Thanks for your post, very insightful. I am pro natural too BUT seriously , I am very sccccaaarrrreddd...
This is a discussion on 'I'll die of pain without an epidural' within the General Pregnancy Discussion forum, part of the Pregnancy Forum category; sun, Nov 14, 2010 The Star/ANN 'I'll die of pain without an epidural' MOTHERS-to-be have heard their fair share of ...
sun, Nov 14, 2010
'I'll die of pain without an epidural'
MOTHERS-to-be have heard their fair share of childbirth stories, some in excruciating detail. A popular fallacy - birth is an illness!
"If you view childbirth as a natural process versus viewing it as an illness, it will shape how you make decisions and go through the childbirth," says UK-trained midwife Jennifer of Kuala Lumpur.
Let's debunk some of these myths:
Baby is too big or pelvis is too small
One of the most common excuses women are wheedled into inducing their labour or to undergo a C-section is that her baby is too "big". In more than 30 years of practice, consultant obstetrician and gynaecologist Dr Choong Kuo Hsiang has delivered many large babies, averaging 3.8 to 4kg through vaginal delivery.
"Ultrasound scans only provide an estimate of baby's weight and are not 100% accurate. I will consider intervention if the woman is physically small and the baby's head is not engaged in the pelvis," says Choong.
"In a borderline case, many babies do still birth normally as the baby's skull bones are soft and compressible, and the joints in the mother's pelvis are able to relax, allowing for slight expansion.
"Sometimes a trial of labour is necessary to determine whether a woman can birth successfully."
Evidence-based UK National Institute for Clinical Excellence (NICE) guidelines recommend against a scheduled caesarean for estimated large baby and/or small pelvis (cephalopelvic disproportion), or low-risk women who are more than one week overdue.
Vaginal delivery equals pain and a slack vagina
"Women should be reassured that if routine episiotomy is avoided, they are likely to recover speedily and experience minimal pain after a normal delivery," says consultant obstetrician and gynaecologist Dr T. Chow.
"But even if episiotomy is medically indicated and it may take longer to recover, generally you can resume pain-free intercourse three months after delivery."
As they say, do your Kegels! "Proper pelvic floor muscle exercises will help strengthen the pelvic floor muscles and tone up the vaginal muscles," she adds.
Asian women's vaginas are too small
Some obstetricians lead women to believe that routine episiotomy is commonplace or necessary for Asian women. An episiotomy is a surgical cut in the area between the vagina and the anus (called perineum) made just before delivery to enlarge your vaginal opening.
An episiotomy may be needed to speed up the delivery process if there's concern about baby's heart rate or if the baby's head or shoulders are too big, for example. "We dont't practice routine episiotomy, at least not in government hospitals," says Dr Hj Mohamad Farouk Abdullah, president of Obstetrical and Gynaecological Society of Malaysia.
"In fact, the Ministry of Health came out with a circular in 2008 to restrict routine episiotomy and direct hospitals to report their episiotomy rates. Government hospitals' episiotomy rates average less than 8%."
The systematic use of episiotomy is not justified, according to World Health Organization (WHO).
Labour is too long
If a woman's labour drags on for a period of time, caregivers may suggest an induction or C-section. The question is how long is "too long"? It's subjective and can be open to abuse.
For first-time mothers, a normal childbirth can easily dawdle from 12 to 16 hours. "As long as the mother is progressing, her condition is okay and the baby's heartbeat is fine, I am willing to wait," says Dr Choong.
"If the labour continues more than 24 hours, we have to stop and evaluate whether there's any danger or advantage in waiting. It's important to differentiate between early mild labour that can be prolonged and true labour that is more intense."
VBAC is dangerous
Most doctors would tell their patients that a VBAC (vaginal birth after caesarean) is dangerous, saying the scars may burst open or it's risky to the baby.
But in most studies, about three-quarters of women attempting a VBAC are successful, with excellent outcomes for mother and baby.
Risk factors for unsuccessful VBACs are: induced labour, no previous vaginal birth, body mass index greater than 30 and previous caesarean section for dystocia (abnormal or complicated childbirth or labour). (UK Royal College of Obstetricians and Gynecologists. Birth after previous caesarean birth 2007. Green-top Guideline No. 45)
It's best to discuss with your caregivers the benefits and risks of VBAC in order to make an informed choice.
I'll die of pain without an epidural
In 's 17 years of experience running ante-natal classes, she finds that most women can't imagine going through childbirth without opiates or painkillers like epidurals.
"A lot women are not mentally prepared for the challenge during labour," says Jennifer of Jenlia Maternal Services. The UK-trained midwife has been running ante-natal classes and post-natal home visits for 17 years. "You need to think about other options to manage your pain and have faith in your body's hormones to cope with the challenges or pain."
In government hospitals, epidurals are not usually available on demand. Due to lack of manpower, it depends on the availability of an anaesthetist to administer the painkiller on the day of labour, Farouk added.
The ups and downs of pregnancy and labour are mentally and physically taxing, added. "But giving birth is the easy part, looking after your child is the hard part. Like an initiation process, these challenges will prepare you mentally and emotionally for the long, hard road ahead."
Thanks for your post, very insightful. I am pro natural too BUT seriously , I am very sccccaaarrrreddd...
wonder if there is any first time mummy out there who survive without epidural.. people around me are encouraging epidural.. =(
Me and my sister, we only use gas that all, it all in your mind whether you can take it anot
Me! My baby weighs 3.6kg, natural birth without epidural.
I'm so scared of using epidural too. But i'm going epi c-sect. must be a very painful injection.
Doc advise to go for C sect? Actually I almost ask the doc to cut me cos too painful till I wanna give up. I am afraid of injection, so I bear with the pain without any injection nor assisted equipment. Just the laughing gas but it makes me almost vomit. Hate the smell. ;-(
That means you went tru natural birth without any injections, just laughing gas?
Yes... The midwives there told me I am in the 10% who do not use needles...
Anyone koes the side effects of epidural??
I cant imagine giving birth w/o that! How painful is that!
Only heard that it's back pain (side effect).
Mentality, willpower & breathing exercises really help..
I think for me cos I die-die also dont't want epi, so die-die also must tahan.
For me the duration of labour also decreases with subsequent pregnancies, for that I'm eternally grateful.
i went thru labour w/o epidural just using the gas.... i dont exp alot of pain just towards the last hr when almost fully dilated
my labour was a very short one... only around 4 hr plus... quite unusual for a 1st time pregnancy.
I'm afraid of epi pain. But i heard that natural birth w/o epi is even painful. Stress...
Had done a natural birth 1 year back and is still surviving and coping well so far. Lol. It was not a choice for me. I was asking for epidural at about 4am, but was not granted the permission. When the doctors came by to confirm my decision for an epidural, it was already 10+ am and just about 5 to 10 minutes BEFORE I dilate to 10 cm ready for birth. -_-"
The painful part, in my opinion, is not the period between the dilation to birth, neither was it the pushing part. It was the unexpected, routine episiotomy that the nurses performed on me without informing me or asking for my permission. That is the pain that I still remember even up to now.
My friend who gave birth about 3 months later than me took an epidural immediately after being pushed into the labour ward. However, the doctors also refused to let her 'push' even though she had dilated to 10cm, instead she had to wait for the epidural to wear off in order to feel the pain, so that she is able to push the baby out. However, there is 1 thing that I need to highlight is that she still feels the soreness and the numbness in her lower half of her body even after 9 months.
Again, it is still up to you to decide if you want to take the epidural. How's your pain threshold?
Side effects, so far after 9 months of birth, my friend is still experiencing soreness and numbness in her lower half of the body. Sometimes, when it rains, there would be a sharp, ant-like sort of pain in her spinal cord. She goes for lots of postnatal massages in order to correct this, but the effects are still there.
My pedicurist had also an epidural before and for her, she could not feel her lower body (namely her legs) for about 14 months before the effects wore off. Even now, she would sometimes feel weak in the legs and could not do much vigorous exercises.
Of course, there are also many who had absolutely no after effects. Ultimately, it is still up to your body on how it recovers and how well you take care of your body and health, postnatal!
Wow... so scary.
I'm also afraid of epi injection. But no choice lei. I'm going for half body c sect.
For my case I didnt want an epidural but halfway thru I sudd felt a super sharp pain that sent be yelping, jumping up n want to pull off whatever they attached on me ...
My hubby was the one whom got so shock he went running to get the dr to issue Epi ...
I didn't have much chance to protest as I was kinda confused from the pain
By d time I m more sober I heard the anaesthetist was in her way and we can't just cancel as she comes from dont know where (not within the hospital)... I was too pai seh to protest n went ahead
Didnt feel any pain at all from injection... Yup no pain at all
I was shaking alot from the Epi I wondered if contractions or this was worse... LolZ
But I was on a minimal Amt n my Pilate lessons helped taught me about pushing
So I kinda surprised my gynae I could still move my legs with no help n I can still feel the baby as i pushed . I pushed baby out without use of any forceps etc in I think under half hr... She said it's fast for 1st time birth
I realized then I had not slept the whole night n yet found the strength to do it...Goes to show our will power as a mom
Oh good thing my gynae didn't do epiSiotomy she's the kind that ll observe first ... Good thing my tear was real small So I recovered fast...
I hope the next time I can consider the option of not using Epi
Yep, i too also heard from my cousins that pilates and yoga really do do wonders for birth, not only in the labour ward but also the recuperating period. *Envy* Your nurse does sound much better than mine. The episiotomy pain is one that I will never in my life forget and also the long recovering period thereafter. Sigh
I had my first baby, 3.6kg....no epidural, no gas...it was painful. for my second one, i'll do the same.
Ya Angelia I was really grateful my gynae made a quick n firm decision not to do the epi
She did make my labour experience a smooth one
I feel for you but hey you got your precious one healthy n now already 1yrs old right
By the way off topic but you look really young n cheery in the photo! Can't imagine you a mommy if I see you on the streets hehe
i didn't use epidural for both normal delivery.
My first delivery was terrible... cos of the pain. I promise myself that i will use the 2nd time. BUT i was 6-7cm dilated when i went to delivery ward for the 2nd time, too late to use, has to rely on gas throughout.