Epidural Fear Factor
Pregnancy opened a floodgate of questions, concerns, and fears. Just thinking about giving birth was like anticipating being the victim of a violent crime. I was haunted by stories such as c-sections after hours of excruciating labor (with meds), and of course, the dreaded back labor.
Women have died giving birth. This was my mind-set. Yet, envisioning having a needle stuck into my spine to avoid the pain of a natural process seemed a bit backward. I quickly listed an epidural as number one on my mental scroll of things to avoid. This was also a reaction to my medical inexperience.
When I’ve talked to other mothers about the standard epidural and I mention that I’ve avoided it twice, they don’t usually say it, but I know what they’re thinking, why would you choose to suffer when you don’t have to?
The fact is I’m more afraid of the epidural than labor pain. Even still, going natural from start to finish wasn’t an easy decision to either make or stick to.
We naturally fear what we do not know. I’ve always been needle, hospital, and doctor phobic. I’d never stayed overnight in the hospital since I was born. Never broke a bone or had surgery; I was pretty much a medical virgin. I might have chosen a hospital alternative if I had been less crazy about my doctors, who always patiently talked about my concerns.
In the meantime, I was mentally exploring and dissecting my ideas about giving birth. Feeling consumed by it, I sat down one day to write a poem, which uncovered the underlying motivation for a drug-free experience:
“… I accept a vow of consciousness no matter how my loins may ache, to be whole-heartedly present, and treasure each contraction, grateful for a moment of intensity to measure the rest of my life against …”
Of course, this is was a sentiment straight from my spiritual core, which said nothing about whether or not my body could handle it. That’s when it occurred to me that I had no gauge on my physical strength. Regardless of the fact that I was fit, my last memory of physical challenge was age thirteen, when I barely tolerated blistered and bleeding feet crammed into pointe’ shoes in ballet class. I’d never run more than a 5K race, never competed in organized sports, never fulfilled the dream of sky-diving. It felt like gearing up to take a walk after standing relatively still for thirty-one years.
Once my courage overshadowed my fear, I categorized giving birth as a sporting event. It would be the first conscious leap from my physical comfort zone. But if I trained properly and could manage with minimal intervention and without medication, it could be like conquering the ultimate challenge—my own personal Fear Factor.
This particular epiphany spun me into a fact-finding frenzy. I eagerly cornered every birth-lete who crossed my path and was willing to talk about it. I found that most women relished in their birth-athon stories, good, bad or text-book c-section. It’s no wonder many consider childbirth their greatest accomplishment. Claire, my dearest friend from high school, boasted two unmedicated births having mastered Lamaze breathing. I wondered, if she could do it without drugs, why can’t I?
Two couples we know had success with The Bradley Method, the art of attaining low-risk status through nutrition, exercise and mind power. One couple (the woman was a nurse) guided us through the twelve-week course at home. While it educated and empowered me, I still felt anxious.
I was addicted to watching A Baby’s Story and Birthday, hoping for a peak into my future. But no such luck. The epidural was often considered the candy of their process. I had already learned how I would avoid having one, and each episode inspired me to want to put that knowledge to the test.
According to the Bradley Method, squatting during labor opens the pelvis, creating enough elasticity to the perineum in order to stretch without tearing, thereby avoiding another hideous procedure: episiotomy.
Ronnie Falcao, LM MS, a midwife in Mountain View, CA, says that having an epidural makes squatting difficult, if not impossible.
"There is considerable debate as to how epidurals affect the progress of labor, but they certainly affect a woman’s ability to get into a squat, which opens the pelvic plane by 20 to 30 percent. “This could affect the possibility of the baby fitting through the pelvis” she says. “Epidurals can lower the mother’s blood pressure so that the baby isn’t getting enough oxygen through the placenta; this can cause fetal distress and the need for an emergency c-section to rescue the baby.”
The threat of giving up whatever control of the natural process I might actually have and making labor more difficult with an epidural kicked my stubborn tendencies up a notch. But learning that no drug has been proven safe for an unborn baby clinched it.
Beverley Lawrence Beech, UK-based mother of two and author of books including, Am I Allowed?, a book informing women of their rights and choices in maternity care, says, “We live in a society that rarely questions the risks of prescribed drugs. While women will avoid taking as much as an aspirin during their pregnancy for fear of affecting their baby once they go into labor they will accept almost any drug that the doctor prescribes.
“In turn, doctors fail to tell women that the heroin derivatives and barbiturates they routinely use in labor could result in their baby developing drug addiction in their teens. If women were routinely informed of that risk they might think about alternative methods of pain relief.”
When having my own children was still a fantasy, my background as a massage therapist got me into my friend Alex’s second birth. She had elected me to be her human pain reliever. For four hours I followed her around the hospital as she walked in her Teva sandals, stopping during each contraction for deep breathing and quickie pressure point work.
When she was ready, she got on all fours on the bed and pushed the baby out within moments. Needless to say, she was my role model and I would reflect on that experience repeatedly the day of my son’s February birth.
Our fun began at 4 a.m. (two days early) when my water broke following one contraction, and a short drive to the hospital through wet snow. I was glad not to have to wait until just the right time to go to the hospital.
After checking in and getting settled, I was left to my own devices. My husband, Guy, got comfy on the couch and dozed off. Feeling a bit lost, I took out a copy of my birth plan, which I had printed out for each doctor and nurse, and put it on the table. I re-read the words, please DO NOT offer me any pain medication or an epidural at any time.
I sat in a wooden rocking chair watching the snow storm out the window, breathing through mild contractions. A nurse came in to start an IV.
“I’m not going to need that,” I said.
“Well, you might,” she said, claiming it made more sense to do it sooner rather than later.
Again, I refused. “It’s all in my birth plan,” I said.
Left alone again with Guy, I suddenly got hit with a wave of nausea. That’s when my mother arrived to watch my peculiar obstacle course from the chair to the bathroom, where I threw up, back to the chair, to the bed, to the toilet again, back to the bed, to the bathroom floor. I attempted listening to music, which only annoyed me, then visualization, but my body twitched in rebellion.
When the nurse checked my progress, I begged, “How long will I be at one centimeter?”
Frustrated by sprinting in place, I began caving to weakness. When Guy left the room for a moment, I completely lost my last drop of cool, as if my strength had walked out the door.
“I can’t take this anymore,” I yelped.
My mother, an RN, breathed a sigh of relief as if to say, thank God, and asked if I was sure. Of course, I wasn’t sure, but rather than huffing and puffing through several more hours of the same agony without progress, I felt the need to change the situation. My doctor came in at that moment to witness my uncertainty, knowing what an issue this was for me. Guy soon returned, startled to find me crumbling.
“You can do this,” he said, and asked if I could be examined again, even though the nurse had just done it less than an hour before. The doctor checked me this time and found that I had suddenly dilated to five centimeters. I almost didn’t believe it. At that point, I knew I could hang in there. Guy rubbed my back, my mother let me squeeze the life out of her hand during contractions and the nurse saved me with a quick demonstration of Lamaze breathing, which hustled me through the next several hours.
Rush of relief came with the strong urge to push. I felt like some kind of bizarre performance artist as I used the squatting bar on the floor, then on the bed. I struggled for a comfortable position, feeling too tired to continue, wondering how much harder I’d have to work to see my son.
When pushing felt involuntary, the nurses called for the new doctor, who had changed shifts. She suggested I lie on my back and draw my knees up. It wasn’t long before my son slid out like a baby on a water slide.
I tried, but couldn’t hold back from weeping at the sight of Vincent’s beautiful, slimy little seven-pound-sixteen-ounce body. Wrapped in a blanket, he nursed immediately while a burst of energy washed over me. I thanked my higher power for saving me from an IV, epidural, episiotomy and who knows what else. Guy accompanied Vincent to the nursery. When he returned, he said everyone was talking about me. I felt euphoric and wondered if it was anything like runner’s high.
Repeating the process twenty-two months later was a lot sooner than I had anticipated. I had fully expected an easier, shorter labor, but still, I questioned by ability. Technically, labor turned out to be longer—Vincent was born in twelve hard hours, while Julia took seventeen, only two of them hard.
I thought of Alex again as I paced the hospital floors by myself, stopping to endure contractions, then continuing my walk to see who else was spending Christmas day in the hospital.
Guy watched the intensity of my contractions on the monitor as I snored through several hours of deep sleep. The next morning I awoke at six, took a long hot shower and pushed Julia out at 8:15 a.m. Again, no IV, no epidural and no episiotomy. I hadn’t even torn this time. The same doctor who had delivered Vincent, said, “Congratulations, you’ve done it again!”