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epidural risks

Posted by on Jan. 25, 2010 at 5:15 PM
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What are some epidural risks? I don't know much about them. I know that for as long as I can remember I wanted to go natural :)

by on Jan. 25, 2010 at 5:15 PM
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DreaKevAiyana
by on Jan. 25, 2010 at 9:00 PM

Here is something I got from another group on Pitocin - still looking for something on the epidural:

Excerpted from Birth as an American Rite of Passage

Pitocin

Description and Official Rationale

Pitocin is a synthetic form of oxytocin, which is the hormone that stimulates uterine contractions. It can be utilized either to induce or to augment labor. According to the authors of Williams Obstetrics, labor augmentation with pitocin is officially indicated when the clinical practitioner diganoses "hypotonic uterine dysfunction"--a condition in which the contractions of labor become ineffective at producing cervical dilation (Cunningham et al. 1989:344). Following this rationale, pitocin should be contraindicated in normal labors, and therefore should not even be included in my analysis. Yet, although Williams Obstetrics warns against its dangers (1989:345), it is commonly used in hospitals throughout the country to augment normal labors. 81% of the women in my study who gave birth in the hospital received pitocin during their labors. Harrison reports a statement by one of her professors in medical school: "If they were to put a dye in the pitocin, you'd see it in the IV of almost every woman in this country who is in labor" (1982:116).

Under the technocratic model, this near-universal use of pitocin for labor augmentation makes sense, as that model holds that labors do not stop and start again, so that any slowing of labor (as was quite common among the women in my study) is interpreted as abnormal or dysfunctional, necessitating intervention (Rothman 1982:260).

The technocratic model also interprets as dysfunctional labors that have not started by a maximum of two weeks past the official medical "due date," as well as labors that have not started after the waters have broken. In most hospitals, the rule is that once the membranes have ruptured, birth must take place within 24 hours, because the danger of infection (mostly from hospital interventions) rises dramatically after that. Under either of these circumstances, the physician will recommend induction of labor with pitocin.6 The woman and baby are then subject to all the dangers discussed below throughout the entire labor. If the due date is inaccurate (as frequently happens), such induction may result in the birth of a premature baby.

Physiological Effects

In a matched-sample comparison of home and hospital labors (Mehl et al. 1977), the hospital labors were shown to be considerably shorter, most probably as a result of the combination of interventions designed to speed labor, including amniotomy, pitocin, fundal pressure, forced pushing, and forceps and Cesarean deliveries. Pitocin augmentation certainly plays a major role in shortening labor, the greatest risk from which is to the fetus: the increased pressure of the contractions can, and often does, compress the umbilical cord and cut down the baby's oxygen supply:

Dr. Roberto Caldeyro-Barcia has demonstrated that uterine contractions stimulated with pitocin reach over 40 mm Hg pressure on the fetal head. The quality and quantity of uterine contractions are greatly affected when oxytocin is infused. The contractions tend to be longer, stronger, and with shorter relaxation periods between....With each uterine contraction, blood supply to the uterus is temporarily shut off. If deprived of blood supply, a fetal bradycardia (decreased fetal heart-rate deceleration) follows with oxygen deprivation and cerebral ischemia causing the grave possibility of neurological sequellae. Truly the fetus has been challenged, and the EFM dutifully records the stressed fetal heart rate. With suspicions confirmed, a diagnosis of fetal distress is noted and elective Cesarean section is the treatment of choice (Ettner 1977:153).

To this warning, the authors of the l8th edition of Williams add their voices: "Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions" (Cunningham et al. 1989:345). These authors go on to urge careful administration of the lowest possible amount of pitocin in order to avoid the tetanic contractions that can cause uterine rupture, and to insist that once the drip is started, the mother should never be left alone. Obviously the potential for abuse here is high: twelve of the women in my study reported that they were left alone for extended periods after a pitocin infusion had been started. (Three of them did experience long "tetanic" contractions, usually resulting from too much pitocin suddenly flowing into their vein when the nurse jiggled the bag or straightened out the plastic tube.)

Aside from their risks of uterine rupture and decreased oxygen supply to the baby, the increased pain for the mother of the pitocin-induced contractions, which are often double-peaked and back-to-back with little or no rest time in between (a function of the amount of the pitocin being administered), is likely to increase her stress and anxiety levels as well, and to cause her to repeatedly request increased pain medication. Moreover, pitocin is a strong antidiuretic, even at low doses; its combination with the IV fluids administered to fasting women can result in water intoxication, which itself heightens the woman's risk of pulmonary edema in those rare instances of gastric aspiration (Cunningham et al 1989:344; McKay and Mahan 1988:214).

Women's Responses

All the women in my study who were given pitocin reported increased pain from the pitocin-induced contractions. Some were able to keep on with their Lamaze breathing techniques (discussed as mediating rituals in Chapter 4) without any pain medication, whereas others called for analgesia soon after the administration of the pitocin. Some felt grateful that their labors had been shortened; others would have preferred less stress and a slower pace:

I was glad to have the pitocin--anything to get the whole thing over with as fast as possible.
-Laura Parker

Once they put me on the pitocin, it was all over for me. The pain was unbearable. I couldn't wait to have the Cesarean--at least it would get me out of that misery.
-Lisa Smith

I needed the pit drip. My uterus just wasn't doing anything. I might have lain there forever with nothing happening, and then they would have cut me, because my waters had already broken. Given that the hospital was only going to give me 24 hours to dilate, I was glad for the chance the pitocin gave me to have a vaginal birth.
-Donna Chapman

Ritual Purposes

Under the technocratic model, time--mechanical and linear, is viewed as being measurable in discrete, almost weighable units, so we say that something should take place within a specific "amount" of time (Lee 1980; Ornstein 1972). As the process that reproduces society, birth must set the standard for the general cultural handling of time: birth must be culturally shaped to occur within a specific amount of time, just as must the production of any factory good. When a woman's labor fails to conform to production timetables (labor time charts), it will be speeded up with pitocin:

At Doctor's Hospital we use [Friedman's] chart of labor, a curve developed by Dr. [Emmanuel E. Friedman] which defined on a graph how a labor should progress. Each woman's chart has a blank graph of hours and of centimeters of cervical dilation which we must record approximately hourly in order to evaluate the shape of her labor curve. When a woman's labor is off the "proper" curve, she is subjected to intervention in several possible forms. Harrison 1982:121

Moreover, the tendency of pitocin to set in motion the chain of events described above by Ettner is entirely in keeping with the structuring and ordering characteristics of ritual described in the Introduction, and with the sense of inevitability--the "conceptual cranking gears" --that ritual's consistent performance can invoke.

The administration of pitocin through the umbilical IV sends several messages to a laboring woman: (1) that our cultural concept of time as linear, measurable, and a valuable commodity is right and true; (2) that her body is a machine; (3) that her machine is defective because it is not producing on schedule; (4) that the institution's schedule is much more important than her body's internal rhythms and her individual experience of labor. Moreover, the increased pain during contractions that results from the administration of pitocin serves the ritual purpose of hazing--that is, of speeding up the breakdown of the initiate's category system through the intensification of physical stress.



"The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease." - Thomas Alva Edison

DreaKevAiyana
by on Jan. 25, 2010 at 9:04 PM

ok nevermind, looks like I got that from this group, lol!  can't find the post I was reading about epidurals recently, though.  Maybe search through some of the posts in this group?



"The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease." - Thomas Alva Edison

tickled_pink09
by on Jan. 25, 2010 at 9:11 PM


Quoting DreaKevAiyana:

Here is something I got from another group on Pitocin - still looking for something on the epidural:

Excerpted from Birth as an American Rite of Passage

Pitocin

Description and Official Rationale

Pitocin is a synthetic form of oxytocin, which is the hormone that stimulates uterine contractions. It can be utilized either to induce or to augment labor. According to the authors of Williams Obstetrics, labor augmentation with pitocin is officially indicated when the clinical practitioner diganoses "hypotonic uterine dysfunction"--a condition in which the contractions of labor become ineffective at producing cervical dilation (Cunningham et al. 1989:344). Following this rationale, pitocin should be contraindicated in normal labors, and therefore should not even be included in my analysis. Yet, although Williams Obstetrics warns against its dangers (1989:345), it is commonly used in hospitals throughout the country to augment normal labors. 81% of the women in my study who gave birth in the hospital received pitocin during their labors. Harrison reports a statement by one of her professors in medical school: "If they were to put a dye in the pitocin, you'd see it in the IV of almost every woman in this country who is in labor" (1982:116).

Under the technocratic model, this near-universal use of pitocin for labor augmentation makes sense, as that model holds that labors do not stop and start again, so that any slowing of labor (as was quite common among the women in my study) is interpreted as abnormal or dysfunctional, necessitating intervention (Rothman 1982:260).

The technocratic model also interprets as dysfunctional labors that have not started by a maximum of two weeks past the official medical "due date," as well as labors that have not started after the waters have broken. In most hospitals, the rule is that once the membranes have ruptured, birth must take place within 24 hours, because the danger of infection (mostly from hospital interventions) rises dramatically after that. Under either of these circumstances, the physician will recommend induction of labor with pitocin.6 The woman and baby are then subject to all the dangers discussed below throughout the entire labor. If the due date is inaccurate (as frequently happens), such induction may result in the birth of a premature baby.

Physiological Effects

In a matched-sample comparison of home and hospital labors (Mehl et al. 1977), the hospital labors were shown to be considerably shorter, most probably as a result of the combination of interventions designed to speed labor, including amniotomy, pitocin, fundal pressure, forced pushing, and forceps and Cesarean deliveries. Pitocin augmentation certainly plays a major role in shortening labor, the greatest risk from which is to the fetus: the increased pressure of the contractions can, and often does, compress the umbilical cord and cut down the baby's oxygen supply:

Dr. Roberto Caldeyro-Barcia has demonstrated that uterine contractions stimulated with pitocin reach over 40 mm Hg pressure on the fetal head. The quality and quantity of uterine contractions are greatly affected when oxytocin is infused. The contractions tend to be longer, stronger, and with shorter relaxation periods between....With each uterine contraction, blood supply to the uterus is temporarily shut off. If deprived of blood supply, a fetal bradycardia (decreased fetal heart-rate deceleration) follows with oxygen deprivation and cerebral ischemia causing the grave possibility of neurological sequellae. Truly the fetus has been challenged, and the EFM dutifully records the stressed fetal heart rate. With suspicions confirmed, a diagnosis of fetal distress is noted and elective Cesarean section is the treatment of choice (Ettner 1977:153).

To this warning, the authors of the l8th edition of Williams add their voices: "Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions" (Cunningham et al. 1989:345). These authors go on to urge careful administration of the lowest possible amount of pitocin in order to avoid the tetanic contractions that can cause uterine rupture, and to insist that once the drip is started, the mother should never be left alone. Obviously the potential for abuse here is high: twelve of the women in my study reported that they were left alone for extended periods after a pitocin infusion had been started. (Three of them did experience long "tetanic" contractions, usually resulting from too much pitocin suddenly flowing into their vein when the nurse jiggled the bag or straightened out the plastic tube.)

Aside from their risks of uterine rupture and decreased oxygen supply to the baby, the increased pain for the mother of the pitocin-induced contractions, which are often double-peaked and back-to-back with little or no rest time in between (a function of the amount of the pitocin being administered), is likely to increase her stress and anxiety levels as well, and to cause her to repeatedly request increased pain medication. Moreover, pitocin is a strong antidiuretic, even at low doses; its combination with the IV fluids administered to fasting women can result in water intoxication, which itself heightens the woman's risk of pulmonary edema in those rare instances of gastric aspiration (Cunningham et al 1989:344; McKay and Mahan 1988:214).

Women's Responses

All the women in my study who were given pitocin reported increased pain from the pitocin-induced contractions. Some were able to keep on with their Lamaze breathing techniques (discussed as mediating rituals in Chapter 4) without any pain medication, whereas others called for analgesia soon after the administration of the pitocin. Some felt grateful that their labors had been shortened; others would have preferred less stress and a slower pace:

I was glad to have the pitocin--anything to get the whole thing over with as fast as possible.
-Laura Parker

Once they put me on the pitocin, it was all over for me. The pain was unbearable. I couldn't wait to have the Cesarean--at least it would get me out of that misery.
-Lisa Smith

I needed the pit drip. My uterus just wasn't doing anything. I might have lain there forever with nothing happening, and then they would have cut me, because my waters had already broken. Given that the hospital was only going to give me 24 hours to dilate, I was glad for the chance the pitocin gave me to have a vaginal birth.
-Donna Chapman

Ritual Purposes

Under the technocratic model, time--mechanical and linear, is viewed as being measurable in discrete, almost weighable units, so we say that something should take place within a specific "amount" of time (Lee 1980; Ornstein 1972). As the process that reproduces society, birth must set the standard for the general cultural handling of time: birth must be culturally shaped to occur within a specific amount of time, just as must the production of any factory good. When a woman's labor fails to conform to production timetables (labor time charts), it will be speeded up with pitocin:

At Doctor's Hospital we use [Friedman's] chart of labor, a curve developed by Dr. [Emmanuel E. Friedman] which defined on a graph how a labor should progress. Each woman's chart has a blank graph of hours and of centimeters of cervical dilation which we must record approximately hourly in order to evaluate the shape of her labor curve. When a woman's labor is off the "proper" curve, she is subjected to intervention in several possible forms. Harrison 1982:121

Moreover, the tendency of pitocin to set in motion the chain of events described above by Ettner is entirely in keeping with the structuring and ordering characteristics of ritual described in the Introduction, and with the sense of inevitability--the "conceptual cranking gears" --that ritual's consistent performance can invoke.

The administration of pitocin through the umbilical IV sends several messages to a laboring woman: (1) that our cultural concept of time as linear, measurable, and a valuable commodity is right and true; (2) that her body is a machine; (3) that her machine is defective because it is not producing on schedule; (4) that the institution's schedule is much more important than her body's internal rhythms and her individual experience of labor. Moreover, the increased pain during contractions that results from the administration of pitocin serves the ritual purpose of hazing--that is, of speeding up the breakdown of the initiate's category system through the intensification of physical stress.

This is good to know too--thanks

I have been told it's crazy that I want to go natural and I don't care. I know this is the best for my baby and myself. Besides, birth is natural. All of it.

JennTheMommy
by on Jan. 27, 2010 at 2:04 PM
  • Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache
  • After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop
  • You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating
  • You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary
  • For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
  • Though research is somewhat ambiguous, most studies suggest some babies will have trouble "latching on" which can lead to breastfeeding difficulties. Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.
  • Jenn- Mommy to Hunter 7-2-07, Expecting 4-19-10, Wife to Brian
                 Student Midwife "Birth Matters, Birth is Beautiful"
    Ticker id: 1b3a

    Imamom4sure
    by on Jan. 27, 2010 at 7:53 PM

    well, I ended up with a nerve injury, and had to wear a back brace to help heal the irratated nerve that wouldnt heal for over a year and a half. (they say its rare for this to happen, I was medically diagnosed and it was attributed to the epidural and I was told it actually isn't as rare as folks are led to believe, there were a number of women being treated for the same thing as me, I got treated at Kaiser Hospital in CA, my original epidural was at a hospital in central florida)

    the epidural caused my body to swell and I remained swollen for two weeks postpadum, and my new born was swollen too, which made it difficult for him to learn how to nurse properly.

    my neighbor's baby suddenly went into fetal distress following the epidural so she had an emergency c-sec.

    her sister in law, who was very pro epidural, ended up anaphalatic from her second one and almost died, and had an emergency c-section too.

    my girl friend said that she had head aches from hers, and went temporarily blind as soon as she had it.

    my sisters epidural kept not working, and I met a lady who had a c-section with the epidural not working and had to be put out, in the middle of the procedure as she was being cut, all it did was affect her legs but didn't numb the pain of her torso!!!

    tickled_pink09
    by on Jan. 27, 2010 at 9:51 PM


    Quoting JennTheMommy:

  • Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache
  • After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop
  • You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating
  • You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary
  • For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
  • Though research is somewhat ambiguous, most studies suggest some babies will have trouble "latching on" which can lead to breastfeeding difficulties. Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.

  • Thank you :)

    tickled_pink09
    by on Jan. 27, 2010 at 9:55 PM


    Quoting Imamom4sure:

    well, I ended up with a nerve injury, and had to wear a back brace to help heal the irratated nerve that wouldnt heal for over a year and a half. (they say its rare for this to happen, I was medically diagnosed and it was attributed to the epidural and I was told it actually isn't as rare as folks are led to believe, there were a number of women being treated for the same thing as me, I got treated at Kaiser Hospital in CA, my original epidural was at a hospital in central florida)

    the epidural caused my body to swell and I remained swollen for two weeks postpadum, and my new born was swollen too, which made it difficult for him to learn how to nurse properly.

    my neighbor's baby suddenly went into fetal distress following the epidural so she had an emergency c-sec.

    her sister in law, who was very pro epidural, ended up anaphalatic from her second one and almost died, and had an emergency c-section too.

    my girl friend said that she had head aches from hers, and went temporarily blind as soon as she had it.

    my sisters epidural kept not working, and I met a lady who had a c-section with the epidural not working and had to be put out, in the middle of the procedure as she was being cut, all it did was affect her legs but didn't numb the pain of her torso!!!


    wow...thanks so much. I really want to go natural and I don't want to "cave in" and take an epidural. I need all the encouragment and support not to.

    I am sorry for the effect of the epidural on you. I do appreciate you sharing :)

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