Controversial question of the week.

Why is it that the same mamas who criticize me for drinking coffee (amongst other things) while pregnant are the first to ask for the epidural? Has the epi become so common that people forget that there are risks involved? (Edited to add: As pregnant women, we all make decisions concerning our actions based on a perceived risk/benefit ratio. My beef is not with other mamas' decisions so much as what I've recently discovered- apparently it's socially acceptable to comment on a mama's choices while pregnant regarding nutrition, exercise, caffeine, etc., but heaven forbid someone mention the risks involved with an epidural. It's a hot-button issue, and I personally feel that many women who themselves have epidurals either haven't been sufficiently informed of the risk, or it is downplayed by their physicians.)

Discuss.

Update: This info is from Marsden Wagner, MD. (If you don't know, he is a perinatologist and perinatal epidemiologist, and served as the director of Women and Children's Health at the World Health Organization). The article was originally published in Midwifery Today, and the whole piece can be found here.

"Twenty-three percent, or nearly one in four women, given an epidural block will develop a complication. One undesirable complication is death—epidural block for relief of normal labor pain results in a three times higher mortality rate for the woman than labor without epidural block. One out of every 500 epidural blocks results in temporary neurological problems, such as paralysis in the woman; and in one out of every half-million epidural blocks, this neurological damage to the woman is permanent.

These extremely serious risks of epidural block are not so common, but several less serious, but still significant, risks are much more common. Fifteen percent to 20 percent of all women given epidural block develop fever that results in the undesirable necessity of administering diagnostic tests and antibiotic treatment to the baby. Fifteen percent to thirty-five percent of all women given epidural block cannot urinate and must have a tube inserted into their bladder. Thirty percent to 40 percent of all women given epidural block have severe backache for hours or days after birth, and 20 percent still have severe backache one year later. So they have traded pain relief during a few hours of labor for severe back pain for a year or more! Because labor pain is an essential component of the normal mechanisms of the body for the progress of labor and since the epidural block eliminates this necessary pain, epidurals also eliminate the normal mechanisms for the progress of labor. So it is to be expected that considerable research documents a longer labor if the woman is given epidural block. As normal labor is no longer possible with epidural block, there is four times greater use of forceps or vacuum extraction and at least twice as much cesarean section after epidural block. These surgical interventions, of course, carry their own risks both for woman and baby. So the woman choosing epidural block trades less labor pain for a longer labor and, if a cesarean section is done, more pain for several days after the birth, as well as increased risks for both herself and her baby.

Thus, epidural block presents many serious risks for the woman. Are there risks for her baby? Since it is unlikely any woman would choose a form of pain relief that puts her baby at risk, women are not told that in 8 percent to 12 percent of labors in which the woman is given epidural block, severe fetal hypoxia (lack of oxygen to the unborn baby) is shown on the electronic fetal monitor. The American College of Obstetricians and Gynecologists, after acknowledging the frequency at which birthing babies suffer hypoxia after the woman is given an epidural block, recommends that all women given epidural block have continuous electronic fetal monitoring so that fetal hypoxia can be identified."