I have talked to a lot of different women who say they loved their epidural, but I am wondering if there is any possibility that medications used during labor may affect my baby and our early breastfeeding experiences. In addition, are there other areas regarding my labor and delivery that I should consider to create an optimum environment for successful breastfeeding?

Although there is a pitifully small number of studies considering the overall importance of such a question, there are at least a few reasonable assumptions that can be made from the studies that have been done. First, Soproski (1992) found that the epidural was related to poorer behavioral outcomes and recovery for the first month, and medicated infants showed less alertness and ability to orient during the first month. Some believe that the critical factor is the length of time the mother is medicated during labor. It is assumed that shorter durations will lead to fewer problems. Nissen (1995) concluded that moms who have labor medications should have a minimum of two hours of skin to skin contact with the baby after birth to increase the probability of early breastfeeding success. Righard and Frantz (1990) observed that drugs used during labor do impact breastfeeding, and that moms who are not separated from their babies after birth have significantly better success with the initiation of breastfeeding. When I was a young girl, my mom taught me a valuable expression that I think is apropos to this discussion, "When in doubt, DON'T!" Unless you are in a serious, life-threatening situation, seek to guard your baby from unnecessary labor medications.

There is a critical link between the support a woman receives during labor and her felt need for drugs during labor. In the book, Mothering the Mother, Klaus, Kinnell and Klaus show the difference doulas (labor attendant, typically experienced in giving birth herself, with some type of specific training in offering support for prepared, natural childbirth) make in labor and delivery by showing the large decrease in choices made for labor medications when women have a doula attending the birth. Interestingly, there is also a significant drop in the percentage of c-sections with women who are attended by doulas at birth. Hofmyer (1991) also concluded that women with good labor support are more likely to do long-term extended breastfeeding. Sosa (1980) showed a direct relationship between the stroking, smiling, and talking a woman received during labor to how she interacted with her baby after birth.

My first birth in 1987 was pitocin induced (which, of course, produces contractions stronger and more intense with fewer natural breaks than does normal labor). I was made to stay in bed, my baby's head was invaded by a scalp lead to monitor him, my water was artificially ruptured, I was put into the traditional lithotomy position (on back legs raised) during pushing, and was administered several doses of Nubain and Stadol. The results were that the drugs took the edge off the leading wave of the contractions so I didn't really get time to get on top of them, I was very stressed during labor, did not receive good support, I had a fourth degree laceration with rectal repair, and in addition, my baby was taken away from me for all the necessary (at that time) testing before I really got a chance to even hold him. My first experience was typical of the barbaric treatment women received in labor during that time. To compare that experience to my second and third births (both doula attended, both doctors supported natural birth choices) is so outlandish as to seem unreal. The difference informed, prepared, natural choices make in labor can not be stressed enough. In this day and age, women are smarter, more demanding consumers when it comes to birth plans and choices. It is your responsibility to educate yourself in order to protect your right to have a good birth experience that is also safe. The interventions that most increase the possibility of breastfeeding success are: immediate suckling after birth, rooming in with no supplements, and continuity of care (investigate the protocols where you intend to give birth!--hospitals play an important role along with your doctor).

I would highly recommend two books for preparation for birth during your pregnancy. The first is The Birth Book, by Sears and Sears. This book has long been a book I have purchased for close friends when I find out they are expecting a baby. The second is a new resource for me, but a wonderful addition to my libary, The Joy of Natural Childbirth, by Helen Wessel (preface by Lynn Johnson and Ingrid Trobisch). You can also obtain ordering information about this book by contacing Apple Tree Family Ministries. This book addresses the topic of pain in childbirth from a very different perspective than any book I have ever read, and for that reason alone, I find it an invaluable resource.

Warning: for those that are easily offended, I am getting ready to make a strong statement (primarily directed to those that would profess faith in Christ as personal Savior). So, if you are among those that cannot take a statement at face value and discard what does not apply to you, then do not read any further.

If you are still with me, how is it that in every other situation we face as Christian women we totally believe in the power of God to sustain us except this one area? I have heard many women say, they don't like pain or they don't "do" pain, but very few talk about childbirth and trusting God to enable them to do the job. The whole concept of pain in childbirth is so mishandled that many women today falsely believe based on their own (or others') bad experience that there is no way to manage labor so that pain is really nothing more than stretching, discomfort, or hard work. Yes, there are special circumstances (induced labor, for instance, is nothing like normal labor--but again, the mismanagement of labor often causes way more inductions that should be necessary), but for the most part, women who have the right kind of support and preparation would find that labor CAN BE a tremendously strengthening and spiritual experience. How is it that it is okay to plan ahead to avoid a difficult circumstance (labor) even though we know that no meds is the SAFEST way to go, all in the name of not being a martyr or "suffering" unnecessarily? The same God who can "supply all our needs," who is the God of all comfort, is our strong defense and high tower, is our buckler and strength, is the same God who can help us experience every aspect of labor and manage it without undue hardship. When my labor with my third child was not progressing (long latent phase) and my husband, doula, doctor and myself all joined hands and prayed individually for God to bring the child forth, that was an incredibly strengthening experience! There was a palpable presence in our room of the Great Physician. Nothing but feeling completely in His hands could bring about the peace that I knew. So, how about it? Are you at least willing to pray about it? Become informed and see if it makes a difference in your labor.

For more online reading about natural childbirth, check out these web sites!
The Homebirth Choice
Doula Information
Gentle Birth Resources. Be sure to check out the study referenced near the top of this web page!
Eyes-Open Childbirth: Writing a Meaningful Plan for a Gentle Birth