Jumping in on the epidural and BF discussion again, with some half-baked
thoughts - if you are working with a population that would no sooner give
birth unanesthetized than have their wisdom teeth extracted, maybe it's more
effective to let them know how they will need to accommodate the baby's
reduced ability to get to the breast if they want breastfeeding to go as
smoothly as possible after their epidural.

They will need more time skin-to-skin - maybe several days, in virtually
constant skin-to-skin contact with the baby.  They will need carers who have
the confidence to wait that long without supplementing the baby, who can
show the mothers how to fingertip-express their colostrum right into the
baby's mouth so baby gets fed while everyone waits for the bulk of the
epidural effects to wear off so baby can root and latch effectively.  They
should have contact with at least one breastfeeding supporter of some kind,
and preferably several, such as LLL and an IBCLC.

This should not be presented as though it were piles of 'extra' work, but
just the normal scheme of things.  Every action causes at least one
reaction, and not all reactions are the ones we were bargaining for.  Also,
in settings where nearly all women have epidurals, the maternity staff are
likely to be unused to supporting women in labor in the ways one does when
they are not anesthetized, and it may take more than we can reasonably ask
of a pregnant woman to subject herself to the risk of inappropriate care.

I'm considering starting to call bottles and shields 'feeding prostheses',
just to convey what I mean about how grossly abnormal they are.  When a baby
is so affected that prosthetic devices are necessary to perform basic life
functions, it is serious indeed.  Patients discharged from hospitals using
crutches or walkers or splints are followed up, are they not?

There is a pressing need for women who have experienced empowering births to
talk about it, write about it, and spread the word, before it's too late.  I
can almost see something along the lines of LLLI, only about birth.  Women
who give birth without epidurals or other analgesic medications are not
amazons or superwomen, they are just women doing what women can do.  The
idea that epidurals (or CS on maternal 'demand') is the same as empowerment
of women, turns my stomach and breaks my heart.

Rachel Myr
who never has dental work beyond routine prophylaxis done without local
anesthetic, is a total wimp about physical pain and risk, but could no
sooner imagine being anesthetized for getting a baby out, than for getting
one in...
Kristiansand, Norway

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