Natural Childbirth V: Epidural Side Effects and Risks | Chris Kresser
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Natural Childbirth V: Epidural Side Effects and Risks

by Chris Kresser

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Before we dive into a discussion of epidural analgesia I’d like to clarify my intention in writing this series in light of some of the comments on previous articles.

The purpose of this series on natural childbirth is to demonstrate that homebirth is as safe – if not safer – than hospital birth for low risk pregnancies, and that medical interventions commonly used in hospital births such as epidurals, induction with synthetic oxytocin and cesarean sections have risks and complications that are often not communicated to pregnant women.

Currently fewer than 1% of births happen at home in the U.S., and I believe this is largely due to misconceptions about its safety. My intention here is to correct those misconceptions.

The purpose of this series is not to condemn the use of these interventions in all circumstances. All of them have their place, and can be very helpful and even life-saving (for mothers and babies) when used appropriately. In fact, I said the following in bold text at the end of the first article in this series:

I want to be clear: no matter where birth takes place, complications may arise that require medical intervention and I am 100% in support of it in these cases.

There is still much we don’t understand about birth, and even more we don’t have direct control over. In some cases, despite a woman’s best efforts to have a natural, undisturbed birth, complications arise that require medical attention (and transfer to a hospital if she started laboring at home). In these circumstances, I absolutely endorse taking advantage of whatever interventions may protect the health and safety of both the mother and baby. At the end of the day, that is far, far more important than the method by which the baby was born.

I also want to be clear that I am not judging women who choose to have hospital births, receive epidurals, induce with Pitocin or end up having a cesarean section. I respect the right of women to choose a method of childbirth that feels safe and comfortable for them.

My purpose, instead, is to tell the side of the story that women are often not told, and to raise awareness of the risks associated with these procedures so that when it comes time to make their own decision, women are adequately educated and informed to do so.

What is an epidural and how common are they?

Dr. Leonard J. Corning, a neurologist in New York, was the first physician to use an epidural. In 1885 he injected cocaine into the back of a patient suffering from spinal weakness and seminal incontinence.

Today, epidurals are by far the most popular method of pain relief during labor in U.S. hospitals. According to the Listening to Mothers II survey (2006), more than 75 percent of women reported that they received an epidural, including 71 percent of women who had a vaginal birth. In Canada in 2005-2006, 54 percent of women who gave birth vaginally used an epidural, and during those same years in England, 22 percent of women overall had an epidural before or during delivery.

In an epidural, a local anesthetic – still derived from cocaine – is injected into the epidural space (the space around the tough coverings that protect the spinal cord). Epidurals block nerve signals from both the sensory and motor nerves, which provides effective pain relief but immobilizes the lower part of the recipient’s body.

In the last decade, a new type of epidural has been developed (called “walking epidurals”) that reduce the motor block and allow some mobility.

Spinal analgesia (a.k.a. “spinals”) are also used for pain relief during labor, but unlike conventional epidurals, they allow women to move during labor. In a spinal, the analgesic drug is injected directly into the spinal space through the dura, producing fast-acting, short-term pain relief.

Epidurals have significant impacts on all hormones of labor

In the last article, Natural Childbirth IV: The Hormones of Birth, we discussed the exquisite orchestration of hormones during birth and the risks of interfering with the body’s natural hormone regulation.

Unfortunately, epidurals interfere with all of the hormones we discussed.

They inhibit beta-endorphin production, which in turn shuts down the shift in consciousness (“going to another planet”) that characterizes undisturbed birth.

Epidurals reduce oxytocin production or keep it from rising during labor. They also blunt the oxytocin peak that would otherwise occur at the time of birth because the stretching receptors of a woman’s lower vagina (which trigger the peak) are numbed.

As Dr. Sarah Buckley explains 1:

A woman laboring with an epidural therefore misses out on the final powerful contractions of labor and must use her own effort, often against gravity, to compensate for this loss. This explains the increased length of the second stage of labor and the increased need for forceps when an epidural is used.

Epidurals have also been shown to inhibit catecholamine (CA) production.

Remember that CA can slow or stop labor in the early stages, but it promotes the fetus ejection reflex in the second stage of labor. Thus inhibiting CA production may make delivery more difficult.

Epidurals limit release of prostaglandin F2 alpha, a lipid compound that stimulates uterine contractions and is thought to be involved with the initiation of labor. Prostaglandin F2 alpha levels should naturally rise during an undisturbed labor. However, in one study women with epidurals experienced a decrease in PGF2 alpha and a consequent increase in labor times from 4.7 to 7.8 hours.

Epidurals interfere with labor and have side effects for mothers

Epidurals have been shown to have the following effects on labor and laboring mothers:

One important thing to note about these studies: in most of them, the women in the “control” groups were given opiate painkillers, which are also known to disrupt the natural hormonal processes of birth. We can assume, then, that a comparison of women using no drugs during labor would have revealed even more substantial differences.

Epidural also have side effects for babies

It’s important to understand that drugs administered by epidural enter the baby’s bloodstream at equal and sometimes even higher levels than those present in the mother’s bloodstream.

However, because babies’ immune systems are immature, it takes longer for them to eliminate epidural drugs. For example, the half-life of bupivacaine, a commonly used epidural analgesic, is 2.7 hours in an adult but close to 8 hours in a newborn. 2

Studies have found detectable amounts of bupivacain metabolites in the urine of exposed newborns for 36 hours following spinal anesthesia for cesarians.

Some studies have found deficits in newborn abilities that are consistent with the known toxicity of drugs used in epidurals.

Other studies have found that local anesthetics used in epidurals may adversely effect the newborn immune system, possibly by activating the stress response.

There is evidence that epidurals can compromise fetal blood and oxygen supply, probably via the decrease in maternal blood pressure that epidurals are known to cause.

Epidurals have been shown to cause fetal bradycardia, a decrease in the fetal heart rate (FHR). This is probably secondary to the decrease in maternal CA caused by epidurals which in turn leads to low blood pressure and uterine hyper-stimulation.

Epidurals can cause maternal fever, which in turn may affect the baby. In a large study of first-time moms, babies born to mothers with fever (97% of whom had epidurals) were more likely to be in poor condition (low APGAR scores) at birth, to have poor tone, to require resuscitation and to have seizures in the newborn period, compared to babies born to mothers without fever.

Older studies using the more exacting Brazelton Neonatal Behavioral Assessment Scale (NBAS, devised by pediatricians) rather than the newer, highly criticized Neurologic and Adaptive Capacity Score (NACS, devised by anesthesiologists – can you say “conflict of interest”?) found significant neurobehavioral effects in babies exposed to epidurals.

In one such study, researchers found less alertness and ability to orient, and less mature motor abilities, for the first month of life. These findings were in proportion to the dose of bupivacaine administered, suggesting a dose-related response.

Epidurals may interfere with mother-baby bonding and breastfeeding

Some studies suggest that epidurals may interfere with the normal bonding that occurs between mothers and babies just after birth.

In one study, mothers given epidurals spent less time with their babies in the hospital. The higher doses of drugs they received, the less time they spent.

In another study, mothers who had epidurals described their babies as more difficult to care for one month later than mothers who hadn’t had an epidural.

It’s important to note that neither of these studies prove that epidurals were the cause of the behavioral changes observed. However, if epidurals were at fault, the effects are most likely caused by their interference with the natural orchestration of hormones we discussed in the previous post, and may also be influenced by drug toxicity and the complications associated with epidural births: long labors, forceps and cesareans.

There is also evidence that epidurals may decrease breastfeeding efficiency.

In one study, researchers used the Infant Breastfeeding Assessment Tool (IBFAT) and found scores highest amongst unmedicated babies, lower for babies exposed to epidurals and IV opiates, and lowest for babies exposed to both.

A large prospective study found that women who had used epidurals were more than 2 times as likely to have stopped breastfeeding by 24 weeks compared with women who used non-pharmacological pain relief.


Epidural analgesia is a highly effective form of pain relief and a useful intervention in certain circumstances.

However, epidurals and spinals also cause unintended side effects in both the mother and baby, and interfere with the natural birth process and bonding between mother & baby.

In some cases epidurals may be beneficial, but the evidence suggests that they should not be used as routinely as they currently are in the U.S. and other industrialized countries.

Articles in this series:

  1. Buckley S. Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early parenting choices. Celestial Arts 2009. pp.117
  2. Hale TW. Medications and Mother’s Milk. 12. Amarillo, TX: Hale Publishing; 2006.


Join the conversation

  1. My children are 24 & 21 and have had great problems with ADD/ADHD that after reading and reading so much research I believe is directly attributable to “non-natural” childbirth. Both labors came on their own, but were augmented with Pitocin and epidurals. Both had fetal distress during the long labor process & birthed with meconium in their lungs which we were told can happen when the fetus is under stress during birthing. Both had to have NeoNatologists suck the meconium out of their lungs. I have always wondered how long they weren’t breathing while that procedure was done. Now it is known that the contractions are more intense/closer together and fetuses don’t have time to “recover” in between each which causes loss of oxygen. I now know from attending many NAMI classes and learning more about the brain that this undoubtedly cause a degree of damage to the frontal lobe, which controls executive function (judgement, impulse control, etc). It has been a lifetime of suffering for both the parents and of my now very dysfunctional young adults. Had I truly understood the risks, I would not have had epidurals or used pitocin. Chemicals in our food and in our bodies do have many negative side effects.

  2. Thank you Chris for writing this article.

    Everyone who wants unbiased information on this topic should study Dr Sara Buckley’s work. She is not only a doctor but also a mother of 4.
    I apprectiate her supportive and respectful approach.

    Her website is:

    I wish all of you love, peace and health with the path you choose.

  3. Epidurals can cause one of the top 10 most painful diseases!!
    Nobody warned me of this….
    I had my first child natural and my second with epidural because I was having my tubes tied anyways and would need a epidural for that.
    The disease I have is called ARACHNOIDITIS! I’m in bed 23 out of 24 hours per day.
    I have a very high tolerance to pain, but this disease would take down the strongest person in the world. Don’t be fooled by reading that this disease is rare because it isnt (keep reading and you will learn the truth)
    I was one of the lucky ones with adhesive arachnoiditis and was actually able to raise my children.
    So ladies come out of the hospital being unable to care for the baby they just had….and others have other children at home that are use to a mommy caring for them and come home unable too!!
    This disease is horrific! Please if you do anything before having a child; read about arachnoiditis!! It took 7 years after a mild car accident to realize I had arachnoiditis. Like I said, “I was one of the lucky ones who only had mild pain from this diesese. The car accident brought it out all the way. Some people don’t know they have it and have a slight fall and it brings it out. We are the lucky ones because most have pain after they have epidural in childbirth.
    I had many MRI’S and arachnoiditis didn’t show up. Hell, most Dr’s don’t know about arachnoiditis. The person doing a epidural does and won’t warn you of this disease. if you bring it up I’m sure you will be told it is rare. It isnt! It’s hard to diagnose so you will spend years and years in pain until it gets so bad and you can’t walk, can’t urinate without catheter, neurological issues and so on and so on. Oh, and you won’t be able to have intercourse and that will just help cause divorce. You won’t be able to care for a spouse or children, not have sex, barley shower by yourself, care for a home and will be in bed with life ending pain….if you don’t have a super husband that can deal with doing it all,it will lead to divorce!
    I had a wonderful job before I ended up with arachnoiditis, but now my family is down a paycheck and we had to drastically downsize. I have one of those super-husbands that does not care that we don’t have sex or that he has to do everything. I was lucky enough that my children were 13 and 18 so I did have time doing p t.a and taking them to baseball and dance, but we lost out on many years of being together and they deserved A LOT more than this diesese gave them. I’ve talked with A LOT of mothers that lost out on taking care of children, lost spouses, homes and so on. Why does this sound so dramatic when I’m not dramatic…..because adhesive arachnoiditis is dramatic!! It will ruin you’re whole family and life. I could have avoided all of this had I been told about this diesese but again….maybe I would have thought it won’t happen to me!
    PLEASE read about arachnoiditis before you ever let a Doctor put anything in you’re dura! Epidurals and steroid injections could ruin the life you have and you’re childrens!!

    • Alicia, I have Arachnoiditis too, caused by an Epidural.
      The pain is dreadful but the loss of mobility and energy, especially being able to care for and play with your child is worst of all.

      I echo your warning, Epidurals are DANGEROUS.

      Wishing you and all the Mothers who are suffering, love, hope and positivity. Xx

    • You probably have tried lots of supplements, but i would try serrapeptase. Its dissolves adhesions. Its is so powerful, it removes plaque from heart arteries, so bypass surgery is not needed. I know this, because i know someone personally who proved this to be true!

  4. In one study you mentioned, “Prospective study to assess risk factors for pelvic floor dysfunction after delivery,” urinary symptom reached 43.6% in those without epidural analgesia. While the incidence was 31% in those WITH epidural analgesia. (p=0.04) Saying that epidural analgesia may be a protective factor instead of a risk factor.

  5. I have given birth four times: two unmedicated hospital births, a home birth, and a medicated hospital birth. In considering options for giving birth to my fifth child, I came across this article, and want to share my experiences and what they’ve taught me, in case it’s helpful to anyone else who may be informing themselves to prepare for birth.

    Baby #1: I was focused on all-natural everything, took hypnobirthing classes, and believed in the moral superiority of unmedicated birth and that “one intervention leads to another until you end up at a c-section.” Labor started spontaneously at 41 weeks. The hypnonsis worked well until it didn’t (somewhere close to transition). Labor was slow, baby’s heart rate became hard to follow, I was exhausted, and my providers (midwife and amazing L&D nurse) convinced me to accept amniotomy and a scalp monitor. With these interventions in place, I was momentarily distraught by the deviation from my birth plan, but labor progressed with a terrifying intensity that literally took my breath away, and soon I was holding a healthy baby boy whose face was a bit bruised from his chin-up presentation. In retrospect, allowing a couple of small interventions actually kept us from a c-section.

    Baby #2: I decided to have at home with a midwife. I felt labor would go more smoothly for my baby and me in our own “nest,” and I would be able to rest afterward with my baby and husband and without all the many interruptions hospital protocol deemed necessary. Labor started close to 42 weeks and progressed well. After about twelve hours and some intense pushing (don’t know how long), my daughter was born, the sac rupturing on the next-to-last push. My experience of pain was definitely moderated by being at home and having an intact amniotic sac. As my baby was crowning, the midwife asked me to stop pushing and asked my mother to hold her head, because the cord was wrapped around her neck a few times. She was very calm about it and quickly unlooped the cord. Then I pushed her out. Of all my babies she was the pinkest—no oxygen deprivation there! My baby thrived from the beginning, and I recovered quickly.

    Baby #3: I had originally planned a home birth. But I became increasingly anxious about that choice, for no particular reason. When I came up GBS positive, I knew I wasn’t willing to risk exposing baby to a bacteria that the research has so strongly shown to be potentially devastating for a newborn, especially when antibiotic prophylactic has been shown to be an effective way to prevent those outcomes. So I decided to give birth in the hospital again, unmedicated (except for abx), with a doula for support. I went ten days past a precise due date and still felt too much anxiety to go into labor spontaneously. After prayerful soul-searching, I opted to have labor induced via amniotomy. Six hours later, a labor pattern that satisfied the doctors was established, and I spent most of my labor in the tub, thanks to my doula. This proved a very effective way to cope with pain. Sadly, I had to get OUT of the tub to birth, and the return of gravity was awful, but soon I had another healthy baby girl in my arms, calm and alert. I felt very much like she and I had worked as a team to bring her to light, which is exactly what that natural interplay of hormones is supposed to do.

    Baby #4: By the end of this pregnancy, I was severely depressed, overweight, anemic. I knew I was in no state, physically or mentally, to give birth without medical help. I also knew that I needed the pregnancy to be over as soon as it was safe for baby. So I went in for a scheduled induction on her due date. Pitocin contractions were much stronger, but I was able to endure until the anesthesiologist came. The epidural worked very well. I experienced no complications, not even a drop in blood pressure. I was alert and actually appreciated NOT being “on another planet”—it made it possible for me to think to ask for glucose in my IV when I became exhausted and ravenous, for example. I felt I was able to advocate for myself because I was more present. I was able to watch in the mirror as my third daughter emerged with her amniotic sac intact, “in the caul.” It was truly amazing to see her dark hair floating in the blue-gray balloon bulging out of the birth canal. I would have missed that without the epidural keeping me “on this planet.” Then the midwife broke the sac and placed my healthy, crying baby in my arms. It took her awhile to stop crying, she was so upset by the sudden change in her circumstances!

    The only bad part of the epidural was that as my body went through transition, and I could not feel it, I experienced my first ever panic attack. My support people talked me through it, and the relaxation techniques I had used in previous labors came in handy. Since that experience though, I have had repeat episodes of panic in claustrophobic circumstances . So I’d say that may be a lasting effect of how my body/mind responded to the epidural. On the up side, my depression improved significantly within a week of giving birth, and even though my fourth child’s birth was quite different, emotionally, from my other birth experiences, I was happy with the choices I made, and my daughter has been healthy and very bright from day one.

    Thoughts: There really isn’t one “right” way to give birth. Every woman is different, and every labor is different. The most important thing a mother can do is listen to her instincts. Inform yourself with the best research available, definitely. But be open and flexible: embrace whatever will ultimately give you and your baby the best outcome. Even if that’s a home birth. Even if that’s a pitocin-induced birth with an epidural.

    A mother should not feel judged or pressured when it comes to such personal, life-altering decisions. She should, however, have access to solid information to guide her choices, and she should be encouraged to trust herself, trust her body, and trust her intuition.

    • I had a difficult labor, spontaneous contractions that seemed to last a few weeks!! I had an epidural after my second night of full swing labor that i was still having spontaneous contractions with. All together it lasted three days and nights, I vomited a lot and needed a drip. The epidural made my labor a nicer memory, as I was able to rest a short while while my drips worked and calm down as I was highly dehydrated. I had no problem pushing my daughter out even though my contractions where still spontaneous and kept stoping. I also breastfed my daughter for ten months and did not leave her side. I highly disagree with these researching as the women that I know that had gas and air did not breastfeed. You can not say a birthing experience or a drug makes you bond more/ loss with your baby, or has an impact on breastfeeding. This is ridiculous.

  6. I have read through all these comments and article , and as much as points were made and facts were proven and opinions were given ….

    I have concluded that those supporting natural childbirth at home alone do so because they have had it successfully and feel like it’s worth bragging about to say you haven’t used medicine

    And those who did use medicine are maintaining its best because it’s better to be safe than sorry , which seem the wisest.

    But in all I know for a FACT that childbirth is different for every woman , my mom has six of us very differently , my 3 sisters and I had very different experiences , and I have a friend who can’t have a child naturally , only by cs ( and trust me most of you natural birthers can’t wrap your mind around her pain , my stomach crawls whenever she talks about it )

    So before you start posting judgemental comments , thinks twice about it , and count yourself lucky if you give birth ( regardless of what method ) successfully.

    Whether by medical attention or not if you and your child survives , it’s not going to call anyone MUMMY but you !!!!!!

    If that’s not enough connection , I don’t know what is , I hope less people have the need for medical attention

    • The fact that childbirth is different for everyone is something I have been trying to get into the heads of many midwives and pregnant women.

      Giving birth at home alone is similar to driving without a seatbelt. You can get away with it for years and probably will be able to brag about it. But when a serious collision does happen the significance of the seatbelt becomes clear very quickly, though often it is too late.

      Pain is pain, and its physiological and emotional consequences are the same. Doesn’t matter if the pain comes from an amputated finger or childbirth (they are more or less similar in intensity). You don’t fail your baby or the family if you get your labor pain treated. This is 21st Century, and yet the only place in a hospital where you can hear mind numbing screams of pain is labor ward.

      • Total bollocks, here the equivalent of a serious collusion would require a level of neonatal care that neither of the two closest hospitals can provide. Those at home and those at either of those two hospitals would both require a 45 minute transfer to that hospital. The vast majority of serious consequences are determined by midwives before birthing at home and if there is even a remote chance of one occurring a home birth would not be supported and the parents would be strongly advised against it.

        • As I said before, the assessment of risk is a personal matter. For me the statistics associated with the home birth makes this mode of delivery unacceptably dangerous. I someone looks at it differently it is their personal choice.

          In terms of the equivalency of a serious car accident and complications, I am not sure why look only at neonatal side of things. I don’t have the statistics, but have been personally involved in quite a few of “RIGHT F****NG NOW!!!” when a woman is rushed from the delivery suite to the theatre with the cord prolapse or severe foetal distress.

          In terms of determining the chances of a bad outcome – I don’t think midwives have the magic mirror to do that. Most dramatic and stressful complications in obstetrics often happen out of the blue, without the slightest warning. The incidence of cord prolapse is between 0.1 and 0.6%, while mortality associated with it is about 9%. Anyone interested can just read the RCOG guidelines and decide if home delivery is worth the risk:

          • Just a quick comment about “pain is pain” from a man who I assume has never given birth. As a woman who has given birth twice, once vaginally and unmedicated, and once via necessary cesarean due to severe IUGR, I have to disagree with that statement. The “pain” of labor was very different and the hormones made me eager to give birth again in the future. The very real pain of recovering from major abdominal surgery was so much worse than contractions. There were no hormones to mitigate what I was experiencing and no purpose. I just felt like I’d been cut in half and was miserable. So please, when you’ve never experienced it before, don’t pretend to know what giving birth feels like.

            And cord prolapse is just as likely to occur while a mother is still at home and not yet arrived at the hospital, given release of membranes early in labor when it’s more likely a baby is not yet engaged, increases the chances of a prolapse.

            Given the % of complications that can come from being in the hospital (cranky doctor pulling on the umbilical cord, ripping it from the placenta and causing a hemorrhage comes to mind but there are so many more, such as “pit to distress”) I think it’s fair to say there are no guarantees anywhere.

        • And Steve – have you ever given birth?.. Then we can discuss the birthing pain. The article is okay, but honestly feel that it is very unfair when males toot that women should be doing natural birth since “it is such a natural pain”. 200 years ago people used to get surgeries without real anesthesia, it does not mean this is the best way to have them.

        • “The vast majority of serious consequences are determined by midwives before birthing at home and if there is even a remote chance of one occurring a home birth would not be supported and the parents would be strongly advised against it.”
          So not true. I was low-risk, monitored by midwives, started to give birth at free-standing birth center. I tried to tell midwives that my Mother had prolonged labor, but they didn’t listen, said everyone was different, and I needed to concentrate on positive thoughts. I trusted them completely, and my baby was the one who paid for this. Long story short, after 30 hrs of labor, midwives still were not sure if I need to go to the hospital or not. They never said that there was potential danger for the baby if I won’t go. I went because of crazy pain only, but it turned out that my baby suffered because prolonged labor. He passed meconium, aspirated, his lung didn’t expand… Luckily, in the hospital they gave me epidural, induced me with oxytocin and I progressed very fast. My baby spend 2 weeks in NICU, first on ventilator, than oscillator, on IV narcotics for pain, 2 meds to keep his blood pressure from dropping, urinary catheter, arterial line, central venous life. They didn’t know if he would survive for a week. 6 months later he still cried from pain. It could have been totally prevented if I gave birth in the hospital, with continuous monitoring, and my providers erred on the side of caution, rather than “naturalness”. Just remember that your child might pay for your choices.

          • I am so, so sorry to hear about your and your baby’s experience with his birth. It was clearly traumatic and I’m thankful that he made it. Hopefully I won’t seem unkind, but do want to point out for others reading this that 30 hours is not an overly long time to be in labor, nor is length of labor necessarily tied to fetal distress. Meconium is passed when the baby is distressed, and distress is caused by lack of oxygenation. All increased risks for causing meconium to be passed, excepting placental insufficiency which can’t be easily determined, would risk a mother out from home birth or birth center (preeclampsia, maternal hypertension, etc.) It occurs most often when there’s compression to the baby’s cord or vagal stimulation from head compression (which causes fetal heart rate to drop). It can be a one time thing that make the baby “pass out” and have a bowel movement, or longer, repeated restrictions of oxygen. Babies can pass meconium inutero during short or long labors. Just the presence of meconium staining does not indicate there will be a problem. The thicker and more particulate, the greater the concern that baby will inhale and aspirate at birth, potentially causing pneumonia. The neonatal resuscitation guidelines state that if a baby is born vigorous and crying then it goes to mom’s chest, regardless of meconium. If the baby hasn’t taken a breath yet then they are to suction and try to remove any possible meconium that could get into the lungs. Planned birth center or hospital birth, this very unfortunate but rare outcome would likely have been the same.

    • The best option for the baby is un-medicated birth in a hospital. Some women would rather not deal with the pain, but that fact remains…the drugs do carry risks and even 1% of an adverse effect on my baby is worth enduring the pain. Criticism of women who you say “brag” is just ridiculous. Why shame someone for doing what is safer when they should be encouraged?

      • Suri, the best option is what your provider recommends as being safe for both you and your baby. I needed induction with Pitocin + epidural for my labor to progress. Because this wasn’t done in time, my baby ended up in NICU between life and death. I also had strong opinions about what I wanted and didn’t want done, but my experience proved that strong opinions are dangerous. Listen to your doctors!

  7. Can anyone tell me what the standard procedure is on checking cervical dilation before giving an epidural. I understand the new procedures are doctors don’t want to check to frequently for risk of infection. But is it accepted to not check dilation at all from admission to the hospital to bring administered an epidural?

    I was against epidurals but after being told I’d be laboring for hrs longer I opted for an epidural. It was administered at 11:45. They finally checked me at 12:00 and I was already 10 cm. if I knew I was at 10 cm I would have never opted for one. They said the baby should prob be here with 2-3 hrs. 4 hrs later I was being prepped for a c section due to maternal fever, fetal heart distress and the baby not dropping or progressing into the birth canal. All things I’ve later could be potential risks or side effects of the epidural. I also had itchy skin for days, chills that literally shook my body and the epidural was so strong all I wanted to do was go to sleep.

    I feel like my epidural high jacked my pregnancy and robbed me of delivering my baby naturally. Not to mention the wks of healing and side effects of the c section. 10 wks later and I’m still devastated and regret my epidural everyday. I fully believe it caused my c section and robbed my of holding my baby after delivery. Immediately after the epidural was given my contractions slowed. At 10 cm I was progressing great and all of a sudden it all slowed down. He wasn’t progressing. Soon his heart rate would drop after every contaction and then my fever. Within 4 hrs of the elidursl I was I tears being prepped for a c section.

    My questions lie in why they refused to check my cervix prior to giving me the epidural, and is that standard or typical practice. She shouldn’t these, and all the potential side effects of the epidural been outlined to me and my partner before it was given?

    • Rebecca I truly feel for you. That sounds like an absolutely devastating blow. After reading this article and your story I am confident I will never accept an epidural unless it is absolutely critical, which I can’t see how it possibly could be. If you can find some light in this situation, know that you are helping other women to know the real truth. Sending love Aisha

      • That’s the point. She wasn’t checked so she didn’t know. It sounds as if they were unwilling to check her dilation before her epidural was administered and just assumed she hadn’t progressed much and would still be in labor for hours. That’s the thing with birth. Moms can go from 3-complete in two contractions. Birth doesn’t usually follow rules.

    • The main requirement when administering an epidural in labor is to make sure that labor is in fact established. Therefore, the presence of regular contractions and the opinion of the obstetrician is sufficient. The timing of epidural in labor has no bearings on the frequency of complications. In some situations epidural can be placed even before contractions start: induction of labor for example.

      • I agree. I was planning a homebirth (in Australia), however had prem rupture of membrane at 35 weeks and had to deliver in hospital, which at 35 weeks was happy to do so. I’d been in hospital for 2 days before my first noticeable contraction at 11pm. By 12pm the next day my contractions were still irregular but 5-7 min apart I was told I’d be in labour for at least another day or two as it was my first and I didn’t seem to be in too much discomfort from the contractions. By 4pm contractions were 2-5 min apart and I called my partner to come to the hospital because I felt I was getting close. Still I was told it could be another couple of days and that I was in pre labour, I was still on theward not in the birthing suite. At 5.44pm I was told I’d tested pos for strep b and that a doctor would be in to see me. At 6.10 I was told I would be induced as my “labour hadn’t started yet”. In the 3 or so min the doctor was there I had 3 very strong and obviously close contraction (but clearly wasn’t in labour…) at 6.30 I finally made it into a birthing suite where they put my on an antibiotic iv and checked how dilated I was for the first time since arriving at hospital, it was the 3rd day. I was 6cm and 15min later my son was born tiny but loud! My labour was fast, calm and mostly quiet. Had I not been tested for strep or if it had come back negative I don’t doubt my baby would have been delivered on the ward and notbin the birthing suite. I was told they don’t do unnecessary internal exams. Pft. Unnecessary…

  8. Just wanted to add a positive note, since there are so many negative comments trying to promote medical intervention and even “elective c-sections”. I had my first baby two years ago without epidural in a hospital setting. The birth was attended by midwife and it was a very supportive experience. Being free to walk around and change positions made the labor so much more bearable. I felt that I was truly able to listen to my body and work to help my baby to get into the optimum position for birth. I had a quick labor and only about 20 min of active pushing, which I credit to the positioning. My daughter was born healthy and very alert, no signs of distress at any point. I had no post-partum complications, such as incontinence, pain during sex, or a severe tear. There are many methods for natural pain management, including massage, hydrotherapy, and I found yoga to be especially helpful. The books Mindful Birthing and The Birth Partner are great resources for learning more. It’s true – our bodies are designed for birth, unfortunately we live in a fear-based culture where there are too many special interests telling us we aren’t capable. Obviously there are always situations that require medical intervention; however, the fact that only 22% of Britons get an epidural vs 75% of Americans is evidence that it doesn’t need to be routine.

  9. Darn, I was reading this because I wanted to find out how many times it was okay to get an epidural. I’ve had two healthy babies so far, both with epidurals and they are the BEST THING EVER. I want to have a pile of kids, but I’m unsure about getting a needle in my spine over and over.

  10. I like the comments since they help the reader see all the stories, opinions, and look into the facts and/or falsities on this subject so that they can make an informed decision. I, unfortunately, could not get through the pain. This could have been for many reasons, but mostly not having a great coach or massage therapist with me and/or not training and getting ready for the big day. But the pain was much too great and I chose the epidural. Each of my 4 pregnancies were very different but had 1 thing in common: at 4 cm the pain was horrific. I think petocin (which i was given with one of my deliveries) did cause the pain to soar so I would never do petocin without an epidural. The most important thing is to make it out alive and healthy. I think a lot of the traumatic stuff comes after delivery when they try and push all the extra stuff like vaccines, antibiotics, etc. on you and the baby. I always got out as soon as possible and i wish pediatricians had more experience (they should have the oldest pediatricians in these wards along with the newbies to learn from them) because they ruined 2 of my 4 delivery experiences.

  11. When mom gets an epidural fever, which can’t be distinguished from infection, causes the mom and baby to be exposed to antibiotic administration, sepsis workups, NICU admissions and longer hospital stays. The epidural itself causes an inflammatory response in the placenta, which is not a good thing for the fetus. The fever rate with epidural is shown to be 23%, vs 6% in laboring women without an epidural. See Sharma, S K, Rogers, B, Alexander, J M, et al. (2014). A randomized trial of the effects of antibiotic prophylaxis on epidural-related fever in labor. Anesthesia and analgesia, 118(3), 604-10.

    • Association of maternal fever with epidural has been known for a long time. Here is the discussion for those interested:
      The question is if epidural is the cause of the fever OR there is underlying pathology that makes labor more difficult and increases the likelihood of request for epidural. I believe it’s the latter.

      When you read articles you should pay attention to the details. In the article it never says that epidural causes inflammatory response in the placenta. It said: “Fever during labor epidural analgesia is associated with placental inflammation”.

      Also, if you have access to the full text, in the discussion you will find the paragraph mentioning previous studies that show that women with elevated interleukin-6 were are likely to develop fever with epidurals. That again suggests an underlying inflammatory process before epidural is administered.

      Lastly, if someone believes epidural causes inflammation of the placenta they have to propose a feasible mechanism that could suggest how and why epidurals would do that. So far there have been none.

      You are correct when you say that babies born from mothers with fever are more likely to be investigated for sepsis. In fact, babies get investigated more often if mother had epidural, even if there was no fever.

  12. Hello-
    I read this article and related comments after having a very traumatic experience with my oldest daughter and her delivery December 2014. My daughter and her partner are very much into “natural” living. She is a very small person and he is a very tall person. Their birth plan was to have my first grandchild at home with a midwife. My daughter is a very healthy and very active individual. Together she and her partner researched anything and everything about natural childbirth. They had a highly recommended midwife and they attended natural child-birthing classes and chose a naturalistic approach to the entire pregnancy.

    While this was not how I chose to have my three kids, I was open to the idea that this could be a good experience. My alarm as her mother, began when she ended up post term and clearly with a very large baby. I even asked her if anyone had spoken with her about what should occur and when post term. This was met with absolute anger and resentment by her partner. I am not going to lie, at 43 weeks I was very concerned. In an odd twist of fate, the midwife who they had paid the entire balance of the birth fee only covered 42 weeks. So, she was unable to deliver after the 42 week mark. They were directed to a renowned teaching hospital in Oregon for the birth.

    My daughter eventually went into labor at 43.5 weeks and she and her partner went to the hospital to deliver via natural childbirth. For two full days they shunned the family while they labored. They were declining cervical exams since in their research these are linked to infection and declining medical advice in general. The text came at 4:00 am on New Year’s Eve from the partner “you win, they have started the epidural and petocin, do you want to come be with her instead of me?” Being a mom and trying to keep peace I tried to calm him but immediately went to the hospital.

    What I found there scared me to death. My daughter had been in hard labor for several days and was absolutely exhausted. Meanwhile, doctors were coming in and advising that they believed a cesarean to be the prudent choice at this point. This was met with a very aggressive and highly agitated angered response from the partner who I assume my daughter agreed with. My daughter and her partner did not want to even hear about cesarean birth and advised the doctors to please refrain from bringing it up again unless “new Information” came available. They accused the doctors of bringing negative energy into the room.

    This continued for most of the day. Psychologists were sent in to inquire without judgment how far they were willing to take their “natural approach”. Was it okay for the baby to die? Was it okay for the mother to die? Both my daughter and her partner became a little more agreeable to putting parameters around it and both agreed that death wasn’t an acceptable outcome.

    They did allow a cervical exam. They also pushed for another 6 hours before doing an additional cervical exam. Ultimately, it was discovered that while she was dilated, pushing, and in full on labor the baby had not moved from its initial position. They were allowed to continue trying and later in the evening the doctors told them the baby was beginning to show signs of distress and that she was showing evidence of infection. They again reiterated the need for a cesarean.

    At this time they conceded to the cesarean, the entire while he was acting like a raging child, ticked off at the world and bringing so much negative energy that it was to me unbelievable. It was as though he believed that this was the hospital’s fault. I went into the operating room with her as did he. The baby was delivered fairly quickly and was very healthy. She on the other hand hemorrhaged losing almost half of her blood and was running an exorbitant fever racked with infection. She almost died. It was crazy to me that people would refuse medical care and yet she later told me that they were absolutely 100% convinced that there was never a real reason other than someone being a wimp for not having natural birth.

    Honestly, the struggle did not end there. She also needed blood and antibiotics which he really didn’t want her to have. I almost wondered if he wanted to kill my daughter. I think natural childbirth can be a great thing for some people. I also think that both sides, medical and natural tend to be very slanted to their beliefs and it is almost like you must make a choice. The choice almost killed my daughter and I have a bitter feeling towards all of these classes that did not address how to identify and accept when natural childbirth might not be a possibility. This is one grandmother’s story and one that I hope people will at least think about.

    • I commend you for realizing the severity of your daughters case.. I’m a labor and delivery nurse and have seen several very similar situations.. Parents are completely and utterly blind to the fact that there is a real risk here.. Sadly I have seen this EXACT behavior from very educated people.. And their baby died simply because they wanted a “natural birth”.. So unbelievable selfish and naive.. Perfectly healthy babies dying because of stupid choices..Your daughter was extremely lucky they have a healthy baby.. People think that hospitals and OBs are out for their own good.. All we want is a healthy mom and healthy baby.. Bad things happen every day in labor and delivery when you least expect it… Even if you had the most perfect healthy pregnancy .. We all want best for the mom/baby whether it ends up w a vaginal birth or cesarean ..

    • What you have described is a fairly extreme example of proponents of “natural” birth. As I said many times before, “natural” should refer to the outcome of childbirth, a happy mother and healthy baby, not to some idea of how the baby should be delivered. Sadly, it is also not uncommon for husbands or partners to force their opinions on women in regards to what they should and should not accept while giving birth.

      Home birth is a horrible idea, in my opinion, for many reasons. Dr Amy Tuteur has discussed it numerous times on her blog, I lost count how many times I anesthetized a woman for urgent cesarean where a few minutes of delay would mean certain death of the newborn.

      • Are you seriously recommending that skeptic blog? She is a fear monger. Even the ACOG website has a load of references in their section regarding why they do not recommend home birth, which are all filled with information on why home birth is just as safe, if not safer, for the low-risk mother. I checked 70% of them, and none or few contain the information they claim. Furthermore, you must know that home birth is safe. That is not refutable. It is not. not. not at all. not one bit. Obviously the woman above has a daughter with a controlling, zealot husband. That is the problem, not home birth.

        • In terms of the safety of home birth, to be honest I have not researched this topic in detail. However, I have participated in quite a few instances when a woman is rushed to theatre and her baby’s life is saved by cesarean section. Were these women at home their babies would be dead.

          When labor goes wrong things often go downhill very quickly, and low risk situation turns into a high risk in one breath. Sure, the chance of a terrible outcome is low. But when it does I advise you to be close to doctors, not midwives, doulas or aromatherapists.

          Let’s put it this way: I would never recommend my daughters to have a home birth. In fact, I would recommend them to have elective cesarean, but this is a different topic altogether.

          • Really, if she was 43 weeks and 5 days, almost a month after her due date… Then her due date was wrong. A doctor would tell you that.

            • Laya-
              You seem very angry at my story. Sadly it is a real story and while you may be skeptical about the due date I am not. A doctor would have likely have provided the same due date but they chose to not have doctors and only midwives. Chill out and realize that you may have a great experience with home birth but it may not be in the cards. You sound very much like my daughter, ie very angry at anything that does not meet your idea of how it should work.

              • Toni-

                I’m sorry… My intention wasn’t to sound angry at your story?

                One of my comments was meant for Epidural Guy in relation to his saying that he would wish for his daughters to have elective cesarean. My point was that cesarean isn’t necessarily a safer option. Obviously in needed circumstances it is.

                I don’t really see how you think my response was angry towards you? I think the story is real and it sucks. It just stinks the way things didn’t go the way they planned, but hey… Things usually don’t go as planned.

                All I meant for you was to say that if she was a month overdue, her due date was likely incorrect. No intentional animosity directed at you.

                • To be clear, I don’t think you are angry at me. I wrote that wrong. At the time I wrote on the blog I was severely pissed off at the “natural” community for failing to address the potential for intervention and what those red flags might be.

                  My daughter and her husband are highly educated individuals (1 phd, 1 masters) and they studied everything natural. They attended everything natural. They were clearly past their due date (even though it was just a midwife there was the use of a sonogram on multiple occasions). They still wanted to believe all the wonderful stories that people shared about being post term and natural methods of induction. As I said before, my grandson was born holding himself up on his arms and looking around so there is little doubt that he was older.

                  I am much less angry now because I realize that my daughter played as much of a role in the birthing decisions as did her husband. While he appeared controlling to me, he was trying to protect her desires and interests.

                  They were 100% convinced that induction was evil. They were 100% convinced that anything other than natural childbirth was a failure on their part.

                  They blame some things still on petocin and the cesarean. They are still very into natural.

                  My anger as grandma was their unwillingness to at least understand what plan b was. So, I would personally never recommend a cesarean for a person who can have a baby through the birth canal. I would also never fault a person who chooses an epidural. We are all different and every circumstance is different. I had 2 natural and 1 cesarean (emergency). Please for your health keep an open mind and look at plan b so it doesn’t have to be such a downer. In our case, the most joyful experience in the world turned into our worst nightmare and it did not have to be that way.

                  All the luck in the world to you!!!!!!! XXOO

              • Guess I accidentally replied to the wrong comment. That was my mistake. But seriously, not angry at you or your story at all. Only was a slight peeved with the suggestion of elective cesarean.

          • You would prefer your daughter to have major surgery than a vaginal delivery? WHO says only 10-15% of women actually require c-section. Cesarean does not mean safety. For example, Brazil’s c-section rate, according to a WHO health report using stats from 2008, is 45.9% (as of 2008), but Brazil’s maternal mortality rate is 2.8% (as of 2013). USA’s c-section rate is 30.3% (as of 2008), but their maternal mortality rate is 1.5% (as of 2013). Japan’s c-section rate is 17.4% (as of 2008), and their maternal mortality rate is 0.4% (as of 2013). You can see the correlation between the increase in the c-section rate and maternal mortality.

            And you would STILL have your daughter have a cesarean?

            Also, the home birth midwife that delivered me has delivered 1,000 babies. She has never lost a mother or baby. She has a transport rate of between 10% and 15% and of those 10-15%, a c-section rate of 3%. 1,000 babies is statistically significant. She’s never lost one.

            AND emergency situations are not as “snap-your-finger, OMG in the next millisecond you WILL DIE” emergent as you make them sound. There are always warning signs to call for action. Licensed midwives are educated enough to know what to do in the meantime IF the situation is so emergent that an ambulance should be called.

            • Correlating an outcome with a single variable is a typical mistake made by amateurs. To start with, several years ago WHO backed away from the “optimal” cesarean rate of 15%. Second, maternal and neonatal mortality ratios are determined by more than one factor, socio-economic status being one of the most important. There are a quite a few other differences between Japan and Brazil, besides the caesarean rate.

              As far as obstetric emergencies are concerned – sure, lots of times you get warning signs in advance. In rare cases though when things start to move downhill very quickly you want to be as close to the operating theatre as possible.

              The midwife you had seems very sensible, and her outcomes is the testimony to this fact. Keep in mind though, that mortality is measured per 10,000 of births, and though one thousand deliveries is not something to shrug off as insignificant in terms of personal experience, this number is not large enough to draw generalised statistics. In clinical medicine the word “never” has limited value.

          • My mother/baby nurse friend would totally disagree with you about recommending your daughters to have c-sections, since we’re not basing our opinions on research but on experiences. Hers involved being talked into a cesarean by her O.B. because she was obese and was going to have a huge baby, estimated at 11 lbs. She had her elective cesarean because she didn’t want a “dead baby” (that’s a nasty card for doctors to play if there isn’t a very really and urgent risk at hand). She almost bled to death in the O.R. as her nurse friends and husband stood by. She couldn’t care for her 7lb 3oz baby, 23 inches long I believe, for days and I think she got an infection (which occurs in up to 1/3 of cesarean births). Cesareans do not save the pelvic floor, they are not risk free. I know women who have had bladder nicks and on-going complications, wounds with tunneling that will not heal despite working with wound care specialists, removal of part of the bowel due to adhesions caused by the surgery, placenta accreta requiring a team of five specialists to attend her birth and planned hysterectomy. Cesarean has it’s place, I’ve had one and I’m thankful that it saved my son’s life (severe IUGR at 29 weeks). But when one third of births are via cesarean and the risks and complications aren’t being taken into account, it needs to be talked about more truthfully.

        • My daughter was very much obsessed with a home birth scenario. Perhaps if they had considered having induction once it was obvious that my grandson was overdue then the complications would not have occurred. I wrote my comments because my daughter was o NOT INTO LISTENING TO ANYTHING that did not fit into the “natural” bucket that she risked her life and almost lost. The good news is that my grandson is very healthy. I would never recommend cesarean for all. On the other hand, when things go wrong it does seem to happen very quickly. At least keep an open mind that home birth may not be a reality for every person but may work perfectly for others.

          By the way, any doctor may have told them differently, however they chose to go a natural route with NO doctor. Also, all evidence points to the actual due date as being spot on. My grandson has acted older from the day he was born.. ie could hold his head up and look around from day one.

          Just keep an open mind and be prepared for things not going the way you desire. That is my message.

        • Apparently he’s serious, but that’s what industry apologists do. Corporate science, regardless of methodology or conflict of interests, is the norm.

    • Thank you very much for sharing your story! I am sorry to hear you almost lost your daughter, that must have been very traumatic. I agree with you that childbirth shouldn’t be an all or nothing dispute. I would like to decline an epidural if possible, however, will definitely take medical intervention when necessary and there are significant risks to myself and the baby. Thanks again for sharing your story, I think it’s very helpful for people who are not going into it with an open mind.

    • SHE WILL HAVE A VBAC successful next time maybe if she’s lucky! Find a good midwife!

      2 months before baby I started having severe HBP and was in and out of the hospital. They never figured out why until after baby came when it stopped. She was laying on an artery.

      In the meantime, here’s what I recommend. Pineapple juice like crazy the last 2 weeks of pregnancy. LOTS. I was drinking half a gallon a day and also taking evening primrose even though my midwife told me not to. I’m rebellious. My cervix was soft, but I wasn’t dilating. I was told to come in at 39 weeks early in the AM to be induced. I wasn’t induced. I told them that they wouldn’t have to induce me. I told them a pharmaceutical for softening the cervix would put me in full blown labor. Sure enough, it did. I got the contractions down to 2 1/2 minutes and 3 cm dialated. THAT WAS ALL. After something like 9 or 10 hours running up and down the halls and squatting and rolling around on the ball and that was all, I could have screamed. Anyway, made the midwife break my water. 52 minutes later my daughter was born.

      I ate whenever I wanted. I drank whenever I wanted. I didn’t do an epidural. I was recommended antibiotics which I did do, but only the kind that keep me down for 30 minutes and allow me to move around. I told them after a while to kiss my ass I wasn’t going to monitor the baby anymore b/c the baby kept changing positions with the monitor on. PEEING IS KEY. I don’t care if the woman has to pee so bad she’s going to pee everywhere but a toilet. JUST PEE. I recommend getting on a toilet. I also recommend a bathtub.

      • I will never have an antibiotic during labor again though. My daughter got staph infection in the hospital and was sick 2 months. It spread from a diaper rash caused by honest diapers. She then got a secondary strep infection too. It was a very scary time. antiobiotics during labor also cause milk protein allergies in babies.

  13. I wish people would stop using the word “brave” for women who use nautral birth. One isn’t lesser or more because they did not use meds or used meds. How are you brave if you die during nautral? Just like epi has a slim chance of risks nautral has a slim chance you could die or your baby could. That’s not brave, that’s sad. So let’s not assume every natural birth is bravery. I rather do what’s best. I dont think any women wants to take a less brave way out they just want what’s best for them and their baby.
    If you think just because having meds you didn’t endure pain , you’re not brave well there are many natural births that are easy and quick, then that’s not brave either. Just lucky.

    Every woman is brave for giving birth, period!

    • Definitely! I don’t like that either. All moms are brave, and some women can’t have natural labors and even if they can but choose not to do things completely natural that’s their right and they should be able to do what they need to to make their labor as enjoyable as possible. No woman should be made to feel bad about it. All women are different and so are all labors!

    • I dont understand this mentality of women bashing, birth bashing, labor bashing, pretty much any kind of bashing one woman can dish out to another in terms of how they are choosing to live their pre-natal days, post natal and of course, the labor and delivery. My mom said that when she was pregnant with us, no one would ever have said anything or questioned/bashed her for her decisions. Granted it was a different time, I know the c-section rate, epidural rate and everything else was much less. However, unless one is planning on abusing or neglecting their newborn immediately after birth, no one should have a say or make a judgmental comment about that woman’s plans. Elective c-section or natural birth, every woman should have to right to freely and openly choose whats best for them at that time. And no one should feel the need to be confrontational about their decision. Lay off one another ladies.

  14. The “inhibit catecholamine (CA) production”, “increase in labor times from 4.7 to 7.8 hours” and “more than 2 times as likely to have stopped breastfeeding” links cannot be opened


  15. I want to know if epidural cause autism or not. The recent study of University of MI was talking about the relation btw recent trend of painless scheduled delivery and the recent increase of autism in US. I am scared to have a verginal natural birth, but also I am afraid of side effect of the painless delivery.

    • I have never looked at any correlational studies linking epidurals with autism, but if it hasn’t been explored it definitely should. Do you have a reference/citation?

  16. For all the commenters on this thread…its good to share & read people’s experiences – only if its non-judgemental…Most of the people using Epidural are not shunning natural birth- but so many of the people supporting natural birth are actually being judgemental about people who opt for Epidural – why?

    The very first comment on this article (I realise its 3 years old, but am sure many people will continue to use the argument) states that why be afraid of something natural? By that logic, falling sick & death is also natural – but don’t people fear them?

    And lastly definitely want to thank the commenter “Epidural Guy” for his comments seem to come from a experienced & well-researched place. As someone who has recently found out about her pregnancy, this is something I still want to research into & being able to see all sides of the story definitely helps…..

    • I just want to re-iterate one thing: natural birth is not about the process, it is about the outcome, a healthy child and a healthy mother. You don’t have to please your midwife, obstetrician or anesthetist. Every approach has its risks, and the best way to go is to research the subject of childbirth in detail and decide which way is most comfortable for you. Also, labor is a very dynamic process, so be prepared for things to change quickly.

      • To all you mums out there contemplating natural birth. I’ve had a natural birth by episiotomy with an epidural and I’ve had a c-section. All I can say was that one baby took 20 hours and one took 20 minutes. If you want to enjoy your baby and not remember the trauma and endless pain of childbirth and guarantee your safety (an the baby’s) for god’s sake have a c-section. You wouldn’t have a tooth out would you without an anaesthetic? Natural birth is barbaric

  17. Thank you so much for this information!! This has helped me think things through for whats to come in the next 3 months

  18. I had my son when I was 15 years old. I was in labor for 19 hours before I requested an epidural. The pain of labor for me was so intense and terrifying that it took me 15 more years to agree to have another baby. My son was 9 pounds 14 oz. He was huge. I was able to relax after the epidural and was finally able to dilate. delivered him 1 hour later. I did have to have an episiotomy but I think with as large as he was and as small as I am, At the time 5 foot tall, 110 pounds, small hipped, I wouldn’t have been able to deliver vaginally with out the episiotomy. I will probably request a epidural again if my labor is long, or the baby is very large again. I didn’t have a problem bonding with my son. I don’t have any pelvic floor muscle issues, kegals took care of that. My hospital stay was longer than usually, 5 days, but I went in with pneumonia and didn’t realize I had it as shortness of breath was my only real symptom and that happens all the time in late pregnancy. I didn’t have a problem pushing with my contractions when the time came and he seemed to finally come out after I was able to relax. My uterus is tipped though which may have led to some of my labor complications and pain as well. I think every one is different and feels pain differently because their bodies are different. I wouldn’t have ever agreed to this pregnancy with out the epidural I had with my son. It was already traumatizing enough and painful enough for me to delay having another child 15 years. I don’t care what any one says you do not forget the pain of labor. It was indeed the worst pain I’ve ever felt in my life, still to this day. And was in a major car accident 5 years ago with several broken bones and bad head injury that I now get chronic migranes from. I shudder and cringe at the thought of going through labor and delivery again in 5 weeks.

  19. Such a wonderful post, I gave birth to my son naturally and it is such a wonderful feeling, to feel everything that is part of nature. I recommend all future mothers to go natural, and most importantly breastfeed! my son is 11 months now and is still breastfed and the bond between mother and baby is so wonderful and strong!

    • Not everyone can have a natural childbirth. I had to be induced at 40 weeks. The fluids protecting my son were low and I was showing no signs of going into labor anytime soon. Thank god I didn’t have a midwife cause it seems all they care about is the natural way and not the health of the baby or mom. None of the women in my family can breastfeed. Our milk doesn’t come in. My son is perfectly healthy. There are millions of ways to bond with your baby, not just by breastfeeding such as feeding your baby with a bottle and changing his diaper.I also had pre-eclampsia, so hospital birth was medically necessary. I did not need a c section, but I was open to it if it meant saving my baby’s and my life. Natural childbirth is great, but isn’t the most important thing to have a healthy mother and baby?

    • I’m tired of hearing how important it is to breastfeed. It makes me feel so inferior and judged because I won’t be able to. I am so upset that I cannot breastfeed, and comments like these only make me feel worse. Like I will be a bad mother for depriving my baby of the benefits. I get it. Those of us who can’t breastfeed get it. Pretty sure anyone looking into formula vs breast is getting it. Those of you who breastfeed should not be telling anyone what to do. It comes off as superiority.

  20. I had identical twins so that was considered high risk, delivered at 37 weeks vaginally but my doc told me it was statistically best to be induced at this time frame with identicals, (mono-di) they didnt even get to the pitocin and I went into labor but I did get an epidural regrettably, because they told me that it did not affect the babies at all and my contractions were crazy- I feel so naive. If there is a next time, at least I will know better. How can the docs tell you that there are no side effects on the baby when that is just not true?

    • Don’t let people trick you into falling for the woo, Twinmom (hey, fist bump: I’m a mono-di twin mom too!). Here’s an article about how epidurals affect the baby–they barely reach the baby at all (most of the medication stays within the spine, and what does get into the blood stream doesn’t cross the placenta in significant quantities). Epidurals also indirectly have BENEFICIAL effects on the baby, by causing dilation of the mom’s blood vessels and thus more blood/oxygen/nutrients etc. to the baby:

      What WOULD reach the babies in significant quantities is general anesthesia if you needed a crash c-section and didn’t already have an epidural in place. Both you and the unborn baby/babies would be knocked out by general anesthesia. Since you never know in advance which vaginal delivery is going to go south and require an emergency c-section, IMHO it makes more sense to have the epi in place so that at least you won’t need general anesthesia.

  21. Hi Chris
    Does C-sec with injection causes pain after so many year for child birth??..I had C-sec because my son swallowed meconium. he was born on 2010..but now I am feeling the pain in my back where injection was given.I didn’t get much chance to rest, since I didn’t had any help…what could be the reason for my pain?

    • The injection is given in your lower back. Lower back pain is very common as people get older, and especially after pregnancy/childbirth (because pregnancy and then carrying babies/little kids around is very hard on the back). Assuming you didn’t get a catastrophically badly done epidural (which you would know if you had), it has nothing to do with whether you got an epidural or not.

    • Hope you get this since last post was 2014.
      Please look up arachnoiditis.
      If you are still in pain and can have mri get one with dye. Regular MRI’S miss arachnoiditis a lot of times. Hope this finds you in the best of spirits and health.

  22. I have 5kids and 4of them naturally no epidural I had no knowledge of epidurals just knew people got them so they don’t feel contractions I just had my 5th baby on January 06,2014 but my due date wasn’t until the 24th due to very high blood pressure and risk of going into seizure I ended up getting an epidural and boy did I feel like a coward I really tried my best and hardest to go all natural as I did my other births but gave in I can’t argue with the fact that it did help my blood pressure go down a bit and I felt more relaxed at the time that is…. how I came across this article is I’m 3weeks post partum and my back is killing me not a back rub, heat pad, hot shower has helped it 🙁 and I assume it’s because of the dam epidural trust me it is not worth it and I do agree on the breastfeeding part too because I couldn’t even latch my babygirl on and only ended up breastfeeding 2days and stopped do to tore up nipples it broke my heart that I wouldn’t be able to share that bond with her I get teary eyed bc of it I wish I would have done more research on epidurals but whats done is done dam blood pressure!

    • Unfortunately this is a natural reaction, to connect whatever problem after labor with epidural. You had complicated pregnancy and – judging by the fact that the pain was considerably stronger than during your previous labors – complicated delivery. Back pain is a very common complication of pregnancy (, and, according to the current clinical evidence, epidural does not cause it. The same with breastfeeding: somehow the problems have nothing to do with complicated pregnancy, high blood pressure or difficult labor, it should all blamed on epidural?

      • What about arachnoiditis?
        If you are the “epidural guy” why not warn of the possibility?
        I will be waiting for your excuse and reasoning.

    • Please look up arachnoiditis.
      If you are still in pain have a mri with dye. A mri without dye will most likely not show arachnoiditis.

  23. I completely disagree with some of these comments, even the ones of people who have been through it, or seen it for years. Especially the one who said a mother can completely stay still for an epidural but are wiggling all around during all the other contractions. First off, maybe for some women it is mental or visual, that when they see it they focus on it etc. I tried natural birth. I was teaching yoga all until I went to the hospital thinking “I got this”. After 12 hours of breathing through the very intense contractions that were only getting worse I was completely depleted of any and all energy I was using through that whole time. I was told I only was 4 cm. I opted for the epidural and any other medication until the epidural got there. I didn’t need to look at the monitor because the pain was very real. Yes I was able to muster up all the energy I could to stay still for that epidural because A. I needed it to work, and B. I did not want to be crippled or have some horrible outcome if I moved. That does not mean I could have stayed still and endured countless contractions. That means for that moment I used all I had. Yes there is mind over matter, but for how long. The body can endure a lot and I know I overcame so much, especially through my yoga practice. I come to love overcoming pain. But my mother warned me. She had 3 horrible painful deliveries and said I was crazy to think I was not going to experience the same. She need blood and was hospital bound for a week after my sister. My brother, her last child, was the easiest for her, but still a horrific painful experience. My cousins wife barely made it to the hospital before giving birth to her second son. For her it was very easy. I think all our bodies are different and the birth different. I had 3 births so far and all pretty different. My threshold for pain is at 4 cm. After that it is horrifying. I asked for less of a drip on my son (the 12 hour natural labor described above) and as I was about to give birth to him finally after 18 hours, I felt it and it was terrifying, even with epidural drip. I commend the women that can do it but don’t think all of us can. I’m sure for every story that someone says they did it naturally, another person almost died or did die giving birth. Don’t knock us that need it.

    • Agree with you. Its modern day people choose epidural more than go with natural birth. If it something could risk yourself giving birth on natural why should pushing yourself to go with that way. Some people have some different labor method that they preferred, and it no one business. Instead of blaming one another on the comment that I read maybe you should just take the knowledge to yourself on what you belief or you not belief. One of friend that I know died from the natural birth due to that her body not able to endure the pain and the giving birth is not something you can judge people decision. No hurt feeling I just said the right opinion that I think is positive. People out there whatever you think what is right for yourself you don’t have to argue someone else opinion. Just waste your time. It not your business in life. Thanks. I’m so sick of people argue with one another for some random discussion/info about things!

    • I totally agree, and I’m sorry you had to go through that much pain. We are all different and it’s kind of obnoxious for anyone to go around saying “Women in labor don’t need epidurals! Med-free is the only way to go!” There is NOT only “one right way” to have a baby! Some women do need epidurals. Several women I know say their labors were stalled by sheer exhaustion until they got the epidural, which let them rest for a little while without pain, and then they were finally able to push.

    • If laboring with working epidural was terrifying maybe elective cesarean is a better option for you. Compared with vaginal delivery in terms of complications cesarean is pretty much “horses for horses”. I am going to address elective cesarean in the next article on my site. For now it is sufficient to say that it is fairly safe.

  24. I’m a labor & delivery nurse (only 4 years in labor and delivery, so I’m not the most experienced) but I’ve also had 3 children. Women may get angry at me but a lot of it’s in their heads. I don’t mean to say that labor pains do not hurt but I honestly believe the reason they hurt so bad is because when you’re in labor (especially at the hospital) you only focus ON the pain. When you’re in a hospital you’re in a different environment surrounded by strangers and you’re hooked up to a machine that tells you when you’re having a contraction. I’ve noticed that when i talk my patients they wouldn’t seem in as much pain until they’d look at the machine and see that it’s showing they’re having a contraction. They don’t seem to even realize it until it’s pointed out to them and almost all of them decide they want epidurals. They’re freaking out screaming and wiggling around all over the bed because it hurts so bad but once the anesthesiologist gets in there and its told that they have to stay completely still they sure can sit still for the next few minutes through all of those contractions that were too hard to handle before and you know why? Because they’re not focusing on them at that moment. They don’t even move a muscle because they’re focused or scared about the epidural instead of the contractions. With my 3 girls I labored mainly at home with the first one and waited until I was a few hours into labor to go to the hospital because I just didn’t feel like I needed to be there yet. I was calm, at ease and honestly it didn’t really hurt. There were a few moments here and there but I was in my own house, I’d do laundry, clean dishes, I took a shower if it was getting worse and used the shower head to help with back pains and once I felt like it had been long enough I went to the hospital and not to long afterwards I had my first daughter. I got pregnant again only two months after my daughter was born (crazy Yeah I know) and was very shook up about having another baby. When my first daughter was 4 months old she kept getting UTIs very bad and at one point got such a high fever that she even had to be resuscitated so of course I was scared and I wanted to be at the hospital the entire time I was in labor with my next daughter. Maybe it’s just because I was stressed during my pregnancy but I went through hell at that hospital. Unlike at home, I couldn’t do anything to take my mind off the pain. I got to lay down in a bed and think of how much I was hurting and I wasn’t allowed to eat and I had to use the bathroom in front of people I just met so I was not comfortable at all. I got an epidural and had such a hard time pushing because I felt like I couldn’t control myself. Eventually I got her out and she was so tired as was I. I honestly had no interest in her until I took her home and felt better. My third pregnancy I decided I wanted to do just as I did with my first and wait until I was farther along in my labor to go to the hospital and I did so much better than before. I believe through and through that most of labor pain is only worsened by the fact that you sit there and focus on it.

    • Chanel- your comments about mothers not even noticing they’re having a contraction until it’s pointed out to them or that they are able to sit still for the epidural because they’re afraid of it and not really in that much pain- is extremely offensive! I was induced as a first time mother and although my contractions were becoming painful I opted to have my water broken before deciding whether I wanted an epidural or not, and the very instant they broke my water I had a contraction and it was so incredibly intense and painful I screamed and was so scared because I knew I couldn’t bare those contractions, there are not words to describe how intensely painful they were, and no amount of distraction would have been able to ease the pain of them, the hospital walls could have been crumbling down next to me and I wouldn’t have cared. Maybe it was the pitocin that made them so horrible, but either way they were unbearable. My anesthesiologist finally came in and when I was told to stay completely still at first I couldn’t, then I had to muster up every last bit of strength, mental and physical, to stay completely still because with as much pain as I was in if I continued having contractions like that I don’t know that I would have been able to maintain my consciousness. So just pointing out that everyone is different and especially as a l&d nurse you really shouldn’t be so judge mental towards others experiences, and at such an important time in their lives it would be awful to have someone on their team who isn’t being supportive.

      • I didn’t mean to offend you! Yes, a lot of women have much worse labor pains with pitocin, and I don’t think labor pains in general are “in their heads” perhaps that came out wrong, but women in hospitals are scared, and let’s face it, nobody likes hospitals. You’re hooked up to all the machines which often times hurts and I think it stresses you out more being in a hospital. I feel bad for the women who need pitocin because from what I’ve seen it hurts them much much worse after they get it. I had a mother who’s labor with her third child was professing very very slowly and the doctor decided to give her pitocin, when I told her the doctors decision she said that she’s always had pretty long labors and that with her daughter she was in labor 17 hours, with her son, she was given pitocin after 7 hours and she said the pain was horrific. She told us she would’ve rather went through the seventeen hours with her daughter again instead of the last 3 hours she had with her son after they gave her pitocin. I’m very supportive of my patients and its definitely their decisions what they want to do. But most of our patients who decide to spend most of their labored at home and then come in once it’s getting time to push have said that it wasn’t as painful as that thought it would be. It’s just a lot easier when you don’t have to sit in a room and focus on the pain, because that can really exacerbate it. All women are different and thankfully we have interventions to help make their labored as enjoyable as can be. I just do feel that if something other than drugs can help than it would be great instead and I’m sorry to hear about your labor pains. Pitocin is very painful, labor is in general of course. When I had pitocin it felt like a little alien was just beating the heck out of my uterus and trying to rip through my stomach lol so it most certainly varies from mother to mother, pregnancy to pregnancy, baby to baby and even hospital to hospital. There’s hospital who have great l&d units, they let their patients walk around, take warm baths, eat, use the labor ball, and there’s the hospital I work at (and had my girls) where the nurses are told not to let the patients out of bed for liability reasons unless they want to go to the bathroom. It’s just so much better when moms have other things to do than sit in a bed the whole time. But if they choose that then they should be allowed. When I was in labor with my second I was so much more comfortable sitting on the toilet, idk why. I didn’t like sitting up in my bed but on the toilet I felt way better but everyone was like “no get back in bed”

        • Who says women in hospitals are scared?!? I felt SO MUCH safer in a hospital than I could possibly have felt trying to give birth anywhere else. It’s so reassuring to know that if anything goes wrong, all the powers of modern medicine will be right there to help you and your baby within minutes.

          If I had given birth at home I would have bled to death. I went into hypovolemic shock and was saved BECAUSE I was in the hospital… and I knew going in that that’s how things worked (i.e. there were doctors there to save me and the babies if things went wrong). It doesn’t get much more reassuring than that.

        • Glad you had such an easy time of it.. I’m currently at the hospital with my wife who has been in labor for 48hrs now with our first child. We labored at home for 8hrs before we went to the hospital for the first time only to find she was a mere 1cm dialated, although 80% effaced. Of course we were sent home.. So we went back to our house and she labored another 14.5hrs with our doula, using all manner of ball, rebozos, showers and baths, lunges and various muscle manipulations. Back at the hospital we found all that work and pain got us to 1.5cm and walking around the hospital for hours. While we didn’t intend to use pitosin or pain medications, her level of exhaustion left us with little choice.. Within 2hrs she has reached 5cm and can finally get some much needed rest so her body is ready to complete the process. I guess she was just a wuss for not being able to labor for days without sleep or food due to the nausea from the contractions. Considering women are already faced with a raft of questions and guilt about how they perform during labor I hope none come across your myopic comments furthering the debasement of their self-esteem.

  25. Please forgive me I left out in my previous comment that I was stuck twice due to the first time was in the wrong spot, or what they said it fell out? I was numb 10 minutes and suddenly thr pain was coming back to the point I was about to faint because of the severity of it. They then inserted another drug realizing it had no effect they then checked my cath and seen it was not in correctly altho I felt the cold sensation of the drug being injected it didnt numb. So they re-stuck me. The pain was so extreme I was all for it. But sadly I do have regrets.

  26. Thanks for this article,
    I am for natural child birth, however with my 2nd delivery I was induced with pitocin it was extermely painful after several hours I requested the Epidural due to the immense pain. My first was painful yet nothing compares to artificial oxytocin. Labour lasted into 20 hours fully numb waist down. After pain staking hours I felt the baby drop and 2 pushes she arrived into the light. No ripping in the vaginal tissues no complications. From my own opinion the labour was prolonged due to already needing to be induced I was42 weeks already. Having the pitocin was the worst and epidurals are almost a must, having natural contractions produced by oxytocin are much easier to endure thus leaving it easier to birth without Epidural. As agian my own opinion I admit since the epidural and delivery I havent been the same, back pain, and bubbling fluid drain down from the base of my skull down the neck with severe migraines/vision problems. Is this related? So for next time I may seek other alternatives to having the “Epidural.”

  27. First of all, Mr. Kresser, thanks for your article and talking about this important topic.

    I have found this article that compares several studies about the impact of analgesia, specifically epidural, in labour:

    The article concludes that epidural increases labour duration and risk of instrumental vagina delivery. On the other hand, it concludes that the risk of C-section does not change between natural labour and epidural labour.

    The article specifically mentions the Thorp article you refer to about the increase of C-section risk and points out several flaws in its methodology. I therefore would not use such a reference in your article without saying it’s controversial, when there are many other studies that do not show this tendency… Your article is well written and well-informed, and it’s a pity to have such an obvious flaw in it, and it can feel misleading to an objective party.

    (and now, my anecdotal evidence)
    I was recently (5 days ago) father of a beautiful girl. My wife initially requested epidural or analgesics, but finally went without it when they told her labour was going to be quick and the midwifes gave her the option not to take analgesics. She is very happy she did without, even though the pain was obvious and she had to endure the painful contractions, specially the last 1,5 hours.
    About her experience, she said she was more in control of the contractions and the urge to push and probably that was the reason she did not tear. She has recovered very quickly in just a few days and the baby was active and bonding with us from the very first minute.
    I myself was more in favour of a natural birth, but never told her as I wanted her to be fully in control of her birth plan without needing to please anybody else but her, as she was the main actress of the experience.

    Again, thanks for the article and hope to see more of these coming.

    • The use of Thorp’s original article is very common – obviously, for the purpose of scaring women away from epidurals. Which is a pity, because Thorp himself is a very professional researcher: in 1998 review he addressed the flaws of his earlier works and, based on the data available at the time, came to the conclusion that epidurals do not increase the risks of cesarean. Curiously, his initial work got stuck with midwives until today.

  28. This goes to show you, don’t believe every cute doctor picture/blog posted on the internet….


    Spinals (spinal anesthesia) does not allow motor movement. That is why they are used during c-sections, when you want the patient immobile and pain-free for surgery. The do provide fast-acting analgesia and immobility, however the general dose given for a c-section will last 8-12hours, not something I call short-term. You will be able to lift you legs with an epidural, NOT WITH A SPINAL.

    I was interested in reading this article as a pregnant women about to give birth any day now, but as an ANESTHESIA PROVIDER I do not believe a word you say anymore after reading how incorrect you are on the basics.





    • I wonder where you got your information. Let me address every point of your post.

      1. The density of sensory and motor block is dose dependent. In my practice I do lots of combined spinal-epidural blocks in labor. Spinal bolus consists of 1.5 ml of 0.2% Ropivacaine with fentanyl. Ropivacaine at this concentration does not cause significant motor block, and the woman is able to move her legs comfortably. Spinal dose for cesarean section, on the other hand, is achieved by 2.5 ml of Bupivacaine, which indeed produces dense motor block. Similarly, epidural with high concentration local anesthetic will produce dense motor block (some anesthetists prefer doing epidurals for cesarean section, not spinal, to have the option of extending the block if necessary).

      2. The block lasts for up to two hours, not twelve. anaesthetists know this very well, because when caesarean takes longer than the usual 45 minutes the block starts to wear off and the patients starts feeling pain. In this situation we usually convert to general anesthesia.

      3. Integrity is another issue. The proof of mine: I gave my wife spinal anesthetic for her second caesarean. She is still married to me (that proof that everything was ok).

      4. In the vast majority of people spinal cord does end at L1. True, aberrant variants are possible, and often it is not possible to know about it before giving spinal block. However, touching the spinal cord with the needle produces such sharp pain that the woman literally jumps off the table, and the probability of seriously damaging the spinal cord is low. In my twenty years of practice I have not come across a patient with the spinal cord longer than normal. Still, direct injury to the spinal cord with spinal and epidural needles has been described, but it is very rare:

      One statement I wholeheartedly agree with: women should choose what they are comfortable with. That is why: educate yourself, find out more about your options, risks and benefits of every intervention. It is your body. Avoiding an epidural does not mean you’re doing “well” and getting it does not mean failure. You’re doing well if you leave labor ward with a healthy baby and free of injury.

  29. I just had my first on 09-13-13 the nurses were in shock when I told them I didn’t want the epidural. She obviously didn’t believe me because she asked me to sign off for it and I told them I wanted to go natural. After 7 hours of labor my baby was stresed and I stopped dilating. My obgyn came in and told me I didn’t have a choice because my baby pooped! I cried for an hour before they did the epidural. Even though I had to get it with my first I want to try natural with my second!!!!!

  30. My mother had extremely hard births, to the point where she needed a family member to come in and donate blood. All vaginal. I had my first very young, so of course I had an epidural. Left a horrible taste in my mouth since it seemed I was progressing quickly but pain got so bad and bf was NOT helping that I took the epidural. Right after I fell asleep. I woke at about 8am. Felt between my legs with my hand and it was very sticky and wet. I assumed my water broke. I could not move at all from my chest down. The nurse got loud and angry asking me to lift my leg, and then the doctor told her I couldn’t. They had to lift my limp legs. I pretended to push and had him 28 minutes later. I felt absolutely nothing. But boy did I have a cute little baby. Because of this 10 years later with my second son, I swore on having a natural birth. My mother thought I was crazy and wouldn’t even discuss it with me except to warn me “not to be stupid”. I was a yoga instructor and taught up until the week I had him so I surely had the deep breathing tools, etc. Well my labor started at about midnight, and peaked at noon (12 hours). I thought for sure he’d come any minute. I had absolutely no energy left and the pain was not subsiding but in stead growing much more intense and lasting longer. I looked at my husband who was completely out of it and had no energy left either, but was ready to go to bat at my command. They checked me and I was only 4 cm. There is no way I could have done it!!! I ended up going for all of it. 6 hours later, with an oxygen mask, and completely overwhelmed, tired, and hungry, I finally had my baby. I felt it a little this time. Asked for 9 cc’s instead of 10 dripping. Felt it get worse and worse culminating to the end. There is no way I could have ever endured that pain. My sister had her first son without meds. It was a nightmare for everyone involved. Some people just can’t! Their body is not built in that way to endure it. My cousin’s wife, on the other hand, barely made it to the hospital with her second child and had him immediately and said, “I wish this for every women.” It was that easy for her! I WISH!!!!! I did really well for 12 hours, I will give myself that. I even had a tub in the room and a shower I was going between. What can help me because I am pregnant again and am will to try one more time.

  31. I was a mother in one of the early trials of inducted labour with mobile anaesthesia at Queen Charlotte’s Hospital in London, in 1995. I am still very, very angry, 18 years later. I was over 9 months when they began to induce me with chemicals, but I was a first time mother and I think, had I been left, I would have had the baby on my own. Being brought into hospital in itself, I think, caused my body to shut down. I had three days of labouring to no effect. By the second day my baby turned round in the womb so her backbone scraped against mine. It was agony. I couldn’t rest: I spent that night kneeling against the bed so the weight of the baby moved forward. At one point that night I went to the window of the ward and looked out onto the flat roof where i could see the train running. I actually wondered if I could force open the window, climb out and escape. If I had not been so heavily pregnant that I could no longer climb I would have gone. By the third morning of no sleep I knew I was running out of the energy to give birth. After my husband had argued for a while with the ward sister my waters were manually broken and I was taken to a delivery suite. The pain of the contractions with the baby scraping my spine was excrutiating. I was so pleased to have the epidural, with the drip on wheels so I could go to the loo. And then after hours it came to the birth, and the anaesthetic stopped, and I was told to push, because I had no idea when to push, because all my natural instincts were numbed. It still hurt though. I remember thinking: I hope this is not a girl, I hope that this baby does not have to go through this. And then it was clear she was not coming out. I thought: “I am like a fox caught in a trap, it is as though I have to gnaw my leg off to get free. I just have to push the baby out whatever the pain.” And I did that, despite the lack of sleep ( I was 40 years old), and I ripped from vagina to anus, and the womb itself ripped. I lay bleeding like a slaughtered chicken (my husband’s simile) and heared the doctor say to the midwife: “OK, I’ll stitch the muscle if you stitch the flesh.” It took the two of them an hour to stitch me up. I won’t describe the pain and indignity of the aftermath, and the difficulties it put in the path of bonding with the child who was, greatest of ironies, a girl.

  32. thanks for this article. I had my first two naturally without any pain medication. Epidurals are awfully tempting for our third because I’ve been reading about others who did it that way. But no matter how birth happens, it’s not pleasant at the time and all us mothers share that bond no matter how we give birth. They say it’s like the pain of breaking 20 bones at the same time. But this article has a lot of reasons why going it natural may ultimately be best for mom and baby, despite being much more painful!

  33. I will repeat it again and again: in general epidurals are very safe. Are they 100% safe? No. Epidural can lead to devastating complications, including paralysis and life long pain. On the other hand, the chances of getting these complications are very low. So: do not rely on tales of friends, doctors or midwives, never mind if they are pro or against epidurals. Instead, do proper research and decide for yourself if the risks of epidural are worth its benefits. Facts, not opinions or anecdotes.

  34. I had my first baby without meds, but I was given pitocin after 12h of labour because the baby was fairly big and got stuck, causing the labor to stop. My baby was born after a total of 25h laboring, no epi or pain relief, loads of episiotomy, needles to say, I suffered hell and as far as the pelvic pavement goes, I couldn’t sit for about a month. So far for the natural birth experience. Second time around, I had to be induced because I had gestational diabetes, I was really upset because I was hoping on a totally natural delivery (this time the baby was also average so I hoped the expulsion would create less problems), I ended up asking for an epidural when the contractions became stronger, I just didn’t feel in a brave mood that day. Turns out it was the best decision I ever made: I was relaxed, could stop suffering for a while, I still felt the contractions, especially the very strong last ones, was perfectly able to push through these contractions and it took 40 minutes after the epidural and 5 minutes of expulsion to get the baby out. I will breastfeed for 6 months like I did with my first, and I don’t see why the epi would keep me from loving or taking care of my second child. Actually, because of the great experience I had, I might even consider to have a third child in a couple of years. So actually, I used to defend the naturally in all things and especially in birthing, but not on this very argument, not anymore 🙂

  35. People don’t understand that even though an epidural isn’t very life threatening it doens’t mean that it isn’t at all. Most likely most women will have a n epidural becuase it is easy and the number of women that have complications are very slim, BUT! what if you are that woman. Do you want to take that chance. be the one that says, “It won’t happen to me”.

    The alternative is also simple and it has nothing to do with chemicals. It might not be as good and as painless as an epidural but it gets very close.

    I like to use the condem analogy: Sex might be more fun without a condem but for those few minutes you might get some STD and suffer all your life.
    True, Labor is a little longer but the effects of a bad epidural reaction could last a life time. So think about it.

  36. I had the luck of having a water birth with a Midwife, I can say I do not regret it one bit, I loved the experience, I cannot say the pain was nothing, because it is painful but the water works miracles, I was falling asleep between contractions everything worked just fine, Something that helped me was having my sister and my partner caress my feet and forehead, it reduced the pain incredibly. All I can say is that we need to trust our bodies, they are so wise and perfect creators of life. I researched this so much, this was my first baby and I feel so proud of myself because I endured it and I got to enjoy all the love hormones and the greatest rush I have ever felt. Once he was born all the pain disappeared, He was so alert since day one. up till now I try not to use chemicals on his body at all and I watch what I eat and what I feed him, as I am still breastfeeding after a year and I know all these choices have been for the best, He has never gotten sick, only one cold so far. Moms please research everything you do, Your child depends on your choices and you cannot afford to make bad decisions with someone else’s life.

  37. I decided to have an epidural after my ninth child. I can say my daughter and I came out very well. No side effects and me and my daughter bonded very well after ward. If I had to use an epidural again I would. .

  38. The risk of epidural is very low, lower than that of driving a car. There is no advantage of waiting to dilate to a specific number of cm before asking for epidural; as soon as labor is established you can have an epidural. Prolongation of labor with epidural varies, and some studies even state that superior pain relief makes labor progress faster. So in your case it is not necessarily the epidural that resulted in longer labor.

    I said it many times: the desire to avoid pain does not make you a worse person or a bad mother. There is absolutely nothing good about labor pain.

    • :-/ ……spoken like a man who makes his money from administering epidurals. Yes you have given good information but you have been very clear about where your stand point and views are coming from. It is your livelihood. I had an epidural for the birth of my first over 16 years ago. It was VERY nice at the time. But had someone told me that I would suffer the results of the hormone inhibiting and have postpartum depression for a full two years following….. or that my epidural site would still flare up and cause me pain on and off still sixteen years later, I would have been inclined to re-think my decision. There are aspects of the those little stories that women share in their own personal experiences that are very valid and just because something is MOSTLY safe doesn’t mean it hasn’t had negative effects in some way other than death (which for some reason is how we tend to measure the safety of things within medicine—well people aren’t dying so it’s all good.) Birth is spiritual as well as emotional and physical and for some women they have a better experience with the epidural——while some women do far better without. Now that being said, I have given birth ONCE with an epidural and my experience was traumatic so I decided not to replay that scene. I have given birth now 6 more times at home without an epidural. And if I could get an epidural without stepping into a hospital and dealing with medical staff and interventions, I very likely totally would! But given that you can’t have one without the the other, I will continue to birth without the “pain-free benefits” of an epidural so that I can get all the other benefits that are of utmost importance to me. SO please understand, it isn’t about scaring women out of epidurals…. it is about helping one another understand not to fear the birth process in the first place. Then if you need and epidural during the course of the journey, fine. But some young women are so scared of birth itself that they want an epidural as soon as they find out they are pregnant….. and they aren’t asking any questions…. they just assume that it is safe and that is what they are doing. They don’t know if they will even need it or will have time for it or that some times, it doesn’t work and that often times it may not work evenly. But that is what they have decided and they are going into their birthing experience uninformed and under educated and unprepared. Posts like this one and the experiences of others who have been there done that, at least allow women the opportunity for information.

      • Your post illustrates the apparent tendency of blaming epidurals for everything. Post-partum depression is not caused or aggravated by epidurals. On the contrary, a recent article suggested that labor epidural reduces its risk:

        Also, while I am not questioning your experience, current data does not support the suggestion that epidural consistently causes prolonged back pain:
        If epidural is the cause of back pain in your case, this is rather an exception.

        Lastly, you’re right, I make a living practicing medicine and my opinions come from a certain angle. This angle also includes near disasters (and actual disasters) where “natural” birth has gone wrong. And I said many times that I don’t expect anybody to take my word for face value. All I do is present facts, in the best possible way I can. Do your research and make your own decision.

  39. Hi there,
    Im now 37 weeks, second baby and YES i plan the epidural. I took it too with my first kid and had no complains whatsoever. I couldnt dialate for six days i was having contractions. I was so exhausted and in pain that i demanded epidural when i open up 4cm. Me generally having low pain treshold i feel the smallest pain double hard than others. The contractions themselves were too traumatic for me so i took the risk coz i was soo anxious about the pain. Thanks God everything went fine. It did though prolong labour…but thats about it. Im so scared of the pain that honestly i gladly take the risk. And as an afterthought to add: even with the epidural it was painful enough for me! Cant imagin how it is without!
    Call me spoiled,call me a coward…whatever…i still support the epidural. 🙂

  40. …but I do have to say…a wonderful advantage of delivering in a hospital is the fact that you’re able to have ultrasounds done, they can tell whether or not the cord is around baby’s neck, whether or not baby’s in breech position and if baby’s heart bit is still normal, if baby’s already in distress. And if any of those happen, then at least you have the peace of mind they do a c-section quick and they’re able to save your baby. If these happen and you’re home, and have no idea there is actually something going wrong….how can you save that baby?! They used to deliver home a lot back in the past, but back then they used to have 6-7 babies and even more…and if 3-4 got lost in the way, not a big problem, there’s still some left…things changed now. Women don’t feel like they should be constantly pregnant just to get out of the woods with one child or two. Now women most likely have one or two pregnancies and obviously want to make sure their babies survive all, not just….34.5% of them. My bottom line is…I would advise any pregnant woman to give birth where they could do something IF something goes wrong. But go in there prepared, well informed, careful and inquiring on everything they’re trying to inject into them, know they have the right to deny a certain service they’re not comfortable with, and be firm about it.

    When my OBGYN arrived to the hospital to see me, I was dilated to 3.5. But before she walked in the room, I felt like using the bathroom (empty frequently so you won’t get an infection). While in the bathroom, my monitor got switched over on my belly and once I got back in the room and hook it up, it won’t read the contractions correctly. And that’s exactly what my OBGYN read — barely any contractions. She left telling me she’ll be back in the morning (it was midnight!). The nurse came in the room telling me she’ll start me on Pitocin, based on my doctor’s orders.

    I told her No! I personally feel my contractions are going pretty strong and did not feel I need any ‘help’. I was very firm about it and told her if the doctor loves Pitocin so much, she’d better go on it. My husband checked my monitor and figured out what the issue really was! Only an hour and a half later my baby was out, without the need of any Pitocin! I could have been injected with that thing just because the doctor read a malfunctioning monitor, but I trusted my instincts and said Stop!! before the trouble happened! I advise any woman to be extra careful, checking on them and double checking!

    Obviously, my OBGYN showed up when everything was too late! The baby was out for quite a few hours already — 2 residents delivered my baby. Luckily, they paged another doctor and he did show up, but didn’t have to do a thing — the 2 very young residents handled the job magnificently!

    So yes…I was lucky, but we do create, produce our own luck, too! Be lucky! Trust yourself! Know your rights! Know you deserve the best and ask for it!!

  41. I gave birth to two daughters. Both natural, without epidural. However, I must say, I wish I was as brave as other women and not need pain killers at all. They gave them to me both times, through the IV. First birth, I had no idea what was going to happen, I said better spare me the pain 🙂 but they could not put the epidural in place because I was so shaky. Whatever they injected in the IV was so strong, I couldn’t feel a thing. Luckily my husband realized and told them to decrease the dosage. But it took me hours of pushing until I finally got the job done! 🙁 they had to mention the word ‘c-section’ and that motivated me! Half an hour later, she was already out! 🙂 Second time…my platelets were way too low for an epidural … I waited until I was dialeted to 7 to ask for painkillers through IV and I requested smallest dosage possible. It gave me half an hour to regain my strength and when I felt like pushing, had them check me, I was fully dialeted indeed, I needed one contraction for the head and one for the body! 🙂 I had total control over my pushing, unlike first delivery when they overmedicated me and could not feel a thing! So I guess taking the pain does have its advantages — motivates one get the job done faster! 🙂 I do admire the women who can go without any painkiller whatsoever! Not so much my first time, but second time I really , honestly tried hard to deliver without any pain meds. But I wasn’t strong enough 🙁 but I do thank God for keeping the epidural away from me twice, and the Pitocin. Both times I was supposed to be induced (gestational diabetes) and both times I went in labor on my own and delivered naturally exactly when I was supposed to be induced. Thank You, God! You’ve been a really good friend to me.

  42. natural birth is too easy. Pains are not as bad, as it is thought. Secondly period of severe pains is too short. Your body becomes well adopted to to tolerate last pains, the mild pains which u r having since 10-12 hours, makes ur body habitual of tolerating pains, and u remain too easy in last few moments of pushing. How God be so cruel to women? How nature be so cruel to women? Now doubt birth is painful, but poin is that, your body is prepared for it. If you keep patience, you can deliver baby in just 1 or 2 pushes. So be confident. I have 2 babies, both times 10-12 hours of mild pains with intervals. And 15 minutes of bit high pains, and only 2,3 pushes of delivry. The main key to have good experience is just to kick out you fears, just stay calmn and confident. Birth is a thing not beyond of this universe 🙂

    • Most women don’t have the easy experience you had. Stop judging and realize that childbirth is different for every woman.

  43. Natural childbirth is good to consider but if the health of the mother is at risk, the experts should decide which method should be the best. We can’t deny that certain medicine has side effects, this is why it’s ideal to consult medical experts first before coming up with a medication.

  44. An educated comment. First of all, the amount of drugs that gets absorbed from the epidural space is very small. Normally epidural is done with 0.2% ropivacaine and 4ug/ml of fentanyl. The former does not have any unfavorable effects on the fetus. The latter, an opioid, potentially can cause side effects and complications. However, given that epidural infusion is done at about 10 ml/hour, the amount of fentanyl given to the mother is 40 um/h. This amount is quickly metabolized and removed from the bloodstream. Compare this to 100 mg shot of meperidine that many midwives consider a better alternative to epidural – and you shouldget no surprise that epidural babies have significantly better Apgar scores than those born from mothers who received IM opioids.

    And yes, the factors that determoine the outcome of labor are numerous, and epidural is only one of them. The last sentence summarizes it best: “Therefore choose what you think is best for you and you little one.” Do that after learning everything you can about all things labor.

  45. I have had 2 healthy labour and deliveries WITH walking epidurals and I am pregnant with #3 and am planning on an epidural. Kudos to those that do it without anything. I have enjoyed my painless, restful labours (I actually got to sleep a little bit) I was just wondering how does the drug get into your blood stream when it is directly put into the spinal fluid (which is part of the blood brain barrier is it not). My kids did not come out drugged – 9/10 apgar with #1 and 10/10 apgar with #2. I had no issues after birth with headaches or excess pain. Minimal tearing in #1 (pushed for 30 minutes) and no tearing in #2 (pushed in 1 contraction/5 minutes and he was out). I realize these studies are done, however there are SO many factors other than epidurals and pain meds that have to be taken into consideration — family history, skeletal and muscular structure and strength, awareness of one’s own body, weight, how the mother carried, uterus position, baby position, the list could keep going. My kids are healthy and happy, so to those mothers now worried about epidurals, just be aware that YES there are risks, but there are also risks with natural birth depending on your individual health and circumstances. Therefore choose what you think is best for you and you little one.

  46. CZS, I hope you get better and wish you to get rid of your headaches. I respect your opinion, however there is no data in the medical literature that supports your view that your chronic headache was caused by epidural. First childbirth is an intense and physiologically traumatic event, which by itself sufficient to cause headache in someone who is predisposed to them. Who is treating your headaches? Your GP or a pain specialist? Once again, I wish you full recovery.

    • I see a neurologist at the headache clinic at my local major hospital. I am thinking about getting my medical records from my deliveries and seeing if there is something else that happened in the first two that didn’t in the last one. It’s been nearly 7 years now….I’ve had a headache basically since then, with no break. Thanks for you well wishes. They are appreciated.

  47. It is interesting that you connect your headaches with the day you got epidural, though on the same day you also got pitocin and you delivered the baby. And you still think epidural caused your headaches even though you had a tendency to have it easily since your teens.

    One way epidural can cause a headache is a dural tap. However it doesn’t seem to be the issue in your case. In general, it is quite common not to be able to find a cause of a headache. It would be a good idea to start a diary to record all possible things that may cause your headache: duration of sleep, detailed record of foods eaten, stress, travel, alcohol, medication etc. Maybe eating some sugar or processed food will ease the headaches? I get severe headaches from oversleeping, so I try to avoid doing it or take strong painkillers early.

    Epidural analgesia in labor is still considered somewhat exotic by many people, and that’s why it is blamed for lots of ills it does not cause. I find it unfortunate.

    • I think the fact that I have always been susceptible to headaches is the reason I ended up with chronic daily headaches after the epidural with my first baby. And yes, I definitely think that the epidural is the cause of the escalation. The epidural is the only thing in common from my first two births (besides the actual baby), as I did not get pitocin with the second and the fact that the headaches did not get worse after my third which was a natural birth as it did with the second, seems to point in that direction. I do have a general idea of what will make it much worse: not enough sleep, an abundance of caffeine, sugar, processed food, alcohol. So while eating better decreases the intensity, they are by no means gone. I do realize that there are a lot of women that can have epidurals with seemingly no problems, but I feel like my issues are from the epidural and maybe it was the pitocin combined with the epidural that screwed up my brain physiology. I have no clue. All I know is I am the one that has to deal with this day in and day out, which is what I find unfortunate and frustrating.

  48. I have had migraines and the tendency to have headaches easily since I was a teen. When I had my first child, I was talked into getting induced early, I tried to go natural, but after laboring all night with no progress I was exhausted and was “encouraged” to get pitocin and and epidural. I said yes. I now have chronic daily headaches. The headaches started the day I got the epidural. They subsided somewhat when I was pregnant with my second. But I ended up with an epidural again, and the headaches got really bad again. With my third, the headaches got a little better again and I was determined to do a natural delivery. I had a midwife and I did. The headaches thankfully did not get worse. However, I still have them. I feel like I have seen every Doc and talked to every anesthesia person I know, I basically get a shrug and a I have no clue answer. No one can tell my a) why I have headaches and b) how I can get rid of them. I take supplement recommended by my neurologist, changed my eating, literally eat no processed food, no soda, no sugar–and I still can’t get rid of them. I would give almost anything to go back and redo my first birth. I get so frustrated with the lack of answers.

  49. This infomation is useful.

    But it would be a lot more useful if it included at least *something* about the frequency of various physical effects mentioned — on either the mother or on the baby.

    For example, the various potential negative effects on the baby of the mother’s receiving an epidural are useful to know. But it would be *immensely* more useful if at least *some* information were provided about how often they occur. (With the full understanding that any generalization cannot take into account the differences in dosages, mothers, and babies.)

    In fact, it is not clear from what I read above whether *any* of the aftereffects on the baby of the mother’s epidural might typically be long-term effects, or whether all of them are short-term effects.

    It is also completely ignored that expectant mothers may be filled with anxiety by worrying about the possibly agonizing pain that labor and giving birth may cause them. This anxiety undoubtedly affects the baby, and its effects have to be weighed against the effects of an epidural. (If the mother knows she can have an epidural with only the faintest risk of long-term effects on the baby, she might be a great deal less anxious.)

    Is its valuable to get this side of the story, but it is *****much***** less valuable when the likelihood of the ill effects, and their duration, are completely omitted. As well as the positive side of epidurals being completely omitted as well.

  50. I was induce a week early. I went in on October 4 7:00 in the morning the doctor checked my cervix said she was still a little high but started the Iv meds anyway at 12:00 they broke my water at 1 they gave me my first epidural. Didn’t help at all they put 3 valves in it still no relief. So at 2 they redid it that time it work but I felt really druged and even my skin was a yellowish color then my little Madison was born at 6:10 pm. She barly cryied after birth. They cleaned her up and gave her to me she didn’t want to eat all she wanted to do was sleep. The next day they notice that her glucose was going down and she had poor oxygen. They transfer her to St.V children hospital they notice at that time that she had Lactic Acic in her blood. Mean While I was also admitted for high blood pressure and my feet and legs were swollen worse then they ever had been, Also my face was really swollen my lips and could barly open my eyes. I was in the hospital for a day and a half before I was able to go see my baby. Time I got to see her they got her Lactic Acid level back down from a 16 to 2 and it was floating between 2 and 5. When she was 6 days old they decided to feed her started her out on breast milk 10 ml every 3 hours the next day her Lactic Acid jumped back up to 12 to 16 she had to be put back on the ventilator they stopped feeding her but they couldn’t get it to go back down. At 9 days old they transfer her to Riley Hosiptal. They was going to do more test but on the 15th at 12 midnight the last check on her levels her Lactic Acid was a 20 then she just gave out. They tested her for all of the matabolic disorders at St.V’s a month later all of her test came back and they could not find an underlined condition just that what ever they could feed her would of poisoned her. I don’t understand how an almost 9 pounds baby could have these kind of problems and the Matabolic Doctor said he never seen a case like hers. I really think it was the Epidural that causes all of these problems I think they over medicated me. Iv’e been trying to find similar story’s on the Internet but haven’t yet. I never knew that the epidural crossed over to the baby I feel so guilty. The only thing I was ever told it could cause damaged to my back, never told it could build up in my baby. I am so mad I have 3 other children all healthy and yes I was induce with all 3 and had an epidural with them but never so much. And nobody in my family or my husband has any type of Matabolic disorder in our family. I think Major Hosipal messed up and poisoned my daughter. So please anybody if you have a similar story or knows somebody who has a similar story please contact me at [email protected] Because I would really like to know if an epidural can poison a baby if to much is givin to the mother. I don’t care if its 2 yrs later I need some answers,

  51. Epidural does not increase the risk of caesarean section, this has been settled in 1998 (and confirmed many times since then). Epidural does not interfere with breastfeeding: studies show some statistically insignificant effect in the first 24 hours only. It is also important to understand the difference between the associations and cause-and-effect relationship. Epidural is associated with tears, that is correct. But it does not cause them. The reality is that women with prolonged or obstructed labour are more likely to get an epidural. Incidentally, these women are at higher risk of tears. Epidural also has beneficial effects on the baby, compared with both opioid analgesia and no analgesia. It may also prevent long-term pain after vaginal birth.

    • If you really research this matter further, you can see that the studies “proving” that epidurals do not cause higher C-section rates, are severely flawed (especially within the united states). C-sections rates skyrocketed at the same time epidurals were introduced to mothers for labor & delivery and has been rising ever since. Epidurals create larger profit margins for the medical industry, so its a no brainer that there is a large amount of disinformation floating around, claiming that its safe and doesn’t cause these additional risks/side effects.

      • Any two things that increase over time will be correlated. It does not mean they cause one another. During that time period during which both epidurals increased, so did average income, college enrollment rates, cable TV subscriptions and expenditures on dog food. By your logic, money, education, television and pets all increase c-sections too.

  52. I wish more people would trust their own bodies and realize that the female body is MADE to give birth. Without artificial interventions (i.e. Pitocin, epidurals, etc.), there are wonderful positive feedback loops that help push the woman closer and closer to delivery. There are just so many things that most women do not understand how labor works.

    • So, Connie, what is your explanation for the fact that before women routinely gave birth in hospitals, women (and babies) routinely died in childbirth? And to this day, the countries where women still die in droves in childbirth or, if they survive, often suffer horrific injuries like obstetric fistulas… are precisely the countries where women don’t give birth either in hospitals, or in birth centers/homes with **qualified** midwives ready to transfer them to hospitals as soon as things start going wrong.

  53. Mr Kressler,

    I’ve worked with mothers and babies for 15 years….Your data is seriously out of date. There is no risk for increased cesarean section in women who receive epidurals- Zhang, 2001. Not only that, in randomized prospective trials (Wang, 2009) epidurals can be given in the latent phase without increased risk of c-section. Yours and other websites only serve to frighten women and when they “give in” to pain relief, they feel they let themselves down. This is just a start…you are twisted in many of your other statements, and by using big words like PGF2- alpha you supposedly lend credence to your misguided article. And, amazingly, you forget to mention one known negative of the epidural which is increased body temperature and unnecessary neonatal workups for sepsis. I can only imagine your agenda but please don’t enlighten me further on those details. Lastly, Don’t forget to remind women that choose natural childbirth at home- when all goes well, wonderful, when it doesn’t, the experience and outcome may ruin your lives.

    • Just let the process proceed as natural as possible. Epidurals definitely influence a babies CNS. Only within the last hundred years or so have women had babies in hospitals, with forceps, and epidurals. Women have given birth naturally for centuries. There is no need to abuse the medical advantages we have today, but rather utilize them in emergency situations.

    • I had each of my 9 children using only breathing techiniques, and each time couldn’t wait to repeat the amazing experience of birth.
      And yet, my 38 year old relative chose a home-birth for her only child, and unfortunately lost the baby because the hospital equipment was lacking. Normal low-risk pregnancy, and yet the child died needlessly after birth and they will never have another child.

      • I’m so, so sorry for what your relative, her baby and her family suffered. HOME BIRTH IS NOT SAFE. I wish more people understood that.

        • Now that is a slanted opinion if I ever heard one. Do home births carry risk? Of course they do, every birth does no matter where it happens. However, lots of women deliver at home with zero emergency. Talk about trying to scare people…

          • Lots of people BASE jump without getting hurt, but that doesn’t change the fact that BASE jumping is dangerous. Certainly lots of women deliver at home with no emergency–my own mom did. But a much higher percentage of women who deliver at home end up with a dead or brain damaged baby, compared to women who deliver in a hospital–especially if you compare home-birthers to comparably low-risk hospital birthers. That still means that most women delivering at home will be fine. It’s just that many of the ones who deliver at home and are NOT fine, would have been fine at the hospital.

            So it’s just that my opinion is “slanted” by facts (such as that even the MANA study showed that home birth is more than four times more likely to end with a dead baby than hospital birth) and common sense (i.e., the fact that in those rare cases where a life threatening emergency does develop during or just after childbirth, mom and baby are much more likely to be ok if they’re already in a hospital than if they’re at home).

            • I have a lot of trouble with studies because most of them fail to compare the correct things. Like the ones you are claiming. My questions would be, how many of the babies would have died even in the hospital? And how many hospital deaths were due to unneeded procedures? There is a lot to consider when giving birth. I think home birth is great if you have a plan b and can make it to the hospital quickly just in case. I think looking at your family history and finding out how it was for your mom, sister, etc. would help make a better decision. I also think doctors should offer home delivery with midwifery skills and medical emergency skills so that more home births can end graciously. And now that more home births are being done at home, I’m interested to see how much the numbers go down in adverse events due to the practitioners gaining knowledge and experience and being able to head off any danger. I definitely think the woman should follow her instincts on how and where to give birth and try and find the most supportive group/person to help her through it.

              • **”My questions would be, how many of the babies would have died even in the hospital?”**

                That’s precisely the problem: most of them would not have.

                The best study I’m aware of is the Cornell one that came out last year. Here’s why it’s so good:

                – It looked only at low-risk pregnancies, clearly defined as singleton, vertex (head down), full term (>37 weeks) babies who were at least 2500 grams at birth.

                – It looked at EVERY birth that fit that description in the entire US over a three-year period (2007-09), so there was no selection bias.

                – It was huge (almost 10.5 million births), so the results aren’t skewed by a too-small sample size.

                And it found that LOW-RISK babies delivered by a midwife at home were MORE THAN FOUR TIMES more likely to die than low-risk babies delivered by a midwife in the hospital. They were also more than twice as likely to die as low-risk babies delivered by an OB in a hospital. You can see the chart on death rates at the bottom of this page (and you can also read the whole study here):

                That is a whole lot of unnecessarily dead babies, isn’t it.

    • Thank you! In full agreement, there is a time to give an epideral that is appropriate that will not increase those risks

  54. Wow thanks for all the great resources!!! I also just can’t believe the possible connection pitocin has with autism and the way the hospitals are gonna just keep pumping into mothers!! People just don’t want to ask questions and demand answers anymore…

    • Keep up trying to educate your woman. She’s very lucky to have such a supportive and well educated guy! Hopefully you’ll get into her head so she can avoid interventions/interferences and have that oxytocin high that every woman and baby deserve and quite frankly need after birth. I’m happy the link has been made between pitocin and autism. I just hope people start to listen. Regardless, the empowerment a new mother can feel when she gives birth (SHE gives birth) instead of the medical establishment forcing birth to occur is amazing. Best of luck. Natural birth is amazing and such a boost for moms, especially first time moms. To know that your body is NOT broken and that YOU are the one to bring forth a life is really enlightening and strengthening. Women have been robbed by a lot over the generations. It’s nice to see men such as yourself and Chris Kresser helping support women in this rite of passage.

    • This article in no way, discusses the connection to autism, you must just be reading between the lines and reading what you want it to say.

  55. I am a guy that is dedicated to his wife and future child. I have been reading, watching TLC, and researching everything. I am outnumbered by my wife and her mother and they won’t listen to my concerns with the risks of pytocin and epiderals. I feel like I have more I interest than my wife about pregnancy and all I get is I wish you were the one that was pregnant. What’s a guy to do?

    • See if you can get her to read anything by Dr. Odent or Marsden Wagner about how you shouldn’t interfere with pregnancy. Ina May Gaskin’s “Birth Matters” might change her outlook. Can you get her to watch The Business of Being Born – I think it does a great job of showing how traumatic pitocin is for the baby. Henci Goer has a book called “The Thinking Woman’s Guide to a Better Birth” that lists the risks and benefits of all interventions. A word of “warning” is that many of these sources will lead you to understanding that a hospital birth is a fight and home birth tends to be more evidence based, but they also do talk about the risks of the interventions you are concerned about. Oh, and please stop watching TLC!!! A Baby Story and those other shows, unless they’ve gotten better, put the moms into risk and then “rescue” them to look heroic – pretty dangerous. Can you guys get a doula? That might also help out. Big hugs to you. It must be hard when you are more concerned than she is. It does sound like though that she just needs the resources to find the inner strength to realize that she doesn’t NEED an epidural to cope with the pain – there is dangerous pain that is causing damage and then normal labor discomfort (pain) that has a purpose. A lot of labor is a mind game – face your fear and decide to give in and relax and go within yourself then it’s very easy to cope with. The pain of labor is made worse by fear, which is sounds like she needs, and made even worse with pitocin b/c pitocin stops your body from releasing natural pain fighters. Oooh, while I don’t know much about it, maybe look into hypnobirthing with her – a lot of women using that technique to help them out and report great success. My first OB even suggested it to me when I told him I didn’t want an epidural. Anything that can help her relax and build her confidence. Women in our culture LOVE a dramatic birth story for some reason. The “best” births are often really quite boring 🙂 go into labor, relax through the contractions/rushes, give into the process, body pushes out baby on its own, all is good – a nice “boring” birth to you and your new family!!!!!!

      • What’s a guy to do? Leave her decision ALONE. If it was you having the baby, then you could choose what happens…but you really need to drop it. It’s her decision. You’ll never understand the pain and feelings that come from having a child. You have absolutely no room to tell her whats best. She’s the one pushing it out, and if she wasn’t to be induced and have an epidural SO BE IT. I’d leave my man if he couldn’t come to terms with MY decisions. You’re only putting more stress on her and the baby by pushing your opinions on her.

        Since this comment was so long ago, I pray she had her baby HER way…theres no reason to intervene.

        • Jordan I respectfully disagree with you. Women aren’t A-sexual and cannot create a baby alone, and it’s just as much his right to voice his opinion in the matter. In the end if she choses not to listen there isn’t much any man can do but you cannot fault him for trying to inform his wife about the risk/rewards of natural birth. Instead of being selfish we should try to consider what’s best for the innocent infant who has NO say in how they enter the world. Inform yourself, make your decision and be at peace with it. My wife and I had a home birth and it was a wonderful experience that I’m eternally grateful for.

        • Jordan,
          I also respectfully disagree with you…it is his child too and he does have a say in what goes into his/her body and how he or she is born since it can affect the child and BOTH parents forever. It baffles me when people don’t educate themselves on something so important! I had a natural birth with my first child and it wasn’t “too difficult” as you mentioned in a previous post, it was something AMAZING I was fortunate enough to experience with my husband and baby. Was it painful?? Yes! But just like all rewards in life you have to work and go through a little discomfort and this is the ultimate reward, a human being that you created WITH your partner! AND with a little research you will find that births with interventions (yes, an epidural is an intervention) actually INCREASES your chance of a c-section, not the other way around. Maybe it would be a good idea to leave our bodies alone and allow them to do what they were created for rather than creating the “emergency csection” by introducing a cascade of interventions?

        • I also disagree with you Jordan. He does have a right to his opinion and to voice his fears about the possible dangers to his future child. Parenthood is a partnership, even when the child is in utero. Yes, the mother has to do the job of carrying the baby and delivering it, but that’s because she doesn’t have a choice. And I feel like women who doubt their ability to go through a natural childbirth are selling themselves WAY short. It is probably the closest thing to a miracle anyone will ever experience, and the woman’s body was ENGINEERED to get through is naturally. Why mess with that? Especially with chemical’s that aren’t meant to be in the body in the first place? I find it a little ironic that woman don’t drink or do recreational drugs while pregnant for fear of what could happen to the baby, but can’t wait to get drugged up when it comes to labor.

        • Jordan, I think your comments are extrely rude. Chris I commend you for putting fourth all the effort in researching and taking the time to weigh out all your options. It’s ultimately YOUR baby as well, so I believe you have every right to have an opinion and a say in what goes on in the delivery room. You should be attacked for caring about the well being of your child and wife. She needs to take into consideration that she didn’t make that child on her own and it’s just as much your decision as it is hers. She’s lucky to have a guy who wants to be a part of the whole birthing process and who cares about what happens during delivery, considering a lot of guys these days never even step up to take care if their child let alone care about what happens in delivery. You seem like a great husband and I think it’s great that you want to be so involved (:

  56. Had an epi and spinal another time…both gave me a very sore back. Spinal tap area ached way more than the darn uterine/abdominal wound.
    My last hospital experience was miserable and I resolved then that number 3 would be at home…God willing and the creek don’t rise.

  57. Thank you for this info. It should be included in all pregnancy test kits JUST so all women will be exposed to it! I was bullied into getting an epidural with my first child after being mocked for not wanting a medicated birth (I had carefully chosen my OB who fully supported me, but, of course, had no control over the L&D nurse I received). I was then flat out lied to by the nurses and doctors who told me point blank that NONE of the drug crossed into the baby. Poor baby had some major issues the first few days including not breastfeeding well for quite some time – later a lactation consultant told me it was most likely the epidural and then labor augmentation drugs as she sees it all the time with medicated births.

    My story, sadly, is not unique. It does point to a reason why women are leaving hospitals to deliver at home, where they are supported in their plans for unmedicated births and surrounded by individuals they know and trust. After welcoming my second child into the world in the safety of my home, I would never go into another pregnancy planning a hospital birth.

    • I to feel like I’m bullied into having an epidural, my aunt told me that I must take the medicine I don’t know why? She never gave birth!!! And whatever my hospital could squeeze out of my insurance they’d do it. My goal is to wait until its the second or final stage of labour and then go to the hospital. I DON’T WANT TO BE INDUSED, I DON’T WANT CC, AND DEFINATELY I DONT WANT EPIDURAL !!!!!

      • Sad to say, but most women (especially with their firsts) plan on going all natural but then realize it’s too difficult…HOWEVER by the time they realize it, it’s too late so they have to have a c-section. There no way I would/could EVER go natural. I would never want a cc.

  58. Typical…..a man telling a woman how to give birth.

    And you can eat the placenta too.

    I have 5 healthy children. Three with pain meds, two without. I’ll take the pain meds, thanks.

    • Mary,

      I don’t recall anyone telling others “how to give birth.” This research and dissemination, whether conducted by a male or female is common knowledge. Take a chill pill.

      • Susan,
        I dont thnk Mary is out of line or “not chill” at all. She actually had the experience of both. She had healthy babies with both procedures, no problems that might have had her inclined to blame the epidural. Your first child I heard takes the longest anyhow… why would someone who took the epidural not be informed that it might have NOT been the epidural. When you dont have an open mind …to me…you are an extremist. I also agree that Men should really not have any say in the child birth process. Thanks Mary for having an open mind set and giving our best oponion, after having tried both sides.

        I am 36 weeks preganant…heard stories of all kinds…and going into the birthing experience with the intent of natural but not being affraid of other options either.

        • Danielle, the article isn’t about closing your mind off to the possibility of an epidural. It’s not telling women not to get them. It is written by a researcher (yes, a male researcher) who is listing potential side effects in order to inform.

          Pregnant women are frequently coddled, treated like they cannot read research, and prescribed interventions without being fully informed or even before they give permission. It’s insulting. I’d rather hear as much information as I can before making a choice.

          A friend of mine was given an amnio because she was over 35. The (small, but real) risks of miscarriage were never discussed with her. It was just–‘get this test, because you’re in the high-risk age bracket.’ She wouldn’t have wanted the test if she’d known it carried a risk to the fetus. She trusted her doctor to inform her.

          Women shouldn’t feel shamed into any kind of birth. It’s just that, a fully informed woman might make different choices. Most women will find the epidural risks acceptable. There really are a lot of healthy babies/mothers after an epidural. A few might not, and it’s best that they be informed.

        • Sadly, both Mary and Danielle are out of line and out of touch here. Men play a hugely important role in the childbirth process. We are the baby’s mother’s most trusted advisor, counselor, partner and advocate in childbirth. We calm their fears, attend all the classes, research all the products and choices, and ultimately are the ones right by their side as they bring OUR (hers and ours) child into this world. My wife and I are true partners in this journey. If you really feel men have no role…maybe you need to have better men in your life. Good luck and good vibes to all the mamas-to-be.

          • I agree with concerned-dad-to-be.
            You must have tuned out during the paragraph in the article where it is stated that the researcher is not against medical intervention when it is actually NEEDED. You seem to only focus on certain words, making this article into something it is not. You attack the researcher for his gender. We are all responsible for bettering medical practices, men and women together. Medicine isn’t perfect and it is our job to be well informed of the risks before signing consent forms. The researcher is helping by putting the information out there. Please don’t twist what he is doing. Research leads to improved practices. People used to think x-rays weren’t harmful. Now we know better thanks to research.

  59. When I failed to progress with my son in 2010, I was given pitocin to get my labor going. Because the contractions started getting so intense, I had an epidural. Within 30 minutes of receiving the epidural, my blood pressure dropped to where the monitors couldn’t read it anymore. I passed out, threw up, was given oxygen, and had to have 3 rounds of medication to counteract the epidural’s side effects. My SpO2 levels were compromised, as were my son’s, and his fetal heart rate dropped during all of this. I was rushed into the OR and had a c-section. If I had it to do all over again, I wouldn’t have allowed them to start pitocin, and I definitely wouldn’t have received an epidural.

  60. So glad I came across your article. I gave birth at 22 years old, naturally. Almost unheard of now in days…My friends thought I was crazy for “planning” a natural birth. I went in well prepared, I read, watched videos, ate well, stayed active, and got myself mentally ready for what I was going to experience. Most importantly, I knew that my body was designed to give birth. I decided to have a midwife who’s beliefs on child birth were much like my own because of that I knew that my nurses wouldn’t try forcing an epidural down my throat or should I say spine. I just wanted to give my baby the best chances in life even if that meant feeling some labor pains. I must say it was the most rewarding and selfless thing I could do for her. 24 hours later both my daughter and I were able to go home. Our bond is like no other…I highly recommend natural births!!!

  61. very important to me that i read ur article which i found it interesting and convinced me to give birth after 20 weeks without epidural 🙂

  62. Thank you so much for writing this article. I have been in a constant battle defending my position, and ultimately had to find a new birth coach, because I am not wanting an epidural unless medically necessary.

  63. Believe it or not, natural childbirth with assistance is illegal in Alabama and other states as well. I didnt have natural birth but if I ever have another child I will definitely try it.

  64. Thank you for the wonderful information. Your reasons for writing, along with an unmedicated birth center birth, are why I am studying to become a birth instructor. Women need to know.

  65. Thank you for this series. At last a website to which I can point all my pregnant friends. It is a shame that women are usually offered – and usually gratefully accept – a suite of interventions, not being informed about associated risks. Having read a lot on the subject, I was always amazed by how little women know and how blindly they can trust the system.

  66. Chris,
    Interesting article. I looked at the references and they don’t support your claims. Firstis correlation is not the same as cause. The studies say that women who have epidurals alos have longer labors and pelvic floor problems. They don’t say one causes the other. It can certainly be that in longer labors, more women request epidurals.
    You say there is a higher c-section rate, lower vaginal delivery rate and higher perineal tear rate. The studies you cite say in the abstract, the c-section rate is no different and don’t say anything about perineal tears. Again instrumentation complication rates are not mentioned in the abstract. Maybe the full study mentions these?
    Just trying to figure out where you got your conclusions.

    • What you suggest is possible, but unlikely. The increased risk of pelvic floor problems is much more likely to be associated with other interventions that typically occur alongside of epidurals, such as induction with Pitocin, instrumental delivery and episiotomy, longer second stage (pushing) of labor and “coached” pushing.

      This study shows a tripled risk of perineal tear, and this one shows slightly less than double the risk.

      The abstract of the study I mentioned does indeed mention an increased rate of instrumental delivery with epidurals:

      Despite this variation, there is sufficient evidence to conclude that epidural is associated with a lower rate of spontaneous vaginal delivery, a higher rate of instrumental vaginal delivery and longer labors, particularly in nulliparous women.

      The impact of epidurals on cesareans is somewhat controversial, with studies showing mixed results. But after reviewing the research, I believe it’s fairly clear that epidurals combined with low-dose oxytocin regimes (most commonly used in North America) are likely to increase cesarean risk by 50%, whereas epidurals with high-dose oxytocin (less common in North America) may actually decrease the risk. This study suggests first-time mothers accepting an epidural who also use low-dose Pitocin may be up to 2.5 times more likely to have a cesarean.

      • This has actually been argued extensively in the medical literature for years. The biggest and best review is from the Cochrane Reviews , which showed no difference in c-section rates. The 2 studies you cite show no difference. You can’t have the same c-section rate and also a lower vaginal delivery rate in comparing with and withoutr epidural. The rough consensus in medicine is that that the longer, harder laboring moms tend to use epidurals more than the quicker deliveries. the harder labors have more c-sections and more epidurals, but the epidurals don’t cause more c-sections.
        Anyway, it certainly is better to have a faster. easier labor and not need an epidural.
        Again, with your other claims, just because 2 things are correlated, does not mean one causes the other. All of these studies are correlation only, one should use that to investigate more, not assume causality.

        • People in general, including ACOG, are not able to adequately discuss reasearch findings in a scholarly manner. Instead they often make leaps of causality instead of correlation. This only adds to the inflammatory and misguided assumptions. Is it that women who request epidural have inherently abnormal, difficult, or medically managed birth that then cuases complications? Rather than blaming epidurals which the research does not prove, we woukd be better discsussing the complexities involved in providing women wirh what they need to safely birth without intervention.

          • Though it’s true that correlation is not causation, Chris’ theory seems the more likely one if one wants to draw a tentative conclusion from available evidence (in other words, if someone wanted to, you know, make a decision…). Otherwise we should throw out all of this evidence in decision making until something is absolutely proved to be causational. (Not something most would be likely to do.) Think about the probability of what you just put forward as an alternative theory. If the explanation of the correlation between epidural use and long labors is that women who would already have labored long or abnormally are requesting epidurals (in other words, the epidurals aren’t “causing” the long labors; women with difficult labors are requesting epidurals) then the frequency of epidurals in the U.S. is a bit astounding — since we’d also have to take that epidural rate, according to your theory, as the rate of women with long, difficult, abnormal labors. If that were so, it should make us wonder about the length and difficulty of women’s labors before epidurals were used so frequently or even available at all). In the Netherlands, according to our poster above, this would mean 90% of women have difficult labors. If that’s so, we should really be worried about the future of the human race. I’m not saying that epidurals are to blame for birth gone wrong, but the more likely explanation for the correlation between them and other interventions is that they are an influence on, not a sign of, a difficult labor. Otherwise, there are a lot of women in industrialized countries with abnormally difficult labors, as signaled by their use of epidurals.

    • Obviously, this article is written by a man who will never undergo the major pains of labor. I have read all of the information, and support any woman who wants an epidural in order to endure labor pains.

      • I had an epidural with my first child and I had a natural birth with my 2nd. Although the epidural blocked out pain. I had to be induced further because my labor slowed down. The aftermath was horrible. I tore in the worst possible way because You feel how hard your pushing. I was sick and I wanted nothing to do with my baby or anyone because I was so groggy from the meds and I was in severe pain from the tear. With my 2nd child, I gave birth very fast. 3 pushes and she was out and I felt like I could have run a 5K right after I had her. I connected with her alot better than my first daughter because I felt so good. I didn’t tear and I had tons of energy. Plus, the labor pains are actually not even that bad. My period cramps are worse than labor. So, I support natural birth. Having an epidural for me was horrible and I’ll never have another one if I get pregnant again.

  67. I wish I had been better informed about the birth process, had a birth plan, and a doula. I was completely unprepared for the sleep deprivation I experienced with #1. And, for #2, I was completely unprepared for a late in the game discovery of a breech baby with a MD who would not do a vaginal delivery.

    Epidural with number one. Epidural plus c-section for number two.

    IDK, I think I was naive and thought I could have natural births with almost no preparation beforehand! We went to the obligatory hospital class and thought we were set!

    It wasn’t until I hooked up with La Leche League that I learned about different births, doulas, education, choices, etc.

    Astonishing to think about in hindsight!

    • The hospital class teaches you how to be a good patient! That’s why we need to spread the word! Putting a link to your site on my blog tomorrow, Chris!

    • I’m in favor of it. Placenta has been used as a restorative and healing medicinal during the post-partum period in Chinese medicine for thousands of years. In the modern Western world, a practice that is becoming more common is to have the placenta powdered and encapsulated so mothers can take it in capsule form for a period of time after the birth.

      • My niece delivered her own baby at home with her husband and nobody else as planned. They kept the pacenta intact connected to the cord and to the baby until it dropped off on its own accord a week later. I had never heard of this practice, but apparently it is so the baby gets all the nutrients from the placenta?

        • Yes, it’s an interesting practice called lotus birth, if you’re interested in googling it. It’s very safe for babies-and good to atleast delay the clamping of the cord until it has stopped pulsating if one is going to choose to cut the cord. One doctor I know of who writes about lotus birth is fantastic and her name is Sarah J Buckley- same one quoted in part of the above article. I’m still reading through her book, I borrowed from a friend, called “Gentle Birth, Gentle Mothering”.
          And btw, Pearl’s cord fell of just 2 days after birth, and Samuel’s came off on day 4, so the length of time is pretty short but varies from baby to baby. Nice surprise to see you here, A. Becky!

      • My wife did this, and it blunted her post partum depression very well! She is now becoming a certified placenta encapsulator and she can’t wait to oper her own business.

  68. I’m sorry to hear there’s such a backlash about your pregnancy/baby posts & program. But, when you’re pissing people off, you know you’re in the right place. We’ve got a massive issue with the cultural acceptance of all things medical as simply something that is “standard operating procedure”, when for centuries, there was no such THING as any of the Western medical approaches. Sure, in life-critical moments, I’ll get myself to a hospital, but in managing what is essentially just “part of nature”, why invite in medical intervention if its not necessary? Keep working hard Chris. I hope many will continue to see how right you are about this stuff!! (and all the other stuff you’ve written…which is all awesome!) 🙂

  69. You keep writing. I completely agree that the mother’s of the babies I see, severely handicapped babies, are even ill-informed about normal birth processes. They have no faith in the natural birth process or their ability to deal with the pain.

    With the estimates of babies with autism at about 1 in 60 right now, I would say your articles are timely and well researched. Keep on writing.

    • I agree Stephanie,
      You hit the nail on the head, that most women fear natural birth and feel that no one in their right mind would want to face labor without pain medication. Part of it, is lack of education on natural methods to cope with the pain.

      • This is (terrifyingly) true. When my mother was in the hospital with a broken back, that because of several complications they could not operate on, the ‘pain’ nurse that administers the morphine asked her to describe the pain hourly on a scale from one to ten – with ten being ‘childbirth’. This woman, and the medical school that trained her, genuinely belived that childbirth was the worst possible pain a human being could feel. She was nothing short of shocked when my mother (rather curtly) informed her that childbirth was far from the worst pain ever.

        • So true. When I had my first attack of gout, they said the same thing about the pain scale, and I said the same thing (quite curtly) that labor for TWINS was a walk in the park on their pain scale around a 2, and the gout pain was around a 20. Wouldn’t wish it on my worst enemy…. although I would wish it on terrorists / pedifiles / rapists, etc. 🙂

          • These are older comments but I was just thinking the same, childbirth pain is not that bad! Definitely not the most painful thing I’ve experienced. Plus it all ends as soon as that baby is out!

  70. Great post! Really sums up the risks associated with epidurals. I really wish parents were educated in advance about the choices they have available to them during pregnancy and birth so they can make informed decisions about their care. I love providing that education! I teach a program called Hypnobabies and we teach women how to use ‘eyes open childbirth hypnosis’ and medical grade hypno-anesthesia which is really powerful! I’m really looking forward to using it for my 1st birth!

  71. Thanks for writing about such an important issue. Regarding epidurals, when I went to give birth to my first child in 1998, the hospital personnel were astonished an thrilled when I said I definitely don’t want an epidural. 71 % in US seems to be far beyond 90 % where I live (in Finland). Most who don’t have an epidural just lack the time to have it, I was told.

    I would never have an epidural, because I’m not afraid of nature’s own pain. I don’t understand how majority of women are more afraid of nature’s own pain than a medical intervention with risks (and a huuuge syringe! :). I’ve given birth three times, all without anestesthetics, and I loved the experiences. For me, the beta endorfins definitely did their job.

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