What to Say to a Woman with an Epidural (Besides the Dentist Analogy)
You wouldn’t go to the dentist to get a tooth pulled without using any Novocaine! It’s the same thing during labor. Who would want to do it without the drugs?!
I’ve heard lots and lots of people use this analogy over the years: women, men, mothers, pregnant women, nurses, doctors, etc. And every time I’ve heard it (or a version of it) uttered, it makes me cringe a little.
To clarify, this is not because I’m “anti-epidural.”
Yes, I do think that women should be given/seek out information about the risks and benefits of epidurals well in advance of their labors (and not when they’re in the midst of a contraction and the anesthesiologist is handing them a consent form and OMG, THEY’LL SIGN ANYTHING, JUST PLEASE START THE EPIDURAL NOW!!!).
And yes, I’ve given birth without an epidural.
But this is different–much different–from being “anti-epidural.”
Because you know what? During that 14 hour unmedicated labor? You’re darn straight there were moments when I considered getting pain medication. I understand the desire to get one. Completely.
And you know what else? I’ve seen births where I believe, in my doula’s heart of hearts, that an epidural made the difference between a vaginal birth and a cesarean section. That’s right. For when used with discretion, in the right circumstances, in cases where women are well-informed, and when it is wholly a woman’s choice to request pain medication, epidurals can be wonderful, wonderful labor tools.
Now that my stance on epidurals is (somewhat) clear, I want to get back to that “dentist analogy”: that giving birth without drugs is somehow comparable to getting a tooth pulled without drugs.
Please bear with me while I briefly put on my philosopher hat: in terms of argumentation, analogies are evaluated in terms of their relative strength or weakness. The more that the two components of an analogy have in common, the stronger the analogy is. The less they have in common, the weaker it is.
So. It should go without saying that giving birth and getting a tooth pulled have essentially only one thing in common, and that is that they both involve a certain amount of pain or intensity in the human body. But this is pretty much all that they have in common.
For the pain of labor is (for the most part) non-pathological, while the pain of getting a tooth pulled is pathological. Uterine contractions are a function of a normal body process, and initiate (unless a woman’s labor is induced) endogenously; extracting a tooth from a person’s mouth is not part of a normal body process, and the pain initiates from a source outside of the body. What’s more, there are many non-pharmacological comfort measures (such as birth balls, massage, position changes, heat and cold, hypnosis, hydrotherapy, etc.) available to women during labor. There aren’t many similar tools available to people getting their teeth pulled. (There isn’t even enough room in your mouth to bite on that proverbial bullet!)
In addition, I think that the dentist analogy belittles the reasons that a woman may appeal to when opting for a drug-free birth.
For unless someone might have to forgo Novocaine during a dental procedure because of some conflicting health condition (and you have my deepest condolences), most people could find no reason whatsover to say, “Hey, Dr. Dentist, I’m good without that shot of anesthetic. Why don’t you just go ahead and drill away, pain-med free!!!”
But there are reasons that women might choose (or at least hope to) forgo an epidural during labor. (And NO! It’s not for that damn medal!)
Some women might find compelling the preliminary research regarding epidurals and their effects on breastfeeding.
Still others might want to avoid other well-researched effects associated with epidurals, such as an increase in instrumental delivery, a longer pushing stage, greater need for contraction stimulation through synthetic oxytocin, and a higher incidence of very low blood pressure and fever in the mother.
And few, if any, people who plan on avoiding pain medication during labor make these plans with the hope of being a martyr for the pain. They have reasons–reasons that are a far cry from the ridiculous notion that it would be “cool” to try out something similar to having a small power tool drilling into their teeth or gums without any anesthetic whatsoever. (Okay, now I’m really cringing!)
But more than this, from my “doula perspective” I don’t think that the dentist analogy offers the sort of reassurance that a woman wants or needs when she gets an epidural.
To be clear, reassurance probably isn’t necessary for a person who has decided well in advance that she definitely wants pain medication during labor. If she made a well-informed decision that was right for her and then followed through on that decision, then good for her!
But for people who were undecided, or who were very committed to going without pain medication, reassurance might be just what they need to move forward in their labor with confidence, empowerment, and peace within themselves.
And I’m not so sure that the “dentist analogy” achieves this goal.
In fact, I think that it does anything but achieve this goal.
So when a client or a friend of mine is feeling unsure of or disappointed with their decision to receive pain medication after they’ve already received it, here’s what I like to say instead:
- An epidural is one of the many tools that are available to you during labor. You’re just making use of one of your tools right now.
- Getting an epidural does not mean that you are weak: it takes a lot of strength to make such a major decision in the middle of labor.
- It takes courage to change course during labor and choose something that you weren’t planning on choosing. You came well-prepared, and one thing you brought with you was flexibility. That’s great.
- I can still help you change positions, and I will stay here with you while you rest. I’m still your doula even when you have an epidural!
- You made the decision that’s right for you–that’s what matters.
- I think you made a good decision.
See? There’s no need for a bad analogy at all.
If you’ve supported a woman during labor and she decides to get an epidural, what words of comfort have you offered to her if she seemed unsure of or disappointed with her decision after the epidural was in place?
If you’ve had an epidural during labor and felt unsure of or disappointed with your decision, what words of comfort or reassurance helped you the most?
image credit athenius22 on flickr.