Sunday, August 27, 2006

Research Epidurals Before Requesting One

I am a thirty three year old mother of three. I recently gave birth to my third child, a beautiful and healthy baby girl (weighing 7 lbs. 12 oz. and measuring 21 1/2 inches) named Isabelle Grace. My first child, Nathan Andrew, (weighing 6 lbs. 9 oz. and measuring 19 inches), was born thirteen years ago, when I was just a babe of twenty years. My "middle child", as she so desperately does not want to be referred, Micaela Carlene, was born nine years ago, (weighing 7 lbs. 11 oz. and measuring 21 inches), when I was twenty four and seemingly in my prime for child bearing (being in pretty good shape physically, mentally, and financially).
Looking back over the differences in the three births, I see that much has changed in thirteen years, especially in the area of pain relief for laboring mothers. When I had my first child, epidurals were only for C-sections or extreme situations (at least this it the impression my doctor at the time impressed in me). I had very little pain relief with Nathan, and none at all with Micaela. In contrast, Isabelle came into this world when pain free is the way to be, and I utilized any and all methods of pain relief available to me.

My first childbirthing experience, thirteen years ago, as mentioned, was a long labor (twelve hours). I had some intravenous demerol distributed shortly before Nathan's birth, but that was the extent of relief for me. It helped to slightly dull the pain of the contractions and the episiotomy, and it also helped me to rest between the contractions. No other form of pain relief was even offered to me, and I honestly had to act like I was going to kill someone or break down and cry in hysterics to get that miniscule amount of relief administered to me. Here I was, a twenty year old girl in labor with hardly anything to calm me except a shot of demerol and a vague recollection of lamaze techniques. My grandmother would (and does from time to time) tell me that I'm crazy for complaining, and honestly, she's right. The pain wasn't excruciating; I can think of many more scenarios where people experience pain at a much higher level and go on to survive. I certainly survived and even went on to have two more children. My grandmother "had seven children, five of them sections, and the only thing they offered was ether....NO ONE wants ether!" she lovingly tells me. I really don't know how women today would survive her experiences!

My second childbirthing experience was nine years ago, and for that birth, there was simply no time for any pain reliever or an epidural to be administered. I was induced for this labor, and shortly thereafter, my first daughter, Micaela, was ready to be born. She tells me she "didn't like drugs" so she came "rushing out". By the time I felt enough pain to complain about, she was well on her way to being born. I do remember the pain of this birth a bit more than Nathan's birth, but I was also a bit more mature and more aware of my body at this time. I actually survived childbirth with NO pain medication whatsoever. Au natural. My grandmother was very proud!

My third and latest birth experience was this July - just seven short weeks ago, and the experience is still fresh in my mind. It was my first encounter with a practically pain free birth, and while I appreciate the efforts of modern medicine, I ultimately do have mixed feelings about the epidural.

Epidurals are very common nowadays and highly recommended by most women who have had them. They seem to be all the rage. My friends were all about them, swearing they were the way to go - the best thing you could do for your comfort and your sanity. Even perfect strangers would walk up to me while I was shopping for baby items and fill me in on their effortless birthing experiences. I heard tales of women playing euchre during labor, having laughs with family members as the contractions flew on by...of babies effortlessly emerging from the womb. It seemed too good to be true. How in the world was this possible? I had initially set my mind on doing it the old fashioned way, just as I had with Micaela, but the thought of a virtually pain free birth was very inviting, and I started to have second thoughts about my decision as visions of euchre playing danced in my head.

My doctor was absolutely wonderful and I trusted him one hundred percent. He not an advocate for or against the epidural; he left the decision solely up to me and my husband (me being, obviously, the main decision maker for this particular issue). He informed us on the risks and benefits and in no way tried to sway us one way or the other. Like most doctors today, he was concerned for my comfort and the safety of my baby. He never left the hospital, even though it looked like I was going to go well into the next day before I gave birth ( I was induced at 12:45 p.m. and Isabelle was born at 11:10 p.m.). I had told him to go home to his wife, have some dinner, and we'd call if things changed, but he stayed on like a trooper!

After about 8 hours of light labor, I had requested a pain reliever, and nubain was the drug administered. I liked the nubain, even the "drunken" feeling that I got that many women do not like. It made me very talkative and really took the edge off of the contractions. I could still feel when I was having them, but I really didn't feel in any significant pain when I was having them for about an hour. Eventually, though, the nubain and the happy feeling wore off and the pain became more frequent and more extreme. I broke down and requested the epidural be given as soon as possible.

The insertion of the epidural catheter did not hurt at all, and my doctor was wonderful about guiding me through the process and keeping me calm and prepared for what was coming next. There was no pain involved in this at all for me. My husband, on the other hand, experienced some mild mental trauma after seeing such a large needle getting ready to be inserted into his wife's spine! He tried his best to hide the emotion on his face so as to not scare me! As I was having contractions, I did not notice at all.

Once the epidural was in, I was hooked up to heart monitors, as the blood pressure can rise due to the medication. My blood pressure did increase, but only slightly, and my nurse assured me that it was nothing to be alarmed about. Just about the time I got hooked up to everything and resumed my position on the bed, I felt some overwhelming pressure. It was already time to push!

The epidural sped up my delivery significantly, but I was not free of pain, as so many of my friends and those complete strangers with huge smiles on their faces had promised me. I could feel pressure, but could not feel the baby coming out of me. I felt a warm, sharp pain in my upper right thigh, and I was shaking pretty badly. The most pronounced shaking was in my jaw, but there was some shaking in my legs and hands as well. My husband was pretty freaked out by this and has since lovingly referred to me numerous times as Catherine Hepburn.

At no time could I NOT feel my legs or toes, which is a good thing in my opinion, and sensation was back in no time. I was able to stand and walk to the wheelchair and then to my bed within the hour. I understand that many women are unable to feel their legs or toes for hours. This was not so in my case. I also understand this is due to the amount and the type of medicine administered.

A factor that I did not even consider prior to the birth of this child was the possible extra expenses incurred in birth. I had estimated paying two thousand dollars, the amount of my deductible (which is on the high side), for my prenatal care, hospital stay, and delivery. Not having any major pain relief with the previous two children, I never had to consider the cost of the epidural or if my insurance would or would not cover it.

They, unfortunately, did not. I now owe my doctor four hundred and seventy five dollars more than I had anticipated, which really strained the budget! I do regret not communicating with my insurance company or my doctor's office prior to the birth concerning the cost of pain medication, but as I had made up my mind to do it naturally or with minimal pain relief, and no epidural, I neglected to do so.

So, to sum it up, there were elements of having an epidural that I failed to explore before requesting one - the side effects, the cost, and really, the necessity. Pain free sounds so wonderful, but nothing is technically pain free. I think it had been such a long time since my epidural-advocating friends had actually experienced childbirth that they forgot some of these issues, or that these glowing new mothers had simply forgotten the negative aspects of their birthing experiences. Everyone made the epidural seem so inviting, and I fell prey to their praises.

I gave birth twice without an epidural, and my children came into the world healthy, and I'm no worse off for not having one. Now that I've had one and experienced it to the fullest, I would definitely think twice before requesting another epidural.

I would highly recommend to anyone considering an epidural to be sure to weigh the benefits of epidurals and see if your insurance company actuall covers them. Had I knownmy epidural was not covered and would be an out of pocket expense, I would not have opted for it. While pain free may be the way to be for some, it came at too high a cost for me.

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