What You Should Know About Epidurals (part 1)

Doctors prepare to make anesthesia

By J. J. Gregor

Having seen the birth of both of my children, I will never be too arrogant to tell any person going through one of life’s most excruciatingly painful experiences to not take advantage of modern pharmaceuticals.  I myself haven’t taken a prescription or over the counter drug for about 15 years, but if I was in as much pain as Erin during TJ’s birth I would have been first in line for drugs!

This is a very delicate topic , but I am going to present the potential downsides of the epidural by providing information so every woman can make an informed decision.

First, let’s talk about what an epidural really is.

Considered the most popular pain relief during labor, epi is defined as above in latin/greek, and the dura is the covering of the central nervous system (CNS).  An epidural is an injection of a drug into your spine above the sack that covers your CNS.  It is usually a mix of an opiod and a narcotic such as morphine and cocaine.  The drug blocks the signals from your motor and sensory nerves.  This gives you effective pain control, but stops you from being able to get up and walk.

There are a couple of new types of epidural-like options that are worth mentioning.  A “walking epidural” reduces the motor portion of the block and allows for mobility.  With a spinal analgesia or “spinal”, the drug is injected into the dura by the spinal cord.  These are fast acting, short lasting painkillers but allow for total motion of the mother.

Now let’s talk about the effects.

During the birth process the hormones are amazing, and extremely difficult to control so lets talk a second about hormones and what they do.

Estrogen and Progesterone are the main hormones in setting up the entire pregnancy and birth process.

Oxytocin, perhaps the most important hormone for delivery, is the “love hormone” and plays an important part in birth and breast feeding.

Beta-endorphin may be the most important hormone for mom.  It is the hormone that creates the “runners high”.  Beta-endorphin also increases pain tolerance.  The combination of Oxytocin and Beta-endorphin work to increase the mother child bond.

Prolactin is the mothering hormone and can help elevate the mood of the breast feeding mother.

Catecholamines are your stress hormones.  These are hugely important in pushing the baby out but if the mother gets stressed too early and these spike it can lead to poor bonding of mother and child.

These hormones are all tightly controlled and orchestrated by complex and constant feedback from the nervous system.  If we block the transmission of these signals with pain blockers, we will be setting up the mother for a myriad of short term and long term problems that can include:

  • Up to almost a double the total length of labor from – 5 to 8 hours.
  • Increased incidence of Cesarean Section when an epidural is administered.  This is probably due to the drugs “turning off” the pelvic floor and uterine muscles.
  • Increased risk of a delivery needing the assistance of a vacuum or forceps due to the mothers inability to engage the final gravitational contractions of labor on her own.  When extraction instruments are used, the doctor has to almost double the force compared to non-epidural deliveries.
  • An increased risk (almost triple) of a severe and painful tear in your pelvic floor.  This can lead to urinary or bowl incontinence and or sexual disorders which are rarely resolved spontaneously.

So although the epidural might seem like the quick and easy solution, it may cause more complications in the end.

Tomorrow I’ll talk about the effect of epidurals on babies.

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