Birthing class today...not one person going drug free — The Bump
January 2012 Moms

Birthing class today...not one person going drug free

When we went around the room with our introductions every single person said they are getting an epidural.  I was surprised not one person said drug free natural.  I said I am on the fence.  I went natural with my first, but I have more medical phobias than I used to and I am open to an epidural, but still considering no epidural...mostly because I am terrified of the shot in the spine.

They also told us that the C-section rate is over 90% in Brazil.  I came home and googled because I wasn't sure I believed it.  It said that in private hospitals, the rate is 93%, but in public hospitals it is more like 35-40%.  Crazy!

They told us the c-section rate is almost 50% in NYC and lowest in the midwest.  She called it the "too posh to push" syndrome.  I wonder what the C-section rate is in Beverly Hills.  My best friend lives there and every single mom she knows had an elective c-section.

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Re: Birthing class today...not one person going drug free

  • I'm going to a pretty posh area hospital and the Csection rate is 32%! That's what they told us at the tour!

    But man 90%+? Geez!

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  • How many people were in your class? They didn't ask us that in my class but it would have been interesting to see what people said. I'm planning on going natural but I'm keeping my options open.

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  • Most in our class were on the fence about it, I think maybe one girl was going to go natural. Then they showed us these real life videos of babies who were born naturally being able to crawl up to the breast and latch on and ones where the mother was medicated and they had a hard time and seemed kind of out of it.  Not going to take that video to heart because the hospital really promotes going all natural which is probably better for baby, but when it comes down to it, if I ask for drugs, they better damn well give them to me, or else ;)  C-section rate here is about 25%.  PS I love the "too posh to push", that's hilarious!!

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  • Our class was the same-- 4/4 couples planning on epidural.  I think most people are less comfortable with the IV meds though, since they get to the baby through the bloodstream.  Our teacher was an all natural lady, so it made for an interesting dynamic.

    Csection rate at my big, but not really posh, hospital in Boston is 33%.  I really can't imagine wanting an elective csection after seeing how uncomfortable it can be...not that vaginal is alway better though, I guess! 

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  • "Too posh to push" is kinda funny. I know around here a lot of women "say" they are having their doctor pull the skin a little tighter when they get stitched back up after a c-section. A little two-for-one procedure, a baby and a tummy tuck! Don't know how true it is, but I have heard it quite a bit. 
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  • lol tummy tuck with the c-section. That doesn't surprise me these days. We took a bradley class so everyone in our class was doing natural, but only us and one other lady were doing it with midwives. The other two had doctors at the hospital. I think think most of the hospitals near us in northern VA have at least 40% c-section rate, which is too high imo. Of course, I guess if you need one, better to have it done by people that do them a lot? lol My cousin had her baby the day before christmas in a hospital around here with an epidural and didn't need a c-section, so at least everyone doesn't!
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  • I thought NYC would have been higher from what I have read in the past.  To each their own, but I cannot see myself choosing major surgery unless it was absolutely necessary for my baby's health or mine. 

    There is a doctor at my hospital that has an 80% c-section rate.  That's a doctor that likes to do surgeries, as OBs are trained surgeons. He is not in the on-call rotation with us,thank goodness.

    And, I plan on getting an epi again this time, even though I know it will mean getting it touched up again several times due to me metabolizing it quickly.  I had a large baby last time and know this one will be too, so any help I can have in being a little bit more comfortable I will take.  

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  • The demographics in your class might have been influenced by women who are planning a natural birth taking different classes.  I did a hyponobirth course that covered all the other hospital procedures, so a general birth class would have been redundant.
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  • I was actually all about the epidural until I got more information on it and saw the video of it being done at the birthing class. Now, I'm not so sure about it.  I almost had a panic attack watching it... (yes, I know, I guess I'm more of a wuss than I thought I was). I don't know about all natural...but I'm more open to the idea of less medication now. 
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  • image tkmiraglia:
    I was actually all about the epidural until I got more information on it and saw the video of it being done at the birthing class. Now, I'm not so sure about it.  I almost had a panic attack watching it... (yes, I know, I guess I'm more of a wuss than I thought I was). I don't know about all natural...but I'm more open to the idea of less medication now. 

    Mine was not bad at all.  The only thing you feel is a bee sting like pinch for the numbing shot.

    I feel like epidurals get a bad rep. I mean, I don't think people have to get them, but it is something that in no way goes into your blood stream, thus not getting to the baby.

    What are your fears or concerns? 

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  • I looked up the c-section rate info after watching the Business of Being Born, and found this awesome website for CA: http://projects.californiawatch.org/c-sections

    It's absolutely ridiculous to think that a hospital would have a 47% c-section rate (!), but nice to see that most hospitals have much lower rates.  I'm with Kaiser (the big HMO in CA), and went to their intro birthing class yesterday.  The instructor indicated that Kaiser has made a commitment to lowering interventions during birth, and is now encouraging med-free births (although 90% of patients still opt for an epidural).  Our class reflected this bias, with about 30 min spent on pain meds and 3 hours spent on relaxation/positioning information.

    While I'm still very open to an epidural, I definitely feel better about waiting as long as possible to get one, which our instructor encouraged (and also indicated that the "too late for the meds" issue is a myth - apparently you can ask for and get an epidural at any time, although by the time your 9 cms you'll probably have the baby before the anesthesiologist shows up).

    It seems like it's a very interesting time for birthing in America - people are really changing their expectations for birth! 

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  • I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

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  • image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This isn't meant to be snarky, but I would like to know where you're getting this information.

    My hospital, my doctor, and the L&D nurse in my family all say that the idea of epidurals slowing down labor is a widely perpetuated myth. In fact, they say many women make more progress after the epidural because they are able to relax and let their bodies do what needs to be done.  

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  • image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This is not always true.  I have seen plenty of women who are having a med-free birth and their labor stalls.  I was on Pit and had an epi and my baby was never in distress (except when I pushing for a little but it was nothing).  My labor stalled at around 7 cm.  One doctor mentioned possibly needing a c-section, then the next doctor (when on-call) said, "your baby is doing great, let's see what your body can do" and within two hours I was ready to push.

    You just don't know, anything can happen in labor and delivery. Is this your first baby? 

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  • image SmittyPants:
    image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This isn't meant to be snarky, but I would like to know where you're getting this information.

    My hospital, my doctor, and the L&D nurse in my family all say that the idea of epidurals slowing down labor is a widely perpetuated myth. In fact, they say many women make more progress after the epidural because they are able to relax and let their bodies do what needs to be done.  

    When I became pregnant I did quite a bit of research on the state of maternity care in the US trying to figure out the best way to get this baby out.  The correlation between epidurals and slow labor and increased interventions is well documented.  Here is one of many examples:

    http://summaries.cochrane.org/CD000331/epidurals-for-pain-relief-in-labour

    "The review identified 38 randomised controlled studies involving 9658 women. All but five studies compared epidural analgesia with opiates. Epidurals relieved labour pain better than other types of pain medication but led to more use of instruments to assist with the birth. Caesarean delivery rates did not differ overall and nor were there effects of the epidural on the baby soon after birth; fewer babies needed a drug (naloxone) to counter opiate use by the mother for pain relief. The risk of caesarean section for fetal distress was increased. Women who used epidurals were more likely to have a longer delivery (second stage of labour), needed their labour contractions stimulated with oxytocin, experienced very low blood pressure, were unable to move for a period of time after the birth (motor blockage), had problems passing urine (fluid retention) and suffered fever. Long-term backache was no different. Further research on reducing the adverse outcomes with epidurals would be helpful. "

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  • image Huahine:
    The demographics in your class might have been influenced by women who are planning a natural birth taking different classes.  I did a hyponobirth course that covered all the other hospital procedures, so a general birth class would have been redundant.

    Yes, that makes a lot of sense.  I am sure the natural birth mothers chose a specialized class.  To the poster who asked...there were 11 couples in my class.  Although 3 of them didn't even bother to come back after lunch.

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  • image Cleo29:
    image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This is not always true.  I have seen plenty of women who are having a med-free birth and their labor stalls.  I was on Pit and had an epi and my baby was never in distress (except when I pushing for a little but it was nothing).  My labor stalled at around 7 cm.  One doctor mentioned possibly needing a c-section, then the next doctor (when on-call) said, "your baby is doing great, let's see what your body can do" and within two hours I was ready to push.

    You just don't know, anything can happen in labor and delivery. Is this your first baby? 


    A "stall" in labor occurs in about 30% of women and is often referred to as the natural alignment plateau.  There may be no measurable progress being made (no dialation, effacement or change in station) however, progress is actually occuring.  The baby may be slowly positioning into a better positon for travel through the birth canal, the head may be molding and becomming more cone shaped for birth or the body may stop labor for a short time so the mother can rest if she's overly tired.  Given time most labors will start up again naturally after a short while.
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  • I read this article while debating which hospital I wanted to deliver at.  It's pretty interesting.

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  • image SmittyPants:
    image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This isn't meant to be snarky, but I would like to know where you're getting this information.

    My hospital, my doctor, and the L&D nurse in my family all say that the idea of epidurals slowing down labor is a widely perpetuated myth. In fact, they say many women make more progress after the epidural because they are able to relax and let their bodies do what needs to be done.  

    I may only be one specific case, but I can say from my personal experience that pitocin (which was used to induce me due to PIH) never caused any distress whatsoever in DS and my epidural actually allowed me to dilate much faster because I was able to relax.  I actually went from a not quite 8cm to fully dilated during a 90 min nap.   It'd taken me 8 hours to get from 2cm to that almost 8cm without pain meds. 


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  • This doesn't surprise me, sadly. I think it's engrained in so many of our minds that it's going to be too painful to handle without drugs. I know everyone I've told (except for some of my family) has thought I'm a little crazy for not demanding drugs immediately. 

    I'd love to go drug free, but won't kill myself to do so. If I can't handle the pain, then so be it! 

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  • I was on the fence with my first ....I was afraid of the pain, however, I was MORE afraid of the epidural.  I wound up having an emergent section under general because of umpteen complications that prohibited any type of spinal or epidural and I completely missed out on the birth of my first child.  Some things you just can't plan.  As for "too posh to push" people are nuts for requesting a section without medical reasoning to back it in a big, big way!  It's MAJOR surgery and the chances of complications are higher with a major surgery than with a natural birth.  That said, I'm having a repeat C!  Lol.  But, granted, I had a 7% chance of living when I delivered my first and don't want to wind up going down that road again - better safe than sorry and the idea of a VBAC after all I've been through gives me so much anxiety I wouldn't even be able to breathe, let alone push!  I sound like a giant hypocrite!  :-P
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  • image nothingbuthappy:
    I was on the fence with my first ....I was afraid of the pain, however, I was MORE afraid of the epidural.  I wound up having an emergent section under general because of umpteen complications that prohibited any type of spinal or epidural and I completely missed out on the birth of my first child.  Some things you just can't plan.  As for "too posh to push" people are nuts for requesting a section without medical reasoning to back it in a big, big way!  It's MAJOR surgery and the chances of complications are higher with a major surgery than with a natural birth.  That said, I'm having a repeat C!  Lol.  But, granted, I had a 7% chance of living when I delivered my first and don't want to wind up going down that road again - better safe than sorry and the idea of a VBAC after all I've been through gives me so much anxiety I wouldn't even be able to breathe, let alone push!  I sound like a giant hypocrite!  :-P

    You don't sound like a hypocrite at all!  The cesarean is a wonderful tool for doctors to be able to use when necessary.  And it seems to me that in your situation it is.  When women in labor are stressed out, the sphincter reflex kicks in and everything tightens up, making it really hard to get a baby out.  Based on your horrific past experience, and the fear and anxiety it is causing for you this time around, the RCS seems (at least to me) like it probably is the best way for you to deliver this little one. 

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  • We went to birth classes that focused on natural birth so everyone planned to get a natural birth at that obviously.  I think in our area the c-section rate is about 30-40% depending on the hospital, but some are better than others.  My midwifery practice the c-section rate is only 9%.


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  • There's definitely a bit of selection bias based on what kind of class you go to.  Since the class we chose (a Lamaze oriented one) was held at a birthing center, I was the one in the minority in that I am not dead set against and epidural.  The other women were actually giving birth at the center and therefore doing midwife/tub births.  I want to go without, and I want to labor at home as long as possible to set myself up for success but if it gets overwhelming I don't feel bad about taking meds.
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  • image Huahine:
    image SmittyPants:
    image Huahine:

    I would absolutely prefer not to have to be in pain during labor.  But my issue with the epidural is that it slows down labor.  And since most hospitals have you on a clock once you are admitted and especially if your water has broken, they will then use pitocin to speed labor back up again.  And pitocin can cause fetal distress.  And once the staff sees the baby's distressed heartrate on the monitor, suddenly you find yourself being wheeled into an operating room.

    There is a reason why the cesarean rate has skyrocketed, and it is directly linked to the fact that 90% of women in America opt for an epidural.  It has far less to do with the "too posh to push" phenomenon, which is mostly just a good tagline for selling tabloids.  Most sane women wouldn't volunteer for major surgery.  But all too many women aren't aware of the potential cascade effect of their decisions regarding interventions during labor. 

    This isn't meant to be snarky, but I would like to know where you're getting this information.

    My hospital, my doctor, and the L&D nurse in my family all say that the idea of epidurals slowing down labor is a widely perpetuated myth. In fact, they say many women make more progress after the epidural because they are able to relax and let their bodies do what needs to be done.  

    When I became pregnant I did quite a bit of research on the state of maternity care in the US trying to figure out the best way to get this baby out.  The correlation between epidurals and slow labor and increased interventions is well documented.  Here is one of many examples:

    http://summaries.cochrane.org/CD000331/epidurals-for-pain-relief-in-labour

    "The review identified 38 randomised controlled studies involving 9658 women. All but five studies compared epidural analgesia with opiates. Epidurals relieved labour pain better than other types of pain medication but led to more use of instruments to assist with the birth. Caesarean delivery rates did not differ overall and nor were there effects of the epidural on the baby soon after birth; fewer babies needed a drug (naloxone) to counter opiate use by the mother for pain relief. The risk of caesarean section for fetal distress was increased. Women who used epidurals were more likely to have a longer delivery (second stage of labour), needed their labour contractions stimulated with oxytocin, experienced very low blood pressure, were unable to move for a period of time after the birth (motor blockage), had problems passing urine (fluid retention) and suffered fever. Long-term backache was no different. Further research on reducing the adverse outcomes with epidurals would be helpful. "

    Thanks for the link, however, the correlation may be documented, but correlation does not equal causation.

    The study concludes that women who use epidurals are more likely to have c-sections but the percentage isn't mentioned. Is it 90% more likely, 10% more likely? Also, this study is comparing epidurals to opiates, not epidurals to med-free births. 

    At the end of the day, everyone will believe what they want, and do what they want, which is good. Women should have as many options as possible when giving birth. However, I still question the idea that epidurals directly lead to c-sections in the majority of cases, and I think many women may fear getting one because they think it does. 

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  • Our hospital has a 28% C-section rate and our class instructor told us the national average is about 30%. She also said that a lot of blame is put on elective surgery but that in fact a lot of them are performed because many doctors won't attempt a vaginal delivery for breech babies whereas in the past they would try first and then move on to a C-section if necessary.
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