From: bwolfe@trentu.ca (BEN WOLFE)
Subject: Re: "Missing out" (was. re:  Justin...)
News-Software: VAX/VMS VNEWS 1.41    
Organization: Trent University Computer Services Department
Date: Sun, 6 Sep 1992 16:20:00 GMT

Judy Drake writes:

>> I still don't understand why so many people choose pain over
>> no pain when the health of the baby is not affected.  I've
>> had two birth experiences--one unmedicated (except for pitocin,
>> that is), and one epidural, and the painless one was way more
>> enjoyable and exhilarating than the painful one, for everyone
>> involved (just ask my husband).

I find it pretty scary to read posts like this. Everyone is fully
entitled to make their own informed choices about birth, but doing
so requires access to proper information.

There is a wealth of solid -- in fact indisputable -- medical evidence
that drugs for pain relief during birth have a negative effect on the
baby. Certainly there are situations in which their use is warranted,
but if you believe "the health of the baby is not affected" then your
doctor is disturbingly out of touch with the medical literature.

It's hard to deal with such a complicated subject in the space of a
posting to the net, but here's a quotation from an easily accessible
source that gives a bit of a summary.

From _The Crying Baby_ by Sheila Kitzinger (New York: Viking, 1989)
"After general anaesthesia, for example, babies may be very sleepy and
difficult to feed in the first days of life, and need a lot of
stimulation if they are to wake up. Whern pethidine (demerol) is given
within a period of four hours before delivery, the baby tends to have
breathing difficulties at birth, is sleepy and slow to suck, and does not
orient so skilfully to the human voice. All analgesics and tranquillizers
are associated with early feeding difficulties and the mother may have to
work hard to keep her baby interested in sucking."

"It is often claimed that epidural anaesthesia does not affect the baby.
In fact, when women ask, doctors often reassure them that bupivicaine --
the drug most often used -- does not reach the baby since it is an
injection only into the epidural space and does not cross the placenta.
This is not true. Bupivicaine, especially in large doses and over a long
period of time has been shown to reduce a baby's alertness and may
modify the ability to orient to visual and auditory stimuli for as long
as six weeks after birth. This in turn affects the developing relationship
between the mother and her baby. A baby who does not interact with the
mother in a lively way is cared for differently from one who is alert
and responsive. One study suggests that interaction between the mother and
child can be affected for many years, and that, following an epidural
birth, even after five years the child's cognitive development is slightly
slower."

There's *lots* more, with detailed references to the medical literature, 
but I think you get the point. Please, understand the seriousness of the
choice when you accept pain relief in labour. Prepare yourself for the
best possible birth by learning about non-pharmacological alternatives.
There are many, but they're not taught in North American medical schools.
They include massage, bathing in warm water (which by the way has been
shown to be entirely safe and is practiced in many other developed
countries), visualization, breathing exercises and, above all others,
proper companionship and support.

If you try all these things and find that medical pain relief is still
necessary, then you will have the satisfaction of accepting it with
full knowledge that you have made a responsible and necessary choice
for yourself and your baby, having exhausted the alternatives.