Easy Labor (Yeah, right!)

On a recent trip to the library, I checked out a book called Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth. Like I do whenever leaving the library with Matt behind the wheel, I dove right into the book. And within the first ten pages, I could tell that it would be horrifying, dry, and obviously written by an anesthesiologist. (Flipping to the back of the book... Yup, Dr. Camann is an anesthesiologist. So of course, "easy labor" really means "get thee an epidural, STAT!"

I will say that, while it was pretty biased, it was at least informative.

The first section was about choosing the best place to give birth, be it a hospital or birth center, and the types of people who would be present, from an obstetrician, labor and delivery nurse, anesthesiologist, nurse-anesthetist, certified nurse-midwife, family physician, or doula.

There was a section on factors that may impact your labor pain (prior education, confidence, the environment, prior birth experience, support, use of Oxytocin or Pitocin, baby's size and position, mom's position), another on common fears (I won't be able to do it, something's going to go wrong, I'm going to lose all sense of dignity, etc.). Then it went right into "Full-Throttle Pain Relief."

It described in detail the difference between an epidural, a spinal, a "walking epidural" or combined spinal epidural (CSE), and a patient-controlled epidural analgesia (PCEA). It also talked about general anesthesia, but that's typically only used in emergencies.

While I certainly haven't ruled out an epidural, I do have some concerns:

• I would have to have an IV, especially since I have lower blood pressure
• Some people get a drop in blood pressure, so changes are, I'd already need more meds
• A drop in blood pressure means less blood flow to the baby
• Some people get itchy (it DOES have narcotics) and need even more meds
• Few people get nauseous...which means yet another med
• I might need a urinary catheter... yuck
• Many hospitals won't let you eat or drink after an epidural
• I'd have to be strapped to a tocodynamometer and an electronic fetal monitor
• Epidurals increases the need for foreceps or vacuum extraction
• Labor would slow down, so you're laboring longer
• Epidurals are suspected in the increase in cesareans over the years
• Some women feel epidurals contribute to lower back pain months or even years after the birth

Other types of medications that can be used are sedatives (nah, I won't want to sedate my baby until later...), analgesics (narcotics like Demerol, Morphine, Fentanyl, Nubain, or Stadol, but I don't want my baby to have to have a narcotic-blocking shot upon birth), local anesthesia like Lidocaine and Nesacaine (more to numb you "down there"), nitrous oxide (more popular in the U.K.).

Then, there are the complementary and alternative approaches, like Lamaze (movement, concentration and coping strategies, as well as breathing), the Bradley Method (a 12-week program for partner-coached childbirth), laboring in water, using a Birth Ball, hypnotherapy, acupuncture, aromatherapy, professional labor support, etc.

Also, it was interesting to hear what the Apgar score actually is (appearance, pulse, grimace, activity, respiration).

I don't yet know what our birth plan is going to include, but I will say I feel a little more prepared with questions for when we tour the hospital, and a tiny bit more prepared for what is going to be happening to me in the next three months!