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Why take Lamaze if I know I’m going to get drugs?

by Jen Fife-Adams, LCCE, CD(DONA)

“I plan on getting an epidural. Why should I take a Lamaze class?”

Teachers hear that question all the time.  The belief is that since the epidural will numb the mom completely she won’t need any education or helpful ideas to birth her baby.

Unfortunately, that just isn’t true.

When you take childbirth preparation classes, you learn about the labor process, comfort measures you can use until you’re ready to get an epidural and tips that will help prevent some of the side effects that can happen when moms and babies receive pain medication during labor.  On top of all that, from 12 to 20% of all women who receive epidurals only end up with a partial block of the pain , and they are the ones that will especially need some good ideas as they try to cope with the pain of labor unexpectedly.

When taking a childbirth preparation class, you and your partner will discuss what happens during labor and will get a much better picture of the hours between the start of the first labor contraction until the baby arrives.  With that greater understanding, the time often goes by a lot more quickly as you and your partner and attendants look for the signs that a different phase of labor is starting.  This knowledge also helps you and your team understand that the pain that happens during childbirth is there for a reason  and usually stems from the baby applying pressure on some delicate places as he or she works to come down and out.  The pain is normal and not usually something to worry about and can be relieved in many different ways from a warm shower to hand massage to an epidural. There are so many different methods to relieve pain, and an epidural is just one tool in the toolbox.  When you and your partner discuss these items, you’re going to get some really good ideas that might otherwise not have occurred to you if you had skipped taking a class.

Many partners and labor attendants know basic ways to help a person relax during a physical challenge, but they will help you, the mom, more successfully if you can tell them what has helped you relax in the past and what pain relief tools most interest you.  Again, a childbirth preparation class is going to give you the opportunity to think about the tools that will help you cope both emotionally and physically with your own labor.

Epidurals can be a great blessing during a painful birth, but they do come with some significant side effects and things to be aware of.  First off, the most difficult part of a labor can be when a woman is receiving an epidural; she has to remain completely still as the needle enters her back and as the catheter is threaded through the needle.  Unfortunately, three or more contractions may occur at the same time as epidural placement, and mom is going to need a REALLY GOOD method of pain relief in order to stay completely still.  Many childbirth educators are aware of how difficult a time epidural placement is and may offer some “secret weapons” that can effectively help you get through this medical procedure.  Once the epidural is placed and is turned on, you and your team will need advice on dealing with some common side effects: lower blood pressure, epidural fever, malposition of the baby and itching, just to name a few .  Again, if you’ve got a good teacher, she’s going to discuss tips for how you can counteract these effects and make your birth even better.  Also, if you end up suffering from some of these side effects, you will be faced with some medical choices.  Having that opportunity in class to talk about the interventions that can occur will make informed consent a greater reality because you will have a better understanding of the benefits and risks of whatever procedure is proposed – and if speaking up for yourself is a challenge, you may get the opportunity to practice the words needed in order to let your caregivers better understand your needs.

Finally, up to 20% of all women don’t end up with the pain relief that they were hoping for when they asked to receive an epidural.  In this unfortunate situation, the partner and labor attendants are going to need to step in and use some creative ideas to help mom get through the rest of labor.  If you go into your labor knowing that you might be one of these women who obtain only partial relief, then you may be better prepared to help yourself get through the rough times if they happen.  Using all of the comfort measures that are taught during a childbirth preparation class will not only be helpful but will most likely be necessary since you will also be missing out on the endorphins that course through an unmedicated mom during her labor and function to soften the blow of the hardest contractions.  With that in mind, every mom should take the opportunity to think about those many low tech pain relief methods like the warmed rice sock and good deep lower back counterpressure that may offer relief.

Skipping a childbirth preparation class just because you plan on getting an epidural may not be a very wise decision.  Learning about the process of birth, what happens and how the partner can be of assistance will aid in his or her understanding.  Learning techniques to provide low tech comfort can be essential, especially if you suffer from incomplete pain relief.  Getting information so you can make the best choices for yourself and can give advice on the best ways to help you through your own labor will most likely make the birth a more positive experience for you and will give you a measure of control.  Also, having the words and questions to ask if an unforeseen intervention is offered can take a great amount of stress off both you and your partner. 
Your birth day will be one of the most memorable days of your life.  Don’t cheat yourself: arm you and your partner with the information and techniques that can help transform an event that might have been scary into an event that is incredibly fulfilling.
 
 
 
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