*for me. Just as each woman and birth differ, so do a woman’s reasons for choosing to prepare for birth the way she does. These are mine.
The trouble with epidurals is not that they take away pain — that is the good thing about epidurals. Choosing pain over pleasure is a sign of genetic defect in laboratory animals; it is not a good recommendation for humans, either. The trouble with epidurals is not that they take away from “experiencing” the whole miraculous thing, beginning to end, with no oblivious gap. (This is a drawback for many women about epidurals, but there are many painful aspects of life I would rather not subject myself to if I can avoid it, like shopping for a bathing suit.) Some women want to do nothing that would interrupt or change the natural order of things. This is an admirable motive for not wanting an epidural, but it is not one of mine. (I think.) (Actually, it is, but then I might feel differently about “nature” after experiencing “natural.”)
And the trouble with epidurals (for me) is not even the potential side affects associated with the epidural medicine or procedure itself, which can include (but are not limited to) 1) spinal headache, 2) sluggish baby, 3) prolonged or excessive inability to move one’s legs, 4) cardiac arrest for mother and abnormal heart rate for baby, and 5) a numb patch on your right leg for months. Of these (rare to very-rare) complications, only the last has happened to me with three less-than-stellar epidural experiences. The most annoying part of my epidurals (so I thought) was that my spine didn’t cooperate so I still had pain on one side and then after subsequent doses, I had absolutely no hope of staying on the bed without help.
The trouble with epidurals is two-fold and relates to the requirements that go along with getting one. First: with an epidural you have to labor in the absolute worst position physiologically, a position (lithotomy/flat on your back) in which gravity works against you, and in which the pelvis/cervix are able to open much less (I have read, up to an inch less) than in a squatting or all-fours position. (Of course it would be even worse to be strung up by your toes, but not much.)
The second requirement is constant electronic fetal monitoring, which increases interventions like forceps and vacuum-extraction deliveries and c-sections, without improving fetal outcomes. C-sections may seem like no big deal for some women, but even when they are medically necessary (and thank God they are available when needed, right?), they are still major abdominal surgery that affect how the mother is able to conduct her life even months later, much less in the days and weeks following birth (a time that already strains a woman’s emotional, mental, and physical faculties).
If there were a magic pink pill that took away all pain sensation from the waist to the pelvis while retaining sensation of muscular positioning and contraction and all motor function of the legs and trunk muscles, with a one hundred-percent guarantee that there was no effect on or transmission to the fetus and no risk of side effect to the mother, of course I would sign up tomorrow. Of course.
The trouble with epidurals is that they are not that magic pill.
The trouble with much of modern obstetrical practice is that epidurals are too-often presented to the pregnant woman as being that magic pill. For my previous three births, I was given information regarding the very slight chance of spinal headache, etc, but no one told me, and I didn’t think to ask, that laying on one’s back was not only NOT the only way to give birth but actually the least-helpful, least-physiologically-indicated position, and that electronic fetal monitoring would not, in fact, make my baby safer.
Those are two hefty omissions.
Which is not to say that epidurals don’t have their place or that women who choose them are in any way “less” somehow than those who do not. For some, epidurals are close enough to that magic pink pill that they are only logical. For others, a very careful weighing of the benefits and drawbacks is necessary, and that weighing can only take place when ALL of the benefits and drawbacks are known and considered.
Now that I know (and am continuing to learn), I am still open to the possibility of getting an epidural; I am not so determined to “experience it all” that I would ignore the actual sequence of events that is this unique, fourth, birth. For example, if I have days of back labor that exhaust my resources without progressing, or if I realize that I’m not dilating completely because instead of being able to relax into, surrender to, or work with/through the contractions I’m instead reverting to my natural inclination — to tense against pain — and that an epidural at this late stage is the only way to get the baby out of me (this assumes I am stalled enough that there is actually time to get the anesthesiologist there), then I would choose to have one. Because in either of those scenarios the two drawbacks to an epidural would be of less concern at that point.
And in the end, epidural or no epidural (vaginal or emergency c-section) I will have succeeded in doing it my way, the way that seems best to me after learning all I can, which is all I ask of life. (Well, that and a trip around the world at some point.)