Medicated vs. unmedicated--how do you decide?

[rbp]

I realize this is a hot topic, and I apologize if this thread gets out of control. But I really don't know how I want to go about labor. FWIW, my H is an MD and is pretty strongly pro-epi, but he will support whatever I prefer. My friends who have given birth recently are kind of split on medicated vs. unmedicated, and it seems that each feels pretty strongly about how she went about it. I can see advantages to both sides and don't know how to decide my preference (obviously this could change due to circumstances of labor). It seems hard to read up on this topic because reading material on either side is awfully biased. How did you make the choice for yourself? 

[tigress]

I went into it seeing what would happen. I wasn't necessarily pro-either way. I got an epi, but didn't have a great birth experience.

So for #2 I decided to do my best to go unmedicated and see if that would help me control the labor better and have a better experience. I did. I doubt it was because it was unmedicated (more that it was the 2nd baby and she came much much faster).

I say if you're not against the epi, then that's great. Go into it seeing how it will go. Most people who go unmedicated in my experience are very against pain meds, and feel very strongly about it. To be successful with unmedicated I feel like you need to be pretty adamant against it.

[MrsDarcy]

Last time I had to be induced so I opted for the epi, as the contractions with the pitocin we coming fast and furious (actually too fast, they had to dial it back quite a bit).

This time (and last if I had had the chance) I would like to go med free. I'm also hoping that if I have to be induced they'll give me the option to just break my water and not go straight to pitocin so I can have the opportunity to labor without any pain medications.

[rbp]

May 1, 2014 7:46:37 GMT -5 tigress said:

I say if you're not against the epi, then that's great. Go into it seeing how it will go. Most people who go unmedicated in my experience are very against pain meds, and feel very strongly about it. To be successful with unmedicated I feel like you need to be pretty adamant against it.

I totally understand what you're saying, but I'm also a very stubborn person, so if I decide that one way vs. the other would be better for me, I'm going to the ends of the earth to make that happen

[mrssandro]

For some reason laboring wasn't that hard for me. DH and I did take a Bradley Method class and it help me during the whole labor process. I never got to a point where I felt like I needed the pain meds. Also when I researched it I found that getting a EPI sometimes would slow down labor and all the side effects afterward. I wanted to give without a EPI a try. I also found it interesting that the human body can do some amazing things and really it can handle a natural birth. Now the question is about preference. Lots of people go straight for the EPI and this is okay. Modern medicine is amazing and well if that is your preference then do it it. Also, if you can't physically handle the pain well of course use the pain meds.

I am all about what is the quickest and healthiest way to get the baby out. Sometimes that includes getting a EPI and sometimes that is not.

Sorry for my ramble. I will attempt a 2nd med free pregnancy but I am not opposed to a EPI if I get that point.

[jeaniebueller]

Well, with DS I showed up at the hospital fully dilated, so I didn't really have a choice  By the way, don't let them convince you that your labor pains and contractions will be consistent the entire time you are in labor and that if you aren't on the ground crying and unable to speak, that you aren't really in labor. I almost gave birth in my car because the nurse on the phone convinced me that since I was the one calling to see if I should come in and not my H, that I must not be that far along. Newp.

With DD, she was a C section, so no choice there.

In seriousness, I did want med free, just because the recovery (aka, no cathedar, not necessarily an IV, etc.) would be easier and it was just something I wanted to do. It wasn't a walk in the park, but for me, med free really wasn't that bad. That said, I went into labor on my own, didn't need pit or any other med that can make contractions feel so much worse. And I am one of those people that had an open mind as to an epi, but did have the goal of med free.

[rbp]

May 1, 2014 7:49:08 GMT -5 RexManningDay said:

Like what Tigress said - from what I've heard from my friends, if you go into it thinking "I don't know, maybe I'll get the epi if I need it ..." You're going to get it. Lol.

That's why I want to figure this out in advance! 

[theatre4life]

I am going to try and go unmedicated, because I have a huge problem with pain meds not working, or not working correctly. (In general, most uppers actually have a downer affect on me, and most downers have an upper affect.) So I tend to avoid them, especially new ones, since I have no idea how my body will react. The being said, I am not opposed to it, if it is necessary, if that makes sense.

[aqualuv]

I've honestly remained very open on this topic. What I've learned from hearing the birth stories in my prenatal yoga class we can have the delivery plans completely laid out but at the end of the day every mom wants to be healthy and have a healthy baby.

I would prefer to labor as much as I can at home but once I go to the hospital I will do whatever is safe for me and my baby. If it's a epi fine, if I can do without the epi fine, if I have to have a c-section that's fine as well.

I've also learned that some moms are forced into a c-section because their body is exhausted from laboring without meds and the baby is in distress.

I support all women no matter their choice and I feel everyone has to decide what's right for them. Having a med free birth makes a woman no more better in my eyes than a woman having a medically assisted birth.

[NandaB]

May 1, 2014 7:46:37 GMT -5 tigress said:

I went into it seeing what would happen. I wasn't necessarily pro-either way. I got an epi, but didn't have a great birth experience.

So for #2 I decided to do my best to go unmedicated and see if that would help me control the labor better and have a better experience. I did. I doubt it was because it was unmedicated (more that it was the 2nd baby and she came much much faster).

I say if you're not against the epi, then that's great. Go into it seeing how it will go. Most people who go unmedicated in my experience are very against pain meds, and feel very strongly about it. To be successful with unmedicated I feel like you need to be pretty adamant against it.

Lurking the new topics and thought I would share my opinion/thoughts. I had med free births with both of my kids. I am not a crunchy hippy, or anti-drugs for myself, however my research (which consisted of talking to people, watching pro natural birth propaganda films, and reading, so super scientific) convinced me that there are too many unnecessary c sections these days, and that one cause of an increase in c sections is that fetal distress/heartrate issues can be caused by the cycle of epi-pit...Also, once you get the epidural you are stuck in bed on your back, which can stall or slow down labor. Basically I was terrified of a c section so I did everything I could do to avoid it. (The only hospital w/in an hour of my home doesn't do vbacs, and I knew I wanted more children)

Andplusalso, I am not convinced that it is as safe as it is currently thought to be. There just hasn't been enough long term research. It could be compared to full body x-rays that pregnant women used to routinely get. At the time they thought it was perfectly safe.

This is such a personal decision, but people on both sides feel the need to justify their decision while putting down the otherside. There is middle ground between "ZOMG HOW COULD YOU DRUG YOUR FETUS???" And "well if you had a tooth pulled you would have pain meds" , you just need to find what's important to you.

*also, my doula told me something for you to think about. She said if you go into labor thinking you are going to "try" and do it med-free, or "see how you feel" then you might as well plan to just do the epi, because it will hurt. A LOT.



GOOD LUCK with whatever you decide :-)

[anna7602]

I was very in the unmedicated-all-the-way camp with my first pregnancy. I wanted to labor at home for as long as possible- be mobile, able to eat if I wanted to, able to jump in the tub (my hospital at that time only had showers, no tubs), not feel the stress of someone checking me every so often to see how dilated I was, etc. Plus, I was very afraid of the "cascade effect" of interventions. I hired a doula and went for it and it all worked out. I think I was incredibly lucky, though. I do not take much credit for having the birth I had originally envisioned/wanted.

Fast forward 6 years and I have many friends whose second births went so quickly they could barely get to the hospital (or flat out didn't make it), and my biggest priority this time is getting out of the house as soon as I start feeling contractions. So, while I have a doula lined up and would very much like to go med-free again, I mainly just don't want to have my baby in a cab or on the side of the road. I know that the longer I spend in the hospital, the more prone I may be to interventions like pitocin, etc. and I think I've come to terms with that.

I don't know if this (coming to terms) is because I already had the birth I wanted the first time or because I am older and don't place as much emphasis on idealistic visions of the "perfect" birth or what, but I am still afraid as anything of a c-section. I have no idea how I would take care of 2 kids if I were recovering from major abdominal surgery.

In any event, it's all personal.

[SJ]

I was exactly in your shoes a few weeks ago. I seriously had no idea where to begin clarifying birth preferences or drafting any sort of "birth plan" (I still don't intend to type one out)

Honestly, the hospital labor & birthing classes helped us both A TON in clarifying some of this. We went over the various options as far as pain relief and medication. The class was taught by a midwife who had four natural births herself, but I thought she did a great job at being fairly objective as we were in a hospital setting.

From what we learned there and other research we have done, I decided that I am not very comfortable with the IV drugs. They effect the baby far more than the epidural. I also learned that it is basically a myth that you can be "too late" to get the epidural (this was a fear of mine). One of my friends got hers at 10cm, my midwife recently had a patient get one at 9cm, etc. They reiterated this in the birth class as well. So that made me feel ok trying to go as long as possible without the epi, but I am also going in somewhat open to an epidural if I feel like I need one- or if it has simply been way too long and I am exhausted. I have heard from many sources that being open to one means I will probably get one- maybe so.

Anyway, some of our preferences (none of which we had clarified a few weeks ago):

-I prefer to remain pregnant as long as possible without being induced
-In early labor, hope to stay at home as long as possible
-I would prefer intermittent monitoring (this is default at our hospital anyway) so I can labor in various positions, walk around, etc.
-Mom, Dad, & Baby stay together as much as possible (this is default at our hospital anyway- all room in together)
-Mom & Baby do skin-to-skin as soon as possible (this is also default at our hospital). We would also like Dad & Baby to do skin-to-skin
-Dad will probably be the only one in delivery room, but my mom will be "on call" in case he is exhausted, overwhelmed, faints, wants help, etc. (we are still somewhat considering a doula, but probably will not go that route)
-Dad does not want to cut the cord
-Mom wants to try med-free, but is open to epidural (does not want IV drugs)
-In general, prefer less intervention over more (avoid pitocin, forceps, inductions, episiotomy, etc.)
-We hope to exclusively breastfeed so would like to avoid baby being given formula or other types of nipples (this is also standard at our hospital- they do not give formula routinely)
-Overall, we trust our practice and the medical professionals and at all times want to focus on health of mother and baby above and over any preferences we may have expressed.

We are still discussing when/how we want to notify & welcome visitors. I would really like the first hour to be just the three of us if possible, and then everyone else can come in once we're cleaned up a little bit, but I'm not sure how realistic that is.

Of course, all of this could go out the window as the baby is currently breech. If she stays that way, our practice will likely do a C-section vs. trying to turn her.

[linz]

I have always planned to do unmedicated births. I think it's fine if people want an epi. I feel like I want to feel it though and know that our body can handle this. I also don't like the idea that once I get an epi I am stuck in the bed, have a catheter, etc. I also have heard that without an epi you can usually push easier since you can feel everything (but everyone has a different birth story).

The one thing I am against is Pitocin. Unless I'm very overdue and have to do it, I don't want it at all.

Either way it is YOUR choice what you do. Just make sure your Dr is supportive on whatever choice you do. I would hate to feel pressured into doing anything if your birth plan was to be med free as much as possible.

[osulori]

Leading up to giving birth, I really wanted to go unmedicated for as long as I could just to see how long I could go but had decided that if I needed an epi so be it. Then I ended up on Pitocin due to my labor not progressing after my water broke (I went from 1cm at 3am to less than 3cm at noon) and after 5 hours on the Pitocin and not much progress to show after all that pain (maybe 1.5cm?) I said F this. I desperately needed to rest and that wasn't happening with the contractions I was having, so I got the epi. Thankfully it didn't slow down my labor-if anything, things progressed faster because I could finally relax and I went from less than 5cm when I got the epi around 6pm to 9cm shortly after midnight. And then stayed there for three hours because they stopped the pitocin and thus my contractions stopped, but that's not the epi's fault The epi ended up mostly worn off by the time AJ was born with vacuum assist, but 2.5 hours of pushing starting 8+ hours after the epi went in will do that. Either way, I guess I got the best of both worlds-I got the benefit of an epi with no side effects, and still got to feel everything (ugh) as he was coming out.

[CrazyLucky]

I don't like pain. The doctors at the practice were all pro-epdiural. It wasn't a hard decision for me. I had back labor. I was in so much pain, long before we ever went to the hospital. I didn't see any point to trying to endure that kind of pain.

With DS, I had the epidural, and ended up with an emergency C-section. The anesthesiologist told me that if I had not already had the epi, he wouldn't have had time to do a spinal, I would have been knocked out. Which I would have hated. So that made me double glad I got the epi.

[scribellesam]

If you do decide to try unmedicated, I recommend taking some type of class like Bradley Method or Hypnobabies to prepare. Of my friends who wanted to go without the epi, the only ones who have been successful are the ones who did some type of more formal preparation to handle contractions.

I went into it thinking I'd rather go without, but didn't do anything about it other than practicing deep breathing. I got to 4cm, thought "Fuck it. This shit hurts," got the epi and had a great birth experience. Of course, everyone experiences contractions differently but if you just have a vague idea of going unmedicated I think it's less likely you'll hold to that as labor progresses.

[lilles]

You might be interested in this book: Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation

[lilles]

You might be interested in this book: Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation

[thatgirl2478]

So with DD I was 10+ days overdue and getting induced. I went in with the intent to 'see how it goes'. After getting hooked up to the pit, the first few hours weren't awful. They weren't exactly FUN but they were bearable. I got to 3-4 cm and the Dr suggested that now was a good time for an epi because the anesthesiologist was available & I wouldn't have to wait too long. I'm glad I did because he also broke my waters at that point and the contractions became a LOT more difficult to handle.

Of course, after the epi I made NO more progress and ended up needing a c-section. No I don't necessarily think those two things are related, I have a feeling that I would have needed the c-section even without an epi. The nice part was that since it was already placed they just upped the meds & I was ready to go.

[obladi]

I am planning to play it by ear which I guess means I will end up with the epi based on what everyone says. I will "try" to go as long as I can but I really don't have anything against an epidural so I assume I will probably end up asking for one.

[magdala]

How do you deal with pain?

I do not deal with pain well. I have already warned DH, my OB and other professional staff that I tend to turn into a very scary raging bitch-monster when I am in pain. I scare people when I am not in pain. I also don't have a scale..pain does not range from 0 to 10. It tends to be either 0 or 10. Since I don't want to scare the professional staff from helping my baby arrive healthy and safely, I have decided to use medication that is safe for baby. I also warned my OB and professional staff that medication tends to work very well on me and to start with low dosages. Our birthing class will be in two weeks and I hope to learn more then.

Medication is a very individual decision just a pregnancy is a very individual process. Different people react differently to medication and the best advice anyone can give is to know who you are. Good luck with your decision.

[teeah22]

May 1, 2014 8:07:34 GMT -5 aqualuv said:

I've honestly remained very open on this topic. What I've learned from hearing the birth stories in my prenatal yoga class we can have the delivery plans completely laid out but at the end of the day every mom wants to be healthy and have a healthy baby.

I would prefer to labor as much as I can at home but once I go to the hospital I will do whatever is safe for me and my baby. If it's a epi fine, if I can do without the epi fine, if I have to have a c-section that's fine as well.

I've also learned that some moms are forced into a c-section because their body is exhausted from laboring without meds and the baby is in distress.

I support all women no matter their choice and I feel everyone has to decide what's right for them. Having a med free birth makes a woman no more better in my eyes than a woman having a medically assisted birth.

I had a long response typed out but then I read yours and you said it all better

I had an epi last time and it was fantastic.  I will do it again unless there's not enough time for some reason.  I really don't think this a decision that you can write in stone in advance though, shit happens during birth and I think it's easy to set yourself up for disappointment if your birth experience doesn't go the way you wanted it to.  That being said, if you want to go unmedicated then you definitely should prepare yourself for it ahead of time (just be ready to go with the flow if they need to get the baby out ASAP).

[nessness]

I am also still undecided. I think I want to go natural, but we have really big babies in my family (I was 10 lbs 8 oz), and I'm somewhat scared that I won't be able to handle the pushing part if I have a 10+ pound baby. Hopefully labor class will help me decide.

ETA: I read in my pregnancy book that most women describe unmedicated labor as an 8 or 9 on the pain scale. That was somewhat comforting to me, that even though it hurts a lot, its not, like, the most painful thing imaginable.

[anna7602]

SJ, I hope I can ask this because it's a message board and because I've been posting long enough that you should know I'm just curious, not judgy or anything. Why doesn't your DH want to cut the cord?

[SJ]

May 1, 2014 9:05:41 GMT -5 anna7602 said:

SJ, I hope I can ask this because it's a message board and because I've been posting long enough that you should know I'm just curious, not judgy or anything. Why doesn't your DH want to cut the cord?

Of course you can ask!

Honestly, I'm not sure. I asked him whether he wanted to and he said "probably not."

He is pretty squeamish about medical things and I suspect he is afraid he will find it too gross. Or that he will "mess up" or do something wrong. I don't know, but I didn't have strong opinions on that one and feel it should be his call. He does want to hold her ASAP and do skin to skin himself.

[teeah22]

Also, you are not a failure if you want/have to "give in" and get an epidural! My mom made a comment to me about not being able to handle it after I gave birth to DS1 and it really pissed me off.

[narockshard]

My biggest concern is doing whatever it takes to NOT have a c-section, unless of course it's basically life or death. I'm really taking those new ACOG guidelines to heart. There are so many reasons for me not wanting one, but a big one is that we are open to whatever number of children happen to come along, and I would rather not have issues in the future because of a c-section. Plus I don't want major surgery!

On the other hand, I am really, really afraid of the pain. I wouldn't say I'm a wimp or have an especially low pain tolerance but any sort of pain or discomfort annoys the heck out of me and I usually do whatever it takes to alleviate it instead of pushing through. I have this image that labor will be the worst pain ever, and it scares me to commit to going into pain like that without getting relief. But I also know that it's not going to kill me either, and my mom, MIL, grandmas, etc. have all done it (many) times and survived so I'm sure I could if I sucked it up lol.

Sooo, bottom line is I'm very torn. Most of the epi births that I know of have worked out perfectly fine, but the points that are brought up that more interventions can lead to a c-section does worry me. So far my plan is to go into labor naturally (no induction unless medically necessary), labor as long as I can at home or in the hospital without pain meds, then get the epi if I really can't handle the pain. And cross my fingers that I'll be able to deliver vaginally! I wish I could get some reassurance from my doctor, but I've met with a different one at every appointment and have no guarantees which one I'll get at delivery, AND each appointment has lasted about 5 minutes tops, so I haven't really gotten a feel for how each one has differed from the other aside from the fact that they have all seemed perfectly nice. Maybe I need to call the office and try to find out information about each one regarding delivery.

[melsamoony]

I have had epidurals in the past for the management of chronic pain and when I have, I always end up with a massive headache. I want to go unmedicated because the headaches associated with the epidurals given during labor can cause terrible headaches that can make caring for the baby difficult. Since I seem predisposed to this I would rather avoid an epidural.

I also do not want to have a catheter (I am fine with an IV) and I don't want Pitocin unless it is medically necessary. For these additional reasons I would rather try to labor naturally. I am very committed to breathing/other pain management techniques.

My choice is based on my personal needs/experiences and I do not project them onto others.  I support the use of any and all medical interventions that are needed to help control pain/make the birthing experience as fast/safe/healthy as possible.  Every woman is different and every labor is different and I understand my desire may not be what happens in actuality.  H is committed to helping me remain strong but if I need the epi I will get it (after he reminds me why I didn't want to lol...I made him promise to remind me but not do anything else but remind me of my initial reasons for not wanting one).

[mrspost08]

I have no issue with medicated or unmediated. My plan is to have an unmediated birth. I have been through a lot over the past 5 years. I had a miscarriage 5 years ago where I was in labor for 12 hours before I passed everything. Last year I had a major surgery. When I woke up I spent 12 hours watching the clock, asking for meds and praying the pain would go away. I was on morphine & it didn't touch the pain. I've decided I made it through both of those things I can give birth with no drugs.

[MamaMaui24]

It's one of those things where I feel like you do need to have a strong conviction. If you go in saying "whatever. We'll see how I goes." Chances are you'll get an epi.

If you're serious about going med free, I suggest hiring a doula and setting yourself up for success. I wanted no regrets or what ifs. If I ended up with an epi, I wanted to know I tried it all.

All that being said, I didn't have an epi for #1 but I'm still not sure what I want for #2.