What Does Lamaze Say About Epidurals?

With all the talk recently about epidurals, we would like to share with you where Lamaze childbirth educators stand -- and what they teach -- when it comes to epidural usage in labor. What is Lamaze's position on epidural use?

• Expectant mothers need balanced and accurate information about the risks and benefits of epidurals to determine the best choice for her and her baby.
• Mothers don't need judgment they need information. Women are not always told all of the risks associated with an epidural.
• Lamaze Certified Childbirth Educators provide the information moms need to make an educated decision.

What risks do epidurals pose to mothers and babies?

• Epidurals are associated with a number of risks, including:
  • Prolonging labor
  • Higher risk of fever and postpartum separation to rule out infection
  • Increased risk of instrument delivery
  • Increased perineal trauma
  • Maternal hypotension, which can lead to worrying fetal heart rate changes
  • Increased difficulty with breastfeeding
  • If the mother opts to have an epidural, the timing is important. The early use of an epidural is associated with increased cesarean rates.
  • Having an epidural inhibits the mother's ability to move freely during labor an important part of keeping labor moving smoothly.

When is an epidural medically necessary?

• Expectant mothers may need an epidural in certain situations:
  • Labor is prolonged and difficult.
  • The mother undergoes a cesarean.
  • The mother has very high blood pressure.

What alternatives are there for coping with pain?

• Lamaze teaches coping techniques to help women cope with labor pain, including bathing and changing position.
• Continuous support from a partner, relative, friend or doula also can help women through contractions.
• It is important to remember labor pain is not a pathological pain, like the pain of a broken arm or illness. It is a natural part of the labor process and signals that the mother's body is working as it should.
  • Pain can actually help keep the birth process moving, triggering a cascade of hormones needed to keep labor active. It can also signal important things to the mother, such as the need to move and change positions to allow the baby to descend.

For additional information on epidural usage, check out the following links:

• Appropriate Use of Interventions: Epidural Analgesia and Anesthesia
• Epidurals: Food for Thought
• When Research is Flawed: Does the Timing of an Epidural Influence the Risk for C-Section?
• Healthy Birth Practice #4: Avoid Interventions That Are Not Medically Necessary

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