Sisterhood Blog

The Epidural Dilemma

By Melissa Langsam Braunstein

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To have, or not to have, the epidural? That is the question. More precisely, in the ninth month of a woman’s pregnancy, it is the only question that matters.

In the fourth and fifth months, I was unsure if I wanted an epidural. How would I know? Women say that labor is intensely painful, but for those of us who have never experienced it before, what exactly does that mean? How does it compare to the pains of pregnancy, or any other pain we might have suffered through in the past? Unsure, I registered for the general childbirth class that covered all bases — natural birth and drug-assisted birth. I figured my choice would become clear as I learned more about both options.

As part of the class, my husband and I viewed two women’s birth stories. One woman opted for a natural birth, while the other took advantage of all the narcotics and epidurals modern medicine offers our gender. That video might as well have been “Rashomon,” as my husband and I had polar opposite reactions. He focused on the mother-baby bonding after birth and found it quite “moving,” while I thought only of the delivery and left class alarmed.

Watching as those women’s bodies were torn apart to make way for their babies looked horrifyingly painful. My gut reaction was that I wanted no part of this. A moment later it hit me that, like it or not, I had already signed up for labor, essentially with a non-refundable deposit when I became pregnant. The thought of feeling every muscle fiber stretch or possibly rip was unpalatable. However, the possibility of being paralyzed from the waist down was terrifying. What if the epidural didn’t wear off?

Our instructor ended class by encouraging us to talk to friends and family about their experiences, so that we could make the right decision for us. My mother made it through labor both times without any chemical help, and she was pleased with her decision. My sister, who is not yet a mother but works as a medical resident, opined that I would be crazy not to get an epidural, having seen laboring women during her obstetrical rotation; the pain, she reported, would be bad even with an epidural.

Another family member used medicine both times, figuring that pain is bad, and if medicine exists we must be meant to use it; she was also content with her experience. One friend had tried both methods, and while the two experiences were very different, she felt that she had made the right call each time. Having just used natural birth for her second child made her feel connected to nature and to women throughout history. She described the major difference between using or abstaining from an epidural as the difference between being an active participant or a spectator at your own labor. This friend kindly directed me to some reading material that had inspired her decision the second time around, “Ina May’s Guide to Childbirth,” by Ina May Gaskin.

An experienced midwife, Gaskin discusses various aspects of labor and delivery in a holistic manner, meaning that she believes the mind and body are connected. She discusses her professional experiences as a midwife and contrasts them with standard doctor-led medical care — namely, the sort of care I have been and will continue to get in the hospital. Interestingly, my OB has never asked me what I want to do about pain medication, or if I have any fears about delivery.

Gaskin talks directly about women’s fears of pain and how Americans have a tendency to hype birth pain, scaring pregnant women into assuming the experience will be unbearable. She repeatedly reassures her reader that nature is wise and that women’s bodies were built for the essential task of childbearing. Given that women have managed to give birth at least since our Matriarchs labored without doctors or epidurals, this intuitively makes sense to me. There will always be some women who need medical interventions — which is why I am happy to deliver at a major hospital — but for most women, labor should be manageable without them.

Gaskin’s book has the most reassuring and positive message about childbirth that I have encountered anywhere, and it has helped me resolve to trust my body during delivery. My birth plan includes the caveat that I may request an epidural if the pain becomes too much. However, I don’t expect to cry uncle and use it. A natural delivery will likely mean work, as we welcome our eight-pound-plus baby into the world, but I think it will be worth it. I have been an active participant in this pregnancy to-date, and I like the idea of being fully present for the arrival of my very own Baby Girl.


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