Monday 4 July 2011

We are not masochists, we just know better.



Why subject yourself to the arduous task of natural birth when clearly there is a pain-free alternative?
Many friends and colleagues have asked me this ubiquitous question. It kind of insinuates a response something along the line “I’m really a masochist, that’s why” and would have passed off as a confession.  If you do think about it, why not go for something to ease the pain right (or so it seems)?  I’d say, why not? It is a conviction that many confident moms out there feel very passionate about.
It is important to know that there has been a paradigm shift on how we look at giving birth.  Till the 1940's, giving birth was largely done at home and attended to by midwives or experienced family members.  It was perceived as a natural process and as an act of God.  Further, this was more often tied with cultural traditions and superstitious beliefs that have kept medical practitioners at bay.

As science begin to gain precedence however, women sought medical help on the belief of a safer and pain-free childbirth without risks.  Epidural, the most effective and thus most commonly used form of pain-relief, is administered by injecting a dose of anesthesia through the lower back into the epidural space. A procedure with risks and undesirable effects both for the mom and the baby.

The administration of this drug causes a series of ‘domino-like’ events.  Because of a likelihood of a drop in blood pressure that can seriously affect the flow of oxygen to the baby, the mother has to be attached to an IV drip as a safety precaution in the event an increase in blood is necessary.  She also needs a transducer strapped around her abdomen to monitor the baby’s condition and a temperature bracelet to monitor chances of fever.   Further, a catheter is placed in the bladder as the epidural makes it difficult to tell when to pass urine.

This leaves the mother confined to bed, unable to move around, helpless and feeling out of control.  If the anesthesia has not worn off at the second stage of labor, she has to rely heavily on the doctor to manage the labor.  With the abdominal muscle weakened, the voluntary muscle is unable to push effectively and thus increased the use of forceps and vacuum extractor.  Moreover, studies have shown that there is a significant link between epidural and c-section.  Risk of c-section is found to be 2-3 times more likely with epidural.

What was previously celebrated as nature’s right of passage into motherhood, childbirth has rather appeared to be an "ailment" prescribing medical procedure. Not only that, a mother (and baby) has to deal with after-birth effects – giddiness from the drugs, headaches (which can persist up to 3 months), backache, decreased milk letdown reflexes due to decrease in maternal oxytocin which might have interfered with oxytocin release after birth, and associated post-partum depression.  It doesn’t stop there, the medication permeates the placenta and subtle side effects are also seen on babies.  They are observed to have difficulty in self-soothing, self-latching and trouble suckling at the mother’s breasts.  

In my opinion, the mother and newborn are somehow deprived of an instantaneous bonding.  An otherwise poignant moment for both, have the mother been fully aware and the newborn fully alert.  These reasons are compelling enough for me to assert that the end just could not justify the means. 













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