Pregnancy

To give birth with an epidural: The advice of the midwife

The advice of Florence C., midwife.

Who do you recommend for the epidural?

To all women! More seriously, it is generally recommended to primiparous (first pregnancies) who do not know what to expect despite the abundance of information they were watered during pregnancy.
We do not live in a society where pain is common. We are very protected from illness, pain ...
When a woman arrives to give birth to her first child, it is the lottery. Some manage to manage this pain and not panic. In general, it is those whose delivery is going well and for whom one can consider not to make an epidural. On the other hand, the others (the majority ... and we do not throw the stone at them!) Are overcome by pain and panic.

The epidural allows for more serene childbirth so?

Research published in 1991 showed that pain causes anxiety, which leads to a whole list of disorders leading to fetal distress.
We must therefore seek to eliminate this pain. Other research shows that if the woman is not anxious, she secretes endorphins, natural painkillers that promote letting go, opening, and therefore childbirth.
This state of letting go allows it to adapt to the pain that becomes "acceptable".
It is certain that if a woman is in the first case, with strong secretions of stress hormones, her delivery will be laborious, she may suffer and her relationship with her baby be weakened. In this case, the epidural is recommended.

But to what extent do you influence women in their decision?

There is no real rule, we let women decide, unless of course their health or that of the baby is at stake.
Practical information is important: for a first delivery, it is common to have an episiotomy or to use instruments to help the baby out. And without epidural, it's still a bit harsh!
Finally, if the slightest complication requires emergency cesarean section, it is preferable that the mother is already under epidural, rather than falling asleep with a brutal injection of intravenous analgesics.
To test your knowledge of the epidural, take our quiz.

Sources and notes:
> The Big Book of my Pregnancy, National College of French Obstetricians Gynecologists, Eyrolles, 2015.
> Site of the National College of Gynecologists Obstetricians, 2015.

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