From: sue@ariel.its.unimelb.EDU.AU (Sue McPherson)
Newsgroups: misc.kids
Subject: Re: Use of drugs during labor (% wise)
Date: 27 Jul 92 06:07:43 GMT
Organization: SOFTWARE CONTRACTS GROUP, University of Melbourne, Australia

>>In article <18598@drutx.ATT.COM>, seb1@leia.dr.att.com (sharon badian) says:
>>>
>>>In my childbirth class this week we discussed drugs. The instructor gave
>>>some statistics for the use of drugs at the hospital where I will deliver.
>>>She said that about 50% of all women get some sort of drug. About 25%
>>>get an epidural. She didn't know how women who get both are figured
>>>in. This is only for vaginal births, not c-sections (where epidurals are
>>>the norm). She said that in Denver the rate of epidurals was 90%!!! That
>>>seems outlandish, but since some hospitals/doctors push them, I guess I
>>>can't be too surprised.

I guess things vary from country to country, even between hospitals in the
same state, so here is an Australian perspective.

There is a current cultural perception that a drug free natural labour is a
'good thing' because any unnecessary medication should be avoided. In the
'huff & puff' classes I attended I was told (and I think it is the 'norm' 
throughout Australia);

1. the mother should have the amount of pain relief she feels she needs!
2. the recommended approach to pain management was to work progressively
   through the following methods until a satisfactory level of pain
   relief was achieved;
   - natural methods (ie. breathing, meditation, distraction, hot packs,
                          massage, hot baths/showers, etc.)
   - breathing nitrous oxide just prior and during contractions, this
     can take the edge off the pain and make it bearable and has several 
     advantages; 1- it doesn't cross the placenta, 2- it is only in effect
     while you need it (the effect wears off in about 20 seconds)
     3- the strength of the gas is variable and they let you control it.
   - an injection of pethedine (I don't know what the US equivalent is)
     this drug can cross the placenta but there are no known complications
     and if the baby does seem to be affected there is an antidote
   - an epidural. There are disadvantages in that it can take up to half
     an hour for the epidural to be given and for the effect to kick in (which
     is why they won't give you one when you are close to the pushing stage)
     and you have to have an IV in case your blood pressure drops. Also, you
     could get very cold or get the shakes.
3. the birthing mother is supported by one or more support persons (usually
   the father) and a midwife. The doctor is present only for progress checks
   and the actual birth (unless there are complications).
4. a 'normal' (ie. not high risk, no complications) birth does not require
   internal monitors, IV drips or lot of other medical paraphenalia.

I had a relatively straight forward birth and found that 'the gas' was enough
to keep the pain down to a bearable level - although I hung on to that gas 
mask with an iron grip - during transition.

The hopsital I went to also offered TENS, but you had to go to an extra
class to learn all about it before they would let you use it.

I guess the main thing they emphasised was that its was primarily the mother's
choice. They told the story of the couple who came in determined to have 
drug free labour, but after some time of very painful contrations the mother
was having difficulty and the midwife suggested that she might like a
pethedine injection. The mother said yes, but the father said 'But we agreed
to a drug free birth' and the mother changed her mind. This happened several
times through a difficult labour and the mother made it through but was a
wreck physically and emotionally. The sting in the tale was that the same
woman came back to have her second child WITHOUT her husband!
    
Sue McPherson
sue@ariel.its.unimelb.edu.au