The study about how epidurals affected breastfeeding rates really only
proves that you can overcome the adverse effects of epidurals IF you do
everything else right vis-a-vis breastfeeding post-partum. It doesn't show
that epidurals don't adversely impact breastfeeding under more typical
hospital conditions.
It's like saying "If you treat a nasty bacterial infection aggressively with
intravenous antibiotics, then the patient will get better, and two months or
six months down the road, you won't see any more infection in those who got
treated than in those who never had the infection." Well duh. Of course
not. But it's much better to try to prevent infections, especially when
lots of people may not have access to the IV antibiotics (perfectly
baby-friendly post-partum care).
I still say we need to change our outlook here and ask why so many women
want epidurals, why women are still laboring on their backs with their feet
up in the air, why so many women are not allowed to move around during labor
and squat during delivery, why so many women are having their labors induced
or "enhanced" with pitocin, etc.
Also, another thought to toss out -- the *reason* for a high epidural rate
at a hospital may influence the breastfeeding outcomes. For example, high
epidurals because "everybody just automatically wants one and gets one" is a
different situation from a hospital where the high epidural rate is because
of the high rate of labor induction using pitocin, and the birth of babies
who really weren't ready to come out. From watching "Baby Story" on TV (not
a scientific study) I know that a lot of US births are of the type: "labor
is progressing too slowly for the doctor/patient's satisfaction (usually the
doctor's), so let's give pitocin, oh damn, now the contractions HURT, so
let's have an epidural, oh damn, now the contractions have stopped, so let's
give more pitocin, etc. etc. etc.". A baby born after this kind of delivery
is very different from a baby born to a woman who comes in well along in
labor and gets an epidural and then just lays there for a few hours and then
pushes (complaining that it still hurts even with her epidural) and then the
baby is born.
Re Stadol: I've had two births with Stadol. The first, in 1980, the baby
was taken away for a mandatory 4 hours, so we didn't get to nurse right
away, but had no problems later. The last, in 1991, the baby was with me
all the time, and nursed within the first 20 minutes, with no problems.
Kathy Dettwyler
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