I don't bring this up to say that actually Epidurals suck, just to bring attention to the fact that they can fail, and that the system has historically handled such failure really poorly, and that the system itself isn't very well aware of this issue. This isn't just opinion from some podcast, but also admitted by the professionals working within this field.
It's also something valuable to be aware of when you or your partner is planning to have an epidural, because there is real space (and even a need) for advocacy for the patient when an epidural fails and the woman giving birth is in excruciating pain.
> The result is unnecessary birth trauma.
Not trying to be snarky, but which is it? This is definitely a situation in which having a midwife there to advocate for you is an absolute plus.
The consensus seems to be shifting more towards converting to general anesthesia after epidural failure unless there are very clear reasons not to.
That sounds absolutely horrible for that little creature. Yet I am a man, so I really am not allowed to speak on the matter and I absolutely let my wife decide entirely on the matter by herself (we had absolutely no time for an epidural, my wife delivered both kids way too fast)
> Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.
In other words, the fetus makes its own oxytocin during labor. It does not come from the mother.
[1] https://link.springer.com/article/10.1186/s12884-022-05221-w
I have no clue, but that's a big relief.
Note that per Wikipedia [0], death by abdominal surgery in general in High-HDI countries is on the order of 100-1000/100k.
Seems to depend a lot on the hospital. We (partner is pregnant with a high risk pregnancy) were at a level 1 prenatal care center in Germany a few weeks ago where they very much insisted that in her and the child's condition, a c-section is pretty much her only option.
We're now in a different, also level 1, prenatal care center, also in Germany (though a different state), where the prevailing medical opinion is "natural birth should work perfectly fine for you. We're not ruling out a c-section in case things go sideways, but natural birth is very much our preferred option in your case."
The first center seems to be quite keen on using as many cases as possible for training their staff in c-sections, even where it's not strictly necessary/beneficial. At least that's what we've heard from other parents in similar situations.
The first place might have a strong surgical team and might be inclined to solve everything via surgery?
So it would be interesting to see the elective vs crash ceasarian rate.
Obviously, I'm only a spectator, but the overall experience seemed way less traumatic and stressful for her with the natural child birth, working with midwives and nurses rather than doctors.
first, childbirth is fucking dangerous. Its also unnecessarily painful. In terms of risk[1], the epidural is not the thing thats going to cause "morbidity", its the baby coming out breech or massive internal bleeding.
A non insignificant number of women literally tear themselves a new arsehole when delivering a baby. Yes elective caesarians can carry higher risks, but also might be required to actually deliver a live baby, or save the mother.
THe problem for the statisics is that there is a difference between elective caesarians and emergency once. If you group them together, then you're going to get a higher mortality/morbidity rate, because there’s a reason why it was an emergency
Personally I have no fucking clue why people wouldn't want an epidural. My wife didn't want one the second time because "she wanted to get home quicker" (by a fucking day) it turns out by her own words: "it was way way more painful without the epidural" bear in mind shes a fucking doctor, and a paediatric one at that.
[1] Women of African origin in the UK have worse outcomes in child birth, partly because of the lower uptake in pain relief.
This seems just plain wrong. It is not at all extremely biologically conserved.
Pregnancy and birth varies wildly across species. Not conserved. For primates, it's got problems; in humans, pregnancy is an absolute mess. The birth itself is historically one of the most dangerous things a woman can do, and remains not exactly a walk in the park even with the best of modern interventions.
Does the popularity of cancers as one ages mean we should just let people die because Nature Always Knows Best?
Compare this to cows or horses - where the baby is of sizeable size, but goes statistically smoothly.
Because the statistics still include all those variations. The variations are also not that huge, and are also independently studied.
You might as well ask how we can talk about the risk/safety of general anesthesia, given that different hospitals and even different anesthesiologists use different drugs.
Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause.
In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg.
Success rates of better than 70%, it's a gamble. But willing to accept that rather than end up on addictive pain pills for life.
3 to 6 months recovery period before active lifestyle again, cannot risk disturbing the "fix". Giving up flip turns in lap swimming for quite a while. Supplemental covers the other 20% that medicare won't pay.
Cash paying patients suffer $35k to $45 K for the procedure.
Medicare pony's up only about $6,500, which the surgeon must accept, no extra cash changes hands.
Supplemental covers the 20% that medicare will not pay.
disclaimer: I know nothing about this
[1] https://www.bbc.com/future/article/20260401-women-were-never...
It made it emotionally difficult to get surgery again.
