When I was expecting my first child, during a conversation with some other pregnant women, I commented that of course I was having an epidural, because I didn’t expect a medal. These women took me to task a little, because they were both in fact planning natural births—and not because they expected medals, but because they thought it was best for them and their babies. I apologized, but the fact was, I really meant no judgment. It was merely a comment on my own very low tolerance to pain—natural birth was fine for other women, but I knew I would need medication.
I did have my epidural—after a shot of Demerol and labouring in the whirlpool tub no longer cut it. I experienced back labour with my first, and had intense contractions minutes apart from the get-go. None of that “mildly uncomfortable for the first few hours” stuff for me. In what I now know to be a fairly typical scenario, the epidural slowed my labour, so I needed Pitocin. I can remember one nurse looking at the monitor and commenting she’d never seen such intense contractions that did nothing. I no longer felt them, which was, I suppose, the point.
Because I was tied to the bed, I couldn’t walk around and help things along. With people coming in and out every few minutes to check on things, I wasn’t getting the rest I’d been promised. Finally the OB on call told me he was sure I couldn’t push the baby out. He said I could try, and likely end up with a c-section. Or we could just go straight to the OR. After so many hours, I hesitated—all that just to end up with a c-section? Finally I decided to go with the surgery. After all, I reasoned at the time, if I ever had another baby, at least I wouldn’t have to go through labour again!
But it was too late—the doctor’s shift had ended, my baby had finally budged, and the OB now on call declared I could push him out. With help from an episiotomy and foreceps. So that’s what we did. But after twenty hours, my baby had passed meconium. Which meant he was taken from me to be cleaned up. They gave him back to me, finally, all swaddled. Which meant no skin-to-skin as I’d read about. While they fixed me up, no one suggested I should try to breastfeed, so I didn’t until I was moved to a room and got the “helpful” advice of “you put him here, you put him there, then you’re done” from the nurse on duty. Which resulted in at least a week of struggling to keep my baby awake and get him to latch, feeding him pumped milk through a tube, consulting with nurses, doctors and a lactation consultant–and lots and lots of tears. And even once he latched, it was a good two months of struggle and pain before we finally got into a groove. It was worth it, but it wasn’t something I wanted to do ever again.
Which is the reason I decided NOT to have an epidural the second time. Not because I wanted a medal or to prove anything (except perhaps to myself). No, I just decided a day of purposeful pain would be worth avoiding the snowball effect that almost led to a c-section (clearly unnecessary, since I didn’t have one in the end), months of healing from the episiotomy, and weeks of breastfeeding issues. To achieve this goal, I knew I had to make different choices, the first one being going with a midwife instead of an OB. I kept my options open—I still signed the epidural consent form, because frankly, back labour sucks. But knowing my care would be transferred to an OB if I had one was good incentive to try other things first.
I did reach my goal, with the help of a supportive husband, experienced midwives, a blessedly short labour (and a baby who was facing the right way!) and a bit of gas during transition. And while there were other complications, breastfeeding wasn’t really one of them.
Look, I’ll never judge another woman for choosing an epidural. How can I? I had one. And even knowing what I know now, I can’t honestly say I would have made a different choice the first time around. What I do judge is a medical establishment that defaults to drugs—often even before a labouring woman requests them–in order to manage birth, without first explaining the risks as well as the benefits. What also drive me crazy is that every conversation about birth with a first-time mom-to-be includes comments like “you MUST have an epidural”. Imagine if I went around saying “you MUST NOT have an epidural”? Yeah, I don’t think that would go over too well either. I know from personal experience that each birth is different. And I couldn’t possibly know what another woman is going through. Her choices may not be my choices. But without knowledge, it’s not true choice.
So I won’t tell another woman not to have an epidural. But I will tell her to research it first—before labour begins. I will tell her to ask questions (and if the instructor at your hospital class says there aren’t any risks, as mine did, don’t believe it.) I will suggest she consider a midwife, or to hire a doula if she has an OB, to support her in her goals, provide other options, and help her make informed choices. I will tell her why it’s a good idea to labour as long as she can without an epidural. I will tell her she CAN do it. And I will respect her choice in the end.