The May issue of Reader's Digest arrived in the mail today and included
the article "Epidurals and Caesareans." Here's the entire article:

Researchers at the University of Texas Southwestern Medical Center
studied 869 women giving birth at a Dallas hospital. Those who opted
for epidural analgesia -- a procedure in which painkillers are injected
into the space around the spinal cord -- reported significantly less
pain than those who received their medication intravenously. But the
women in the epidural group labored, on average, an extra 90 minutes;
they were also more likely to have a forceps delivery, and twice as
likely to need a Caesarean. This study adds to the mounting evidence
suggesting that epidurals sometimes change the course of a normal
birth.

"While epidural analgesia provides superior pain control, women need to
be aware that there are trade-offs." says lead author Dr. Susan Ramin,
associate professor of obstetrics and gynecology. Instead of asking for
an epidural at labor's onset, a woman may first want to try an
alternative method of pain relief; an epidural can be started later if
pain becomes too great. <end of article>

I especially like the last sentence of the first paragraph.

My past experience with public health prenatal clients was that these
women usually had natural childbirth and very low rates of C-section.
They all delivered at a large teaching public hospital. I don't recall
anyone being *scarred* by natural childbirth (just my observation), I
think the pain was expected and accepted. Free natural childbirth
classes were offered but most moms didn't take them. I haven't seen
prenatals since 1993, but would be interested in knowing what the
current incidence of analgesia/C-sections are in the same population.
When Medicaid increased OB payments (early 1990s) and the private
hospitals started courting Medicaid recipients, lots of clients opted
to go to private OB's.


Diana Dietz, RN, BSN
http://www.prairienet.org/community/health/laleche/diana.html