"Enjoy your Labor" by Gilbert Grant is GREAT!

[christy]

Dou dou I too slept through my second stage of labour in between contractions. I loved feeling my baby move down the birth canal as well... it was like a celebration for us.

With my first labour, the epidural dropped my blood pressure so much that it caused heaps of issues. They had to turn off the drugs which then led to me being unable to move while the contractions ripped through my body and then... well it was traumatic.

I would suggest to move women to read more than one study on their own and with their birth support before listening to second hand advice.

[fatmama]

LOL - all your posts are second hand advice too my dear
And until you've read the evidence he presents you can't even argue with it. But well done at sticking to your guns. No one can say the midwife lobby isn't tenacious.

[christy]

I am not a part of the midwife lobby, thank you very much. I am someone who has had to do heaps of research leading up to my own birth, and am passionate about women having the opportunity to make decisions for themselves.

[fatmama]

Great, so am I. That's why I provided the info that I thought was relevant to this topic.
Congratulations, we both want women to make fully informed decisions. FULLY (italics) informed. Right?

[Oorki Galoorki]

can you point me in the direction of some of the cited studies in the book i would like to look at the studies im not interested on his spin of the studies i want to read them my self.

[fatmama]

Well I don't think that's very nice, after all he's more qualified than you to interpret peer reviewed obstretic anesthetics journals frankly. But I'm not going to sit here at 11pm and type out the bibliography. I'm sure you can find a copy in a library. Enjoy! (your labour)

[Oorki Galoorki]

i do hope you get a nice profit for trying to sell his book..

if you cant even refer to some of the studies unlike some that have been posted in here against your opinion then i doubt its worth reading.

im not pregnant

[christy]

How do you know he's more qualified?

I've studied anaesthetics in my job. I've written reports, had exams, and had to teach anaesthetics to students. How do I know he is more qualified to interpret these reports than I am?

[Trillian]

Fatmama, you are walking a very fine line at the moment and you are bordering on not only being offensive, but you are also flaming other members.

Here at BellyBelly we do encourage women to take a natural approach to childbirth and educate about the risks involved with certain aspects of birth, such as pain relief, but we are also suportive of a woman's right to choose and that includes the use of pain relief in labour. I'm sorry if you think that there is a 'party line', but that's the way the majority of this community think and if you feel that we are pushing our own agenda then you are wrong.

This thread is being watched very closely and if this antagonistic behaviour continues then it will be stopped.

[MantaRay]

There are no mws posting in this thread fatmama. Just experienced birthers sharing our experiences. And I could read 1000 books and none of it would change how I feel because my experience carries more weight for me.

I would be very interested to hear how an epidural prevented a c/s - given that it usually works the other way I am sure your story would be worth a read.

BTW - you can put words in italics but highlighting them and then pressing ctrl-I.

You have 9 posts and 8 are in this thread - what commission do you get for book sales?

[Oorki Galoorki]

Product Description
Enjoy Your Labor is an informative and easy-to-read book that contains everything an expectant mother needs to know about state-of-the-art options for pain relief for labor and delivery: epidurals and spinals. Enjoy Your Labor gives readers the facts about modern pain relief techniques. It is the only book that takes the fear, mystery and guilt out of epidurals and spinals. The author develops the premise that administration of medication to relieve labor pain is a sensible approach, and he explains the reasons women can and should get an epidural before the severe pain of labor starts - if they decide they want one. The refreshing view presented in Enjoy Your Labor regarding the timing of the epidural challenges the conventional wisdom, and is a radical departure from current approaches, where women typically delay getting an epidural for as long as possible - until the pain becomes unbearable. Enjoy Your Labor empowers women with the knowledge they need to help them make an informed choice about pain relief for childbirth. The author encourages readers to advocate for themselves, and to carefully consider and discuss the management of their labor and delivery pain with their health care providers before labor begins.

About the Author
Dr. Gilbert J. Grant has been Director of Obstetric Anesthesia at New York University Medical Center since 1992. He is also a faculty member of New York University School of Medicine, where he is an Associate Professor and Vice Chairman for Academic Affairs in the Department of Anesthesiology. Dr. Grant earned his MD degree from the University of Michigan Medical School in 1982. He then relocated to New York City, where he completed an internship in Obstetrics and Gynecology at Columbia Presbyterian Hospital before moving to New York University Medical Center where he completed a residency in anesthesiology. Dr. Grant has published numerous scientific papers and chapters for medical textbooks, and he lectures at educational institutions and scientific meetings in the United States and abroad.

this is what i found about the book.. seem like the usual bollocks that they have for "expectant" mothers

[christy]

LOL of course! He's a professor of obstetric anaesthesia..... so totally unbiased then

[MantaRay]

This might be just me, but the title makes me cringe and the bit about "before the pain becomes unbearable" is just plain old scaremongering. Pain during labour is not unbearable - even without drugs. It might be uncomfortable, but it is bearable. Otherwise how would all us women who have labours that are too quick for pain relief survive? It is our fear that the pain will be unbearable that leads us to look at pain relief options. And who says you can't enjoy a drug free labour - I did. Far more than my epidural labour TBH.

[fatmama]

I am glad it is being monitored.
I have in no way been offensive. Others, I believe, have been.
I have no ties to Dr Grant other than having been a patient of his by chance.
I found the experience liberating. The pain WAS unbearable to me, if unbearable means "wish you were dead" kind of pain. Maybe some women never feel that kind of pain but I assure you many do, and would be grateful to know this is safe, and much safer than other medications that "seem" less invasive such as pethidine etc.
I am confident that some women out there who may read this would like to hear that story. And I don't feel bothered one bit that some of you don't want that message heard.

I would genuinely, truly, love to hear an honest on-the-level taking me seriously kind of response to why midwives aren't biased but Drs are. I really would. I have never heard an attempt at that even, and I'm sure someone out there could make an argument even if I disagree, it disappoints me no one ever tries. There must be some subliminal reason so many believe a midwife/non Dr and won't believe a Dr when its on exactly the same point. I can't relate to that and I admit it. Just can't relate.

I'm glad its stimulated discussion though I wish that had been dealt with. So many responses I have to turn off notification or I'll never get anything done! And my DS will wake any second...

Have a lovely night!

[suse]

Fatmama, as well as research that I had undertaken on my own whilst pregnant, the information I received was provided by the obstetric department at the hospital that I birthed at. It provided information on all of the available analgesia and included detailed information on the benefits and risks of each type of pain relief, including (amongst other things) the increased likelihood for reduced contractions or stalled labour requiring oxytocin supplementation and an inability to push as a result of loss of sensation due to epidural, which can result in instrumental delivery or caesarean section. It is not just a myth perpetuated by the 'midwifery lobby'. Much of the research to support this is performed by obstetricians and published in obstetrics journals.

To answer your question about bias, some obstetricians support a medicalised approach to birth because they are, after all, trained doctors, and their methodology is shaped by medical training. They can see birth as a process requiring pain-relief because pain management is something that doctors are trained in - the see pain as a symptom of a problem and seek to avoid it where possible. They are also specialists who are trained to manage the problems and complications associated with pregnancy and births, so in some ways they are like a nuclear physicist at a barbecue - at an uncomplicated birth they may apply their specialist training to an extent that is not necessary. Whereas most midwives (and some obstetricians) encourage as little intervention as possible because it has been demonstrated that in an uncomplicated birth, the outcome for both mother and child is better. Funnily enough, the main agenda of either faction is to ensure the best outcome for birthing women, yet a much better outcome can be achieved when these stakeholders see their roles as complementary rather than oppositional. Disregard for the benefits of either role can be detrimental to outcomes and to choice.

Certainly there are people who do benefit from an epidural (and FWIW, I was one of them, although I had hoped to birth without intervention I was one of those who did benefit from it), but this does not negate that there are risks to both mother and child.

[Julie Doula]

FM, any woman giving birth in Australia can access an epidural if she wants one, and for the most part, within a reasonable period of time (and any undue delay is considered a failure of care). That's as it should be. A woman giving birth at home, or in a birth centre, who eventually decides, 'stuff this, I want an epidural', can transfer to hospital, and access one.

As a doula, I have supported at least one women (she actually planned a homebirth) in which a timely epidural was the appropriate use of technology, and it helped her avoid a c/s. Every midwife knows that the appropriate use of epidural, in difficult labours, can occasionally help avoid an unwanted or unnecessary c/s.

Any obstetric intervention carries risk - as the seasoned obstetrician who assisted my homebirthing client pointed out to her, as he carefully discussed with her her options (after 50 hours of labour which did not progress beyong 8 cm at home -hence we tf to hospital.)

Women don't need to fight for an epidural. It's on offer. Check out the peri-natal stats and see how many women who give birth in hospital end up having one.

Yet research and experience combine to demonstrate that for many low risk women, continuous emotional support, continuity of care from a known, self-chosen midwife, and access to a deep birth pool to labour in, greatly reduce requests for epidurals.

Australian birthers can easily access epidurals. Women in Australia cannot easily access:
- continuity of care from a known, self-chosen midwife
- midwife-led care by midwives who are autonomous professionals, who not reduced to 'obstetric nurses' and are actually enabled to practice the midwifery model of care, as defined by Marsden Wagner.
- birth pools
- continuous emotional support
- freedom of movement and mobility (this varies from institution to institution)
- privacy (ditto)
- funded homebirth.

How I wish all of the above was as esaily accesible, and actually ON the menu of birth choices for Australian women, as epidurals!

Needing an epidural is a perfectly valid reason to have one. So is wanting one. And you can have one. Usually the anaesthetist is in your room within half an hour of the request.

Try asking to labour in a birth pool. Or for your own midwife. Or for there to be no changes of shift while you give birth. Or for funded homebirth. Or for practicing rights for your two homebirth midwives in the event of a transfer. Or the right to have a VBAC labour in a birth centre.

% of women in Australia who have an epidural: 28%

% of who have a homebirth: 1.7%

% who have use of a birth pool in labour: 3%

FM, you're hardly the persecuted minority being hounded or pressured in any way by the 'tenacious midwife lobby' (otherwise known as consumers who have found through personal experience that there is ample support for the obstetric model of care - but if you want to know about natural birth options, be prepared to take responsibility to find out for yourself, and to fight for your rights.)

Not sure what your agenda is. Have you ever experienced difficulty on obtaining an epidural in the Australian hospital system?

It's not epidurals that aren't getting a far rap, it's natural birth. And natural birth hormones. As explained so well here.

By the way, I really enjoyed the three labours I experienced without epidurals. I mean, I really enjoyed them.

[fatmama]

FM, any woman giving birth in Australia can access an epidural if she wants one, and for the most part, within a reasonable period of time (and any undue delay is considered a failure of care). That's as it should be. A woman giving birth at home, who eventually decides, 'stuff this, I want an epidural', can transfer to hospital, and access one.

...
Women don't need to fight for an epidural. It's on offer. Check out the peri-natal stats and see how many women who give birth in hospital end up having one.

...

% of women in Australia who have an epidural: 28%

% of who have a homebirth: 1.7%

% who have use of a birth pool in labour: 3%

... Have you ever experienced difficulty on obtaining an epidural in the Australian hospital system?

Thank you for giving real content to your reply JulieDoula, as that, unlike just opinions and rants actually adds to the discussion.

To respond briefly:

1. Totally disagree that anyone can have an epi, even less within a reasonable time. I have 10 (just counted them off) friends who between them have had 34 children and none of them got an epi when they asked, or anything near it. Many asked for it as soon as they arrived in labour and were yelled at, ranted at, pressured and generally stonewalled for hours. Some occasions they missed out as they got to transition first. Also, there's a shortage of anesthetists in many Australian obstetric wards so c-sections obviously get and deserve priority and people are missing out on requested epidurals. Then there are those who are conditioned to "hang on" as long as they can, then end up getting one on request. Many of those feel they shouldn't have been pressured to hold on but should have had it sooner. I also have 1 friend who is a midwife in a public hospital and who reports to me that for public patients midwives are encouraged to discourage epidurals as a cost-saving measure. Which, frankly, IS a failure of care as you rightly point out. So "ending up" with an epi isn't the only thing that matters, but getting one promptly on request and being fully informed that it is not adverse to have one sooner and you don't have to "hang on" unless you really actually want that. It is a common misconception capitalised on by public hospitals imho.

2. As for the figures - those are not numbers that interest me. And that brings me nicely to my "agenda" though I'd say its more my passionate commitment to full scientific information and choice. I wouldn't matter to me if 100% of births were homebirths (I'm hardly against them if that's what people want with no indoctrination), or if 100% were epidural users, or if 100% were c-sections even. What matters to me is how many were DENIED the birth they wanted, either by not knowing enough, or by actual denial by the people supposed to care for them, or by active misinformation about the dangers/safety.

That goes for homebirths too. I wouldn't want a woman who was a good candidate for homebirth and really wanted one to not have one. But I suspect that happens less than being denied epidurals precisely because so many want epidurals - most, if not all - who ask for an epi get less than they ask for and are entitled to.

And yes, since that would be my choice (even if I didn't need one) I care about women being denied that especially. I know how wonderful they can be.

Thanks for your post anyway. I really think the rest of the thread has not engaged with the real issue and has engaged in mere ad hominem attacks. I respect your different opinion on what an ideal birth is, but I don't think we actually want anything much different for women. I'm just *more* concerned with the denial of epidurals which I'm entitled to be. That doesn't mean I want women to be denied homebirths. They're not incompatible.

[Lady-bug]

FM-Do you have any stats for women who 'are being denied' an epidural? I was given one as soon as I asked.