Women in Control of Epidural During Labor Use 30% Less Anesthesia

Epidurals have become the “drug of choice” in maternity wards across the United States. As of 1997, “nearly two-thirds of all women who give birth in hospitals with high-volume obstetric units had an epidural during labor. In many hospitals, epidural analgesia is routine and is provided to more than 90 percent of all women who are in labor in that hospital.” Yet epidurals are not without potential risks for both mother and baby, which is part of the reason the findings from a new study on laboring women are so promising.

new study reports laboring women given control over their epidural anesthesia resulted in a 30 percent reduction of the amount of anesthesia used and were “basically as comfortable” as women on a continuous dose. Researchers also report a trend toward fewer deliveries that required instrument assistance, such as forceps, in the patient-controlled group.

Dr. Peter Benstein, a professor of clinical obstetrics and gynecology and women’s health at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, said:

“My personal belief is that epidurals tend to slow labor down. So, if you can get away with less medication with patient-controlled analgesia, I think it’s a wonderful thing.”

“And, it’s not a surprise to me that women used less anesthesia. If you can titrate your own medication, you’re probably not going to give yourself a lot. An anesthesiologist will tend to give you a little bit more because they want to make sure there’s no pain.”

The author of the study is Dr. Michael Haydon, a perinatologist at Long Beach Memorial Medical Center in California.

Generally, epidural anesthesia is given on a continuous basis, according to Haydon. But patient-controlled devices that can control delivery of the anesthesia are widely available, he added. Patients are given a button to push when they feel they need more medication. The devices are programmed to only provide a specific amount of medication for specific time periods to ensure that people don’t give themselves too much.

The study randomly selected first-time mothers for one of three groups: “the standard dose given as a continuous infusion; a continuous infusion with an additional patient-controlled option; and patient-controlled anesthesia only.” The first group used an average of 74.9 mg of anesthesia during labor. The second group used an average of 95.9 mg, while the patient-controlled group used the least anesthesia of all, an average of 52.8 mg, according to the study.

Women in the patient-controlled group did report slightly higher pain scores when they got to the pushing part of the delivery, but also reported being satisfied with their pain relief overall.

Women’s Views On News says:

This is good news because epidurals, despite having made labor more bearable for scores of women, have their pitfalls: they can lead to prolonged labor and an increase in vacuum and forceps deliveries. They can also result in more C-sections, which is far from ideal.

Rebecca on Babble writes:

Less meds with the same level of relief? What’s not to like here? A lower dose of medication with adequate pain management would benefit both moms and babies. I find this study so exciting because it opens up new possibilities for women as active participants, not just passive patients, in hospital births. It’s ideas like these that may help us progress toward a hospital birth model that takes into account the needs of both babies and the mothers who give birth to them.

Laura Nelson at Think Baby writes about the study’s findings and how they might impact maternity care in the United Kingdom.

Patient-controlled epidural analgesia is currently only available in one-fifth of hospitals in the UK due to the expensive costs of the equipment needed. Experts are now looking into whether the positive effects outweigh the costs.??“The technique reduces the need for anaesthetic which in turn reduces the need for forceps delivery – and it gives women a feeling of control. The question is whether the small clinical advantages are enough to justify the cost of new equipment and staff training,” Dr Elizabeth McGrady, a honorary clinical lecturer in anaesthetics at Glasgow University said to the BBC.

Personally I’m all for empowering women to be, as Rebecca said, “active participants” in hospital births. Although I did not have an epidural with either my daughter’s hospital birth or my son’s home birth, there was a point during my induced labor with my daughter that an option like this would have appealed to me (had I not had complications including low platelets that prevented me from getting an epidural anyway). I hope this study leads to hospitals adopting patient-controlled epidurals as standard practice for women who choose to have epidurals.

Related links:

  • Over at Women’s Health and Pregnancy, there’s an informative post with diagrams and pictures about how an epidural is given, as well as the pros and the cons.
  • At Anticipation and Beyond, there’s another informative post about the dangers of epidurals. The author writes, “This blog isn’t to insult those who have made this choice, but to increase your knowledge, so you can make informed choices for the future.”

Photo credit: Women Health and Pregnancy

Cross-posted at BlogHer

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Growing meat in a lab to solve the global food crisis?!

Thanks to a scientist in South Carolina, we may soon have something more disturbing to worry about than the recent deregulation of genetically modified alfalfa and the genetically modified fruits and veggies that are increasingly common in the average American’s diet.

drumroll please

Meat that has been created in a laboratory!

Vladimir Mironov — a scientist working for the past 10 years on bioengineering “cultured” meat — thinks meat made in a lab could solve the future world food crisis that’s resulting from diminished land to grow meat the “old-fashioned way.”

Or. Hmmm. I have an idea that could help solve the food crisis. Let’s just stop eating so much meat! Or we could start eating bugs, which are apparently “good to eat and better for the environment.” Um, yeah. Let’s just stick to eating less meat.

Nicolas Genovese — a visiting scholar in cancer cell biology working under a People for the Ethical Treatment of Animals three-year grant to run Dr. Mironov’s meat-growing lab — said, “There’s a yuck factor when people find out meat is grown in a lab. They don’t like to associate technology with food. But there are a lot of products that we eat today that are considered natural that are produced in a similar manner.” Genovese references yogurt as well as wine and beer production.

I’m not sure how one can compare yogurt, which is bacterial fermentation of milk — not to mention something I can make in my own kitchen — with bioengineered meat currently created in a lab.

On one hand, we have milk and cultured yeast, which can easily be made into yogurt in your crock pot in your own home — something I’ve done on several occasions. On the other hand, we have meat that comes from a once living, breathing animal. Yet instead of getting it from an animal, we’re talking about creating it in a “carnery.” If Mironov gets his way, he envisions “football field-sized buildings filled with large bioreactors, or bioreactors the size of a coffee machine in grocery stores, to manufacture what he calls ‘charlem’ — ‘Charleston engineered meat.'”

How are these AT ALL the same?

There’s so much that concerns me about all of this, but especially Mironov’s statement, “Genetically modified food is already normal practice and nobody dies.”

Nobody dies. Is that all that matters — that nobody dies? And who’s to say GM food isn’t killing us slowly? How long have we been guinea pigs eating GM foods? Are there any long-term health studies? Considering it has only been available in the United States since the 1990s, I would venture to guess no, though please correct me if I’m wrong.

Linda Johnson — a naturopathic doctor in New Mexico — speaks to the possible issues of consuming GMO food. She points out:

90% of all corn planted in the U.S. is genetically modified. This corn seed is specially made by Monsanto and engineered to ward off root worm by producing its own pesticide, which you then consume.

So you say you don’t eat corn? If you eat animals that eat corn and they managed to force this food on them, you are eating GM food. Specific animal studies showed that when rats were fed this corn, they developed many reactions that included anemia, increased blood sugar levels, kidney inflammation, blood pressure issues, increased white blood cells and more.

It’s very likely these health problems are affecting humans as well. Since the FDA doesn’t think GM food need to be examined for humans to eat safely, it’s been on the market for a long time.

Johnson adds, “European countries feel there is something wrong with this manipulation of food and they don’t allow it in their countries.
… It is not known what the long-term ramifications of eating food daily that has been genetically modified. What are the damaging effects of a newborn ingesting nothing but formula made with GM ingredients? No one knows.”

So why do we allow it here in the United States?

What are your thoughts about lab meat? Would you eat it? Would you feed it to your kids? Do you think it’s the answer to the global food crisis? Are there positives to this I’m missing? Enlighten me, please.

Related articles:

Photo credit: Yo My Got

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Thank you for the past six years

Today marks the sixth anniversary (blogiversary) of my blog! Six years of writing about a myriad of topics — some controversial, some very personal, some heartbreaking, some educational, and some just plain fun.

Looking for an outlet to share my passions and ups and downs of parenthood, I started blogging when my daughter Ava was eight months old and have been writing — albeit sometimes more regularly than others — ever since.

I wanted to take this opportunity to thank all of you who’ve been a part of my blog over the years — whether you are a reader, a commenter, an advertiser, a sharer, a collaborator, or perhaps a little of each — I have been blessed to make connections with so many of you. Staying at home with my then babies and now kids can be a somewhat isolating experience, but thanks to blogging and other forms of social media, I have a community — a tribe — of which I feel fortunate to belong. We laugh together. We cry together. We share stories, empathize, debate, raise awareness and educate together. You know who you are and I love you all.

For old time’s sake, I thought I’d highlight just a few of the posts that have either meant a lot to me or have received a lot of feedback over the past six years. Here they are, in no particular order.

  1. Breastfeeding until age 3, 4 or 5: More common than you think? – originally posted Jan. 2, 2009
  2. My Road to Recovery from Generalized Anxiety Disorder – originally posted June 11, 2009
  3. The Circumcision Post – originally posted Nov. 6, 2006
  4. The Updated Nestle Product Boycott List – originally posted Oct. 7, 2009
  5. Nursing a Toddler while Pregnant – originally posted Oct. 30, 2006
  6. Why Bother? (about living a green lifestyle) – originally posted April 28, 2008
  7. Toys, Tots and Toxic Paint Don’t Mix – originally posted Aug. 15, 2007
  8. Grieving the loss of my sister Carrie – originally posted Nov. 8, 2010
  9. One Year Later: Julian’s Footling Breech Home Birth Story – originally posted Nov. 28, 2007
  10. Best Granola Recipe Ever – originally posted Sept. 7, 2008

Thank you again for welcoming Crunchy Domestic Goddess into your lives. *hugs*

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