I was recently having a conversation with my friend who is graduating from nursing school in mid December, and she told me that she had learned in her clinical that day that epidurals have no affect on the baby whatsoever. In fact her words were that the anesthesia doesn't cross the blood/brain barrier, and therefore does not enter the baby's system at all.

I was shocked to say the least. She went on to say that her teacher(a physician) said this was a "common misconception" in the birthing community.



Is this doctor and teacher flat out lying to his students or is he severely undereducated? How is it that we have men and women poised to enter the health care field so hugely mis-educated???

Or perhaps I'm hugely mis-educated?

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Our anesthesiologist here at the hospital I work at tell all of our patients that the epidural doesn't cross over to the baby at all.
How convenient that a mother comforting epidural is safe and only affects the mother, but EVERYTHING else you put into your body in any way some how does go to your baby. Hmmm, odd isn't it.
If you see a baby born completely natural, drug free and compare it to a baby born to a mother with an epidural...you WILL see a difference in the babies behavior as far as alertness is concerned. I have witnessed it personally.
You have to tell a mother that the epi won't affect her baby so she doesn't feel guilty or like she is hurting her baby. I don't think it matters one way or the other. Most women would probably still go for it either way, but this way you can make them feel better about it.
Not to mention, we wouldn't want to hurt the anesthesia business. ;)
I teach classes and one of my couples went to a local hospital for their birth place tour. When they asked about the effects of the epidural on the baby the nurse said, " It doesn't really effect the babies, it just makes them CALM" Isn't that an effect?

My neighbor works in the new born nursery at another local hospital and when I asked her if she can tell the difference between medicated and unmedicated babies she said "ABSOLUTELY"

I do not believe for a minute that epidurals don't effect babies. The problem is that so many babies are medicated that they are the ones who look normal to the staff at the hospital.
So I thought I would post this response from a friend of mine who is a birth professional. She wiped out a quick response to me regarding my questions form this discussion.

"OK, here's what i know: the debate here is whether the *drug* in the epidural crosses the plcental (not blood-brain) barrier. the anesthetic (bupivicaine, ropivicaine) does not. fentanyl (sublimaze) absolutely does. it has neurological impact on everything from respiratory pattern to the ability to suck. but the real issue is not just the drug passing to the baby's circulation. it is whether the epidural, and whether an anesthetized mother, has any indirect impact on the well-being of either. now, i agree that it is a choice. a lot of aspects of birth are. but you're right--parents must be informed, and i really think that something that poses such a multitude of risks as to appreciably affect perinatal outcomes should really be thought over before being routinely offered. we don't use morphine because it has risks, right? this is not a mother's choice. it's simply not safe.
so here's what the epidural can really do that moms are not being informed about: all of the gas-exchange alterations mentioned in the first comment in your post are correct. they are directly dependent upon the MOTHER'S hemodynamic changes and the fact that those impact the baby. though no ropivicaine reaches baby, it causes maternal blood pressure to drop so precipitously that we actually treat everyone for it--you have to have at least 750 cc's IV fluid before they'll even start, and that's why--to try to prevent that. then the orders allow you to give ephedrine, a potent hypertensive agent, in case it falls anyway. if maternal blood pressure falls, baby will become rapidly bradycardic. i have run back for many c-sections for this alone. the longterm outcome is usually fine, but the other consequences are serious, i believe. epidural anesthesia is known to cause benign fever in many moms. while this is harmless in and of itself, in most hospital protocols, if mom has a fever in labor, not only is she more likely to have a section, but it's often required that the baby has a post-birth septic workup, which includes a blood draw, possibly a lumbar puncture, and certain separation from mom for evaluation. baby will most likely recieve formula during this time, and usually recieve IV antibiotics until bloodwork comes back in 2-3 days showing absence of sepsis or infection. again, longterm outcomes as far as death or illness are good, but important things like bonding, breastfeeding, and pain or procedures are big risks to me. and after having a section myself, the increased risk of that is no small thing either :)
there are really not a lot of data to suggest huge problems like paralysis and nerve damage. it honestly almost never happens. but short-term scary things llike a "high block" (when the med gets delivered higher than the level of T-6 or 7 in the spine and mom needs to be bagged for respiratory arrest) DO happen, and they are scary and risky too. SO, choice? yes, but a lot more women would refuse knowing the true and indirect risks they are taking, and if it were emphasized that labor is not as deadly without anesthesia. women are REALLY taught from the beginning that to birth without meds is nearly impossible. i'd like to see epidurals revisited as routine pain control, even with informed consent, and resedrved for times when they are of benefit. there are those times, for sure. sometimes i think they prevent a section. but the sheer volume of regional blocks we administer in the US brings with it some sobering impact on mom and babies' best interest in the first days of life. i do discourage them unless the individual situation appears to call for one. the breastfeeding link is huge, and i really believe strongly in breastfeeding as one of the single most important life-saving tools we have for infants and small children."
Thankyou for this well written response!
Do you REALLY think that the majority of women would make a different choice knowing this information?
I don't.
It may make a slight difference, but I really believe that MOST women would do it anyway because they are so terrified of having a baby naturally. I don't think most women would ever even consider natural birth. All of my peers, except for one or two, think I am a complete weirdo for birthing naturally. Unfortunaltely, that is the conception of the majority of our society.
In reply to Sarah's post, I think this is exactly why it is so important for women like us to give birth naturally and share our stories with other women (whether they think we're crazy or not).

Websites like this and documentaries like BBOB are also key. We've got to basically start a grassroots movement to educate women on the TRUTH about natural childbirth. They are scared of it because they've been conditioned to be scared of it. This means they can also be conditioned to not be scared.

The more success/birth stories we share, the more change that will come. Things have really gone wrong in the American maternity system, and it's time for a movement in the natural direction.

I made the decision to go natural late in my pregnancy and would have GREATLY appreciated one of my friends (I have several who've done natural childbirth) would have talked to me early on in my pregnancy to make sure I was thinking about these things. I'm lucky that I figured things out, did the research, and was able to switch from an OB/GYN to a midwife before it was too late.

Keep spreading the word, ladies! I think that's our best chance of convincing women that they can do it without the epi and that they're birth experiences and that of their babies will be a lot more satisfying and safe.
I think that mom's would listen to this info if it came from their health care providers and not the "crunchy granola hippie" moms that want to "birth in the woods and eat our placentas". :)

Think about it from the other side of things. If you believe that your physician's only interests are to care for you and your baby in the best way possible, and that they tell the whole truth without omitting any info, then when your doctor says you can have a "pain free childbirth and it won't effect you baby at all, in fact it just might be safer" then basically you've been handed the holy grail of childbirth.

If you have no idea of the potential consequences and the domino effect of those consequences that can stretch long after birth, why wouldn't you have an epidural? If physicians were honest about ALL the facts with there patients, then yes, I Do think more people would choose to do it naturally.
I agree.
Doctors know EVERYTHING. They are the smartest human beings alive and we should all listen to every word they say because they are right all of the time. hahaha
If it came from them more babies would be breastfeeding past one week, but that's never going to happen people because patients without epidurals make for a real cramper in their schedule.
That buys the doctor a lot of time to get to the hospital. They have office hours to keep to! No epidural patients don't wait for their doctor to arrive. (Including me!)
The majority of nurses hate taking care of patients without epis too because they are way more work and the nurse has a lot more to deal with than a laboring patient sleeping away, quiet as can be. I see this everyday people and it's very sad.
In my experience, the doctors and other nurses that I work with, have no clue what to do with a patient who is not using an epidural. I received no training and I'm sure doctors don't also. I think we need to start a campaign to educate them:)
Isn't it backwards that we have to educate more on a natural process, and the unnatural one is second nature?
i agree, most of the childbirth education classes have a nice little visit from the anesthesiologist, and the talk quickly turns to how much it will hurt and how early you can get your epidural.

in my own situation my husband's family (his aunts/uncles) are all doctors. me having a home birth...whew. well we won't go there. but i was told at least once that i shouldn't try for a natural birth. not with my first child.. because my pelvis wasn't "proven".

these are people who were all born AT HOME in burma! Their mom had 7 kids and didn't lose a single one.

It is really very backwards, as someone else said, that the natural way is secondary to intervention.
I think if we had more physicians who told moms "listen i believe that you can do this, and i'm going to be there in whatever way i can to help you and we'll see how things play out..."
then allow moms to labor how they WANT to... not strapped to the bed with monitors telling them not to move so they can keep track of baby.. well i think we'd have more moms who ended up having a drug free birth because of the support.
and we need more nurses on staff.. so they're NOT over worked and CAN take the time to help those natural birthing moms. a great, supportive nurse does WONDERS!

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