How to find facts on whether to epidural or not?

  1. You have chosen to ignore posts from winter09wedding. Show winter09wedding's posts

    How to find facts on whether to epidural or not?

    I know that some people have strong opinions about this- and am not really looking for more advice- my problem is that I feel there are people on either end of the spectrum that are tending to "tweak" the facts a bit.  I have family/friends in both camps and am starting to feel really pulled- and I have heard that the birthing classes usually sway in one direction or another, depending on the instructor. I am receiving care at the Brigham and have some potential medical issues that can complicate the birth (a spinal malformation), so I have tried to not have a "exact birth plan" knowing that things may change in the moment for me (I may need a c section even if the baby is effaced, I know that I can't get an epidural in the normal location, etc.)  However, I am not sure where people go for accurate information- For example, I just got an email from my sister in law who is telling me that I will certainly need pitocin if I get an epidural because it slows labor. Have people found a source of information that they feel comfortable with aside from their doctors? I would like to be able to look at actual facts (e.g., how many babies have trouble latching, etc.) so I have a basic understanding in order to talk with my doctor about the different options.

     
  2. You have chosen to ignore posts from amy-lynn. Show amy-lynn's posts

    Re: How to find facts on whether to epidural or not?

    I'm not sure if there is a good place on the internet to find what you need (maybe WebMD, it is pretty unbiased, but often lacking in details). The problem with the internet is that opinions often are presented as fact, with very little ability to separate the truth from fiction. But I would say you might wnat a very detailed birth plan - That you can go over with your doctor(s) before you are even close to labor - Beacuse you have existing medical issues, you might want to talk with them in detail about what complications they think might be more of an issue for you. Also, if the doctor you usually see is not on duty when you go into labor, if your birth plan is available, with details like - I must have an epidural in location X, not location Y because of my medical history - it might help the on duty staff (especially if you are in hard labor and not as able to express yourself clearly as you would be in normal circumstances.)
    I'm not saying a detailed birth plan will be the end all and be all, but by really going through what you would like to have happen, with some contingincies for what could happen, it might help you have the conversation with your doctor that can answer your questions. Because the other problem with just about everything in pregnancy, is that for every woman it can depend (For example, if you have an epidural, you might need pitocin, but you might not - it can depend on how far into labor you are when you get the epidural, how your body responds to it, etc. etc. and only you and your doctor can make those decisions, sometimes only as the time comes.)
     
  3. You have chosen to ignore posts from winter09wedding. Show winter09wedding's posts

    Re: How to find facts on whether to epidural or not?

    thanks for your thoughts- I should have been more clear. There is definitely a contingency "birth plan" in place- anesthesia will be contacted once I check in, I have already met with them (at 23 weeks), etc. However, I have been a bit hesitant to make the typical decisions that other "moms to be" have made (e.g., like whether I want an epidural or not) because I want to make sure that I can be responsive if there are things that need to take place to maintain safety for the baby and me (e.g., the worst case scenario is that I will need full anesthesia for a c section because an epidural won't work, which is not something that I would like but I feel I need to be open to it.)    

    That said, I am clearly in a very "medical" setting because of these complications, and am just not sure how to make sure I have the complete- and totally accurate- picture. I have been hesitant to use the internet because of the same reasons you mentioned.

    thanks for your thoughts! helpful to at least know I am not crazy!
     
  4. You have chosen to ignore posts from Daisy75. Show Daisy75's posts

    Re: How to find facts on whether to epidural or not?

    I would think your OB and the anesthesiologists you've spoken to could be a good resource for providing this information and statistics.  And they may be able to point you in the right direction research-wise too (journal articles, websites, etc.).


     
  5. You have chosen to ignore posts from kargiver. Show kargiver's posts

    Re: How to find facts on whether to epidural or not?

    I really like my Mayo Clinic's Guide to a Healthy Pregnancy, and I'm not the only one - it gets 5 of 5 stars on Amazon with over 200 reviews.


     
  6. You have chosen to ignore posts from miss-cellaneousJones. Show miss-cellaneousJones's posts

    Re: How to find facts on whether to epidural or not?

    I'm with Kar as well on this one and have frequently referred to The Mayo Clinic's Book during my pregnancy. The format of the book is quite clinical but also unbiased and seemingly fact and statistically based. My recommendation would be to read, read, read as much as you can to get all the different facts and pros and cons to proceeding with an epidural during labor. Only YOU will know if you are comfortable adding that level of pain management to your birth plan.
     
  7. You have chosen to ignore posts from winter09wedding. Show winter09wedding's posts

    Re: How to find facts on whether to epidural or not?

    Great will grab this book!! Seems to be exactly what I was looking for.
    thanks so much
     
  8. You have chosen to ignore posts from EZola. Show EZola's posts

    Re: How to find facts on whether to epidural or not?

    Another vote for the Mayo Clinic book.
     
  9. You have chosen to ignore posts from kiwigal. Show kiwigal's posts

    Re: How to find facts on whether to epidural or not?

    I want to make sure that I can be responsive if there are things that need to take place to maintain safety for the baby and me

    I don't have much else to add to everyone else's advice, but just wanted to make sure that your spouse/partner is also well aware of your condition and wishes so that he (or she) can advocate for you during labor. I would try and include your spouse at these meetings with your doctors if at all possible.
     
  10. You have chosen to ignore posts from SarahInActon. Show SarahInActon's posts

    Re: How to find facts on whether to epidural or not?

    I think the Mayo clinic book is just so-so if you are looking for factual information.  Mayo tends to gloss over the real statistics.  Mayo was great for the development of the baby but as far as birth and labor go, I thought it was only marginally better that "What to Expect" (which I thought was total crap).

    A more appropriate book is Henci Goer's "Thinking Women's Guide to a Better Birth."  Goer actually give information and cites real sources for her statistics and facts unlike the Mayo book.

    If you want to go nuts (very nuts) then read her more clinical book, "Obstetric Myths Versus Research Realities."  This book is a more technical examiniation of the clinical research done.  It is well organized and very informative but is not a light read.

    Because it was published in 1995, there is a lot of research on the various stimlants for labor which everyone heard so much about in "Business of Being Born," the movie Ricki Lake did.  Much of the stimulants looked at are rarely used in the hospitals around here.  I don't think anyone uses prostoglandin gels or cytotek.  Pitocin seems to be the choice of OBs in the Boston area.

    Good luck and don't freak yourself out.

    Daisy75's advise of talking to your anesthesiologist is good.  Actually, you might want to seek one out for a consultation.

    Kiwi's advise of getting your hubby/spouse/partner/whatever to be your birth advocate is VERY important.  They can act like your buffer should anyone get pushy!  (Remember the scene in "Knocked Up" when the OB was being nutty??)
     
  11. You have chosen to ignore posts from Notanewbie. Show Notanewbie's posts

    Re: How to find facts on whether to epidural or not?

    "Because it was published in 1995, there is a lot of research on the various stimlants for labor which everyone heard so much about in "Business of Being Born," the movie Ricki Lake did.  Much of the stimulants looked at are rarely used in the hospitals around here.  I don't think anyone uses prostoglandin gels or cytotek.  Pitocin seems to be the choice of OBs in the Boston area."

    I don't want to go way off topic here, but my doctor tried both prostaglandin gel and cytotec to try to induce labor via cervical ripening instead of via uterine contractions which I think is what pitocin focuses on.  I was strongly against interventions but I had to consider them and ultimately had a c-section (after two prostaglandin gel insertions and two separate tries at a a pitocin induction - all methods failed to produce either dilation or contractions despite the fact that I was almost a week overdue).  I needed to be induced due to gestational diabetes and large baby size. So again, be sure to fully explore all the options that are possible with your OB.
     
  12. You have chosen to ignore posts from lemonmelon. Show lemonmelon's posts

    Re: How to find facts on whether to epidural or not?

    I have nothing helpful to add, but I just wanted to say that I was totally determined to have a natural birth and ended up getting an epidural because WOW, and since I'd been so adamant about not getting an epidural the midwives tried -- gently and briefly -- to talk me out of it. Not because they aren't supportive of choices, but because they didn't want me to be filled with regret and remorse later (also because I was 8cm dilated and pretty much ready to have the baby right then, so what was the point, right? but I was getting that epidural even if I had to have it AFTER the baby was born). So I think that going into birth with an open mind is important, because really, the baby is going to do what it wants and your body is going to do what it wants, and if you try to exert too much control over the process or place too much importance on the actual birth you're setting yourself up for frustration and disappointment.
     
  13. You have chosen to ignore posts from SarahInActon. Show SarahInActon's posts

    Re: How to find facts on whether to epidural or not?

    ALways exploring all the options good as newbie states

    notnewbie: How big was your LO when he/she was finally born?
     
  14. You have chosen to ignore posts from Notanewbie. Show Notanewbie's posts

    Re: How to find facts on whether to epidural or not?

    9 lbs, 8 oz.  He wouldn't have been impossible to birth naturally which is what I really, really wanted, but my doctor was not comfortable letting me go past one week overdue and since my blood pressure was creeping up and the placenta was showing signs of degrading we decided to induce. I like to tell my story about failed induction because I had never heard of anyone who didn't have pitocin work on them at all.  Usually it works too well and they worry about contractions being too strong or the baby being stressed.  In my case, nothing was working down there...no dilation and very, very mild, cramp-like contractions which did nothing to move the baby down. My doctor commented that he had never seen a baby so high in the abdominal cavity...he was really tucked in good.
     
  15. You have chosen to ignore posts from KAM2007. Show KAM2007's posts

    Re: How to find facts on whether to epidural or not?

    Winter-considering your history, I would keep the conversation between you and your doctors. I know you're looking for objective information on epidurals, but one thing is for sure with deliveries, they are all different and you can never know what to fully expect, and I doubt you'll find much info to help your specific situation. You have to take care of your health so you can take care of your little one.

    From experience with a spine problem and  epi's not working-have a detailed plan with your ob and anesthesiologist! Details, details details-then be flexible. :)

    Best of luck!
     
  16. You have chosen to ignore posts from winter09wedding. Show winter09wedding's posts

    Re: How to find facts on whether to epidural or not?

    Kiwi & Sarah- my hubby has been with me during these appointments- we both have research backgrounds with respect to work and have been frustrated with the amount of "opinion" offered like facts depending on who you speak to.  I completely trust my OB and anesthesiologist (already done a consult) and they have been great with questions.

    I know I have a unique situation and don't expect to find precise details or birthing plans anywhere but in a discussion with my doctors, I just wanted to know what the base rates of problems with epidurals were so that I could put all of this info in perspective instead of blindly following others based on who was more persuasive at the time.

    thanks again!
     
  17. You have chosen to ignore posts from lemonmelon. Show lemonmelon's posts

    Re: How to find facts on whether to epidural or not?

    winter, I think that a big part of the problem with the lack of hard facts regarding epiduals is that there are so many factors contributing to the labor process. For instance, it's believed that just being in the hospital can psych a woman out enough to slow or stop her labor, which is why it's common practice to not admit women until they are, I think, at least 4 cm dilated. So if they admit you and you get an epidural and your labor slows, was it the epidural? Or was it something else? And I imagine it would be difficult to perform any sort of scientific study because who is going to try to tell the woman screaming and begging for an epidural that she can't have one? So one is left with the overall impressions of the midwives, nurses, and doctors who witness births every day.
     
  18. You have chosen to ignore posts from GC1016. Show GC1016's posts

    Re: How to find facts on whether to epidural or not?

    Nodding -- what lemon said.  I'll add that how we all perceive and react to pain varies from person to person, so one person's 4 (on that charming 1-10 scale) is someone else's 11. 

    But it sounds like you're more interested in pursuing data on the effect of epidurals, is that right?  I'd ask your anaesteh ... the gas man to point you in the direction of stats, data, that kind of thing. 

    FWIW, here's my take: I would like to deliver without interventions, drugs or any other miracles of modern science, which makes me like most expectant moms, I think.  But my only "plan" with my delivery is to walk out of MGH with a healthy baby. 

     
  19. You have chosen to ignore posts from lemonmelon. Show lemonmelon's posts

    Re: How to find facts on whether to epidural or not?

    or gas woman!
     
  20. You have chosen to ignore posts from canukgrl. Show canukgrl's posts

    Re: How to find facts on whether to epidural or not?

    I tihnk you're on the right track, you're not dead set on a specific turn of events, you're just looking for as much info as possible, esp. because of your particular circumstance!

    I like how GC summed it up - I was going to try to go without the epidural, but had I not, I would definitely ended up with an emergency C-section - I almost did anyway, as labor stalled, even with pitocin - I had been a few cm dialated since Wed or Thur, and Sunday night my water broke... the nurses thought DD would arrive by noon, she didn't make an appearance until 9:40 PM... I went for the epi around 1, and it was only that, my pushing when I could push no more and my husband wispering encouragement in my ear that kept us from having a C section.
     
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