Epidurals Are Not Safe for ALL Patients!

The Epidural Debate

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Yesterday's blog post pissed off some people, scared others, and even enlightened others. My intention was not to do any of those things. I only wanted to tell my story. To put my experience out there, like I do much of my life.

I live.
I write.
That's who I am.

I happen to be pregnant...and it was a glorious surprise in my life. I'm so happy to have this little one inside me, kicking me to death and causing me discomfort (hehe) that I want to share it with the world. If my experiences help another mother-to-be, then that's great! I'm glad to hear it and I'm happy to have gotten a few thank you notes from ladies on the BabyCenter forum yesterday. Many said things like, "After reading your story, I now know what questions to ask my doctor about the epidural."

THAT MAKES ME HAPPY.

If I had actually hoped for a result, other than me simply blabbering on and on about everything with this pregnancy....THAT would be the result I'd hope for.

Why people were pissed: 

I had a link to this page on BabyCenter and my title said, "How Epidural Almost Killed Me Yesterday." Some of the responses were:

"I wish you would change your title. I can't unread it now and it scared me."
"You were hardly at the Pearly Gates."
"Low blood pressure is a side effect of the epidural..."
"Ladies, please don't let this scare you. This is not normal or common."

You can read the entire thread, if you like and see the responses from various people.

I received a few private messages as well, but those were thank you notes and one said she loves my blog. That was nice to hear. :)

So anyway...my response to all of this?

Now, I'm GLAD my blog post incited so much emotion. I'm glad some folks got pissed and I'm glad some got scared...and I'm glad some have good questions to ask their doctors pertaining to the epidural. Why am I glad? Because such emotions generally come with the response of ACTION. Emotion leads to real learning.

Even those who completely disagreed and thought I was...I don't know, overreacting? Have it in their heads now. I would almost bet they won't simply be like, "Oh great, an epidural!" and not ask a few questions about the risks involved.

The discussion from yesterday got me interested more in them as well, because I wanted to know if what I experienced was a side effect or a complication. To me, a side effect is a common, benign complaint/experience a person might have due to taking medication. A complication is a rare event that occurs as the result of taking medication.

That's how I view it. How do dictionaries view it? Let's see....

SIDE EFFECT: 

1. (Medicine) any unwanted nontherapeutic effect caused by a drug (from freedictionary.com) 
2. any effect of a drug, chemical, or other medicine that is inaddition to its intended effect, especially an effect that is harmful or unpleasant. (from dictionary.com)
3. Side effects: Problems that occur when treatment goes beyond the desired effect. Or problems that occur in addition to the desired therapeutic effect. (from medterms.com) 

COMPLICATION: 

1. Any adverse medical response to a procedure or therapy; in drug therapy, aka, adverse–side effects. (from medical-dictionary.thefreedictionary.com) 
2. Complication: In medicine, an unanticipated problem that arises following, and is a result of, a procedure, treatment, or illness. A complication is so named because it complicates the situation. (from medterms.com) 
3.  http://www.merriam-webster.com/medical/complication (I couldn't copy and paste this one with the source, so you can view this definition by following the link).

So, it seems to me that a side effect is one that is anticipated and a complication is one that is not, unless a side effect goes beyond the realm of what IS anticipated and then it becomes a complication.

Great! That's settled.

Except for me, it puts up a giant fucking red flag! 

If a sudden drop in blood pressure is a common side effect of an epidural, why is this not discussed with patients (like me) who already have low blood pressure? I've had two in my life. Neither time were side effects/risks discussed with me. I should have asked, of course...that's my motto, after all. However, with my first one, I was 19 years old and I did everything as my doctor ordered/suggested. He could have told me to stand on my head for an hour each day during that pregnancy and I would have without question.

I didn't know if what happened to me was the result of no sleep the night before because I was scared of the induction or if it was typical or what. Even after running a temperature of 104.5 after having my son (another effect of an epidural!), nothing was mentioned about what happened to me and I had no idea what to ask...I was just thankful it was over.

So what are the possible side effects of an epidural?

Here's a link with a list and it lists things I STILL hadn't heard of until I just read it. "Loss of perineal sensation and sexual function?" Really? How did I not know this until AFTER I've had two of them?

Epidural Side Effects

The following link is one that supports home birth as a safe option for birth...something I completely agree with when dealing with a normal, healthy pregnancy. It discusses the risks of an epidural. According to this source, epidurals "lengthen labor," "triple the rate of perineal tears," and increase the risk of a c-section by 2.5%.

AGAIN....why was none of this discussed with me PRIOR to having one so I could make my own decision pertaining to the administration of the drug?

If you read the entire piece, you will also discover the side effects the drug has on the babies. For example, it states that babies immature immune systems take longer to eliminate the drugs from their bodies. "2.7 hours for adults and close to 8 hours for babies."

NOTE: this varies for adults too. It took my body 5 hours to eliminate the drug this time and I was given a smaller dose due to my blood pressure prior to the procedure. With my first son, I was numb for 6 hours AFTER having him and I was given the epidural very early in labor.

Epidural vs Natural Childbirth

I think it's a shame on the medical community that things are not discussed with the patients. Sure, some may still jump on the epidural bandwagon regardless of the risks involved, but at least they KNOW what is involved. For people like me, who actually might want to decline based on the risks, I feel I'm entitled as a patient to be informed!

I think considering my normal low blood pressure, I absolutely should have been informed of the risks involved. I should have been told what they would do should an emergency (like BP of 50/30) arise. It should not have been left to guessing.

Had I been informed, perhaps I would not have thought I was headed to the "Pearly Gates..."

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The way I see it is this...

If a child is allergic to bees, do you allow him to play near a Russian Sage bush that is covered in honey bees because you have an Epipen that will save him should he go into anaphylactic shock?

beespotter.mste.illinois.edu

If your hiking in the mountains of the Mojave Desert, do you wear flip flops and bash about without concern of where rattlesnakes might be, because you have anti-venom in your backpack?

www.kingsnake.com

Probably not...at least not if you have half a brain. 

HOWEVER, this is exactly how it is for an epidural. they give it to you and if you have a terrible reaction, like plummeting blood pressure, they have an injection of ephedrine available to give you so you don't die.

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So why are people simply allowed (practically expected) to have an epidural if there are, in fact, side effects that can be fatal to the patient and NOT INFORM THE PATIENT OF THEM? 

Why is this happening? 

For many doctors and hospitals, childbirth goes like this: 

1. Induce with Pitocin (OR, if spontaneous labor does occur, and does not progress with X amount of time, administer Pitocin to speed it up). 

2. Administer epidural. 

3. Check cervix often for progress. 

4. If progress is being made within X amount of time, wait for head to crown...if not, c-section. 

5. When head crowns, mother pushes. Episiotomy is given to avoid tearing. 

6. Baby is whisked away to station for cleaning (to remove vernix, which is actually helpful to the baby), eye medication (which prevents the baby from having a clear view of the mother), and a quick swaddle. 

7. Baby is handed to mother.

If you want something different than this...you better be discussing it with your doctor ahead of time! Labor is not the time for discussion. 

Of course this IS NOT the case with all doctors and hospitals....but it is the case for a lot of them. Are you sure which one you have? 

In my opinion, epidurals are NOT a safe pain reliever for ALL patients. Sure, they are safe for many, but NOT all. I do not consider them to be safe for me at all. 

You can take that as you want it, or toss it. I don't care. It's my opinion, based on my experience. 

To me, getting an epidural without knowing the risks (as I did when 19 years old) is as irresponsible as letting your child play near the bees when he has a terrible allergy to them...or walking in the Mojave in flip-flips, without being on the look-out for rattlers. 

I also don't think epidurals should be routine with vaginal deliveries. Just my opinion...feel free to share yours below, if you'd like. I think women need to be TAUGHT how to deal with pain on their own. No woman has ever, in the history of mankind died from the pain associated with a vaginal delivery. 

None. 

If you find an example of this, please let me know and I'll recant what I just wrote. I think I'm safe to leave it though. 

Yes, the pain of childbirth is excruciating at times...especially if you have back labor with it. I know. Yes, you may have a very large baby...I understand. I truly do. MY point is, I don't think a woman should jump right to saying "I plan to have an epidural," when she hasn't even started having labor. She has no idea what her pain tolerance is yet, especially if it's her first baby. Even if it's her second, she doesn't know what that particular birth will be like. 

I had back labor with my second son and the thought of it scares me, but I MADE it through without having the epidural and it was a WONDERFUL experience for me. I was up and walking within an hour. I felt tired, but GREAT! 

I'm not saying, "suck it up, you don't need pain meds!" I'm saying, give your body a chance...see what it can do before deciding you're having the epidural or other medication and DEFINITELY discuss the risks/benefits of an epidural BEFORE you're in labor so you can make an educated decision should you find the pain of labor too unbearable. 

One thing I want to add is this...when you're in labor, there is a point where you will think you can't do it. You'll truly believe your body is incapable...it is at that point (for most) when you're ready to push and the pushing part is not painful. Your body creates its own "pain relief" and it doesn't hurt. You'll feel pressure and there will be a little burning just as the baby's head comes out, but that's it. 

Just educate yourself. 

Please. 

It's your body and your baby. 

Do what is right for both. 

Do your best to be the best mother you can be. 

REED Works! 

Research: all you can to...

Educate yourself to...

Empower yourself to be able to...

Discuss effectively with your caregiver.