience labor and birth. . .please take my advice with a grain of salt, but here is my take.

With an epidural, you are simply delaying the inevitable. Birthing 7 pounds of baby will NOT go unnoticed, whether you get an epi or not.

Allow me to explain

With a natural delivery, you are more likely to be able to eat and drink so that you have energy to push your baby out. You will also be more able to move into positions that are much easier for your baby to descend, and thus less likely to experience things like shoulder distocia and the like.

Basically, you 'get it over with' and you are done. Yes, you'll be a bit sore, you *may* tear a bit, but if all goes well that will be the end of it. Physically, your body will be RUSHED with hormones that are both loving/bonding hormones (sadly, you don't get those in medicated deliveries), as well as natural pain killers (endorphins).

Now for the epidural

When you get an epi, you will not be allowed to eat or drink. Remember that a laboring woman burns a LOT of calories.

You will likely have a catheter, which can cause infections, discomfort, etc.

You will be stuck in bed. This makes it harder for the baby to come out - as the movements mom makes in a natural delivery assist the baby in descending.

Epi's often cause labor to slow. The doctor may augment with pitocin, which causes very painful contractions and is also hard on the baby.

That slowed labor COULD result in a c-section.

Laying on your back to push is counterproductive, but with an epi, you will probably be required too. Remember, you haven't eaten in several hours, are tired, and hungry. This is where the 'delay the inevitable' part comes in! Pushing on your back increases your risk of tears, as well as increases your risk of things like shoulder distocia. You may also need a forceps or vacuum delivery, which usually require an episiotomy, and can be dangerous to your baby. Most OB's will treat an epidural/shoulder distocia by landing a nurse on your belly to push down HARD, while they cut your vagina open and pull the baby out, possibly breaking it's collarbone. (NOTE. . .there are safer ways to relieve a Shoulder Distocia. . .lookup the Gaskin Maneuver. . .it makes PERFECT sense. . .breaking the clavicle should be a last ditch effort)

Because you are on your back (fighting gravity. . .try pooping on your back!), the doctor will likely pull on your babies head to help birth the shoulders. . .this can cause serious damage to the baby.

When all is said and done, because you couldn't feel your lower extremities, you probably pulled muscles and caused nerve damage in your legs during pushing. This WILL hurt when the epi wears off. As will your new episiotomy, and worse yet. . .

THE C-SECTION! You do NOT want to recover from one of those. . .but getting an epi, especially one where it results in dosage of pitocin/syntocin, increases your risk of landing in the OR.

Let's not forget, you are DRUGGED. Ever felt a hangover?

So, I'll say it again. Go natural, experience the rush of hormones that come from birthing your baby, breath, relax, and let your body do what it is MADE to do. . .OR. . .get the epi, don't feel a thing during the birth (except for loads of pressure. . .epi's don't take everything away!), but really eat your words when it comes to recovering from all of the above Ask any woman who has had a medicated birth, and a natural one. . .most, if not all, will say they'll take the natural birth and the quick recovery over the medicated one and it's complications.

HTH! It's perfectly normal to be scared. As a first time mom myself I have some days where I seriously can't wait for delivery day and I'm unafraid. . .other days I question my sanity and resolve. It doesn't help that here in the U.S. you are 'weird' if you aren't signing up for an epi at 3cm.

What I find helps. . .is to imagine yourself having a safe, easy, natural delivery. Imagine how you might cope with the experience. . .do you embrace the pain (one step closer to baby). . .do you think of it as 'pressure' instead of pain (a new sensation, yet one that is normal), or do you allow yourself to freak out? Imagine what you WANT, and you're more likely to get there

 

[aliss]

Great information Ouverture. The only thing I wonder is that I was under the impression that the clavicle fracture is another last ditch attempt after the Gaskin maneuver fails. I think many doctors go straight to that rather than attempt the Gaskin with a woman who has an epidural but I think the Gaskin can still be done in that circumstance. I know my son's clavicle fracture was only done after several other maneuvers had failed and things got a bit panicky.

 

[KandyKinz]

I had Demoral (a narcotic) during my first birth. It made me feel incredibly drugged, dizzy, incredibly sleepy, lightheaded and sick to my stomach. Once I was given that med I felt that as though I had lost any control I had left over the situation. I just layed there wanting to die while they "managed" me. Despite it given with a anti-nausea medication I vomited and vomited. It was given to me 1 1/2 hours prior to me delivering.... I was only 5cm at the time but because I was only 5cm they had told me I still had hours and hours left despite experiencing several signs of transition. I started pushing 1/2 hour later. When my son was born, the demoral was at full effect. In my fuzzy dream like state I remember holding him but I couldn't open my eyes because when I did the room appeared to spin, I could see the pictures and clock on the wall rock back and forth and the motion of it all made me sick so I couldn't even look at my son. But they ended up having to take him away to the table anyways for quite some time to observe his respirations because narcotics have a tendency to cause problems with baby's breathing if given too soon prior to the birth. When given less then 4 hours from the time of birth it's not uncommon for babies to not be able to breathe at all on their own (the drug effects depresses the function of the parts of the brain stem which control breathing) and in situations like those a counter drug must be given to stimulate breathing and the baby must then go to the NICU. Luckily my son was still able to breathe unassisted so he didn't need this additional drug and NICU care but they "watched" him more closely cause he's breathing was slower then what is classified as normal. We then were moved to the postpartum ward where I needed to have two nurses assist me to get into my wheel chair and I almost passed out in the bathroom while they were changing my gown.... the room was still spinning (btw my blood loss was completely normal, in fact it was on the lower side of normal so that wasn't an issue). The nurse ended up having to dress me on the toilet because I wasn't able to change on my own. I felt completely humiliated. Made it to the bed and attempted to breastfeed despite just wanting to sleep (it had already been more then an hour postpartum by that point) and our intial breastfeeding experiences were awful. My son had been sleeping the entire time (likely due to the sedative effects of the drug) and refused to wake up to feed and I just hadn't the energy to deal with it all. A very bad combination. He slept the majority of his first 24 hours and I had to wake him to attempt feeds. The second 24 hours he just screamed non-stop. He was a terrible latcher and I think the combo of the effect of the drug on his sucking reflex as well as the delayed and decreased number of feeds had a big effect on that. Because of his poor latch I ended up experience awful nipple pain and damage. Overall it was a very awful experience.

With my second, I decided to go natural. Throughout the entire labour I felt as though I was still in control of myself and my thoughts and I was able to continue to advocate for myself thoughout the whole process eg when it came time to pushing and the nurse went to turn on the lights I said no because I wanted it dimmed and she agreed and when she told me to lay down to push I said no and she agreed. It was so so nice to be able to voice what I wanted in order to birth in a comfortable position and environment. Then when my daughter was born I felt so alert and energized. The euphoric feeling I experienced was absolutely amazing. I can't even begin to explain it but it was the most amazing natural high ever! And then following the birth I felt great. I didn't feel drowsy or lightheaded or sick to my stomach. I felt like I could run a marathon. I felt well and I was actually able to change my clothes by myself without passing out... And immediately following the birth my daughter was so alert. It was lovely. We breastfed immediately and her latch and suck reflex was perfect. We never had any breastfeeding issues at all. She cued herself to feed so we were able to breastfeed on demand and everything was great.


In terms of general risks etc with the use of pain meds in labour here's some:

Narcotics (eg Demoral)
-Nausea and vomiting
-Spaced out drugged feeling
-Dizziness
-Drowsiness (for mom and baby)
-Increased risk of baby developing fetal heart rate abnormalities which if they don't resolve could mean cesarean
-Neonatal respiratory depression (baby not being able to breathe on their own following the birth)
-Difficult time breastfeeding afterwards

Nitrous
-Nausea and vomiting
-Spaced out drugged feeling causing a disconnect from the birth and experience
-Dizziness

Epidurals
-Risks of the procedure (infection, nerve damage)
-May not work at all or may only work on one side
-Spinal headache postpartum
-Delays progress in second stage which can increase risk of cesarean
-Increases the need for instrumental delivery (forceps and ventrouse) which increases the need for episiotomy. Instrumental deliveries also increase the risks of the mother experiencing pelvic floor damage and there are risks to the babies as well (eg nerve damage, brain hemorrhage etc)

There's more I just can't think of any more off hand.

 

[Ouverture]

Great information Ouverture. The only thing I wonder is that I was under the impression that the clavicle fracture is another last ditch attempt after the Gaskin maneuver fails. I think many doctors go straight to that rather than attempt the Gaskin with a woman who has an epidural but I think the Gaskin can still be done in that circumstance. I know my son's clavicle fracture was only done after several other maneuvers had failed and things got a bit panicky.

Aliss I'm sorry they had to do that to your son! Ouch. . .

It should be a last ditch attempt. . .in the U.S. many doctors, especially if you've had an epi, won't even try the Gaskin Maneuver (like you said). I believe *most* shoulder distocia babies get out regardless without the clavicle fracture, which is good. It's still a really really sad risk

Shoulder distocia is scary stuff! ! !

 

[Mark&Annie]

You are very brave I guess I want to do this too, but I have had one baby and kind of know what to expect. I had gas and air on and off which didn't do much TBH but was nice to bite the mouth piece. Don't have any horror stories, but if you want to do it, you will My Grandmother had her children before the days you were offered anything, as did most of our Grandparents - they did it. I like to think of all the millions of women who gave birth before pain control, and those cultures where they still don't. It's perfectly do-able, breathing and relaxing through your birth will help to control the pain. Just keep in the back of your mind that this pain is temporary, and it's for the best reason ever!

 

[fancyshmancy]

Fancyschmancy,

... my labour down so badly that after a full day (my labour was 3 days), I was so exhausted from zero sleep that I lost the ability to push and he got trapped (shoulder dystocia) and his collarbone had to be intentionally fractured to pull him out. If she didn't break it, I would have had to have a zavanelli C-section which is when they shove the baby back up the birth canal (head already out) and then C-section. It has a 92% success rate, and 8% death rate. NOT good odds.

Yes, many women do fine with their epidural, but this is what can happen with excessive interventions (primarily induction and epidural). I won't even get into how hard it is to try and feed an infant with a fractured collarbone (you can't breastfeed without them screaming in pain, so they don't eat).

Oh my goodness, thank you for sharing! I'm sorry you had such a terrible experience, and LONG labor! I never considered shoulder dystocia as a possible complication from an epidural, but it makes sense now.

I had Nubain and Epidural with ds1. The Nubain made me feel like I was extremely drunk. I couldn't focus, couldn't close my eyes, couldnt' keep my head still, was getting a lot of motion sickness. It was horrible. The Epidural did take away the contractions for about 45 minutes. But the Epidural made me feel very disconnected to everything, baby came out needing oxygen (which my Doctor told me is a side affect, eventhough many sources try to say it's not), I still have backaches from the injection site and it's been almost 4 years.

I have heard about women having back pain for years after an epidural, and is a VERY good reason not to have one. Thanks for the story, I definitely don't want to feel drunk while giving birth.

Having yet to experience labor and birth. . .please take my advice with a grain of salt, but here is my take.

You will likely have a catheter, which can cause infections, discomfort, etc.

Thank you for the awesome information, and for taking the incredible amount of time it took to share it! Thank you!!

I am scared to death of catheters (whether in my bladder, or in my back!), and am prone to UTI's, so this is one reason I definitely did NOT want an epidural.

In terms of general risks etc with the use of pain meds in labour here's some:

Narcotics (eg Demoral)
-Nausea and vomiting
-Spaced out drugged feeling
-Dizziness
-Drowsiness (for mom and baby)
-Increased risk of baby developing fetal heart rate abnormalities which if they don't resolve could mean cesarean
-Neonatal respiratory depression (baby not being able to breathe on their own following the birth)
-Difficult time breastfeeding afterwards

Nitrous
-Nausea and vomiting
-Spaced out drugged feeling causing a disconnect from the birth and experience
-Dizziness

Epidurals
-Risks of the procedure (infection, nerve damage)
-May not work at all or may only work on one side
-Spinal headache postpartum
-Delays progress in second stage which can increase risk of cesarean
-Increases the need for instrumental delivery (forceps and ventrouse) which increases the need for episiotomy. Instrumental deliveries also increase the risks of the mother experiencing pelvic floor damage and there are risks to the babies as well (eg nerve damage, brain hemorrhage etc)

There's more I just can't think of any more off hand.

Thanks for the breakdown, and I can't believe that narcotics were administered so late in your labor! I know they are only supposed to be during the latent phase to AVOID many of the complications you experienced.

I plan on asking my Doc what his views on pain control and positions during pregnancy are. I haven't had this talk with him yet, and am wondering what the heck has taken me so LONG! I don't want to switch docs this late in the game, but don't want to fight a battle my entire L&D. Cross my fingers for a supportive nursing staff!

 

[KandyKinz]

Great information Ouverture. The only thing I wonder is that I was under the impression that the clavicle fracture is another last ditch attempt after the Gaskin maneuver fails. I think many doctors go straight to that rather than attempt the Gaskin with a woman who has an epidural but I think the Gaskin can still be done in that circumstance. I know my son's clavicle fracture was only done after several other maneuvers had failed and things got a bit panicky.

Aliss I'm sorry they had to do that to your son! Ouch. . .

It should be a last ditch attempt. . .in the U.S. many doctors, especially if you've had an epi, won't even try the Gaskin Maneuver (like you said). I believe *most* shoulder distocia babies get out regardless without the clavicle fracture, which is good. It's still a really really sad risk

Shoulder distocia is scary stuff! ! !

Shoulder dystcocias are SCARY!

Sadly here in Canada many doctors are not even familiar with the Gaskin maneuever let alone be willing to practice it should the need arise. Doctors here like woman to be on their back at all times

 

[aliss]

Great information Ouverture. The only thing I wonder is that I was under the impression that the clavicle fracture is another last ditch attempt after the Gaskin maneuver fails. I think many doctors go straight to that rather than attempt the Gaskin with a woman who has an epidural but I think the Gaskin can still be done in that circumstance. I know my son's clavicle fracture was only done after several other maneuvers had failed and things got a bit panicky.

Aliss I'm sorry they had to do that to your son! Ouch. . .

It should be a last ditch attempt. . .in the U.S. many doctors, especially if you've had an epi, won't even try the Gaskin Maneuver (like you said). I believe *most* shoulder distocia babies get out regardless without the clavicle fracture, which is good. It's still a really really sad risk

Shoulder distocia is scary stuff! ! !

Shoulder dystcocias are SCARY!

Sadly here in Canada many doctors are not even familiar with the Gaskin maneuever let alone be willing to practice it should the need arise. Doctors here like woman to be on their back at all times

Yep! I remember thinking "what the hell are you doing to my legs, just pull that thing out!!" lol cause they didn't tell me what was going on (although I couldn't understand why the nurses were running in screaming at me at the time???), ahhh hindsight

 

[KandyKinz]

I received an interesting link to a midwife's blog today in regards to shoudler dystocia... Here it is if anyone's interested https://midwifethinking.com/2010/12/03/shoulder-dystocia-the-real-story/

 

[Bournefree]

I love that blog.. thank you fo posting.
XxX

 

[Ouverture]

Love the article - thanks for posting that!

 

[KandyKinz]

She also has some real good info on VBAC's but that's getting even further away from the original topic of this thread....

Sorry for derailing!

 

[aliss]

Thanks for that link!!!

Mine was not even a "big" baby (sorry in my family, 9lb 3oz is still a runt, LOL!), I was a grand total of 5'5 160lbs at delivery so the last thing I expected was for the poor kid to get stuck. We are so conditioned to think that big mom/diabetes = big baby gets stuck, that it never even crossed my mind that excessive medical interventions (induction when clearly not ready, morphine, epidural, 3 day labour, 4 hours pushing) would lead to such a disastrous consequence.

Thanks for sharing I am still debating between elective C-section & natural home birth next time. Have a very hard decision.

 

[KandyKinz]

Thanks for that link!!!

Mine was not even a "big" baby (sorry in my family, 9lb 3oz is still a runt, LOL!), I was a grand total of 5'5 160lbs at delivery so the last thing I expected was for the poor kid to get stuck. We are so conditioned to think that big mom/diabetes = big baby gets stuck, that it never even crossed my mind that excessive medical interventions (induction when clearly not ready, morphine, epidural, 3 day labour, 4 hours pushing) would lead to such a disastrous consequence.

Thanks for sharing I am still debating between elective C-section & natural home birth next time. Have a very hard decision.

Yep, I'm only 5'3" and pushed my 9lbs 3oz baby out in just 3 pushes..... I think when it comes to shoulders there are many more factors then just the size of baby and size of mom involved.

And good luck with your decision! It is a tough one after going through something like that!

 

[pester]

As to the orginal question. This is just my perspective as someone who hasen't given birth yet.

For me I am concerned about the affect the drugs would have on ME-(of course they affect the baby too). I don't want to feel out of control/druged/disconnected from what is happening. I have concerns about feeling attched to the baby. "I" want to be as clear headed after the birth as possible. Depending on your birth that may mean medication or no medication. How do "you" respond to medication.

So much of pain is in the mind. So if you go into labor with the mindset that "this is going to be BAD!!! I'm deffintly going to NEED help that is likely what is going to happen. But what if you go into the expirence with the idea that yes I may feel pain but what can I due to manage that it. Water/breathing/meds. Understand what is causing the pain and what you can due to relieve it. I have found that I can stand a lot of pain if I know it has an end.

 

[ladyredlainey]

Only time I had pain relief was with my eldest, after having contractions for over a day!, and it was morphine, and all it did was make her fall asleep when I went to 8cm, cause her heart rate slowed down.

My best experiences were with using gas and air, although I was sick with it lol!! but the way to look at it, is that you will not be in pain forever lol (this was at the back of my mind each of my labours with my girls), once one contractions comes, it is one less in the journey (i read out a book, but so true), you will never had that same contraction again

Best of luck, in what ever you decide to do in regards to pain relief, hope the labour is a lovely quick one x

 

[Bumpontherun]

My story isn't nearly as bad as some of the other ladies but I had morphine with Helen. The anti-emetic didn't work and unfortunately I had it just before the midwives changed shifts so they were off doing their handover when I started vomiting. I threw up every 5 mins for over an hour before my new midwife realised I really did need something else and got me another anti-emetic. My husband said he could smell the ketones on my breath afterwards and he was really worried about how dehydrated I clearly was (the poor man kept following me around the room with a cup of water). I've lost about 5 hours of my labour because the morphine had such a profound effect but I know that I went from having an active labour where I was managing my contractions well to being totally out of it, falling asleep on my feet and talking gibberish. I also feel it slowed things down a lot and was partly responsible for me ending up needing syntocin at the end. I can't speak for an epidural but I feel the morphine just wasn't worth it. It eased the pain but certainly didn't eradicate it, it prolonged things and it stopped me from managing my pain. I won't be having it again.

My best friend had it during her labour and athough she didn't have such a bad experience she felt it didn't help the pain, all it did was make her drowsy and then she would be woken up without warning by a massive contraction. She also said she wouldn't have it again.