Will and I still remember the screaming. It was the woman in the next room in the hospital and she screamed to hoarse silence as she gave birth. I hadn’t gotten tired yet and was still in a chatty mood, but the screaming made us scared.
"Will it get that bad?" I asked. "Is this usual?" The doctor shook her head. "No, that lady didn’t want an epidural, and now she is regretting it. Don’t worry, pain like that isn’t common with an epidural."
The doctor was at least partially right - I never felt like screaming. I did sing Beethoven very loudly when they cut off the analgesia for the last stage of labor (apparently music is my dinosaur brain’s way of coping with pain), but labor hormones combined with the epidural helped me remember C’s birth as a challenge rather than a trauma. I'm guessing, though, that the doctor was wrong about why the woman didn’t have an epidural. When epidurals are provided to far less than 10% of women giving birth in a community, your next door neighbor's drug-free delivery most likely isn’t about a real choice.
Less than 10%. In 2002, MedLine reported that over 60% of women in labor in the United States used epidurals (65% in California). In Western Europe and Scandinavia, the average seems to hover around 30%, depending on location (women in the countryside have a lower epidural rate than women in cities). Availability of an anesthesiologist, cost, hospital willingness, and the education of families are the key contributing factors to women receiving epidurals.
How do I know this? Besides a MedLine/Google addiction, I am in the middle of reading through a worksheet on epidurals, provided by my obstetrician. It is actually part of a packet of documents that I have to sign and hand back to the clinic next week. Most of these papers are related to the birth certificate or to reserving a space in the hospital and I’ve read through the lot, but the epidural pamphlet, that kept my attention. Eight pages long, it not only asks for my approval and sign off on all risks (which I expected), it also presents a history of epidural analgesia, a list of frequently asked questions, and anecdotal stories from doctors and patients.
One doctor’s story: "I personally recommended delivery with the help of an epidural to one of my patients...to my surprise the anesthesiologist informed her that her legs could become paralysed as a result of the epidural."
The doctor had three possible explanations for this. "Either this anesthesiologist had little experience with epidurals and was afraid to apply them, or he didn’t want to spend the night monitoring his patient, or he wanted to save his hospital money, as the insurance companies reimburse clinics only for a small amount of the actual cost."
Sounds like an honest appraisal to me, and I’m guessing the lady next door to us had a similar story to tell. Or maybe, based on one of the FAQs in the brochure, her husband talked her out of it. See below. I liked the answer, though I would have been more blunt.
Q. My husband calls me a coward for wanting pain relief.
A. That is a somewhat old-fashioned and incorrect opinion, especially since men will never have to go through such pain.
Based on Will’s still remembered fears from listening to the lady next door, I’d bet that husband called his wife a coward before her water broke. At least she got the birth hormones.
Dining out for Life
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