Pain relief debate – agree with epidurals RD

Our expert and mums put forward the case for having an epidural in your birth plan

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Are you in favour of pain relief during labour?

‘Proper pain relief helps you to enjoy your labour,’ says Dr Gilbert J Grant, author of Enjoy your Labor: A New Approach to Pain Relief For Childbirth. Dr Grant is an obstetric anaesthesiologist who has been caring for women during labour for over 20 years

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“Although it’s possible to have a pain-free delivery that is safe for both mother and baby, many women continue to suffer throughout the experience out of guilt, fear and ignorance. There is a prevailing belief that modern anaesthesia is the easy way out and that it compromises the safety of both mother and child. I’m here to debunk a few myths…

Studies have shown that epidurals do not significantly prolong labour, and modern low-dose walking epidurals allow women to remain upright and active during labour, while retaining the muscle strength needed to effectively push the baby out.

Some claim that epidurals lead to an increased likelihood of Caesarean section. It’s true that statistics show that there is an association between epidurals and higher rates of C-sections, but not a causal relationship. Think about it: women who have difficult, prolonged labours and end up having a C-section or assisted delivery also tend to have more painful labours. They are more likely to request an epidural, but it was not the cause of the Caesarean.

What about breastfeeding? It’s true that any medication you take during labour will reach the baby, and that systemic pain relievers such as morphine or pethidine make both mother and breastfeeding baby sleepy, but at present there is scant scientific evidence to suggest that modern low-dose epidurals impact negatively on the mothers’ ability to breastfeed.

Unrelieved pain can have harmful consequences for mother and baby. Severe pain causes the body to release adrenaline, which narrows the blood vessels carrying oxygen to the placenta. So, when the mother experiences pain, the baby receives less oxygen. It is also becoming increasingly apparent that unrelieved pain may also contribute to the development of postnatal depression.

I chose the title Enjoy your Labor for my book because that is what I tell my patients after I give them an epidural. Ultimately it is your right to decide the type of pain relief – if any – that you would like to receive, but if you take advantage of what modern medicine has to offer, you truly can enjoy your labour.”

Mums’ stories:

Ruth Adam, 31, is married to James and mum to William, five months:

“I’m 100 per cent in favour of epidurals! I’m a physiotherapist, so I talked to consultant anaesthetists about pain relief during labour. Having considered all the options, I decided to go for an epidural. I was induced and, once the pain became intense, I requested and was given an epidural. I was able to enjoy the remaining 10 hours of labour and delivery – I actually read an entire book!

I was completely relaxed and can say that I enjoyed the whole experience. I was very apprehensive about labour, but can now say that I’m looking forward to having my next one – but not just yet though! What I find hard to believe is the way that some women think that if you have pain relief it makes you less of a mother, and your birth a lesser experience. It’s ridiculous!”

Ruth Ainley, 33, and husband Alex have sons James, two, and Jonny, three months:

“Labour is one of the few pains that people seem to think is acceptable – indeed almost preferable – to endure without pain relief. It doesn’t make sense to me. Why is requesting an epidural seen by many as such a sign of failure and weakness in labour?

Some women seem to think that if you can’t do it “naturally” you haven’t really done the job properly. I know quite a few other mums who seem a bit embarrassed because they’ve had an epidural and feel they have to justify their decision. I am definitely all for adequate pain relief. Good for you if you can manage without it, but labour doesn’t often end up as you would imagine or like.”

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Now read the other side of the argument with campaigner Sheila Kitzinger…

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