Risks and benefits of an epidural verses a natural nonmedicated childbirthWhen a

Risks and benefits of an epidural verses a natural non-medicated childbirthWhen a woman is pregnant it is very important for her to investigate what pain management she would like to use when she goes into labor; figuring out a birth plan can be useful. Even if she doesn’t follow it, knowing the risks and benefits of certain medicated and non-medicated methods beforehand with a clear mind will aid in the best judgement for her and her unborn baby. Childbirth is painful process; an epidural is a good method for pain management as it is a simple procedure to get done, the benefits outweigh the risks and there is not as much pain verses if you had a natural non-medicated childbirth. The key is to understand what an epidural is, the process and what it does. Then looking at the risks and benefits of an epidural and its effects on the pregnant woman and her baby. While there are other expectant mothers who chose non-medicated pain management throughout their labor. Psychologically it doesn’t make you less of a person if you get medication to help you with the pain; everyone has different pain tolerance levels. I have done both ways and I didn’t fell less of a woman when choosing an epidural, it was best for my situation, less stress on my unborn baby as well as for my mind, body and soul; therefore, I could enjoy the miracle of life. An epidural: what it is, the process and functionMany women are unsure what an epidural does, as there is a lack of understanding with provisional of antenatal education, women tend to be misinformed; having healthcare providers up to date on information is key. In addition, have the health care providers take the time to discuss the topic with only information based on facts. (See Figure 1) (Cutajar, L., & Cyna, A. M., 2018) An epidural is a slower onset of a central sensory nerve blockade not only the nerve roots in the epidural space but also blocking the nerves from transmitting pain to the sympathetic nerve fibers that travel together. (Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A, 2018) The procedure is common, the patient is sitting up hunched over in a C-shape position, then a needle goes through and punctures the dura-arachnoid membrane and enter the subarachnoid space (lower lumbar area). (Chau, A., & Tsen, L. C., 2018) A catheter is then inserted through the epidural needle to deliver local anesthetic (usually bupivacaine) and an opioid (generally fentanyl or sufentanil) medications into the epidural space to provide ongoing analgesia. (See Figure 2) (French, C. A., Cong, X., & Chung, K. S. , 2016) A misconception is that an epidural is painful to get, where in fact, sitting completely still along with the contracts are more painful than the procedure itself. Depending on the pain level, the patient can use intermittent manual top-ups by a Patient-controlled epidural analgesia machine, just by pushing a button that the nurse or doctor provides them. (Chau, A., & Tsen, L. C., 2018) Risks and Benefits of an epidural affecting mother and babyFor woman who are concerned with breastfeeding, no significant differences were found when initial timing of the lactation rate, however, the epidural group showed shorter starting time of lactation, larger milk secretion and higher prolactin levels 48 hours postpartum. (French, C. A., Cong, X., & Chung, K. S. , 2016) After giving birth the mother can often be tired, but the numbing effect of the epidural can keep pain under control and woman reported a better postpartum mental state. (French, C. A., Cong, X., & Chung, K. S. , 2016) This is because the woman can relax and get much needed rest during labor. Side effects to the mother such as a fever, shivering, a ringing of the ears, backache, soreness where the needle was inserted, nausea, or difficulty urinating are all common. Woman will require assistance when walking due to the lower half of the body may feel numb. Complication affecting the mother can consist of post-dural puncture headaches as a result of a leak of cerebrospinal fluid into the blood stream, uterine tachysystole (excessive frequent uterine contractions) due to the intrathecal opioids that were used. (Chau, A., & Tsen, L. C., 2018) Permanent nerve damage may result in the area where the catheter of the epidural was inserted. As for the fetus, complications are from the medications that can reach through the blood stream, therefore any medication used during labour can affect both in-utero and ex-utero baby. In addition, there can be a decreased placental blood flow leading to fetal bradycardia due to intrathecal opioids that were used with the epidural. (Chau, A., & Tsen, L. C., 2018) The complication rates are low, but do happen, that is why women need to have the proper and correct information prior to labour so they can make an educated decision that is correct for them. Natural Birth with non-medical interventionsThe natural beliefs imply that birth is a natural and safe process and that a woman’s body knows how to birth with minimal intervention and that pain is an intrinsic part of birth; allowing the process to happen at its own pace. (Preis, H., & Benyamini, Y., 2017) That is not the case at all, labour and delivery can be a complex process and unexpected situations can arise. Woman are often thought to be stronger if they choose a natural birth; this is built on basic beliefs about the nature of the birthing process and how closely it is linked with the woman’s belief system. (Preis, H., Gozlan, M., Dan, U., & Benyamini, Y. , 2018) Some non-medical interventions are breathing and relaxation techniques, massage, hot/cold therapy and/or a water birth. Women who chose to have a natural birth do not fear the process itself, are well educated in the birthing process and often consider birth as a non-medical procedure; it would be hard to change their opinion as it is considered to strengthen the women’s belief in themselves and the natural process of birth improving their experience. (Preis, H., Gozlan, M., Dan, U., & Benyamini, Y. , 2018) Choosing a natural birth is also highly connected with the obstetric history the woman has had and entrusting that her mid-wife knows what is best. Woman who want to have a natural birth are faced with a medical system that does not encourage it, as there are higher maternal and infant mortality and morbidity rates when choosing a natural or home birth. (Preis, H., & Benyamini, Y., 2017) In recent years many women turn to fertility treatments to become pregnant and have a greater chance at having a high-risk pregnancy making a natural birth a risky situation. With an epidural this allows the body to be in a relaxed state and the woman can enjoy the birth process.Conclusion In the end the final decision is up to the mother and what she wants to do; if there is not an emergency or harm to the unborn baby. Pain is perceived individually and can be different for each woman. For my experience with having both ways, with my first; I was terrified of the epidural as I was not well educated on what it was, no one explained the procedure to me; so, I went ‘superwoman’ and did it naturally with non-medicated methods. Then with my fifth; I went naturally as he was a stillborn baby and for personal reasons, I wanted to feel every ounce of pain. For my second to fourth, then sixth to eighth pregnancy the epidural was always the way to go. As even though I do have a high pain tolerance I just wanted to enjoy the birthing process; where I was lacking sleep already and giving birth is an exhausting procedure, I wanted and needed the rest. I was not well equipped with the necessary information and wasn’t sure on the exact procedure; having the necessary information would have been great giving me a good mind set and peace of mind. Knowing the risks and complications would have been good to know what risks I was potentially taking; as it can be very serious, you could be paralyzed if the anesthesiologist did something wrong. In the end, woman must understand their basic beliefs and psychological factors pertaining to childbirth; as people presume the epidural disempowers woman; however, that is not the case, it empowers them, to take hold, make a choice and experience birth with minimal amount of pain while enjoying the labour process.

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