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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Preparing for a Wedding vs. Preparing to Give Birth – How Much Time Do You Invest?

I read a Tweet this week by Kristen (@OmahaBabyLady) that made me take pause. She said, “Why will people plan for a year for their wedding but 12 weeks of childbirth classes is too long? WTF?” I’d never thought of it in that way before, but it resonated with me. Many people spend a year or longer planning and preparing for their wedding, but how much time do they spend preparing for the life-changing and life-giving event of giving birth to their child?

Kristen, who is a Bradley childbirth educator and doula, was prompted to Tweet and blog about this after a potential client reacted to the news that the birth classes Kristen offered would be 12 weeks long. “Twelve weeks!,” she exclaimed. “You expect me to spend 12 weeks on something so simple as giving birth?” Kristen was at a loss for words and reflected on this for a few days before she made the analogy between preparing for a wedding and preparing for a birth. She said on her blog Baby’s Best Beginning that she planned for her wedding for more than 15 months, including visiting wedding message boards, interviewing people and spending “countless hours agonizing” over all of the details and says most of the people she knows did/do the same. “Of course at the end of the day all that really matters is that they are able to marry their partner but very few people say ‘well, the minister/priest/rabbi etc. is the expert on marriage I will just do whatever they say in regards to my wedding,’ yet when it comes to birth so many couples simply defer to whatever their doctor tells them is best even when there is no medical evidence supporting those choices.”

So is 12 weeks too long to spend preparing to give birth? Kristen obviously doesn’t believe so. She feels, “When it comes to bringing your child into the world this is truly not a case of less is more.”

Not everyone agrees though. @SybilRyan argues that the two events (wedding and birth) are “not even remotely similar” and shouldn’t be compared. Genevieve is taking Bradley classes now and thinks 12 weeks is too long, but eight weeks would be perfect. “I love my teacher, the other parents, etc., but 12 weeks is a really long commitment when you have so much else to do to prepare for your baby.” @Reecemg who blogs at Metagestation said she took an eight-week class and it was the perfect length. Others, such as Heather who blogs at Christian Stay At Home Moms thinks an intensive four to six hour one-day class would be good, as “its difficult to find time to go to a class 1x per week for 12 weeks.”

Mary, who blogs at One Perfect Mess, said on Twitter, “The length [of the class] probably depends on the quality. For us four meetings was plenty.”

Merry With Children also commented on Twitter and said, “I know there are things to learn but so much of it [birth] is going to go how its going to go. Too much info is just scary.”

Rebecca thinks people put more time preparing for their wedding than childbirth for exactly that reason — fear. She commented on Twitter, a “wedding is fun, childbirth is scary. ‘Experts’ will take care of everything when you show up at hospital.”

Andi who blogs at Confessions of a Judgmental Hippy agrees with Kristen and thinks, “if a woman can commit to 12 prenatal appointments (average) then 12 weeks (sessions) of [childbirth education] should be easy.”

Whitney blogs at The (Un)balancing Act of Motherhood took Bradley classes and thinks the length of time was “perfect,” although admits she gave birth before attending the last two classes. She added, “I can’t imagine learning about what happens in birth, what to expect, what to do, etc. in one class or even four classes. But like I said, that’s just me. Others would be fine with one or four classes.”

What do you think? Can the two events – a wedding and a birth – be compared? What is the “right” amount of time to prepare for giving birth?

I planned for more than a year for my wedding, and although I didn’t attend a 12-week Bradley Method session, I feel like I put a good deal of preparation into childbirth. I took Hypnobirthing classes before my first child was born, which were six two-hour classes if I remember correctly. I also read a lot and practiced the Hypnobirthing techniques.

I agree to some degree with Merry With Children in that no matter how much one prepares, birth is “going to go how its going to go.” But I also think the more you know and understand about birth, the better informed you will be to make choices along the way. Knowledge is power.

Photo credits:
Bride – http://www.flickr.com/photos/diannadesign/486944603/
Maternity – http://www.flickr.com/photos/mcgraths/3656184801/in/photostream/

Cross-posted on BlogHer

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Kourtney Kardashian: Inspiring Women with her Zen-like Childbirth?

Two weeks ago I wrote about the way childbirth is generally portrayed, even mocked, in popular culture and how that often negatively colors women’s beliefs about birth. Sunday, however, on the season finale of the E! network reality show Keeping Up With The Kardashians, surprisingly, amazingly labor and birth were shown in a largely positive light. In the episode, which had a record 4.8 million viewers, Kourtney Kardashian, 30, calmly gave birth to her first child Mason Dash Disick (born on Dec. 14, 2009).

I have to admit I don’t actually watch the Kardashians, but thanks to Jezebel, I was able to watch some clips from the episode. (Go watch. I’ll wait.) My friend Denise, who blogs at Eat Play Love, told me that she saw the whole episode and said, “I have to admit for the K-women coming off as such primadonnas the episode/birth was shown in a great way. I was shocked.”

Instead of the typical Hollywood water-breaking all over the floor in one big “sploosh!” followed by the frantic Oh-my-God-I’m-freaking-out-and-have-to-get-to-the-hospital-RIGHT-NOW, after Kourtney’s water broke and was shown(!) slowly trickling out onto the floor, she was totally calm, did some laundry, said she needed to shave, took a shower and put on make-up all before going to the hospital. A reality TV show actually showing reality? Wow!

Then there was the birth scene at the hospital, which appeared very serene. Kourtney was surrounded by her family who all looked on in awe as baby Mason was born. She appeared very calm, even zen-like. Once the baby was half way out, the doctor asked Kourtney if she wanted to grab him and she did. She reached down between her legs and pulled her baby right out of her vagina and onto her chest. It was amazingly peaceful and really quite beautiful.

Of course that had to be followed by some commentary from her sister Khloe saying, “that’s not normal.” But uh, yeah, actually it is. That’s what normal birth can look like.

Photo credit: The Unnecesarean

I can’t find any information about whether Kourtney received an epidural or gave birth unmedicated, but she certainly looks very zen in the video. She said in this interview about labor, “It was surprisingly easy and just an incredible experience. I always thought your first is supposed to be really hard, but it was easy.”

Regardless of whether or not she had an epidural, the fact that E! showed (millions!) what a normal, peaceful birth can look like is seriously huge, especially when you consider the demographic watching this show. According to this LA Times article, “Kardashian viewers tend to be single, college-educated women with no children, white-collar jobs and annual salaries of more than $60,000.” Keeping Up With The Kardashians “is the highest-rated series on cable among women ages 18 to 34.”

The Unnecesarean had this to say:

Kourtney Kardashian and E! showing a generation of young women someone reaching down and pulling their baby out of their vagina was one of the coolest things I’ve seen in a long time. Cedars Sinai in Los Angeles has gained a reputation as the celebrity c-section center, but there’s some mother-friendly stuff going on in the clips on Jezebel.

I didn’t watch the whole episode, but I smiled at the clip of her water breaking. When do you ever see that televised beyond the ridiculous images of actors having a gallon of water dumped between their legs, then instantly doubling over with contractions and being rushed down the hall to L&D on a gurney?

Momotics said Kourtney Kardashian renewed her “faith in birth.”

I was SO impressed to see Kourtney so calm, and cool while giving birth to her son Mason who was born in December. It seems like Hollywood has had a huge rash of scheduled cesareans, inductions, and over all just horribly medicalized births and this was just a huge refresh to the Hollywood natural birth stigma.

Carla Fran from Millicent and Carla Fran calls Kourtney “awesome.”

I cannot believe, I repeat, I cannot believe that the Kardashians are paving the way for positive images of childbirth. Last night’s finale showed Kourtney Kardashian going into labor, and pretty much backing up what doulas, Rikki Lake, and your friendly neighborhood midwife have been saying all along.

This finale is tremendous because of the audience the show has. If young girls see pop icons like Kourtney Kardashian having this kind of birth experience, their expectation of the event in their own lives is changed. I hope an entire generation of people saw this and thought “I didn’t know it could be like that.”

It would seem that’s exactly what some women thought. Here are a few of the comments on the Jezebel blog:

  • Kali Mama: “While am all for freedom of choice and choosing your own birth plan, big props for girlfriend not being too posh to push. No elective c-sections or nothing.”
  • Doyouloveit: “For years I’ve been chanting that I will get a C-section if I ever procreate, ‘Knock me completely out! I want to wake up like it’s Christmas morning with a baby under the tree!’
    But wow! Kourtney was really inspiring! Why can’t it always be shown this beautifully? Great documentary film making, Keeping Up With The Kardashians!”
  • Lilspitfire: “I am not a big fan of reality TV but the way they showed childbirth in this episode was nothing but positive.”
  • La Madrugada: “Okay, as someone who’s going to give birth to her first kid in a month and a half, I have to say, this is AWESOME. I’m not a huge fan of this show, but seeing a woman laughing and relaxed while in labor is extremely cool.”
  • Gra: “I have never given birth and therefore had NO IDEA that this was even possible. Its weird to realize that everything I know about labor and birth is based on what I’ve seen in the movies.”
  • Hotpants McGee: “It’s so crazy to say this, but I think I learned something from a Kardashian! Kourt was AMAZING. I had no idea you could just pull it out! I still can’t believe it. She could have just stayed home and done it all by herself!”

Yep, the Kardashians are changing the way women view birth – for the better. Who woulda thunk it?

Cross-posed on BlogHer

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For Better or For Worse? Childbirth in Popular Culture

After watching the live cesarean birth on the TODAY show last week and then the commercial for Jennifer Lopez’s new movie The Back-Up Plan during the Superbowl*, I’ve been thinking a lot about the way childbirth is portrayed in popular culture – on TV and in the movies – and how that influences us. In a perfect world I’d like to believe that women (and men) would learn about childbirth from reading books and websites and talking to their care provider (doctor or midwife), to a doula, to their mother, aunts and friends, but the truth is that unless ya live under a rock, women (and men) also learn about childbirth every time they are bombarded with images on TV and in the movies that depict childbirth as something scary, painful and out of control. Whether we want to believe it or not, our perceptions of birth are bound to be influenced – for better or for worse – by what we view and hear in popular culture.

Movie: The Back-Up Plan, photo credit: Jezebel

On Rixa’s blog Stand and Deliver she lists 61 film clips she compiled for a conference presentation about depictions of childbirth in cinema. That’s just movie clips. Think about all of the episodes of A Baby Story, or ER and many other TV shows where women are giving birth. Each one further reinforces popular culture’s birthing stereotypes.

Birthing Beautiful Ideas believes:

it’s pretty foolish to dismiss the effects that popular culture has on a woman’s beliefs and decisions about pregnancy and childbirth. In fact, I would venture to say that these effects are pretty widespread. Of course, I’m not saying many of us literally turn to pop culture when we’re deciding whether or not to consent to an episiotomy or to request pain medication in labor or to choose one care provider over another. That would be stupid, right? But that doesn’t mean that what we see on television or read in a (non-birth-related) book or watch in a movie has no effect at all on our thoughts about pregnancy and childbirth. Quite the contrary, in fact.

Because every time a woman reads that she “won’t be able to make it without an epidural”…

…every time she sees natural childbirth portrayed as something only for hippies and freaks…

…every time she sees a movie in which birth is a crisis or a catastrophe or a comedy of errors in which the mom is a crazed, expletive-hurling woman who is seriously out of control…

…those images and words start to affect the way she thinks about birth in general, and they may even have an effect on her specific beliefs about birth.

She goes on to give a real-life example (a positive example) of how a TV show changed her beliefs about birth. She describes an episode of Sex and the City where Miranda gives birth. Miranda asks Carrie to be there for the birth and tells her that when it’s time to push, she doesn’t want everybody getting all “cheerleader-y” on her and shouting “PUSH! PUSH! and shit like that.” She said that when she saw that scene, “it signaled a major change in the way I thought about how I was going to give birth some day.” Her birth paradigm shifted and she believes she has the ladies of Sex and the City to thank for that. She’s currently a doula and future lactation educator who’s working on a PhD in philosophy.

Not all examples of how popular culture influences women are as positive though.

Heather from A Mama’s Blog told me that watching TLC’s A Baby Story – which she described as “high drama” and ending more often than not in a c-section – “seriously warped” her view of childbirth.

The Feminist Breeder said:

When I first found myself pregnant, I was just like the vast majority of pregnant American women who never get truly informed about the birth process, and instead spend their pregnancies watching “A Baby Story” and reading Jenny McCarthy books. I got my hands on “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine, which told me that Lamaze was useless, as were all other birthing classes, and what I really needed to focus on was how quickly I could get the epidural.

Yeah — I got the epidural. The epidural that only went down half my body, that caused me uncontrollable shaking, that shut down my labor, that necessitated more pitocin, which put my baby in distress, which then necessitated a nice, traumatic cesarean surgery. Yep. That epidural.

Honey B., in her post Childbirth: Hollywood’s Take, wrote that after year of watching A Baby Story, 18 Kids and Counting, Knocked Up, Four Christmases, etc., she realized how much of what she thought she knew about childbirth was based on TV. She then shares sarcastically all that Hollywood taught her about birth. (The descriptions are longer on her blog.)

Natural Birth: The choice of masochists, women who don’t shave their armpits and have children named Moon Flower, and optimistic first-time mothers who don’t know any better. (My note: Case in point, The Back-Up Plan‘s home birth scene)

Birth with Epidural: This is the smart woman’s choice. This is what she does for the second birth, after going through the above ‘Natural Birth’.

C-Section (Emergent): These are completely normal, and happen all. the. time. And the doctor always knows best.

C-Section (Planned): This is the choice of the truly enlightened woman, the Real Housewives of Orange County type who view pregnancy as an invasion of their body. (My note: Perhaps this is why, according to the most recent data available (from 2006), the United States’ c-section rate was 31.1%, ranging from 21.5% in Utah all the way up to 37.4% in New Jersey. The World Health Organization actually recommends that the cesarean section rate should not be higher than 10% to 15%. When the rate is higher than 15% there is some research which shows it results in more harm than good. But who wants to talk about that in movies?)

Mallory who blogs at Pop Culture believes, “Childbirth in Hollywood movies is from a male perspective; rarely does childbirth show angles from the female viewpoint during the actual birthing.

We show killings, bombings, shootings, rapes and torture in movies, so why not show a woman giving birth accurately? Is it really that obscene and disgusting?”

Naomi, a birth doula, wrote her top 10 suggestions for an easier birth. Number two is “Prepare for an easier birth, now!” She cautions:

Don’t watch A Baby Story! Instead (if you are interested in watching birth videos), watch movies like The Business of Being Born, Orgasmic Birth, Pregnant in America, Water Birth, Special Women, and normal birth videos on YouTube which represent birth as it usually is. TV specials on birth are designed and promoted to offer drama and attract viewers, not to support women preparing for birth.

I also want to add What Babies Want and Birth Into Being to that list.

Teba told me that her sister was there when she had a home birth two months ago. “She said after seeing birth in movies she never imagined it could be so peaceful.”

That’s just it. Birth can be peaceful. It doesn’t have to be a hysterical emergency, but as a result of popular culture, most women are never exposed to anything that suggests a peaceful birth is even a possibility.

How has popular culture affected your beliefs and decisions surrounding childbirth?
* I didn’t actually watch the Superbowl, but have Lynn to thank for telling me about The Back-Up Plan commercial.

Cross-posted on BlogHer

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Follow-up to TODAY show guest post: childbirth resources

If you are visiting from the TODAY show blog, welcome and thank you for visiting. :) If you haven’t yet read my guest post on the TODAY show, you can read it here: Viewer: Learn more about cesarean births. I’d love it if you would like to contribute to the discussion and leave a comment over there.

Because there was only so much information I could include in my guest post, I’ve put together some additional resources here for those of you who are interested in learning more about c-sections, VBAC, giving birth vaginally to larger babies, and more. I believe in informed consent. Knowledge is power.

Information about Cesarean Sections and VBAC:

  • International Cesarean Awareness Network – “The International Cesarean Awareness Network is a non-profit advocacy and support group whose mission is to improve maternal and child health by preventing unnecessary cesareans through education, provide support for cesarean recovery, and promote vaginal birth after cesarean (VBAC).”
  • Childbirth Connection’s Cesarean Section Resources
  • The Reality of C-Sections by A Mama’s Blog – Heather writes about the many things about c-sections that she didn’t know and wished she had been told before she had her own c-section, as well as includes pictures of actual c-sections (something we didn’t get to see on the TODAY show).
  • VBAC Facts – Jennifer, teacher of The Truth about VBAC classes, deeply believes that women, after educating themselves on the risks and benefits, should be the ultimate decision makers on their medical care – not OBs or insurance companies.
  • Maternal Death Rates Rise, C-sections Now Considered a Factor – another post by Heather from A Mama’s Blog
  • The Unnecesarean – The Unnecesarean provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond.

Giving Birth Vaginally to Large (Macrosomic) Babies – Information & Birth Stories:
Although your doctor may suspect that you might have a larger baby, that does not mean you should automatically schedule an induction or a c-section. Ultrasound exams are notoriously inaccurate for predicting the weight of a baby and can be off by a pound or more in either direction. There’s no way to know how much a baby will actually weigh until it is born and weighed. If you are told you are going to have a large baby, weigh the risks and benefits of any intervention and make the choice that is right for you and your baby.

  • Big Baby Bull****
  • Baby Julian – My son (pictured above) was born at home and was a surprise footling breech. He weighed in at 9 lbs. 8 oz., and was 22 inches long.
  • Baby Lazlo – Justine gave birth to her 11 lb., 23-inch son at home
  • Baby “D-Man” – Kat’s son weighed in at 11 lbs., 3 oz.
  • Baby “Muski” – Kate’s son was a VBAC and weighed 10 lbs., 3 oz.
  • Baby Peggy – Annette‘s daughter was 9 lbs., 6 oz.
  • Baby Jaxon – Jaclyn’s son weighed 9 lbs., 4.4 oz.
  • Baby Iris – Sybil‘s daughter was 9 lbs., 14 oz.
  • Baby Mikko – Lauren’s son was 11 lbs., 13 oz.
  • Baby Emma – Jessica’s daughter was 9 lbs., 2 oz.
  • Baby “Boychick” – Arwyn‘s son was 10 lbs., 6 oz. and born at home
  • Baby Julian and Baby Emma – Annie‘s two kiddos (not twins) were 9 lbs. and 9 lbs. 8 oz.
  • Baby “Junior” – Candace’s son was 10 lbs., 4 oz. and sunny side up
  • Baby “M” – Jennifer’s son was 9 lbs., 10 oz. – a home birth after cesarean (HBAC)

Additional Childbirth Resources:

  • Business Of Being Born – A documentary that “interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system.”
  • Pushed Birth a book by Jennifer Block – “The painful truth about childbirth and modern maternity care”
  • Ina May Gaskin – Author of Ina May’s Guide to Childbirth. “Discover the proven wisdom that has guided thousands of women through childbirth with more confidence, less pain, and little or no medical intervention.”
  • Doulas of North America – A doula is “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.”
  • Considering an induction? Use the Bishop’s Score for Labor Success – “This tool measures certain components with regard to the mother’s cervix and baby’s position to evaluate her readiness for an induction and ultimately increase the chance of having a vaginal birth. This scoring system can also be used to determine the likelihood of spontaneous labor.”
  • Post-Partum Crotch Care 101 – A humorous, but very practical list. This is one of those things that nobody ever talks about, but is good information to have.

Are there any childbirth resources YOU think should be on this list? Leave a comment and let me know. Thank you. :)

Disclaimer: The information included on this blog is not medical advice and should be used for educational purposes only. It should not be used as a substitute for the advice of a medical professional (doctor or midwife).

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Is there more to the Christmas “miracle” mom & baby “mystery?”

In what’s being called a Christmas “miracle,” a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then “inexplicably, astonishingly” both suddenly came back to life. At least, that is the picture that was first painted by ABC News.

Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. “‘Half of my family was lying there right in front of me — there’s no other way to say it — dead,’ Mike Hermanstorfer told ABC News’ Colorado affiliate KRDO. ‘I lost all feeling. Once her heartbeat stopped, I felt like mine did too.'”

First I must say that I’m so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can’t imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one’s heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother’s cardiac arrest or the recovery. “We did a thorough evaluation and can’t find anything that explains why this happened,” she said. In the video linked above Diane Sawyer says, “To Tracy’s doctors, the events are still a complete mystery.” A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the “mystery” may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest – the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were “a lot harder” than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy’s hand was cold, her fingertips were blue and a nurse noticed the color in Tracy’s face was completely gone.

Henci Goer, “an acknowledged expert on evidence-based maternity care” and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping the heart. High blockade happens rarely… It does happen, though, and I am willing to bet that high blockade and its sequelae happened to Tracy.

The moral of the print version would be: have your baby in a hospital where you can be saved should this happen to you. The video interview, however, reveals a different picture. The real moral of the tale is that the safest and healthiest births will be achieved by avoiding medical intervention whenever possible.

Danielle from Momotics asks, “Why was there a need for pitocin? Because no one wants to be sitting around waiting to deliver a baby on Christmas eve?” She also wants to know why the possible correlation between the epidural and the cardiac arrest isn’t being talked about in the media. “Why is the mainstream media not reporting these things? Mass hysteria? Loss of money for the pharmaceutical companies that make pitocin and these anesthesia drugs?”

Jasmine who writes for The Examiner offered up her own take on the situation:

Knowing the side effects of both pitocin and the epidural, Hermanstorfer’s history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing “miracles” and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

Nicole from It’s Your Birth Right speculates a few possibilities of what may have gone wrong. She admits that there is no way for her to say for sure what happened in Tracy’s case, but she wants people to know that having an epidural does carry risks.:

I just want it to be clear that Epidurals can indeed cause cardiac problems and can also stop a woman’s breathing immediately after administration. Does it always happen? NO. Does it usually happen? NO. Can it happen? YES. And did the media completely ignore the possibility of the epidural having anything to do with the cardiac arrest? YES.

Nicole adds:

Often when I tell people I don’t want an epidural they don’t understand why. THIS is why. The risks in my humble opinion are high for a procedure that is considered elective.

Often when I tell people epidurals carry risks that are not discussed with women resulting in misinformed consent for a procedure they know little about, I am considered an extremist. PLEASE if you want an epidural, that’s your choice but get INFORMED!!!

Here are the reported side effects of epidurals on both mother and baby.

Conspiracy theories aside, I think one of the reasons the possible cause of Tracy’s cardiac arrest wasn’t reported by the media is because it diminishes the feel-good Christmas miracle aspect of it. I think the media sensationalized the story to draw as much attention to it as possible. They succeeded.

The truth is we may never know what caused Tracy Hermanstorfer’s heart to stop beating, but it seems likely that the sequence of events – pitocin, epidural, lying on her back (which can cause “problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava).”) may have had something to do with it. While this story had a very happy ending, most like it do not. What can we learn from this? Educate yourself, learn about the risks of common interventions, and hire a doula.

Once again, I wish Tracy and Mike Hermanstorfer and their family all the best. :)

Cross-posted on BlogHer