No Pain, No Gain? The Value of Epidurals During Childbirth

LONDON -- Just as Americans have been busy this week deconstructing Sonia Sotomayor's every word, gesture and reference to "settled law," citizens on this side of the pond have been expressing their views on a very different topic: childbirth. Earlier this week, a prominent doctor/midwife here (and not incidentally, a man) published a paper arguing that pain in childbirth is a good thing and exhorted women to have fewer epidurals during labor.
An epidural is a procedure in which painkilling drugs are passed into the small of a woman's back via a fine tube, rendering the lower part of her body numb. The doctor, Denis Walsh, said that the jump in epidurals -- which rose from 17 percent in 1989-90 to 33 percent in 2007-08 in the U.K. -- carries with it assorted medical risks, including prolonged first and second stages of labor, a heightened chance of the baby's head being in the wrong place and lower rates of breastfeeding. Instead, he advocates alternative forms of pain management for women such as yoga, hypnosis and birthing pools.

If the good doctor had confined his arguments to medical risks, I think he might have been OK (although experts in the medical establishment disagree over the extent to which epidurals are overdone in the U.K. The figure is more like 65 percent in the United States.)

But Dr. Walsh had more to say. He referred to pain in childbirth as a "rite of passage" that "prepares you for the demands of motherhood" and "more women should be prepared to withstand the pain."

Hmmmm. Them's fightin' words . . .

"That sounds a bit Old Testament to me," responded the Times On Line's Alpha Mummy blog, noting that understaffed hospitals aren't all that well equipped to escort women through natural childbirth. Others were less restrained in their reactions. "I dare you to say that to a woman in labor!" retorted a writer at the Daily Mail, adding that she was "damn glad" Dr. Walsh wasn't at her side when she "was begging for a hammer to the head during labor."

Dr. Walsh's words brought me back to the childbirth class I took when I was pregnant with my first child some nine years ago. Our instructor -- "Marsha, Mother of Six" (as she preferred to be called) -- made it clear exactly where she fell on epidurals, episiotomies and birth plans: Bad. Bad. Good. Even though this was ostensibly just an informational seminar -- not a Lamaze class -- the message was clear: Grin and bear it. (I didn't endear myself to good ole' Marsha. When asked to draw my "ideal birth scene," I drew an epidural. But it could have been worse. The guy next to me drew himself out of the picture entirely. . . )

As this story illustrates, I'm partial to epidurals and have had two. But some of my closest friends went natural and would have it no other way.

For me, whether to have an epidural comes down to the same fundamental principle that governs whether to breastfeed or to Ferberize your child, two other hot-button parenting issues floating around out there. All of these things have been and will always be about personal choice. Not moral soundness or personal fortitude or maternal authenticity. Just personal choices based on what's right for us. Our Bodies, Ourselves, right? Or did I miss something along the way in Feminism 101?

I was, however, struck by a recent study suggesting that swearing may be a good technique for coping with intense physical pain. And I couldn't help but wonder if -- once the yoga balls and hypnosis and soothing baths had run their course -- Dr. Walsh would mind if his female patients had a few choice words for him?