Thursday, January 6, 2011

Labor and Delivery, the "QECH" Way

My DH, my Certain Little Someone, and Baby Boy - aren't they precious?
So I know that the words "Quick, Easy, Cheap and Healthy" are rarely used in combination with the words "Labor and Delivery", but stick with me for a minute. Just last week I went through my second labor and delivery experience, and while both were very different from each other, one thing was the same: I chose not to have an epidural. 

Some of you are probably nodding your heads and saying "Good for you!". The rest of you are probably scratching your heads, rolling your eyes and saying, "Why the heck not?!"

Oh, I'm glad you asked!

Believe it or not, the reasons behind my decision not to have an epidural fall within the same principles that govern my overall approach to food, nutrition and health: what is QUICK, EASY, CHEAP and HEALTHY (with as NATURAL as possible thrown in there for good measure).

Note: I am no doctor and no midwife; all the information I share below was gleaned from the multitude of books and articles I read prior to the delivery of my first child, my own experience, and the experience as shared to me by many other moms, some who had an epidural and some who did not. 

So why in the world would I consider a non-medicated labor to be "QECH"?

Studies have confirmed over and over again that non-medicated labors generally proceed more QUICKly than those treated with pain medication, especially those where the epidural is given before active labor has really begun. I know so many moms whose labors were progressing in a normal time frame, but stalled as soon as the epidural was given. Most of the time, oxytocin is required to re-start the labor, and in worst case scenarios, the delivery ends in a C-section.  On top of that, depending on the strength of the epidural and the skill of the anesthesiologist, a mother may not feel the natural urge to push, which will considerably lengthen the pushing stage.

From my own personal experience, my first labor lasted less than 14 hours start to finish, and the sum total of pushing time was 30 minutes. With my second, the entire labor (excluding the lengthy week of pre-labor that I endured before active labor finally started) was less than 8 hours, and only 9 minutes of pushing. This is not the experience of all women, of course. Sometimes unmedicated active labor can last so long that the mother is exhausted, and in those cases, it can be helpful to have an epidural just so she can relax and regain her strength.

Based on what the nurses were telling me during my postpartum care, recovery from a natural delivery is also QUICKer than that of a medicated one. Because I had no epidural, I needed very little intervention even immediately after the birth, mostly because I could move around of my own accord. There were also other precautions and measures the nurses realized they didn't have to take when they saw I had not had an epidural.

No labor is ever EASY, medicated or not! It's certainly not a walk in the park. However, there are a host of medical interventions that have to take place whenever the mom is given anesthesia, and all of them can complicate the birthing process:

  • possible catheterization
  • additional monitoring
  • the mother's position restricted
  • prohibition of food or drink, and the use of IV instead
Each of these things is a complication in and of itself and can lead to further complications both during and after the birth. 

Depending on how your insurance is structured, foregoing the epidural can be much CHEAPer. In our case, we pay 20% of whatever the insurance company pays, which means that if they paid $1500 for the epidural and the anesthesiologist, we would pay $300, a hefty sum for a medically unnecessary treatment. 

The use of the epidural in and of itself is not likely any more or less HEALTHY than going without. It's all the accompanying measures I spoke of before that can create an unhealthy situation either during or after delivery. For example, catheterization can lead to UTIs. The use of an IV can create excessive swelling. A mother's position being restricted and/or additional monitoring can inhibit the natural progress of labor, resulting in more and more medical interventions. 

There do seem to be some HEALTH benefits for the baby when anesthesia is not involved in the labor process. For one thing, in unmedicated labors, endorphins can be found in the placenta and umbilical cord, which helps the baby through the delivery process as well. And because the medication in an epidural reaches the baby as well, unmedicated babies are more alert and active immediately after the delivery, which helps with bonding and learning to suck and eat (important survival skills!).

No comments:

Post a Comment