lamaze..drugs or..?

Mrs beagledave is due July 5th (our first). I have a friend at work who had good experience with lamaze…and used no drugs at all during delivery (even during the episiotomy) although she did use a TENS (sp) unit for back pain.

Another co worker poo poos the whole lamaze thing…says it didn’t work squat for her…

What say you SDMB moms…what was your labor/delivery approach?

Epidural. No doubt about it. I had two labours with one, and two labours without. Nothing compares to it.

I have to say that it does depend on the person. I don’t handle pain well, and I was actually in a state of semi-panic for the duration of my last pregnancy, because I felt that I could not possibly go through child birth one more time. I do know at least two people who said that childbirth wasn’t that painful for them, several others who said that it wasn’t great, but certainly a little Demerol was all they needed, and several more people who would never enter a labour room again without an epidural. I also know one person who refuses to have a second child because of the pain of labour.

I would say that the pain seems to vary from person to person, but if you don’t find a method that helps you control the pain to your satisfaction, it will colour your attitude to having more children.

One thing I heard a lot of good things about was Hypno-Birthing. Sadly, I didn’t hear about it until it was too late for me. I would try that first, if I was having another baby now.

By the way, I haven’t known anyone who had any real success with any kind of breathing method for pain control.

I had friends who went the hypno-birthing route. It was great for her, but she stressed that it would not be the best method for everyone. What she liked best about it is that, apparently, she does NOT deal well with pain, and the midwives were great at keeping her calm and focused, something she doesn’t feel she would have gotten from another method.
I can’t speak about any method from personal experience, though.

My first birth was without painkillers. I didn’t use Lamaze (all those prescribed breathing exercises did nothing for me.) Instead I had a birth assistant who taught the Bradley method, which emphasizes relaxation.

I was on pitocin because my labor wouldn’t start naturally. As you might know, this makes contractions stronger and more relentless…um, I mean regular. I was still able to get through the birth.

The second time I intended to do the same thing and made it through about 9 hours. After that though, I just ran out of steam and decided to go for an epidural. The baby was born less than an hour later, and I’m pretty convinced it was just because I was no longer in horrible pain and was able to relax.

Now, I do advocate trying to minimize the amount of drugs you take, and I think it’s very wise to practice relaxation. However, there is no benefit to anyone in trying to tough it out when you are exhausted and miserable. Epidurals are safe and marvelously effective.

If I go through the process again, I will get as far as I can without painkillers, but I won’t hesitate to ask for help if I need it. One thing I do recommend is looking into the idea of getting a doula or birth assistant. It’s great to have someone there on the spot who can suggest ways of making the woman more comfortable and who isn’t as emotionally invested in her pain as hubby might be.

Mrs Chance delivered our first (not the sig) last May. She was doubtful about the natural childbirth thing from the beginning, being of the ‘why endure pain if you don’t have to’ school of thought.

But she decided to go without drugs at first.

The first two hours she hurt a lot and got all sweaty and cranky. All the (so they tell me) normal stuff. Then she pulled the plug and said, “Bring me an epidural”.

They shooed me out of the room (“Lunchtime!” says I.) and when I got back she had the epidural in place and was on oxygen and gappy as a clam. No worries from that point on.

Really. I (and Mrs Chance) don’t get the whole lamaze thing. Why go through it when you don’t have to?

Lamaze is not your only option. There’s also Bradley. It pushes the no-drug thing harder, which can be annoying if you’re open to them. But the information was very very useful and very thorough. I’d take some kind of class, even if you think you don’t need the techniques. It’s affirming to meet other pregnant couples and swap info, and there is other useful information to be had about birth in general.

IMHO, it’s best to go in with an open mind (as opposed to the attitude “I’d like the epidural while we’re still in the parking lot”). Who knows how Mrs. Beagledave will feel? Labor is different for everyone.

As for myself, I did Bradley and had a doula but was open to pain relief if needed. It was. Morphine at first, then eventually the whole nine yards and then some.

There are some things it is good to know: pain relief can slow down a labor, especially an epidural which puts the woman off her feet. Of course that’s not a universal–if the pain is tying you in knots, then that’s probably slowing your labor worse than any drug would. Also, some people believe that labor drugs interfere with breastfeeding, and can make it a little harder to get that going right away. It might be the drugs’ effects on the mom, or the drugs’ effect on the baby. Not everyone agrees, and the difficulties aren’t at any rate insurmountable. If you go the dope route, ask for the lactation consultant to come asap after junior is born, and put junior to breast as often as possible. (er, if you’re planning to breastfeed, that is).

A coupla other things: (A) I really liked the way Dr. William Sears’ pregnancy book discussed labor. Helpful, encouraging, etc. (B) No one gets a medal for bravery during labor, nor do they get a pie in the face for being a wimp. Do what you have to do. © Don’t let any doctor or nurse tell your wife what she is feeling. [i.e. “You’re hardly in labor yet, it doesn’t hurt THAT much” or “No, you can’t be ready to push yet, I just checked you an hour ago and you were at 6”] Some of them may try, and they can fuck off. Let Mrs. Beagledave concentrate on herself, you run interference on the attitude problems. (D) Feeling like you can’t do it (your wife, I’m talking about) is actually an emotional signpost of labor. It’s not her copping out, and doesn’t mean anyone should panic. It’s a very common reaction and means the time to meet beagle jr. is getting closer. (E) Don’t freak if they give your wife oxygen. It’s more common than you might expect, and it doesn’t mean your baby is in serious trouble. (F) If your wife does get the epidural, don’t be offended at the loving look she gives the anesthesiologist when it starts working. It may be warmer and more affectionate than any look you’ve ever received from her. Don’t take it personally.

Well, I can’t remember any more at the moment. But that’s a start.

Well, if you’re like my friend who just had her second child after 2.75 hours of labor, why bother with drugs?

If you, on the other hand, are like me…who was in labor for 52 hours and had no sleep* and they’ve threatened pitocin, you say, “I refuse to be given anything until you get me a f-ing epidural!!!”

Basically, you can go into it with the best laid plans and you still have to be prepared to change your mind. It really depends on the person and the situation at hand.

*I was complaining to my OB about being dead tired and he decided to give me a shot of Stadol and something else to make me sleep. All it did was make me sleep for 8 minutes at a time, at which point I would wake up for only the peak of the contraction, not able to prepare at all for it. It lasted four hours and it was hell.

To second some of what Cranky said: Remember that you are an advocate for your wife. People seem very dismissive of first-time mothers regarding what’s going on it their bodies. (ie, it took me two days to go from closed up like a clam to 4 cm, 45 minutes later I was at 10 while the nurses were still saying I wouldn’t be delivering until the next day).

I fell in love with the anesthesiologist. I hugged him when he left the room.

My husband went to “Bootie Camp” something he highly recommends to new dads. Here’s the site: http://www.newdads.com/

to echo the above -

Prepare for the best, be flexible when the time comes. No one can accurately predict what will happen for any individual birth. Yes, in general, we’d want to avoid pumping drugs into the kidlet. However, if you’re about to have a c-section, I highly recommend Demoral[sup]tm[/sup] (:smiley: ).

Ditto being the advocate for the mom. Frankly all I could do was swear a lot. (mom didn’t know I knew words like that).

Also, and I can’t emphasize this enough, do not munch on sardines in the birthing room and then lean into your wife’s face and say “Breath with me, he, he, he, whoooooooooooooooo”

.snort…well there goes my Mountain Dew for the day over the keyoboard :smiley:
I should mention that Mrs beagledave is going the midwife route (there are 2 midwifes and 2 MDs in her practice…she will end up with one of the midwifes during l/d)…and so I guess will have an additional advocate with here throughout the l/d process…

Thanks for all the suggestions…the hospital offers a lamaze class…I have not seen anything mentioned about hypnobirthing or the Bradley method…but I’ll give it a look…

Much like the previous posters noted, I recommend having a brithing plan but remaining flexible enough to having them change at the last minute.

Mrs QuickSilver had a 3 day labour with our first child. Now most of it took place at home and we didn’t go to the hospital until things looked like they were going to stall and our midwife thought it best to be under hospital supervision. Mrs. QS was in a lot of pain and though we planned a natural child birth at home, Mrs. QS wound up getting an epidural and giving birth to our daughter in the hospital. Needless to say, our birth plan was pretty much trashed due to the circumstances of the extended and painful labour.

For the birth of out second (and last) child we planned to have Mrs. QS give birth at the hospital with the aid of a midwife (BTW, midwives are a wonderful idea, they can make the entire process a much more relaxed experience). The birth of our son was a much quicker experience (under 12 hours) and was also aided by a midwife and the availability of a large bathtub in the birthing room. Now my wife did not give birth in the tub but immersion in the water did help her through some of the rougher contractions while building up to full dialation. The final moments of birth came on so quick that there was no time for an epidural, but the pain was more manageable since Mrs. QS was not as exhausted when compared to the marathon labour she experienced with our first child.

The two experiences were as different as night and day but the results were both absolutely beautiful.

I did the no-drugs thing. I didn’t do Lamaze or Bradley or anything, just reminded myself that women had done this for thousands of years without the benefit of any of the above. (You wouldn’t think that it would help, but it did.) I went in with an open mind, figuring that, if it really really hurt, I’d get an epidural, but mindful of the fact that an epidural would involve a BIG GIANT NEEDLE GOING INTO MY SPINE. I was pretty sure that, if I moved too much when they were doing it, I’d be PARALYZED FOR THE REST OF MY LIFE, & for me, the worst part of the contractions were the full-body muscle spasms. What helped me the most was having the nurses hold down my arms & legs so they couldn’t move. Again, it sounds weird, but that’s what worked for me.

I must mention that I woke up at 5:30 a.m. when my water broke, but I was not in any pain at that point. I called my doctor, walked over to the hospital, & didn’t feel even a LITTLE pain until 6:30. I gave birth at 8:37. Anyone could do natural childbirth with a labor like mine. I am eternally grateful for my wide hips.

Another ‘don’t plan, but prepare for anything’ mom…

We learned Bradley Method (from the books, BTW, not a class). Deep relaxation is the key to that method. Practice early and often, and it really kicks in (three months of practice to get really REALLY good at it). However, it is no guarantee that you will have a great labor.

In my case, I was in labor (3.5-8 minutes apart, 45 sec to 3 minute contractions) for 66 hours without needing meds at all - actually, I never needed them for pain (as far as I can tell). I needed meds to sleep. Just for fun, I had only had a nap the full day before labor started (just after I went to bed), so I was basically going on around 80 hours without sleep by then. Can you say EXHAUSTED? So we went to the hospital (walked over from the birth center), I had an epidural (already decided in the backup plan, since I don’t do bloodstream narcotics well), and slept for 12 hours or so, in two-hour increments (between top-ups of the epidural). After that, I was nearly ready to push, pushed for 2+ hours, and there was my boyo. :slight_smile: 80 hours start to finish (of labor, that is). And not at all bad, as long as I kept relaxed. But only your wife will be able to say what is or is not too much for her to cope with. Don’t let anyone tell her how she feels!

My opinions:

Lamaze works for those who deal with pain by focusing away from the pain (go outside themselves). I know people for whom it worked like a charm, and others for whom it did less than nothing.

Bradley works for people who work better WITH their bodies than outside their bodies, as well as adding the deep relaxation part. I honestly felt the difference between fully deeply relaxed (even hands and face) and even a micron NOT relaxed. The former (relaxed) had as strong contractions, but they just did not register as pain at all. The latter was horrible. Having someone tell me when I was tensing was paramount - I couldn’t tell, myself. Bradley also will tell you what the risks of any meds are, at each stage of the game. This is useful, because making a decision in the middle of a situation is sucky if you don’t already have a clue why you might want one option over another, let alone what other choices you might have (that haven’t been mentioned yet). The Unofficial Guide to Having a Baby also lists meds with their impacts.

Hypnobirthing and New Way Childbirth (the home-audio/video hypnosis/NLP method) are excellent for people who are decent hypnosis subjects, and outstanding for such people who tense up under stress. I’m going to be using the New Way program for the next one (bought it two miscarriages ago). It is new-agey, kind of spiritually oriented (lots of divine love and soul bonding), but not offensively so (to me). The speaker has an annoying voice, but you get used to her pretty fast. According to a birth instructor (who listened to it with me to check it out) it is a general deep-relaxation and positive attitude program, open to pretty much any ‘training’ program you want to use with it (from Lamaze to Bradley to Active Birthing to Spiritual birthing programs). Best point is that it teaches deep relaxation really well. Not as expensive as Hypnobirthing can be, but not as individually tailored, either. Both Hypnobirthing and NWC have good reputations for pain management and smooth progession of labor. Worth exploring. Both have web sites.

Birthing from Within (spiritual birth method) and … um, there’s one based on Christian scripture, can’t remember the name. Both have decent reps, but again, depends on who you are. If reading scripture will make you relax when you are feeling out of control, then go for that one (if not, then run!). The Birthing from Within one is a very healing approach for people who have traumas around self, birth-expectations, motherhood, etc. Also relaxation-based, with more emphasis on trusting yourself, IIRC. Also very practical attitude about meds - you’ll know if you need them, and then you decide based on that situation. Hard to find teachers, in some areas.

Water birth (laboring in water, usually, rather than actually birthing there) - even the shower, a bathtub (ask the OB/midwife first), the jacuzzi at the hospital… some people get no releif, some get as much pain releif as an epidural (complete releif). Worth a try, if the option is available. No practice needed, though if you want to rent a birthing pool, you will have to do that ahead of time. Bathtub helped me a LOT, as did the Jacuzzi.

I also cannot recommend doulas too highly. Hire one, they are worth every penny. I had two (both volunteers, but still … ). They helped immensely, and they allowed epeepunk to be there for me as fully as possible, without making him fear for me if he had to go pee or eat. Plus, they could fetch and carry, run messages, run errands, get food, get the nurse, help encourage, massage the other leg (very helpful for baby’s heart rate when the epidural makes the legs numb), pass wet rags to the sink for refills, take notes on what happened when, offer suggestions on position changes, remind you about things in your birth plan, and so forth. Please consider one!!! (You can also hire postpartum doulas to help with the first few days or weeks at home, also invaluable! They cook, clean, encourage, guide, they can be there a few hours a day to all day long, and they aren’t your mom or MIL!)

As for meds, please do your research, and know what your risks are going in. Epidurals (as with other interventions) do have risks, which can impact the baby (even if not always directly). If you know what the risks are, you can make an appropriate judgement about using them, when, and how. You may need them. I’d probably have died or gone psychotic without meds (if my son didn’t give up first). They were necessary, but I was glad I knew what the risks were before choosing, so I didn’t later spend time second-guessing the choice. I ended up with some side effects, and in my notes from after the birth (1 week, and again three months later), I note to “NEVER HAVE AN EPIDURAL AGAIN (unless necessary)”. I won’t be signing up for any meds in advance, but I’ll use them if I need them. I really really hope I don’t need them (assuming I ever get pregnant again and actually carry to term).

My last advice: even if you think she’ll go for meds, please learn (and practice) a ‘natural’ method of some sort. Too often the meds don’t work, they don’t get there in time, or they don’t kick in all the way - and then if you don’t have some other backup, you are shit-out-of-luck. The most traumatic natural births I know of were where the meds didn’t get there and they had NO other coping mechanisms.

Labor and birth was really cool, amazing, powerful, transforming - hope your wife has a good one.

#1 Son - stadol, then an epidural. I had really wanted to go drug free, but the ass-backwards hospital policy required total confinement to bed if you were 4cm or more dilated. After an hour of that, I got Stadol - which just made me feel drunk - and did nothing for the pain. An hour after that I got an epidural, but it was over-effective and I pushed for nearly 4 hours because I couldn’t coordinate my muscles. Got a massive episiotomy that turned into a bad tear that required a ton of stitches to close. I felt like crap for a couple weeks - exhausted and sore.

#2 Daughter - Determined to avoid a birth like my son’s, I read everything I could get my hands on. We couldn’t find a Bradley class in our area that worked with our schedules, so we both read the book instead, as well as a ton of other books - Sheila Kitzinger, “A Good Birth, A Safe Birth”, “Birthing From Within” and “Active Birth”.

Instead of rushing off to the hospital at the first contraction, I did deep, relaxing breathing at home. I ate and drank during labor to keep my strength up. My hubby did counterpressure on my lower back during contractions, and I found being on all fours really helped w/ the pain as well.

When we got to the hospital, I was 8 cm dilated, and in transition. My husband sat behind me on the bed and supported me, and the lights were low in the room to help me relax. I did get pretty noisy :slight_smile: . My water broke naturally, and I pushed instinctively - no counting to 10, holding my breath pushing a la TLC’s “A Baby Story” (am I the only one who wants to reach through the TV and shake these women to convince them to take control of their births?) Got her out in 15 minutes with a teeny tear (along my huge episiotomy scar). She was placed on my abdomen immediately after birth, which was neat!

I felt about a million times better after my daughter’s birth. I was walking around, chatting on the phone, and on a high for hours after the birth. Went home after 14 hours in the hospital, and felt great apart from a broken tailbone!

I won’t tell you there was no pain with my daughter’s birth. There was a lot. But it was purposeful pain. My coping techniques of deep breathing worked well for me. The Lamaze breathing I tried w/ my son just made me woozy.

–tygre

My wife and I did the home birthing route, with midwifes for the first two, and just us for the 3rd child. No drugs for any of them. Labor was between 2 hours and 10 hours. You have alot of good advice here, and I just wanted to add that one of the valuable things we learned was to do perennial massages, especially in the last month or so. My wife had very little tearing and required no stitches due to perennial (sp?) massages. It’s fun too!

No matter which method you choose, those babies still make there way out. Enjoy the birth for the miracle it is, and your baby and toddler years. They become teenagers way too quick!

Good Luck.
later, Tom.

Congratulations to you and your wife. Regardless of the method that you choose (or circumstances choose for you), I’m sure it will be one of the most memorable experiences of your lives.

My first bit of advice: She’s the one with the labor pains, so let the decision be hers. I read TONS of books in preparation for childbirth, and I remember one (I think it was not Bradley’s, but one written by some Bradley practitioners) where they gave you some advice on what to do when the nurses came in the room pushing drugs on your wife (which they probably will). They even gave the husband the dialogue to practice: “Thank you, nurse, but WE think that WE are handling the pain just fine without any drugs, thank you.” I told my husband I’d kill him if I heard any of this WE stuff out of him. WE got me into this, but it was ME who would be feeling the pains ---- I would make any decisions on whether I wanted any pain relief.

I had a nurse midwife through the Kaiser Permanente OB/GYN department I was seeing for Son #1. You had to request to be delivered by her — and on your first visit, the first thing she said was “If I’m going to deliver you, don’t plan on an epidural or pain meds.” I said fine (thinking to myself that if I decided I wanted them at the time, I would just make a big fat hairy nuisance of myself and demand drugs and an MD.) My husband and I started referring to her as the Nazi midwife. He would hum the first few lines of “Deutschland, Uber Alles” (sp?) to me every time I went off to an appointment. (She was actually just fine at delivery time, though — except for her enthusiasm for pitocin and an episiotomy. This was Nurse Natural Childbirth? Still, she was very supportive, and spent much more time with me than the MD at birth #2 under a different insurance plan.)

Whether your wife plans to do the epidural route or not, definitely take a prepared childbirth class first. (That’s sort of the generic term used for Lamaze now.) Check around — the one offered by your hospital may not be your best choice. I got a lot of good advice from the class offered by Kaiser with my first child. I took the refresher course for my second child from the hospital, and I was very turned off by it. They were STRONGLY of the “better birthing through chemistry” school, and gave sort of a petulant sniff whenever they talked about those of us who wanted to do it without drugs. (“Martyrs!”)

A lot of her ability to handle labor & delivery without drugs (if she chooses) will depend on her general outlook, as well as how her labor is progressing. I was fortunate in that I didn’t have back labor with either delivery (constant, unyielding pain.) That is, my labor pains were finite — I would cramp up for a minute, with it hurting like hell at the peak, but then it would back right down. I had no pain between contractions. Knowing the pains were finite let me deal with them, and not feel totally out of control.

When I was in transition (the contractions are very hard, with very short rests in between)with my first labor (probably because they cranked up the pitocin too high), my L&D nurse said that if I wanted, she could get me some Stadol. I asked her to tell me about it, just for the vicarious pleasure of thinking about pain relief. She told me “it would take the edge off” (whatever the hell that means), but that it might make me nauseated. Also, she said that if I needed it more than once, the first hit is far and away the most effective.

I can handle pain FAR better than nausea, and I didn’t want to use up my “insurance policy” by using the good hit of pain relief too early. I opted not to take it. (Turning the damned pitocin down helped, too!)

As an aside, I broke my wrist 2 years ago. In the emergency room, they gave me demerol (which I am told is similar to Stadol). This was my first experience with the stuff. I was SO VERY GLAD that I had not taken it during labor. I guess “taking the edge off” means that it still hurts like hell, but you’re so zonked that you don’t give a damn. The major effect of it was to just create total apathy (Sure, Doc, go right ahead and yank that wrist back into place. I don’t care. I’m just going to take a nap, OK?)

Labor IS hard, but it wasn’t unbearable. It really is an incredible experience. I felt that being undrugged was the healthiest option for me and my baby, and one of the best things I could do to help prevent a C-section. (Although I did always leave myself an option to ask for drugs if I felt I needed them to get through it.) Besides, it didn’t seem fair for me to be getting the lion’s share of the drugs, and only giving him the leftovers when he was the one whose head was being used as a battering ram. I am so glad that I was fully aware of everything going on, and wasn’t in an apathetic state at one of the most important events of my life.

Best of luck to you both!

Three births, all drug-free.

My first one, I took a Lamaze class. I was happy with it, and the one thing it did do was take my attention away from the pain.

The second one was nine years later. I had forgotten how badly it hurt the first time (oh, I remembered that it hurt, alright, I just thought “hey, I did it drug free the first time, I can live through it again”). The minute that first real contraction hit, I said “Oh s***. I want drugs.” Unfortunately for me, my husband wasn’t home at the time. Although I did manage to get to the hospital in time to keep from delivering my child on my front porch, I was dilated to 10 already. No time for drugs. But I remembered my Lamaze, and that helped. My daughter was born about an hour after I got to the hospital.

The third one was two years later. From the first office visit, I said “I want drugs. I’ve done it drug-free twice now. I’ve got nothing to prove to anyone. Just give me the drugs.” The doctors (I was in a group practice) were fine with it. My son, on the other hand, was not. Once again, a really fast labor prevented me from getting the medication I craved.

What really matters most, though, is that your wife and baby make it through okay. That’s the ultimate goal. As others have said, though, the decision is really up to your wife. She is the one that’s going to be in pain, and the pain of labor is indescribable. The end result is worth it, but in those hours before that magic moment, you’re really going to wonder. Don’t be afraid to use the drug option.

And have that baby on July 2nd. That’s my birthday. :smiley:

I was talking to my Mom (an RN) about how little the Stadol helped the pain and my Mom said that she’s always had problems with it RE patients, that it never seemed to be much help with pain at all. She said it was, “worthless in her mind.”

YMMV

A repeat of what has been said.

Have a plan, but have an open mind. You may want drugs, but have a short, no time for drugs, labor. You may decide no drugs and have the three day marathon of pain ending in a c-section. Don’t let what happens spoil the miracle (and when you wife is hopped up on hormones post-birth, she may).

Be prepared to be your wife’s advocate.

The real problem is no one can say “it will be one hour” or “it will be twenty hours.” You – well your wife is in pain, and, although they can make a guess, there are plenty of cases where women decide not to take meds because the baby will be born quickly, only to go through hours of pain, or take meds because it looks like they are in for the long haul, only to have the baby pop out minutes after the Nubane or epidural.

One piece of advice that hasn’t been mentioned. Have your wife invite her best female (preferably one who has been through it) friend to be a back up labor coach. You can sleep a little if you end up in marathon mode (or run to the cafeteria), you won’t feel as helpless, and the friend will boss the nurses around and provide a trusted voice of experience. You can hire this professionally - its a doula, which has been mentioned. Most of my girlfriends think their husbands (even the prepared, thoughtful, sensitive ones) were pretty useless during labor - although we don’t tell them that (OK, I have and he knows).

My daughter was born after labor was 9 1/2 hours, with an epidural, which was wonderful. Once you get the epidural, labor feels like the longest, biggest bowel movement you’ve ever had - especially the pushing part. Same pressure (have you wife memorize the muscle movements now, cause its hard to do under medication). No side effects and the epidural had worn off completely by the time my daughter was bathed. The shower was wonderful before I got the epidural (bring swimtrunks and a bathrobe for yourself). I had real problems walking or standing (or doing anything other than laying flat on my back and screaming) in labor, but others swear by walking, sitting in a rocking chair, the birthing ball, etc. My son came from South Korea on an airplane, 45 minutes waiting in the airport was our “labor.” But its probably too late to recommend going that route.

First, the disclaimer: I have four children, all of whom were delivered without drugs. I used the Bradley Method and was so pleased with it that I am currently in the process of becoming a Bradley teacher.

I can’t tell you what is the right choice for you. But I can strongly suggest that whatever choices you make should be educated ones. If you do decide to go the medicated route you should be aware of the risks to both your wife and your baby and be able to weigh them appropriately against your specific situation.

Many doctors, nurses, Lamaze teachers and hospital-based childbirth educators will present labor drugs as perfectly safe (i.e. “a little Demerol won’t hurt anything”) or will minimize the risks. For instance, you may be told that the drugs in an epidural will not reach your baby. Some doctors actually seem to believe this, on the assumption that they are putting the drug into the spinal space and it will stay there. However, tests of umbilical blood and fetal scalp samples (blood taken from the baby’s scalp before it is born) clearly show that the drug does indeed transfer to the baby almost immediately. Some doctors like to inject lidocaine into the perineum just before birth to save the mother from feeling the burning sensation common as the baby crowns. They probably won’t tell you that they will be able to detect lidocaine in your baby’s urine for 48 hours after the birth. Henci Goer wrote a very informative book on this subject, Obstetric Myths Versus Research Realities.

Why should you be worried about the anesthesia reaching your baby? Basically, the drugs are going to depress your baby’s respitory system. How much of an effect they will have will depend mostly on whether or not your anesthesiologist is able to guess correctly when your wife will deliver and is able to adjust the medication so it is mostly wearing off just as she delivers. Before the baby is born, his mother’s liver helps to detoxify his blood. If he has a significant amount of anesthesia still present after his birth he will have to get rid of it himself. Several studies have shown that babies delivered to medicated mothers are less alert, have poorer muscle tone and have a poorer sucking reflex. The differences between medicated and unmedicated babies can persist for a full month after delivery. What we don’t know is what permanent damage we may be causing with these drugs.

Epidurals and such will also affect your wife’s ability to give birth. A common side effect of anesthesia is a slowing down of labor (which is then augmented with pitocin, which often causes much stonger contractions than she would have otherwise.) She may also have difficulty working with her pushing contractions when the time comes (because she can’t feel them) and may need a forceps delivery. Forceps are generally safe, but do carry a small risk to your baby. They will also require a large episiotomy.

One of the reading assignments in my training was an obstetrical textbook. The section on anesthesia lists the various complications, but rather than teach the doctors how to avoid using the drugs, the textbook simply goes on to teach them how to rescusitate a depressed infant. Does this really seem like the best we can do?

The other facet of childbirth that you want to learn about is interventions-routine IVs on admission, breaking the water, continuous fetal monitoring, etc. You need to know why these things are done (sometimes it is necessary, sometimes it is just “procedure”), what the potential complications and risks are, and be able to make informed decisions. For instance, we generally refer to the normal gestation period for humans as 40 weeks. We’ve been using that number for hundreds of years. A recent study, though, showed that the actual average full-term pregnancy is 41 weeks and a day. There are a lot of women being induced because they get to 42 weeks without giving birth. The usual reason given is the risk of stillbirth. But they probably won’t mention that the risk of stillbirth at 43 weeks is just slightly less than the risk at 37 weeks. Instead, they go ahead and induce, with the accompanying risks that brings with it.

Certainly, medical advances have saved lives. Drugs and interventions are sometimes necessary. It is the overuse of those drugs and those interventions that teachers like myself are trying to avoid. Ultimately, the decision will belong to you. Make it an informed, conscious decision.