Epidural anesthesia
An epidural anesthesia may be presented as a substitute
for the natural opiates (endorphins) a woman is supposed to release
when giving birth. The need for epidurals is a symptom of an inappropriate
hormonal balance. It is therefore highly dependent on environmental
factors. It is related to the degree of privacy.
While the effects of an epidural on maternal
behaviour are easily demonstrated at an individual level among
non-human mammals (e.g. ewes don’t take care of their lambs
after such an intervention), it is difficult to demonstrate specific
short-term and long-term effects among humans. In our species
the effects of a disturbed hormonal balance are attenuated by
the influence of the cultural milieu. For obvious reasons randomised
controlled studies are not feasible. We have to rely on anecdotes
and observations by practitioners.
The most convincing hard data we have at our
disposal are related to foetal position during labour. A prospective
study of 1562 women has evaluated changes in foetal position during
labour by using serial ultrasound examinations. A strong association
of epidural with foetal occiput posterior position was clearly
demonstrated.(1) One of the main effects on statistics has been
an increased rate of c-sections.
Reference:
1 – Lieberman E, Davidson K, Lee-Paritz
A, Shearer E. Changes in fetal positioning during labor and their
association with epidural anesthesia. Obstet Gynecol 2005; 105:
974-82
