Global Midwifery


We learned about Nairobi epidurals today. We laid one of the women on the floor and taped long strings of toilet paper to her to represent all the different things the mother must negotiate during labor. The epidural is still very new and so is met with skepticism from locals. Women are afraid to use one because they do not know about the side effects. They think it may make them go blind, or worse. So women avoid them. But at only about US$25, women are starting to take notice. Almost every international resident uses one at birth.

Families share the fear of epidural, and families can be just as destructive to a mother’s trust in herself as they are in the US. So families complain the woman is weak if she uses an epidural. In some cases, the women will use an epidural but not let her family know she did.

I’m not sure how I feel about epidurals that must be planned in advance. On the one hand this means the woman must meet with the anesthesiologist before labor begins to learn about the process and consent to the procedure. She is better able to ask her questions and be properly informed before agreeing. But on the flip side, this means that a woman must choose to use an epidural before she even tries labor, and the epidural is often placed at 3 cm so the woman gets complete pain control for the entire labor. Nothing is ever easy.


Jennifer Vanderlaan (Author)


  1. renageibel

    Actually, a woman can meet in advance with anesthesiologist, but can go into labour and she decides when or if she even wants an epidural. I have had ladies that met in advanced and went their whole labours without having an epidural, others who do labour for a while and get an epidural at 5-6cm, and yes there are those that will opt for an epidural in early labour. However, the anesthesiologists do not like to administer this prior to active labour.
    And…you can receive an epidural even if you have not had a preliminary meeting. It means you may have to wait a bit longer before a dr can attend to you.
    I would also challenge the “almost every international resident uses one at birth”.

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