Dear Friends:
    All the posts about epidurals in different countries and attitudes about
women inspired me to put on my childbirth educator hat this morning.
    I am encountering more and more pregnant women that are scare to death of
labor and wonder if they will survive. I think this is a vicious cycle. Most
mothers are a LITTLE fearful of labor; (I remember this with both babies.)
This little fear is good: it makes them improve their diets, cut down on
things that aren't good, go for prenatal care, and go to childbirth class.
    These pregnant ladies then talk to their friends who have had horrendous
birth experiences (because of the technology and the non-therapeutic birthing
environment). The slight fear is then magnified in the pregnant mother. Now
the normal slight fearfulness has become terror.
    No one stops to wonder that perhaps a woman has a horrendous birth
experience BECAUSE of the technology and non-therapeutic environment. Was it
Doris Haire who said long ago that the presence of NICUs in hospitals was a
testimony to the risks of hospital birth? (Of course that was in the days
before micropremies, AIDS, and crack.)
    At one hospital, women are advised to get epidurals by their physicians
at  prenatal visits. What they hear is "Oh, this shot is wonderful, takes
away the pain, and doesn't cross the placenta to hurt the baby."
    What they get in my childbirth class is "Did your doctor tell you that an
epidural also means a dynamap (continual blood pressure monitor), pulse
oximeter, continual fetal monitoring, confinement to bed, IVs, possible
cardiac monitor, bedpan or urinary catheter, and pitocin?"  Then we go on to
discuss all the possible risks of epidural: maternal fever, hypotension,
longer labor, greater chance of operative delivery (which may lead to urinary
and fecal incontinence), greater chance of cesarean, and losing control of
their birth. They are shocked and confused after my class. They can't even
think about breastfeeding at this point because they are upset about labor,
because what they have learned in class is so different to what the doctors
have said.
    This is an awful situation, and I have seen it getting  worse. I didn't
encounter women feeling that they would not survive labor when I started
teaching about 12 years ago. Today, women are terrified of the pain, and
receive medication for the terror.
    In the fall, on PBS, there is going to be a documentary on birth called
"Born in the USA" that shows 4 births in various settings. VCR alert!
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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