Dear Friends:
    It will be interesting to read the whole article.  Dr. Lieberman is the 
researcher who found that 16.6% of mothers developed fever  in labor on an 
average of 5.9 hours after an epidural was given.
    In the US, if the mother has a fever in labor, the  baby is likely to be 
taken to intensive care after birth for a septic  assessment, which often 
includes blood cultures and a spinal tap.  Maternal-infant separation after birth 
is a risk factor for breastfeeding  success.
    Dr. Lieberman's conclusion in that article (about  fever) was that more 
investigation has to be done to see if infant seizures in  the nursery (more 
common if the mother's fever in labor went over 101 degrees F)  are harmful to 
babies. I would have preferred if the conclusion had been that  epidurals have 
serious risks and potential health consequences so epidural use  should be 
limited!
   
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NEW  YORK (Reuters Health) - Receiving epidural analgesia during
labor seems to  increase the risk that the baby will be delivered
face up instead of the  normal face -down position, new research
shows. This may explain the higher  rate of c-sections associated
with epidurals. 

It has been theorized  that women with infants in the face-up or
"occiput posterior" position have  more painful labors, which
leads to their request for epidural analgesia. In  the
current study, reported in the May 2005 Obstetrics and
Gynecology, the  researchers found that it was more
likely that the epidural was administered  before a fetus moved
into this position.

Dr. Ellice Lieberman and  colleagues examined 1,562 pregnant women
during labor and delivery.  Ultrasound examinations were performed when women 
were first admitted to the  labor and delivery unit, at the time of epidural 
administration or 4 hours after  the initial examination, and
when they were close to full  dilatation.

Ninety-two percent of patients received epidural  analgesia.
Requests for epidurals were NOT associated with fetal  position
in early labor or with more painful labor.

Fetal position  changes were common during labor, and the initial position 
was not a strong  predictor of position at delivery. At the initial examination, 
approximately 49  percent of fetuses were facing sideways, 27 percent were 
facing down and 24  percent were facing up. The corresponding rates at the time 
of delivery were 8,  80,and 12 percent.

At delivery, fetuses were in the face-up position in  12.9
percent of patients given epidurals, but only 3.3 percent of
those  without epidurals. Epidural analgesia was not associated
with the  sideways-facing position.

warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
Support the WHO Code and the Mother-Friendly Childbirth  Initiative

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