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Epidural

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.

 

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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