Dear Lactnetters: I have been reading with great interest the discussion on epidurals. I'd like to through in my 2 cents as a psychologist. In Marsha Walker's post of 4/16, (which I liked enough to print out), she described an article about why we should do epidurals to prevent psychological problems in mothers and fathers. Because of the pain of labor, mothers and father may experience psychological fallout--therefore all mothers should have epidurals!! I can understand Marsha balking at this and her pointing out that many women experience births that are terrific and empowering. However, I think we must also acknowledge that there are frequently psychological ramifications of difficult births for both mothers and fathers. What we fail to take into account is that the interventions and medicalization of birth frequently create the very conditions that foster epidural use. For example, we all know that birth is frequently more painful if a woman is flat on her back attached to a monitor. We know that birth is more painful if she has no one to talk her through each contraction. Some husbands/partners are overwhelmed by the hospital environment and cannot help. Others, let's just say it, are putzes and are of no help (and can make matters worse). The literature is full of references and stories of women describing their births and also describing subsequent symptoms that are post-traumatic stress reactions. These include flashbacks, panic attacks, depression, numbing, phobic reactions. The author of that article is correct in indicating that these reactions do occur. However, it is ridiculous to assume that an epidural would remedy this. How about good old fashioned labor support?? How about giving women power over their birth experience? I personally know 2 women who had c-secs with failed epidural anesthesia. In this case, the epidural caused the problem. Even in cases where medical intervention was clearly necessary, there can be psychological fallout. Who can come that close to death or death of a loved one and not have some reaction? Yet most of these women are sent home without a word to indicated that they might feel badly following their experience. I am presenting a paper this summer at the International Trauma and Memory conference on some of the psychological implications of negative or frightening births. To my knowledge, it is the first time birth will be discussed at a mainstream trauma conference. I have a whole chapter on this topic in my book "Postpartum depression" I'm afraid these types of negative births are on the rise. All of us who work with postpartum women should be sensitive to these issues (as I know most of you are), and offer information for helping women to heal and have a better experience next time around. Enough for now. Can you tell that this is one of my favorite topics? Kathy Kendall-Tackett