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The Top Ten Reasons Why Epidurals are Risky Business
1. Use of epidural anesthesia for labor may increase your chances of a
cesarean delivery by 10-50% depending on how early it is placed.
Epidural anesthesia is one of many interventions in a chain of
events that happens once labor becomes a "managed" event. The chances of your
birth ending with a cesarean delivery, which is major abdominal surgery, is
increased by 10% with each centimeter early it is placed. Epidurals slow labor
down, decrease the uterus's function and ability to produce effective
contractions, and affect the neurological relationship between the brain and the
uterus. Once the intervention cycle has begun, other interventions must be
introduced to counter act the undesired effects of the previous ones. Many women
caught in this negative chain of events end up with cesarean deliveries which
may have been avoided. The rule here is that if a epidural is required to wait
as long in labor as possible to get it, reducing your chances that it will
negatively effect your contractions.
2. Use of epidural anesthesia decreases the mobility of the laboring
mother.
One common effect of epidural anesthesia is numbness the legs
and feet. Once the epidural is in place a laboring woman is confined to the bed.
Some vertical positioning is possible, but with this comes a greater degree of
numbness in the legs and feet due to gravity pulling the medication down the
body. If side lying placement is used, then a woman may become numb on one side
and have some or total feeling on the other. Movement is important in labor to
help the baby get into a good position for birth. Once you take maternal
movement and positioning out of the picture, labor becomes a riskier and highly
managed event.
3. Consumption of any food or drink is extremely limited after epidural
placement.
Because of the increased surgical risk consumption of food
or drink severely limited to prevent a sedated woman from aspirating the
contents of her stomach should she vomit. Epidurals commonly cause nausea and
vomiting as well. An IV must be used to deliver fluids to the mother, as a means
to counter the drop in blood pressure associated with the use of the epidural
medications.
4. The procedure is painful and frightening.
Epidural anesthesia
is both uncomfortable and unnatural. The laboring woman is forced to maintain a
very uncomfortable position for anywhere from 15 to 45 minutes or longer. The
slightest movement or malpositioning can cause the needle to miss the epidural
space and the anesthesiologist may have to make multiple attempts with the
needle to find the proper location. Imagine being doubled over your pregnant and
contracting belly for anywhere from 5 to 25 or more contractions with a nurse
holding you still, and someone poking you in the back with needles. Not a
comforting image. Your spouse and other family members are asked to leave for
the procedure as well. Some hospitals may allow your doula to stay, but many
will not.
5. Epidurals commonly provide inadequate, partial or patchy, or no pain
relief at all.
Because epidural placement can not be an exact science
it is difficult to judge how adequate the pain relief may be. Many women
complain of little or no pain relief or of patches or windows of pain, for which
there is no relief. Here you have all of the side effects and precautions of the
epidural with few or none of the benefits.
6. Use of epidural anesthesia increases the second stage of labor an average
of 21%
Once a laboring woman has completed the first stage of labor
(the dilation stage) with an epidural in place, she will most likely not have
much if any urge to push. This lack of direction slows the baby's descent and
increases the need for such interventions as pitocin use, valsalva pushing,
forceps and vacuum extraction, episiotomy and cesarean delivery.
7. Maternal fevers are a common side effect of epidral anesthesia, which
leads to unnecessary treatments of the infant for infection.
It is
unknown why women with epidurals run fevers during labor. One can logically
deduce that it has to do with the body rejecting the catheter being placed in
such a vital area. When a mother runs a fever during labor it is often
associated with infection. The babies are then treated as though they were born
to an infected mother and subjected to a host of exams and tests as well as IV
antibiotics "just in case". These treatments often interfere with early bonding
time between the mother and baby and cause the baby unnecessary pain and
suffering.
8. The long term side effects of epidural anesthesia include; low and mid
back pain & weakness, headaches, leg pain & weakness, nerve damage in
the spinal area and even paralysis.
These side effects may be present
for years after the procedure. Because the anesthesiologist can never be sure of
exactly where the needle and catheter are placed there is always a chance of
nicking or damaging a nerve, vertebrae or some other part of the spinal area, or
an inadvertent spinal tap where there is a loss of spinal fluid. These events
can cause the mother extreme pain and may have lasting effects. Also the loss of
feeling in the legs may lead to poor positioning for labor and/or delivery which
may cause injury to the lower extremeties. Over extending the hips and knees are
common when you cannot feel the pain in these joints during pushing.
9. Babies who are exposed to prolonged use of epidural medications
consistantly score lower on the Brazelton Scale in the area of motor control and
development.
Recent research shows that babies with any amount of the
medication used in epidurals in their blood stream after birth have difficulty
with motor control both after birth and beyond. The higher the con- centration
of the medication the greater and longer the degree of the difficulty with motor
function indicating that the longer the baby is exposed to the medication the
longer lasting and greater the effects. In addition studies indicate that it can
take as long as 21 days for the medication to vacate the babies blood stream.
10. Babies born during epidural anesthesia have a greater degree of difficulty
with initial latching during early breast feeding.
As a result of the
reduced motor function, reduced neurological function affecting instinctive
behavior and a longer, more stressful second stage many babies born during
epidural use have a great deal of difficulty in latching on to the breast. Some
researchers think it may also affect certain reflexes such as rooting and tongue
thrusting.© Jo L. Davis, DEM, PMUS, EMT-B, 2009
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