Thursday, September 23, 2010

Didn't you have that baby, yet?

Well, if you're looking at someone who is extremely pregnant, I would venture to say no.  LOL

How many times have we had someone call every day and ask if we've gone into labor the moment we hit 38-40 weeks (if this is your first pregnancy, it will happen)?  "Weren't you do on x date?"  Is usually the question you hear the most.  But, so is, "Wow, you're really late!"  But, you're probably not, and this is why:

We have all been taught that the Estimated Due Date (EDD) is 40 weeks from your last menstrual cycle.  This "figure" is based upon a 28 day cycle.  And we all know that every single woman ovulates at exactly the same time every month and that no one's cycle is longer than 28 days.

Or is it?

The reason that the 28 day cycle was used is because it is the 'average'.  Some cycles go longer and some not that long, but it looked like a pretty "even" number.  The doctors in the old days used this to give a general idea of when a woman could possibly go into labor.  Most women go into labor, naturally, between 38 and 42 weeks.  But, as time has gone on modern medicine has decided that if a baby was not born by 40 weeks, it meant that the child could die, the placenta would deteriorate, etc...all of those fun, encouraging things they tell a mom they want to induce/section.

Now, my cycle is *about* 32 days.  I track it pretty good, it's been pretty dependable and it does change every couple of years.  But, on average, it's 32 days.  Every single one of my babies was born late.  My oldest was born at 43 weeks (induced), my 2nd was born at 41 weeks and 3 days, and my 3rd was born at 43 weeks.  My younger kids were spontaneous (they came when they were ready).  My oldest was induced because of a ripped bag.  But, this made the doctors all too happy as they were trying to induce me right at 40 weeks.

Now, the kids are all very, very healthy.  There were no complications with any of them (the placenta was in great shape for all of them).

The estimated due date is just estimate.  So, the next time you go to your doctor and he/she starts hassling you about inducing, just smile and nod and then leave.  Most homebirth doctors/midwives will not even consider inducing before 42 weeks (43 at the latest).  In fact, even ACOG (American Congress of Obstetricians and Gynecologists) states that doctors should not be interfering in normal, uncomplicated pregnancies before 42 weeks is up.

But, the fact remains that the baby's lungs are the last vital organ to develop.  Since everyone needs their lungs to be developed as much as possible, isn't it best to allow your body to tell you when everything is a go?  Let's face it...if there were problems that necessitate an earlier induction, you would do it.  But, if they check on baby and heartrate is fine, amniotic fluid is fine, placenta looks/sounds good and everything is still a you really think it necessary to be induced just because of your due date?

Not every baby needs to be born at 40 weeks.  Not every mom will go into labor within 40 weeks.  You do have the right to know WHY the doctors are pushing for induction.  Is the baby showing signs of distress (low heartbeat, etc)?   If so, then maybe induction is best.  But, if there are no "distressed" signs (as was in my case with my oldest), then it may be better to allow baby to come on its own.

For more information on the EDD (and why it's not the "do or die" date), see here and here.  :)

Thursday, September 16, 2010

Delayed Cord Clamping and Why You Should Do It

I was talking to a friend who is due any time now and she said that during her last visit (last week) her doctor mentioned that they do not "infuse" the baby (some refer to it as "transfuse"), it's not their procedure and it takes too much time.  She asked me what the doctor was talking about.

Infusion is when you birth the baby and then allow the placenta to transfer the remainder of the blood within it to the baby.  This accomplishes a couple of very important things (from Midwife's Thinking Blog):
  • Provides the extra blood volume needed for the heart to direct 50% of it’s output to the lungs (8% before birth). This extra blood fills the capillaries in the lungs making them expand to provide support for the alveoli to open. It also aids lung fluid clearance from the alveoli. These changes allow the baby to breath effectively.
  • Increases the number of circulating red blood cells which carry oxygen. This increases the baby’s capacity to send oxygen around the body.
You can see how important this is...especially if a baby is born by C-Section (well, at any time).  During natural birth, the baby is massaged through the birth canal.  This helps expel any fluids in the lungs to prepare the baby to breathe oxygen.  During a C-Section, this does not occur and the fluid needs to be manually removed, but the massaging action also stimulates the baby's body, increasing the blood flow.  By prematurely clamping/cutting the cord it prevents the baby from getting even more of what he/she needs to breathe effectively outside of the womb.  It's easy to see why so many C-Section babies are NICU'ed for respiratory issues.

If you need something to take review on your way to the doctor's for this conversation, see these websites/articles:

For those of you who prefer actual scientific studies, see "Delayed Cord Clamping" on the Birth Balance Blog.

And watch this video with Dr. Stuart Fischbein.

You can insist on infusion in the hospital.  This is not illegal and it is not against the rules of the hospital.  It is simply a way for the doctor to be done with the birth faster, although waiting an extra few minutes will make no big difference to the doctor/nurses and a whole lot of difference to the baby (unless, of course, there is an emergency to deal with). 

This is something that needs to be discussed with your doctor/care provider in advance.  So, make sure this topic is covered.  Print up the importance to the baby for infusion and talk it over with your doctor.  Most midwives will, however, do infusions, as they prefer to wait until the body is ready and are not on a "time crunch".  It is still important to discuss this no matter who is going to attend your birth.

You have every right to demand that your baby be allowed to benefit from the infusion or that the placenta is allowed to stop pulsing on it's own before the cord is clamped and cut. 
An extra few minutes after birth is a short time to wait to ensure your baby has as much as they need to begin the first moments of their lives. 

Besides, you'll never notice the time because you'll be too busy admiring the beautiful baby in your arms.

Monday, September 13, 2010

Postpartum's not just an excuse.

If you have had a traumatic event in relation to your birth, please seek help.  There is help available and you do not have to "heal alone".  You can visit this website or this website for more information, or you can contact your midwife/OB/healthcare provider for some referrals to help you deal with the event.  Whatever you do, you do not have to do it alone.

Postpartum Post Traumatic Stress Disorder: "PPTSD is often caused by a traumatic or frightening childbirth, and symptoms may include flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event." --from

I've been finding a lot of discussions about PPD (postpartum depression) and thought that, since it's something I have personal experience in, I should write about this.

The homebirth of my 2nd child was very easy and I have no regrets about it.  I did end up having issues with delivering the placenta and the events that ensued to get that done were nothing short of extremely traumatic (both physically and emotionally).  Even though I can not remember a lot about what happened, I still "feel" it.  They occasionally come up unexpectedly every once in a while.

When I was first recovering from my labor/delivery, no one told my husband, my family, or myself that I should probably look for someone to talk to about the trauma.  I mean, I was physically ok.  I felt tired, but ok.  As the weeks went on, I couldn't snap out of my funk.  I had trouble getting out of bed, took all of my effort to get into the shower, on a good day I would brush my teeth and put some clothes on.  A lot of people wrote off the lethargy as recovering from a very difficult after birth, being a mom to two kids, on and on...but no one ever thought depression, much less PPTSD (honestly?  No one even knew about this).  Even my husband thought I was a "little depressed", but I now had a newborn and a pre-schooler to take care of and he thought that I would eventually "snap out of it".  But, the truth is that I felt numb.  I felt "dead".  I could feel feelings, but I didn't feel connected. 

The thing about PPTSD (and most other forms of PPD) is that it sneaks up on you.  You don't realize you have it.  You feel depressed, lethargic, angry, annoyed, irritated...but it is usually not so bad that you say, "Hey, that's not a normal response...I must have some PPD or PPTSD."  It gradually gets worse.  As time goes on and the memories or feelings sit inside longer, the depression, anger, irritability and fear set deeper and deeper.  You hit a "comfort zone" within the depression and then just keep going deeper.

I was pretty good at "hiding" my depression for a few months (although I didn't consider it hiding anything and thought it was more of "acting normal").  As my emotions became more and more suppressed, it became harder and harder to do.  I was angry at everyone...and no one.  I was sad about everything...and nothing.  I wanted to die, but I didn't want to leave my kids.  I remember sitting by myself, late at night, and trying to imagine how my kids would turn out if they didn't have me around anymore.  My temper was boiling over and lightening quick.  I was irritable, unpredictable...and just not myself.

I remember days where my 2nd child would be crying and I just couldn't bring myself to really comfort him.  I would hold him, but I just couldn't "connect" and soothe him.  I remember one night when my son kept waking up crying...I was so mad that he kept waking me up.  I was so mad that I left the room (he was about 7 months old at the time) shaking.  My husband got him and comforted him, not understanding why I left him alone in the room crying by himself.  I couldn't bring myself to tell him how angry I was at him, how guilty I felt for being so angry with a innocent baby.  How badly I wanted to not be a mom anymore.

There was something eating away at me, and although I could feel it--this numbing sensation, I could not stop it and could not pinpoint where it was coming from.  I couldn't explain it.  How do you explain something that you do not understand?  I could not even put the words to what I was feeling.  I wanted to feel close to my son and I wanted to cuddle him and snuggle him...but I just could not connect.  I wanted these things, but I felt too numb to feel them.

It was soon after this that my nightmares started.  They were few and far between at first (the first few months...from about the time my 2nd was 8 or 9 months old).  However, at this time, I had found out that I was pregnant with my 3rd child.  I think it just made my depression worse.  The nightmares happened every couple of weeks, and so I just wrote them off as "hormonal".  It was enough to upset me, but not enough to "scare" me.

It was hard for me to deal with the kids at that point.  I just wanted them to leave and leave me alone.  I wanted to crawl into a hole and die.  I felt this way, but I didn't know why I felt this way.  I would keep thinking the same thoughts over and over to keep myself from thinking about dying, running away, or from remembering the pain.  "Pick up DD from school" was typical for the morning so I wouldn't forget to get my daughter from her pre-school.  "Change baby's diapers, nurse him, put him down for a nap."  Thinking the same thoughts over and over were the only things to keep me moving at that point.  It was the only way to keep my mind from going over the pain of my afterbirth.  As soon as I stopped thinking inane thoughts, it would come flooding back.  And I never remembered the details...I remembered the pain, the fear, the uncertainty, the numbness, the disconnect...but never the details.

One night, I was about 8 months pregnant (my 2nd child was about 16 months old), I had the most disturbing dream where I jolted out of bed in the cold sweats.  In my dream, I had just had a baby and a few weeks afterward, I literally exploded like a bomb.  I remember standing there and I kept hearing this ticking noise.  The closer my children got to me, the louder the ticking got.  They got to me and wanted me to hug them and the ticking stopped and I exploded and the explosion killed all of my kids.  It scared me to the core of my being and it scared me enough to wake my husband up and tell him that there was something seriously wrong with me.  That something was not right.

A few days later, we came into contact with the woman who, literally, saved my life.  Her name was Ellen and she was a retiring Homeopathic Doctor.  I originally took my 2nd child to see her due to some chronic congestion and we got to talking about my depression and what had happened.  It was at that point that I realized just how bad it was getting.  I had no life, I let go of all of my friends because I just didn't have the energy to "keep up the facade", my children were never sure of which mom they would get at any given time (angry, sad, sleepy, etc).  It was no way to live.  Not for anyone.

She got me started on homeopathic remedies for helping put my hormones back into balance (stress, depression, etc. all alter hormone balances) as well as helping me clean up my diet even more.  I talked with her whenever I had questions about which homeopathic remedy was needed.  As I began to take the remedies, and I finally released some of the fear/anger/etc. that I was holding on to, it was then that I saw that there was a different way.  A different life that I was slowly shrinking from.  I had the option of going down farther into my depths of despair or breaking the comfort zone and moving upwards, again.  As much as I had problems with moving upwards, it's really where I wanted to be going. 

I also started doing EFT (emotional freedom technique).  I saw an EFT practitioner and he helped me release a lot of the fear/anger/frustration/etc. that had been building up inside for so long.  The days seemed brighter and the kids seemed more relax and I felt alive, again.  I felt like I was getting back to the person I used to be.  I still have my depressed days, but they are happening less and less.

I know that I cannot look back and wish it was different because there is nothing that I can do about it.  It happened and all I can do is make sure that I am aware of my state of mind, my state of being, and making sure that I am the best person/mother I can be.  I have to be aware that I am communicating with those around me, especially when I start to feel uncomfortable/angry/fearful/numb.  I strive to remember that I am not alone and that there are others around me who are willing to help, but I have to ask.  I do not have to sacrifice myself and it does no one any good when I do that.  I am human and not perfect and I cannot strive for perfection, but I can strive to be better tomorrow than I am today or was yesterday.

Before I went through this, I used to think that mothers who suffered PPD (includes Postpartum Depression, Postpartum Obsessive Compulsive Disorder, Postpartum Post Traumatic Stress Disorder, and Postpartum Psychosis) were just using it as an excuse (ie. Andrea Yates).  "How could you not know this?  How could those closest to the mother not see this?  She must be lying because someone who is "that bad" could not have possibly hidden it for so long..."

But, from my own experiences, the demons and the feelings are all inside.  By the time they bubble up enough for people to see anything, the PPD is much more serious than realized.  I believe I was truly lucky that I had the dream I had and that it shook me to my core; it made me really realize that whatever I was feeling/doing/ was not taking me in the direction I wanted to go.  I realized that something was very, very wrong.  I see, now, how strongly and severely it can affect someone...all while those who love them the most don't realize it...don't see it because there is, really, nothing to see.  And when the depression/psychosis hits after the arrival of a baby, most of the "symptoms" are written off as normal due to lack of sleep, etc.

I think it should be required that any close family member (hopefully as many as possible) are given a check list of what to look for in depression (and not just assume that they will "seek help if they need it").  It's that change that the loved one thinks something is wrong, but are not sure.  Those are the times when someone needs to come in and talk with the mother.  Especially for mothers who have a traumatic birth experience.  Having a traumatic birth experience does not mean the mother had a bad doctor, or the labor was horrendous--although that most certainly can be the case.  It means that, for whatever reason, the mother felt traumatized.   That trauma needs to be dealt with as soon as possible.

Taking it a step further, it's important to make sure that the mother has a constant stream of support.  A network into which she can depend on/tap into when she needs the help.  People who just are there because they want to be and can be.  It does take a village to raise a child.  But raising a child is not solely dependent upon teaching that child or nurturing that child.  It is also lending a hand to the parents of the child, nurturing and supporting the parents.

There are people out there who fulfill this role (postpartum doulas, midwives, etc.) and other individuals.  If you feel that something is wrong, it is always, always better to look into it and deal with it immediately than hope it will get better.  Baby blues (the "downs" after a baby is born due to a drastic drop in hormones, etc) is normal for the first several days after a baby is born, but if the mother is still feeling the blues more than a few weeks or so later it is strongly advised to seek professional help.  While some of the depression issues can be handled by balancing the hormonal, vitamin and mineral levels, some of the issue is probably emotional and needs to be dealt with accordingly, as well.  You do not need to take prescription drugs to deal with depression, but it does need to be dealt with.  In my case, I was able to deal with the depression by using homeopathic/naturopathic means.  I know of some others who have used prescription drugs.  It does not matter how you work through the depression, it's just important to do so.

There is a great article in the current Mothing Magazine ("Beating the Baby Blues" in the September/October issue) about Depression.  Its main focus is that breastfeeding helps mothers overcome PPD, due to the hormones released and the closeness they get with the baby, even if they are depressed.  Breastfeeding moms are more apt to hold their baby more/longer (even when not breastfeeding) than formula feeding moms (who are depressed).  I do like this article because it also lists "breastfeeding safe" medications based upon studies done by a doctor who has explicitly tested all types of drugs for this very issue (for more information, please visit Breastfeeding Online)

In our current society, most new moms are sent home from the hospital (or visited at a homebirth) after a few days...and everything "goes back to normal".  But, the new mom needs a lot of support (regardless if it's her 1st child or her 4th).  I know that was my downfall.  People had assumed that since I'd "been there, done that", I didn't need much help.  But, I had more than just newborn demands on my time, I also had a very active preschooler.

The best help for a new mom is not offer advice, do not tell her how she can do things better (unless she's asking), but just let her vent...about her birth, her breastfeeding issues, housework, husband, the baby crying/not crying/too many wet diapers/not enough...whatever.  Let her get all of that off her chest.  And then ask her what she would like to have help with and do whatever you can to help her.  I know one friend whose family members all pitched in to have the house cleaned once a week (and paid extra to make sure dishes were washed) for a full 2 months.  Each family member also brought over homemade foods that could be used that night and stored for later use (and they also helped stock the freezer with foods before she gave birth, as well).

PPD (and all of the disorders that fall beneath it) is a very serious issue.  It does need to be addressed and the best way to do that is by ensuring that the new mom has the help she needs.  We all love to dote on and cuddle the new baby and, very frequently, we forget about the mom.  Next time you visit a new mom, let her keep the baby and offer to do something for her...whether it's a load of laundry, dishes or cooking her a nutritious meal/snack.  It could even be taking the older kids (if she has any) to the park or outside for the day.  She doesn't necessarily need help taking care of the baby, but she is going to need help taking care of herself.

Postpartum Depression comes in all shapes and sizes.  If you or someone you know is concerned about PPD, please seek the help of a qualified professional.  You do not have to do this alone.

For more information about PPD, please visit this website. 

Thursday, September 9, 2010

The Shock of the Twins

So, a few months ago, my husband and I agreed that we were done having kids.  My husband was making arrangements to take one for the team and I spent my days getting rid of all our baby stuff, all the maternity clothes, everything.

Of course, within a few weeks of having given away the very last item, I started to feel pregnant.  I told my husband that we were going to have a 4th child joining us and while we were a bit shocked, we settled into the thought of a bigger family.  A couple weeks later, I started having heavy bleeding and cramping (which I never get) and so I figured that the pregnancy was just not meant to be.  I bled for 5 days--although I noticed that there were really no clots/tissue/etc.  I decided that it was probably forthcoming and I would just need to relax and "allow the process".  But, the bleeding stopped...and my belly grew.  At this point, I was concerned that there may be something wrong, so I booked an appointment with my OB and went in almost a week later (knowing that if any other changes were to happen--severe cramping, fever, etc. it was ER time).

I had a blood test done and the doctor said, "Are you sure you had a miscarriage?  Your HcG levels are still really high...and are you sure about your last menstrual cycle?"  I assured her that there was no way it was implantation bleeding (it was way too heavy, went on for too long and was accompanied by a lot of cramps)...and yes, my LMC was right on.

So, she sent me to the hospital to get an ultrasound.  Since I had to schedule with the hospital, it took another week to get an appointment.  By this time, it had been almost 3 weeks since my bleeding and my belly grew more and I figured I had a vanishing twin.

On the morning of my appointment, I checked in and went into the Ultrasound room.  I laid down on the table, endured the freezing cold gel on my belly and looked at the screen.  I about fainted when the tech asked if I knew I was carrying twins.  TWINS?  I started crying, "But, I already have 3 am I going to deal with twins?"  She looked at me and smiled and said, "Hey, they look pretty good to me."  And then I told her about the bleeding and the cramping.  I could have sworn it was a miscarriage.  How could there still be twins?  Is it possible to have all that bleeding and cramping and not miscarry either one?  She didn't really know the answer...until....

She was measuring the twins (to tell gestational age) and came across a 3rd sac.  Yes, a 3rd.  It was misshapen and she looked at me and said, "Well, it is possible there were 3 and you actually did have a miscarriage.  This is a sac of's not as big as the other ones, but you said you had the bleeding and cramping about 3 weeks ago..."

I couldn't even say anything.  Triplets.  All 3 in their own, individual sacs.  What are the odds?  On one hand, I was sad to lose one...a miscarriage is not easy.  But, on the other hand, I was suddenly relieved I "only" had twins.  It's amazing at how a change in circumstances changes your perspective.

So, yes, now...we have 3 beautiful children (8, 3 1/2, and 2) and are having 2 more beautiful children (due in January 2011).  It'll be a full house, but at least we won't be bored--although I must admit that it took a couple months for me to not feel so overwhelmed and to start getting excited about the twins.  And, yes, my husband is seizing the moment and getting fixed soon so we won't have to have another shock like this next year.  :)

I do plan on having a homebirth for my twins.  I am not above getting a C-Section if needed, as I know twin births can have a higher incidence of something going wrong.  But, I am fully preparing for a  homebirth...I'll deal with the rest later.

Wednesday, September 1, 2010

The Down-side of Epidurals

"Epidural analgesia is one of the most striking examples of the medicalization of normal birth, transforming a physiological event into a medical procedure."
World Health Organization

*Please note that I have gathered my information from numerous sites/sources and have them all listed/linked at the end of this blog.  If you have any questions, please let me know.  Thank you.*

Epidurals became more widely used by laboring women in the 1970s. 

Nowadays, the number of women who request epidurals for their labors are compounding yearly.  In 1975, 20% of laboring women were using Epidurals.  Today, almost 80% of women rely on Epidurals for pain relief.

Let's take a look at the side effects, to the mom, from the Epidurals:
  • Hinders the body's ability to release Oxytocin.  This natural occurring hormone in the body helps the uterus contract.  Most women who get an epidural will also need the synthetic form of Oxytocin, called Pitocin.
  • Along with the hindering Oxytocin comes the risk of "preventing" the mom to bond with baby after birth.  Oxytocin is called the "Love Hormone" and in natural birth, the body is flooded with this hormone, helping the mom bond with her baby. With epidural use, this is hindered.
  • Hinders/prevents the body from releasing other hormones called catecholamines.  These hormones are normally released during times of stress (and not just in laboring women).  These hormones are what give you that "final rush" or renewed strength to push at the end of labor.  With the epidural hindering the body's release of these catecholamines, laboring women often need assistance to birth their babies (from vacuum/forceps extraction to C-Sections).
  • Postpartum Urinary/Bowel Dysfunction is when the mom loses the ability to control her bladder/bowel movements.  This can last anywhere from a few hours to a few months.
  • Uncontrolled shivering is a very common side effect (and reported to be very uncomfortable).
  • Loss of perineal sensation and sexual function.
  • Postpartum Backache which can last for months or even years.
There are other, more serious side effects (though rare) that should still be taken into consideration:
  • Epidural abscess is when a pus pocket is formed between the outer membrane of the spinal cord and the bones of the spine. 
  • Meningitis or MRSA
  • Blood clots are rare, but can pose a big problem if the clot travels (heart/lungs/brain).
  • Drop in blood pressure.  This happens with the administration of epidurals in almost half of the women who receive it.  Having the blood pressure drop can cause fetal distress due to an inadequate oxygen supply (via blood/placenta) but also can cause respiratory issues for mom and baby and sometimes even cardiac arrest.
  • Urinary Retention is an issue during labor for several reasons: having a bladder that becomes too full will hinder the dilation of the cervix and the rotation of the baby's head (in natural birth, the mom has frequent urges to empty her bladder for this reason).  A full bladder also increases the risks of mom having a bladder and/or urinary tract infection after birth.  In order to prevent the risks of an over-filled bladder, a catheter will be inserted when the epidural is administered.
  • Increase the chances that your upper body will feel itchy.  Women who have this side effect are given the option of taking another drug to combat the itchiness.
  • Nausea/Vomiting is extremely common with epidurals.  It does not, however, usually last long.  You may be given a drug to combat the nausea, but the side effect of most anti-nausea drugs is drowsiness.
  • Fever is not as common (only affects about 15% of all women who get epidurals) but the risks increase the longer the epidural is being utilized.  Epidurals hinder the body's ability to sweat (which is very common in naturally laboring moms) and sweat is the body's way of releasing excess body heat.  The danger to the excess heat is that it adds more stress to the baby.  This may cause the baby's heart rate to fluctuate and become erratic, increasing the odds that a C-Section is needed.  Most moms who get an epidural induced fever are also given antibiotics to prevent infection.  Fevers during labor may also prompt the medical team to give the baby antibiotics (and possibly a stay in the NICU).
  • Inability to effectively move around.  This is true in 100% of epidural cases and this can hinder the natural processes of labor, increasing the odds of needing birth assistance (vacuum/forceps) and/or an emergency C-Section.
  • Spinal headache is reported in about 10% of epidural uses.  Some spinal headaches can be mild and some spinal headaches can be debilitating (where you must stay laying down and prevent yourself from any sudden movements).  These spinal headaches can last a few hours, weeks, and in some rare cases, months.
  • Some studies have shown that there is an increased risk with postpartum hemorrhaging with the use of an epidural.  A British study found that epidural use almost doubled the chance of having postpartum hemorrhaging.
There are other very rare, but very serious side effects that can happen, including:
  • Allergic shock due to sensitivity to epidural medications.
  • Cardiac Arrest due to a sudden drop in blood pressure (which will also affect the baby).
  • Convulsions
  • Respiratory paralysis
  • Death
A big concern of mine was the possible side effects on a newborn baby.  While I have not been able to find many studies on the effects of an epidural on a newborn, "it has been noted that possible problems to the newborn are rapid breathing during the first few hours of life and vulnerability to low blood sugar." (Wikipedia).

Despite women being constantly reassured of the "safety" of epidurals, very few woman are given the possible side effects of epidurals.  If you read over the list and decide that the epidural is still your choice to help with birth pain, at least you are making an informed decision.  I do wonder, though, of all the women who are made aware of the possible side effects, how many would have still chosen an epidural.

There are other ways of managing labor pains.  The vast majority of labor pains can be managed through movement (walking, squatting, rocking, etc) and through guided visualizations/meditations.  When you learn to listen to your body and desired positioning, the "pain" factor diminishes immensely.  It has been proven that practiced visualizations and meditations also help to calm/quiet the mind enough to allow the laboring mom to go through the contractions without "fighting" the contraction.  The more relaxed the rest of the muscles of the body are, the more easily the uterus can contract effectively and less painfully.

There are other, drug-free, alternatives to pain management in child birth.  Did you know that dehydration and hunger increase the pain of childbirth?  This is why it is so important that laboring mothers are drinking plenty of fluids and eating when she desires.

Epidurals can be a very useful tool for emergency procedures, but there are very real risks to using an epidural.  The more you know about the possible side effects of epidurals; the more you know about alternative pain management during labor, the more informed your choice can be when it comes time to make the choice. 

Please note that I may not have included all possible risks and encourage you to do more research into the risks of an epidural.