# Do you think women have a "right" to a painfree childbirth?



## Beppie (Oct 24, 2005)

I'd just love to hear what MDC mamas think of this.
My reaction is no, it's not a "right." but just mulling it over in my head and thought it'd be great to hear what other mamas think ...


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## MrsReady2bMama (Mar 6, 2006)

Sure, why not? It's America and it's legal and available. Pretty much to me that defines having a "right" to something... .


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## lovebug (Nov 2, 2004)

i think one has the 'right', but just because one has the 'right' does not make it right. i think so many go in blind and have no clue the risks and there ARE risks to it. i think if more people knew the true and real risks with a painfree, rushed or 'planned' birth they may think twice.


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## Beppie (Oct 24, 2005)

I agree with you that it's legal and available and women can do it if they want to, and that it should be legal, of course, etc. But in my mind that doesn't mean that it's a "right" and that's what I'm getting at here.

How do I word this better? Is it a fundamental right that women have childbirth without pain? Maybe I'm getting too philosophical here.

let's try it a different way. the natural order of things is that childbirth can be rather painful, depending on the woman. That's what I'm getting at---is it a "right" of women that this pain be taken away?

For example, women have a right to live free from domestic abuse/violence. That is a right of every human being (to be free from abuse). Do you see where I'm going with this? sorry, maybe i'm not making sense. here's another question that builds on this: do women have a right to an elective cesarean?


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## possum (Nov 23, 2004)

I believe that rights, in their truest sense, are not things that others must provide for us. They are just things we can freely chose to do or not to do - speak our minds, worship as we choose, own a gun to protect ourselves, live without fear of the government invading our homes without cause. Sometimes these rights must be protected, but never provided.

I think the concept of rights gets really sketchy when we start saying that we have a right to something that someone else has to provide us.
In some cases, such as a right to a trial by jury, I consider this a right to live without people accusing you unjustly and having to prove that you did commit a crime rather than you having to prove your innocence, IYKWIM.

So, no, I don't believe anyone has a right to a pain free birth.
I'm not even sure such a thing is a possibility for many women - even with tools ranging from epidurals to hypno techniques for labor and birth, I think at least some women would not be able to avoid all pain.
I do think that we should have a right to choose any medical care we receive from all available options that we can afford. I don't think that we as a society should feel obligated to provide all options for indigent medical care. I think perfectly adequate OB care does not include a lot of things that have come to be the norm and which most women have come to expect, but I don't think that means everyone has a right to those thing at taxpayer expense.


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## lach (Apr 17, 2009)

What about if you rephrased it as "women have a fundamental right to give birth as they see fit"?

For decades, medicated birth were the norm and it took a lot of advocacy for some women to normalize the idea of not using them. If you think that someone should have the right to chose a non-medicated birth, why shouldn't they also have the right to choose a medicated one?


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## lovebug (Nov 2, 2004)

i think i understand where you are going with this... but i want a home birth and i dont want anyone to be able to take that from me. there are rules a mile long to do a home birth. so if someone wants the right to have a pain free birth so i can have my right to a home birth, so be it...


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## witchygrrl (Aug 3, 2006)

This was an old feminist argument--that because men ddn't have to undergo such a painful experience to have a child, why should women? That led to the "twilight sleep" kinds of births, wherein teh woman would actually have a traumatic experience but because she was blacked out during it, she had no real memory. Kind of like the date rape drug, IMHO.

Because it's a normal physiologcal process, I guess it's nice to have ways to manage how it feels, though I wish most of those ways weren't so potentially dangerous. It's not like surgery, where anesthesia is a necessity, especially if the procedure's particularly invasive. I dunno...I felt that giving birth was a hugely spiritual transformative experience, and while I'm glad that laboring in water was available to me, I wouldn't have wanted any sorts of numbing agents involved because that would have altered the experience in such a way that I find undesirable.


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## Storm Bride (Mar 2, 2005)

I honestly can't even begin to figure out where I stand on this one. I, personally, wanted the right to _not_ be painfree, because I'd rather be in pain than numb. (Since I ended up with all c-sections, I obviously didn't get my wish.) I find numbness horrifying and freaky. Pain is different. I liked the pain with ds1, not because I'm even remotely masochistic, but because I could feel it prompting me to move around and shift positions and such. Numbness doesn't tell me the things I need to know. Pain-free birth is just so horrifying to me that I can't wrap my head around anyone claiming it as a right, yk?

I think women should be allowed pain management if they want it - but they should definitely be getting proper information about possible risks.


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## MegBoz (Jul 8, 2008)

Interesting Q.
Someone posted here ages ago that the paperwork at her hospital said, "You have a right to a pain-free birth."

I think what they _meant_ to write was, "You have a right to pain-relieving medication."

"Pain-free"? No. That is simply impossible! They won't admit you into the hospital as a patient in labor until you are having ctrx, so those first few ctrx may be painful. So, it's not realistic to expect to never feel any pain!

However, I DO believe women have a right to pain-relieving medication if they want it.
I also remember reading here that some hospital had a policy of no epidurals for vaginal birth. (I find it hard to believe this was in the USA, but i can't remember.) That, IMO, is wrong. It should be a service that's available if women want it. Not that all hospitals must have 24/7 anesthesia available, but just, if docs are there, it shouldn't be a hospital's call that epidurals are only for c-sections!

(I'm not addressing the issue of _who pays for the medical care!_ that is rather hairy. But I'm saying, it is within the realm of choices women should be able to make for themselves.)

Quote:


Originally Posted by *Storm Bride* 
I think women should be allowed pain management if they want it - but they should definitely be getting proper information about possible risks.

That sums up my view well. I also think they should be provided non-pharmacological pain relief _first_ as a matter of course!


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## AllieFaye (Mar 7, 2007)

Considering this is MDC, my knee-jerk reaction is "Of course, that's why my first choice is unassisted childbirth, either solo or with dh, and hypnosis." Then, it occurs to me that the rest of the world is _not_ MDC, and pain-free birth means something completely different. Let me guess the question isn't about the right to orgasmic birth?

Hmmm, I think it must be time to get back to knitting my own wool diaper covers and soaking some grains...


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## Jaesun's Dad (Feb 19, 2010)

Quote:


Originally Posted by *lach* 
What about if you rephrased it as "women have a fundamental right to give birth as they see fit"?

Exactly. We were planning a natural (ideally water) birth at a birthing center. We went to all the classes. We saw the films. Yes: even that animated wonder of a film entitled The Moose and the Epidural. We read books. We were going to have a natural birth! Yessssir ... even through those last few annoying tests she had to take to make sure the placenta position was ok and the blood sugar was in check and the infections were in check and all that ...

Then the contractions started. On a Wednesday.

Prodromal labor ... but there ain't nothing "false" about contractions every 7-15 minutes for FIVE DAYS (total sleep during this time: about none). So by Sunday we were given this choice: 1) a shot of morphine and go home, try to sleep and hope she wakes up in active labor or 2) xfer to the hospital and get an epidural

We went for option 2. While it would have been nice to have our ideal birth plan realized it just didn't happen that way for us. My partner was a real hero and got our son out still vaginally and with very little time to spare before they would have done a no-questions-asked emergency C (his vitals were dropping FAST) I am very proud of my partner and even though we didn't get the water birth we had planned, under the circumstances I think the epidural was the right decision. We have no regrets. It was a welcome and much needed relief -- for both of us -- at the time. It let the rest of the labor progress as it should have and we now have a perfectly healthy baby.


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## CherryBomb (Feb 13, 2005)

Quote:


Originally Posted by *lach* 
What about if you rephrased it as "women have a fundamental right to give birth as they see fit"?

For decades, medicated birth were the norm and it took a lot of advocacy for some women to normalize the idea of not using them. If you think that someone should have the right to chose a non-medicated birth, why shouldn't they also have the right to choose a medicated one?


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## GoBecGo (May 14, 2008)

Sure, they can have the "right" to it if it's a right they want, but they also deserve to hear accurately what responsibilities come with that "right" - obey the staff, do as you're told, accept the possibility of trauma to you and the baby and so on...


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## RedOakMomma (Sep 30, 2004)

Quote:


Originally Posted by *witchygrrl* 
This was an old feminist argument--that because men ddn't have to undergo such a painful experience to have a child, why should women? That led to the "twilight sleep" kinds of births,

This is what it reminded me of, too. Historically women were told they had to have painful births (some women were even burned at the stake for asking for pain relief during birth..it went against the word of God), and then the pendulum swung in the absolute opposite direction...complete avoidance of pain. I don't think that it's reasonable to insist or expect the majority of women to have pain-_free_ births. Birth is an intense physical experience, and that can include pain.

Personally, I'd trade some pain for being able to be physically and mentally able during and after birth.


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## KaylaBeanie (Jan 27, 2009)

Obviously women do not have the fundamental, god-given right to medication during birth, since most of the women in the world don't have the option.

In the US? Sure. I wish there was more information given about the risks, but I believe that women have the absolute right to birth however they want, everything from UC to elective C.


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## MeepyCat (Oct 11, 2006)

Quote:


Originally Posted by *GoBecGo* 
Sure, they can have the "right" to it if it's a right they want, but they also deserve to hear accurately what responsibilities come with that "right" - obey the staff, do as you're told, accept the possibility of trauma to you and the baby and so on...

I really do not think that women should be told that they have to trade obedience for pain management, and this trade has NOT been my experience. I don't think this trade should be anyone's experience.

When I was in labor with DS, the epidural allowed me to be very present and articulate while it was working, and I was able to refuse pitocin, and discuss episiotomy and surgical vs. instrumental delivery with the delivering OB. My wishes were heard and respected whenever possible. When my wishes had to be disregarded, I was told why. The doctors involved in DD's birth (which was an emergency section involving very few choices at all) also did their best to hear, understand, and accommodate me whenever possible.

I don't think that we can usefully advocate for women or for birth choice while buying into the notion that some choices demand the abandonment of all autonomy and agency, or while denigrating those women who choose anesthesia.


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## MCatLvrMom2A&X (Nov 18, 2004)

Quote:


Originally Posted by *lovebug* 
i think one has the 'right', but just because one has the 'right' does not make it right. i think so many go in blind and have no clue the risks and there ARE risks to it. i think if more people knew the true and real risks with a painfree, rushed or 'planned' birth they may think twice.


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## Arduinna (May 30, 2002)

no


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## Gena 22 (Jul 3, 2008)

Since this seems like a edgy question, I'll weigh in too.

No right to pain-free birth (is that even possible?), but yes a right to pain-relieving medication when requested. I'm of the camp that basic medical care should be a right in a civilized society, and I consider a low level of pain relief at the option of the patient to be part of basic medical care.

However, I do not think women has a "right" to the birth they want. If a woman, pregnant with one baby and without any medical indications for a surgical birth requests a c/s, I think that woman should have to pay for it, or at least pay the additional cost. If a woman wants a water birth, and there aren't facilities available, she's going to have to swing that herself.

To me, if something is a right, it has to be either free or freely available to every member of our society.

So, urgent medical care, including pain management if requested = right, care above and beyond what's medically required = something you have to make your own provisions for (ie, pay for it out of pocket).

Health insurance could be so much cheaper if we all weren't paying for epidurals and c/s that weren't requested or needed!


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## GoBecGo (May 14, 2008)

Quote:


Originally Posted by *MeepyCat* 
I really do not think that women should be told that they have to trade obedience for pain management, and this trade has NOT been my experience. I don't think this trade should be anyone's experience.

When I was in labor with DS, the epidural allowed me to be very present and articulate while it was working, and I was able to refuse pitocin, and discuss episiotomy and surgical vs. instrumental delivery with the delivering OB. My wishes were heard and respected whenever possible. When my wishes had to be disregarded, I was told why. The doctors involved in DD's birth (which was an emergency section involving very few choices at all) also did their best to hear, understand, and accommodate me whenever possible.

I don't think that we can usefully advocate for women or for birth choice while buying into the notion that some choices demand the abandonment of all autonomy and agency, or while denigrating those women who choose anesthesia.

Epidural anaesthesia increases the chance you will need an instrumental delivery and perineal trauma, so in a very very REAL sense, women are accepting responsibilities when they exercise their "right" to a pain free birth, and one of them is to accept they may not have a particularly pain free beginning as a mother.

As for autonomy - you are numb and cannot move from the sternum down. How will you move? How will you make choices if you are NOT supported by your doctors and midwives? How will you refuse the augmentation if you only find out about it after your new "saline" is put up and your contractions suddenly become very painful? How will you decline consent for the episiotomy which is done without your knowledge? How will you insist you be with your baby when you are still numb and someone who could walk has already taken it to the nursery?

I am glad that you were supported, but many many women are not, and the majority of those who weren't do not even realise the way they are being treated is unnecessarily unkind/unhelpful/dangerous.

As i write this i am watching One Born Every Minute, broadcast in the UK, channel 4, tuesdays at 9pm. I have just seen a woman screaming and screaming as she is given a vaginal examination where the midwife inserted most of her hand into the vagina to see if the very posterior cervix was dilated enough to break the waters through (it was not). The baby in this case was perfectly fine and happy and the mother was barely contracting, it was by no means an emergency. This might not have been your experience of "care" but here it is clearly so normal they feel it can be televised to the nation without anyone raising serious questions about professional sexual assault.

If we are to advocate for women we first need to accept the very serious flaws with the way those women are treated in the current system.


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## loveneverfails (Feb 20, 2009)

Women have the basic right to make the best choices for themselves among the options available. I think every woman has the right to draw a line for herself on what pain is manageable and what pain crosses the line into trauma.

Every woman has the right to draw that line for herself and to do what she deems most prudent to manage the pain. Epidurals can absolutely be the best option when your choices are trauma or surgical level anesthesia. And an individual woman's life circumstances may be such that *any* amount of pain is an unreasonable burden for her to bear, one which will cause trauma.

Do I think that there are sociological factors that make women think they are significantly less strong and capable than they actually are? Absolutely. But it's not remotely my place to judge another woman's capability, although I can be her friend and encourage her to see herself as strong and capable of handling difficult circumstances if she feels such a sacrifice is worthwhile.


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## GoBecGo (May 14, 2008)

Just to update since it further illustrates my point, the screaming mother with the whole hand inside her was being induced for GD at 38 weeks. After 4 days of induction and multiple painful VE's she had a c-section for failure to progress. Her baby did not look even 7lbs.


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## possum (Nov 23, 2004)

Quote:


Originally Posted by *loveneverfails* 
But it's not remotely my place to judge another woman's capability, although I can be her friend and encourage her to see herself as strong and capable of handling difficult circumstances if she feels such a sacrifice is worthwhile.

I judge *all* women capable of birthing without anaesthesia. Of course individual medical circumstances arise, and in a modern society, a woman and her doctor are able to make choices that were not available before modern medicine. Some mothers' and babies' lives are saved by modern medicine while others are lost because of it. For some women, an epidural can be a very wise medical decision.
Anaesthethics are only recently available. For millennia, women birthed without them. If pain meds were not available, would we really question whether we were capable of enduring the pain of childbirth?
How can we say we have a right to something that has been unavailable to humans for most of our history?

No, it's not my job to judge individual women for their choices. They are clearly free (or should be) to make their own decisions just as doctors and midwives should be free to provide whatever services for which there are economic demands. If women want elective c-sections and epidurals the moment they arrive at the hospital in labor and there are people willing to provide those women with those services for an agreed upon price, then how could I have an issue with them?

But a right? Nope.


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## Amatullah0 (Apr 7, 2009)

no. but i do believe that if it is available, and she is actually aware of the risks, and especially if her birth has turned "medical" (i.e. pit) then she should be allowed to choose pain meds(or hypnosis, or someone for massage/counter pressure, etc.)

with this also comes the RIGHT to not be scared into believing that birth is a terribly painful experience, and the RIGHT to informed consent, and as a pp mentioned, the RIGHT to not be assaulted.


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## Hannah32 (Dec 23, 2009)

"Right" is probably not the most useful term, but I do believe that all women in the US should have the option of pain medication if they request it. Honestly, natural birth advocates do their cause no favors by basically trying to guilt women or scare them into refusing pain medication. I saw "The Business of Being Born." While it made a number of interesting points and some very good ones, I saw the message basically being that you need to put up with the pain or bad things will happen to you. I didn't find that an effective argument.


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## zip27 (Aug 14, 2009)

I do not believe that anyone has a fundamental "right" to health care services. That said, I do strongly believe that it is in a society's best interests to provide a certain level of care to all its members (particularly a society as rich in resources as ours), and that those services should include pain management for laboring women at their request. I absolutely cannot stand hearing stories about uninsured or undocumented women being denied pain relief, or proposals that they should be denied pain relief because it's not a "necessity" - these stories always seem to have a sadistic edge to them that's more about punishing certain groups of women and not at all about the conservation of resources or ensuring the best health outcomes.


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## loveneverfails (Feb 20, 2009)

Quote:


Originally Posted by *possum* 
I judge *all* women capable of birthing without anaesthesia. Of course individual medical circumstances arise, and in a modern society, a woman and her doctor are able to make choices that were not available before modern medicine. Some mothers' and babies' lives are saved by modern medicine while others are lost because of it. For some women, an epidural can be a very wise medical decision.
Anaesthethics are only recently available. For millennia, women birthed without them. If pain meds were not available, would we really question whether we were capable of enduring the pain of childbirth?
How can we say we have a right to something that has been unavailable to humans for most of our history?

No, it's not my job to judge individual women for their choices. They are clearly free (or should be) to make their own decisions just as doctors and midwives should be free to provide whatever services for which there are economic demands. If women want elective c-sections and epidurals the moment they arrive at the hospital in labor and there are people willing to provide those women with those services for an agreed upon price, then how could I have an issue with them?

But a right? Nope.

I think you're misunderstanding what I'm saying. Can every woman *survive* childbirth pain without anesthesia? Obviously. That doesn't mean she can just "suck up" the pain without there being unnecessary trauma done to her. There is a tremendous amount of variability between an orgasmic birth and one that results in PTSD due to traumatic amounts of pain and suffering. The decision of how much pain is too much is something that needs to be left up to the woman. Someone else may be able to tolerate what I don't find tolerable, and I may be able to tolerate what another woman would find intolerable.

I'm not arguing about free market forces here. I'm saying that it's such a widely variable, personal decision that doesn't fall into the category "has a right to" very easily. The question is framed oddly. Women have a right to choose between options that are available for them based on their own judgment of their situation, not because of some overarching entitlement to a pain free birth or because of some lofty moral ideal where Real Women and Real Moms Don't Have Epidurals.


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *loveneverfails* 
because of some lofty moral ideal where Real Women and Real Moms Don't Have Epidurals.

Big WORD to this. It's a really annoying attitude that some have.


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## loveneverfails (Feb 20, 2009)

Quote:


Originally Posted by *Hannah32* 
Big WORD to this. It's a really annoying attitude that some have.

I find it annoying, and I have drug free and largely pain free home births! There has to be a happy medium here. In my dream world, every woman would know that she could handle normal labor on her own power, that her giving birth wasn't dependent on her having the nice doctors give her medicine because otherwise she'll somehow implode and disappear forever. But she'd also know that if things were abnormally painful that she was able to choose pain relief to avoid unnecessary trauma to herself.

Not for anything, but technically in the absence of medical problems, all fertile women are capable of having a baby every roughly 18-36 months from menarche to menopause. That's another thing that women did for thousands of years, and they largely just sucked it up. Do women have a right to birth control? To the knowledge of their fertility to avoid or achieve pregnancy? Epidurals are largely chosen for convenience and comfort within the realm of what individual women judge is best in their own lives. Avoiding pregnancy through any means (NFP, FAM, condoms, IUDs, pills, etc) is also largely a choice made with an eye towards convenience and comfort within what women judge is best in their particular situations.


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## Teensy (Feb 22, 2002)

> I do not believe that anyone has a fundamental "right" to health care services. That said, I do strongly believe that it is in a society's best interests to provide a certain level of care to all its members (particularly a society as rich in resources as ours), and that those services should include pain management for laboring women at their request. I absolutely cannot stand hearing stories about uninsured or undocumented women being denied pain relief, or proposals that they should be denied pain relief because it's not a "necessity" - these stories always seem to have a sadistic edge to them that's more about punishing certain groups of women and not at all about the conservation of resources or ensuring the best health outcomes./QUOTE]
> 
> This. Exactly. And I think that those types of stories are why the language that the OP referred to were placed in hospital admissions materials.
> 
> I choose to give birth without utilizing the pain-meds that were available to me. But it was my choice, and I hate to think that any mother in labor would be denied the ability to make such a choice because she lacked funds or insurance.


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## Juvysen (Apr 25, 2007)

I don't think it's possible for it to be a "right" because 1) sometimes labor goes too fast and they can't get the epidural in there... did that woman just lose her right? 2) what happens when, say, a hurricane comes or something and there's no electricity... those women too lost their "right"? (I actually think I read something about deliveries during one of the hurricanes a few years ago where they didn't have the facilities to do all the drugs/meds/whatever so these women were stuck doing natural childbirth) I think women have the right to birth in the way that they see fit, but sometimes circumstances come in where it can't be controlled...


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## possum (Nov 23, 2004)

I don't think it's some lofty moral attitude not to consider epidurals and other modern birth choices as *rights*. I also don't think that cosmetic surgery is a right. I see them as things that I have no right to deny to other people if they can provide themselves with them.
Some of the mamas nearest and dearest to me have had a variety of elective and non-elective interventions in their births. I don't think of them as lesser women because of those choices or lack thereof. In fact, most of the women I know have not had natural births.
But that doesn't mean I believe most of those interventions were NEEDS. They were mostly wants.


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## mamakah (Nov 5, 2008)

Women have the "right" to a birth that they choose. Whichever way they go.


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## Romana (Mar 3, 2006)

Absolutely women have a right to a painfree childbirth. I think it would be a violation of human rights to deny a woman pain relief in labor that is available and, really, quite safe.

In the rubric of biomedical ethics, I consider autonomy to be the primary pillar of ethics that should be given greatest weight - meaning that the informed patient has the right to make decisions regarding his or her care. The others - benificence, non-malificence, and justice - play important roles but are secondary to the individual's autonomy.

In examining this as an ethical question, I'm ignoring monetary concerns - for example, the increased cost of a c-section by maternal election. In part, I'm ignoring this aspect because you could use increased cost to justify forcing all kinds of suffering on people, yet we find plenty reason to relieve suffering even when it is costly. And also setting the cost question aside because very few women choose a totally non-medically indicated elective c-section without a separate good reason for it (sexual abuse trauma, pathological fear of birth, etc.). I don't think access to that sort of choice should be especially easy, but neither should it be totally blocked. If a woman is informed and making the decision she should be able to find a provider who will offer it.

And pain relief is a much simpler question. To me, it's like saying, "Do you think people undergoing surgery have a "right" to painfree surgery or pain relief during surgery?" The pain relief carries its own unique risks and it's provided at an expense - yet it would not be morally or ethically acceptable to deny pain relief to someone undergoing surgery if it was available.

Both of my natural births were excruciatingly painful and while I didn't opt for pain medication, I would absolutely consider it a violation of basic human rights to deny pain relief to a woman who wanted it if it was available. The pain was traumatic and unforgettable.


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## nashvillemidwife (Dec 2, 2007)

The question is faulty. No one can guarantee or provide a painfree childbirth. You might as well ask "do you think people have a right to live into old age and die of natural causes?"

Quote:


Originally Posted by *Beppie* 
let's try it a different way. the natural order of things...

The natural order of things is that some women and babies die in childbirth due to events that are preventable now with technology (ruptured uterus from obstructed labor, placenta previa, placenta abruption, neonatal sepsis). It's the natural order of things that some women will have lifelong complications from rectovaginal fistula or prolapse from giving birth. It's the natural order of things that many people would die from ruptured appendix, pneumonia, embolism... I don't think "natural order" is the way you want to go here.

Yes, I think women have a right to pain medication during childbirth.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *Beppie* 
For example, women have a right to live free from domestic abuse/violence. That is a right of every human being (to be free from abuse). Do you see where I'm going with this? sorry, maybe i'm not making sense. here's another question that builds on this: do women have a right to an elective cesarean?

Putting it this way, YES. No woman should be forced to endure pain, against her will, when there is a way to relieve that pain.

And yes to your second question.

Women should have the right to attempt (because really they can do nothing more than attempt when it comes to birth) any birth they choose, from elective c-section to UC.


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## nikirj (Oct 1, 2002)

Quote:


Originally Posted by *mamakah* 
Women have the "right" to a birth that they choose. Whichever way they go.

Nature or circumstance often take that choice away from us. That, IMO, means it can't possibly be a right.

Women have a RIGHT to be treated as autonomous individuals capable of making their own decisions about their bodies.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *nikirj* 
Nature or circumstance often take that choice away from us. That, IMO, means it can't possibly be a right.

In that case, there are no rights at all. Because nature or circumstance can take away any choice in life.


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## claddaghmom (May 30, 2008)

I already got slapped for this one.


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## beckyand3littlemonsters (Sep 16, 2006)

I'm not really sure about this, i suppose in a way pain relieving meds for labour is more a privelige (sp) than a right (not that i'm saying women shouldn't be allowed it ) for thousands of years women had no hospitals and deffenately no pain meds and now well we all know know what we have now.
my personal opinion is that labour is painful for a reason or as my mw i had with my first 2 would say "it wouldn't be labour if it wasn't hard and painful" in my labours i've just forced myself to manage the same way i forced myself not to swear and scream when the pain got too much, not every woman is the same and some women really can't mange without it.
if you actually understood any of that especially with all my spelling mistakes


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## dannic (Jun 14, 2005)

Quote:


Originally Posted by *possum* 
I judge *all* women capable of birthing without anaesthesia. Of course individual medical circumstances arise, and in a modern society, a woman and her doctor are able to make choices that were not available before modern medicine. Some mothers' and babies' lives are saved by modern medicine while others are lost because of it. For some women, an epidural can be a very wise medical decision.
Anaesthethics are only recently available. For millennia, women birthed without them. If pain meds were not available, would we really question whether we were capable of enduring the pain of childbirth?
How can we say we have a right to something that has been unavailable to humans for most of our history?

No, it's not my job to judge individual women for their choices. They are clearly free (or should be) to make their own decisions just as doctors and midwives should be free to provide whatever services for which there are economic demands. If women want elective c-sections and epidurals the moment they arrive at the hospital in labor and there are people willing to provide those women with those services for an agreed upon price, then how could I have an issue with them?

But a right? Nope.


Quote:


Originally Posted by *Amatullah0* 
no. but i do believe that if it is available, and she is actually aware of the risks, and especially if her birth has turned "medical" (i.e. pit) then she should be allowed to choose pain meds(or hypnosis, or someone for massage/counter pressure, etc.)

with this also comes the RIGHT to not be scared into believing that birth is a terribly painful experience, and the RIGHT to informed consent, and as a pp mentioned, the RIGHT to not be assaulted.

I agree.


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## grumpybear (Oct 5, 2006)

Haven't read the PP's but I think women have a right to whatever type of childbirth they'd like to have.
They may make selfish choices but they have a right to them nonetheless.


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## Altair (May 1, 2005)

Quote:


Originally Posted by *Romana* 
I think it would be a violation of human rights to deny a woman pain relief in labor that is available and, really, quite safe.

100% yes.

A woman is an autonomous human being and can make medical decisions for herself. Denying her pain relief for birth (but allowing it for other medical interventions in her life) does not make sense at all. It is moralistic and demeaning. She is an adult and can make these choices for herself and her unborn baby.

She should be given truthful information, of course. But at the end of the day she is allowed to do many things to her body during pregnancy, birth, and for the rest of her life that are none of my damn business. Like it or not, in our country a pregnant woman is still legally a person first. It's a dangerous slippery slope telling women they must sacrifice their own amount of (potentially) extreme pain for a possible statistical benefit to their baby.

Before I became a mother, in my 10 years as a homebirth doula I may have answered differently. 60 hours of labor and 15 hours of involuntary pushing, and PTSD from the pain and hospital transfer and eventual c-section have since humbled me. I chose not to have pain relief during my labor/pushing, because I *wanted* to feel every second of it, but my God I could not blame anyone for one second for wanting to take that torture away. I'm not less of a woman for saying the pain of a stuck baby jamming against my cervix and pelvis for 3 days was traumatizing.


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## zinemama (Feb 2, 2002)

Birth is indeed a natural physiological process. An extremely painful natural physiological process. I wasn't scared into this viewpoint, by the way. I arrived at it all on my own after giving birth twice. Women have the right to make individual choices about how to deal with that pain, whether it's breathing, hypnotherapy, visualization or an epidural.

Natural order of things? We are so far from that by now that even discussing what's "natural" in birth is beside the point. As a pp pointed out, it's quite natural for many women to die of childbirth complications, post-partum infections etc. that modern technology can prevent. But we prevent those deaths whenever possible, circumventing nature entirely in the process. That's not a bad thing.

Nor is a woman choosing pain medication, if she wants.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *nashvillemidwife* 
The question is faulty.

I suspect the question was framed the way it was, because a woman's right to painfree labour/birth is one of the legs that the OB community builds their tower of "we know best, and those natural birth/anti c-section types are out of their gourds" upon.


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## Kelly1101 (Oct 9, 2008)

*shrug* Just because I don't use pain meds doesn't mean use of pain meds is "bad."

Also just because I birth in a hospital doesn't mean home birth is "bad."

I think a lot of the time, some women are way too concerned about other women's births. From both sides of the issue.


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## possum (Nov 23, 2004)

Thinking something isn't necessary or a right doesn't mean you think it's bad necessarily.


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## MeepyCat (Oct 11, 2006)

GoBecGo, I think we agree with each other. What I'm saying is that pain relief should not entail accepting any and all treatment or being denied the opportunity to consent to further treatment.

Quote:


Originally Posted by *GoBecGo* 
Epidural anaesthesia increases the chance you will need an instrumental delivery and perineal trauma, so in a very very REAL sense, women are accepting responsibilities when they exercise their "right" to a pain free birth, and one of them is to accept they may not have a particularly pain free beginning as a mother.

As for autonomy - you are numb and cannot move from the sternum down. How will you move? How will you make choices if you are NOT supported by your doctors and midwives? How will you refuse the augmentation if you only find out about it after your new "saline" is put up and your contractions suddenly become very painful? How will you decline consent for the episiotomy which is done without your knowledge? How will you insist you be with your baby when you are still numb and someone who could walk has already taken it to the nursery?

Even during my c-section, I was never "numb from the sternum down". I felt cutting, it just didn't hurt. Epidural anesthesia often leaves the patient able to move (if not particularly stable). The epidural for my son's delivery left me mobile, it certainly did not render me completely numb. During both births, I was supported by my husband and could have brought other support people to the hospital with me. If I had found out that I was given pitocin without my consent, I would have raised holy hell, and considered removing the IV myself, but as it happened, I didn't have to. If someone had tried to take the baby away unnecessarily, DH would have gone after them and brought them back. That's what he was there for. We aren't powerless just because we aren't suffering, and refusing anesthesia doesn't prevent the various disasters you describe from happening.

If I had had lousy care providers, they could have disregarded, belittled and ignored me whether or not I refused pain medication. We don't fix this problem by telling women that they have to suck up the pain or they won't have a say in what happens to them. We fix it by demanding better from the profession of obstetrics.


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## StrawberryFields (Apr 6, 2005)

Quote:


Originally Posted by *GoBecGo* 

*As for autonomy - you are numb and cannot move from the sternum down.* How will you move? How will you make choices if you are NOT supported by your doctors and midwives? How will you refuse the augmentation if you only find out about it after your new "saline" is put up and your contractions suddenly become very painful? How will you decline consent for the episiotomy which is done without your knowledge? How will you insist you be with your baby when you are still numb and someone who could walk has already taken it to the nursery

I had an epidural with my first birth and this was not my experience. I was not numb, I could feel my contractions and I could move my legs just fine. A little slow, but it definitely wasn't like I was some rock trapped in bed incapable of moving or feeling anything!

I completely agree with the following:

Quote:


Originally Posted by *Romana* 
I would absolutely consider it a violation of basic human rights to deny pain relief to a woman who wanted it if it was available.


Quote:


Originally Posted by *nikirj* 
*Women have a RIGHT to be treated as autonomous individuals capable of making their own decisions about their bodies.*

As a pregnant or laboring woman *I* have the right to make medical decisions about my body. And that includes decisions about pain medication, homebirth/hospital birth, C-section etc. I will be damned if some doctor or natural childbirth advocate or the Pope himself tries to take that away from me or make my decisions for me. The idea that some provider could deny a woman something that is legal and available and force her against her will to suffer the pains of childbirth makes me ill. I do think that it would be a violation of her rights in this country. And yes, I advocate natural childbirth and planned two homebirths.


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## kltroy (Sep 30, 2006)

I remember being told that I had this "right" as part of my checking into the hospital. I actually busted out laughing. At first I thought it was quite absurd - I mean it was just so far from what I had planned. But the thing is, in many countries whether you can opt for an epidural, say, or really any other form of pain relief, is dictated NOT by your desire to have it, but by your ability to pay. So by saying we have a right, what they are really saying is that, as covered under the EMTALA laws, you may choose this as part of the standard of care and you will receive it without regards to your ability to pay.

I think that's pretty important, actually. I choose not to have it, but it should be a right in that context.


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## ferndoula (Feb 4, 2010)

As a doula I always support my clients right to choose whatever feels right for them. I feel they have a right to be educated about anything they choose, and unfortunately many women do not get this information. Even when they directly ask their nurse or doctor what the side effects of an epidural are, they will get a "oh, not much, it might slow your labor, but not to worry!" sort of answer. So I educate my clients, then once educated, yes, I support their right to choose.

One thing that does bother me is hearing an OB or nurse refer to a woman getting "Her" epidural. This for me puts the "right" to pain relief in a whole new twist, one that I do not like. I feel as though the OB (or whomever, not to pick on OB's, just an example!) is actually using the idea of a womans "right" to pain meds, and getting "her" epidural, that she "dererves" as a way to strong arm women into doing what they see as the right thing. In this way, when most women choose an epidural, it is not a real cloice, not an educated choice and with a lot of forces pushing her to get it, without an equal amount of push in the opposite direction, not to get it.

I think that one can only really exercise the right to choose when educated and knowledgable and not pressured. Of course even when you are pressured, and uneducated you still have to choose an option for yourself, but it is not the same level of freedome.

Also, I am in Canada, so all woman, regardless of financial bracket, get to choose an epidural, or whatever care they want.


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## MamaChicken (Aug 21, 2006)

Quote:


Originally Posted by *Kelly1101* 
In that case, there are no rights at all. Because nature or circumstance can take away any choice in life.

Yup. That's correct.

We throw that word around an awful lot - "right". Define what you mean and I will give you an answer. Kids have a "right" to a food and shelter - IMO, no we have RESPONSIBILITY to provide this for them.

Are you asking "Should we give each permission?" "should we agree to grant this right?" "Is this an inate right that is due all humans?"

IMO, there are basically no "rights" that humans inately have - only responsibilities that we all have to each other.


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## ferndoula (Feb 4, 2010)

Quote:


Originally Posted by *kltroy* 
I remember being told that I had this "right" as part of my checking into the hospital. I actually busted out laughing. At first I thought it was quite absurd - I mean it was just so far from what I had planned. But the thing is, in many countries whether you can opt for an epidural, say, or really any other form of pain relief, is dictated NOT by your desire to have it, but by your ability to pay. So by saying we have a right, what they are really saying is that, as covered under the EMTALA laws, you may choose this as part of the standard of care and you will receive it without regards to your ability to pay.

I think that's pretty important, actually. I choose not to have it, but it should be a right in that context.


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## Amatullah0 (Apr 7, 2009)

Quote:


Originally Posted by *StrawberryFields* 
And that includes decisions about pain medication, homebirth/hospital birth, *C-section* etc.

bolding mine

i don't know about this. I mean, I think a surgeon would deny surgery to someone who didn't need it, right? I mean, if I booked an appointment to get my tonsils out for no other reason than because I want to, or that I want my intestines shortened because I think its weird that they're so long, or, in an attempt to lose weight I ask to get a kidney removed, I would expect the doc to look at me like i'm crazy and tell me to go home. I don't think that any doctor is obligated to provide treatment to someone who doesn't need it, especially if it may be harmful to them. I mean, what if docs started giving c-sections to women at 30 weeks because they decide that they don't want to be pregnant anymore? I'm not suggesting there be legislation against it, because I think thats dangerous for women(and babies), I'm thinking about the doc's rights too...


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## Amatullah0 (Apr 7, 2009)

Quote:


Originally Posted by *ferndoula* 

One thing that does bother me is hearing an OB or nurse refer to a woman getting "Her" epidural. This for me puts the "right" to pain relief in a whole new twist, one that I do not like. I feel as though the OB (or whomever, not to pick on OB's, just an example!) is actually using the idea of a womans "right" to pain meds, and getting "her" epidural, that she "dererves" as a way to strong arm women into doing what they see as the right thing. In this way, when most women choose an epidural, it is not a real cloice, not an educated choice and with a lot of forces pushing her to get it, without an equal amount of push in the opposite direction, not to get it.


that bothers me too, its also the same terminology they use with regard to immunizations i.e. "does he have all his shots?" its as if it already belonged to her, and as if its a responsibility. i.e. "go get your coat"


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## *Erin* (Mar 18, 2002)

of course.
primarily, i think women have the fundamental right to INFORMED CONSENT and then freedom of choice. all mothers to be should recieve informed consent of what a drug free birth is/can be and of what pain-control measures are available if they desire and what side effects and risks are involved.

the judgement of mothers who elect to have a section or who *gasp* choose an epidural is seriously.....very very sad and disheartening to me, as a woman and as a mother. it also makes me very wary of labeling myself as a crunchy mother/natural birther, lest i be affiliated with such a judgemental and hateful viewpoint.

i have chosen to birth my way, and while i would encourage other mothers to choose natural birth also, sometimes it needs to go another way.
such is life.


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## accountclosed3 (Jun 13, 2006)

i suppose this depends on so many things.

i guess the real question is do women have the right to have access to medical pain management methods during labor and birth?

because i believe in medical access, then i believe that yes, women have a "right" to have access to it. they have a "right to choose" to use it.

but, there are so many ways to create a pain-free birth experience (or a pleasurable birth experience), and there is also nothing inherently wrong with experiencing physical pain due to birth or other reasons.

but, as always, people have a right to choose.


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## emnic77 (Sep 12, 2009)

Of course. The same "rights" that allow me to choose to not have medical pain relief also allow a woman to choose TO have medical pain relief. I'm certainly not willing to give up that right, whether I agree with the opposite of my choice or not. Kinda like free speech...I hate hate hate what some groups get to say under the umbrella of free speech (picketing funerals for instance) but I sure don't want that right taken away from them, because it would, by default, take rights away from me.

It's a two way street.

ETA: I think informed consent is also a right, and informed consent with most things childbirth related is, at this juncture, a joke.


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## coldandsleepy (Aug 5, 2008)

I think women should have the right to decide what kind of birth they want. I absolutely and totally believe that epidurals should be available people to women who want one. I also believe that this right goes along with the right of knowing the risks that go along with epidurals and other epidurals. I don't think anyone should ever have to make an uninformed decision about labor and birth!


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## lovebug (Nov 2, 2004)

Quote:


Originally Posted by *Amatullah0* 
bolding mine

i don't know about this. I mean, I think a surgeon would deny surgery to someone who didn't need it, right? I mean, if I booked an appointment to get my tonsils out for no other reason than because I want to, or that I want my intestines shortened because I think its weird that they're so long, or, in an attempt to lose weight I ask to get a kidney removed, I would expect the doc to look at me like i'm crazy and tell me to go home. I don't think that any doctor is obligated to provide treatment to someone who doesn't need it, especially if it may be harmful to them. I mean, what if docs started giving c-sections to women at 30 weeks because they decide that they don't want to be pregnant anymore? I'm not suggesting there be legislation against it, because I think thats dangerous for women(and babies), I'm thinking about the doc's rights too...

I totally agree!


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## mntnmom (Sep 21, 2006)

If I choose to have a "pain-free" birth, but the epidural hurts going in, have my rights been violated? Or if the epidural doesn't take has my autonomy been violated? Of course not. I have choices about what goes into my body, and what procedures I can allow, but mother nature and random circumstances don't recognize anyone's "rights". That said, if nobody makes sure that my informed consent includes the possible problems of epidurals, or refuses to give it for non-medical reasons, that's a whole different issue!.


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## phoebemommy (Mar 30, 2006)

While the discussion is interesting, I just don't think the word "right" belongs in this context. Because where does that right come from? I think rights, by nature, have to come from a source, be it a god, the constitution, a legal precident, whatever, something recognized accepted as an inalienable foundation. And I don't know that there is one in this instance. Unless I'm missing something. Women have a right to medical care while in labor, yes, but is pain relief covered under EMTALA? And then there's the issue people have mentioned -- that the epidural might not take, or that before and after the epidural there may be a great deal of pain. It seems like, just logistically, a "painfree childbirth" can't be a right.

We really have to be careful when we start demanding that things are "rights" just because we think they're important. Where does it end?


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## babygirlie (Jun 4, 2009)

I believe all humans deserve the right to have health care and the right to a pain free birth or a birth in any means they choose.

I was in excruciating pain before and with my epidurel and I could still feel the contractions. the magnesium however (which i did not want) made me not able to walk.

As someone who lives in excruciating pain every single minute of my life I do not need the ritual of another painful experience to prove I am woman. Though a week in the hospital I'm sure I felt plenty.

Why not say you do not have a right to a novocained tooth extraction. You ate the sugar you now must suffer the consequences. Just silly.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *StrawberryFields* 
As a pregnant or laboring woman *I* have the right to make medical decisions about my body. And that includes decisions about pain medication, homebirth/hospital birth, C-section etc. I will be damned if some doctor or natural childbirth advocate or the Pope himself tries to take that away from me or make my decisions for me. The idea that some provider could deny a woman something that is legal and available and force her against her will to suffer the pains of childbirth makes me ill. I do think that it would be a violation of her rights in this country. And yes, I advocate natural childbirth and planned two homebirths.









Like how you say it.

Quote:


Originally Posted by *Amatullah0* 
i don't know about this. I mean, I think a surgeon would deny surgery to someone who didn't need it, right? I mean, if I booked an appointment to get my tonsils out for no other reason than because I want to, or that I want my intestines shortened because I think its weird that they're so long, or, in an attempt to lose weight I ask to get a kidney removed, I would expect the doc to look at me like i'm crazy and tell me to go home. I don't think that any doctor is obligated to provide treatment to someone who doesn't need it, especially if it may be harmful to them. I mean, what if docs started giving c-sections to women at 30 weeks because they decide that they don't want to be pregnant anymore? I'm not suggesting there be legislation against it, because I think thats dangerous for women(and babies), I'm thinking about the doc's rights too...

Now, keep in mind that I am pro-choice, so that may flavor my opinion on what you have said here, but I think the only thing that demonstrates a woman's "need" in this case is if she WANTS to. Her reasons are her own, and none of anyone else's business. It's her body and she is in control of her reproduction. I mean, your other examples are purely medical-- how would you like it if someone said "well, I know you want a homebirth or a waterbirth and a nice experience, but you don't NEED it, so really why don't you just go along with the standard of what we decide, because medically this is what is better." I bet a lot of people here wouldn't like that much. Since we come from the perspective that childbirth is NOT just a medical event.

Freedom of choice in birth should be absolute, not just limited to what one person or group decides they like best.


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## Amatullah0 (Apr 7, 2009)

Quote:


Originally Posted by *Kelly1101* 







Like how you say it.

Now, keep in mind that I am pro-choice, so that may flavor my opinion on what you have said here, but I think the only thing that demonstrates a woman's "need" in this case is if she WANTS to. Her reasons are her own, and none of anyone else's business. It's her body and she is in control of her reproduction. I mean, your other examples are purely medical-- how would you like it if someone said "well, I know you want a homebirth or a waterbirth and a nice experience, but you don't NEED it, so really why don't you just go along with the standard of what we decide, because medically this is what is better." I bet a lot of people here wouldn't like that much. Since we come from the perspective that childbirth is NOT just a medical event.

Freedom of choice in birth should be absolute, not just limited to what one person or group decides they like best.

hmmm, interesting point. but, if water was controlled (say we lived somewhere where water was so scarce it had become extremely rationed, with people not having enough to drink at times) then I would have to say that you do NOT have a RIGHT to a waterbirth. I can't go up to everyone I know and demand that they give me their water ration so I can give birth in it. similarly, I can't go to an OB office and demand they give me a c-section.

but, I do believe that as a human being, you DO have the right to use your own water ration for a water birth(even if it may only be a few cups of water, or even a polluted water source) and they you have the right to give yourself a c-section(no matter how silly that sounds)

No matter how much I would be against doing these things, both of which could easily mean death for yourself and your baby, I don't think the choice should be taken away from women. When the choice is taken away, sometimes better options and choices are taken away with it. When legislation comes out that is supposedly "in favor of the baby" it often comes at the expense of both of them. (such as fetal monitoring being required and leading to something more, or required(even court ordered, like in Florida) c-sections at 40(or even 42) weeks or because of a prior c-section, or whatever other reason a doc can cook up.


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## transylvania_mom (Oct 8, 2006)

I had to re-read your question, I thought by "pain-free" you mean natural...
I don't mean to say that natural birth is painless (I've experienced two of them myself), but I would be VERY scared of recovery after c-section, catheter insertion, headaches after epidural, episiotomies and needles in my back. When I was labouring with ds, my midwife gave me a sterile water injection which took the edge of my back labor for about 30 minutes and it was horrible. She asked me if I wanted another one when the first one wore off, but I preferred back labor over that.

So yes, I think women have a right to a truly pain free childbirth...


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## MsBlack (Apr 10, 2007)

This is such an interesting discussion on various levels. Mainly, though, I think that the answers (no offense to anyone in particular or to the group) are narrowed down by a question that is in itself too small and individualized in it's scope (no offense to the OP either! I think it is all too easy in this era to come to a question from a limited perspective rather than a holistic one...given the strong and pervasive influences of our medico-legalistic society).

First: as a feminist and entirely 'pro-choice' woman, I absolutely believe in women's right to self-determination and autonomy with informed consent, where that is possible.

'Where that is possible' is one of the somewhat operative phrases here, because (at least in Free Republics such as the US, Canada, UK, others) as the cliche says 'Your own rights end where others' rights begin'. That is, we are not isolated individuals making choices in a vacuum; when it comes to birth we are also making choices for our babies. And when it comes to health care in general, we are also making choices that impact--directly and indirectly--everyone else in our world as well. More on that later. For now, I want to touch upon the other operative phrase, which is 'with informed consent'.

As one pp has stated, 'informed consent' is pretty much a joke in the world of allopathic medicine. Most people utilizing medical care don't have the foggiest notion what true informed consent even is. I won't go into it here, but believe me it involves WAY more than 'taking the epidural class' at your local hospital, and WAY WAY more than signing the General Consent Form upon admission to the hospital. What I am getting at here is the reality that women choosing medicated births and csecs are very far from choosing on a basis of informed consent.

See, not only are we not given a clear picture of the real risks of medicalized birth, we are also not told about the numerous real and irreplaceable benefits to natural birth for mothers and babies, in both the short and long term. Those benefits are very much physiological as much as emo-psychological, impacting the 'whole life' of both mother and baby, and entire lifespan of both (and family also). Also, while we are promised (and generally given, after the tech-mechanical fashion of industrial medicine anyway) full staff 'support' for medicalized birth, we are certainly NOT supported in the choice to go natural.

Mind you, it is very difficult indeed to even find a medical provider who is 'ok with' natural birth, or who actually knows a freakin thing about normal birth. Beyond that, however, those who really do want a normal, natural birth in the hospital do not have institutionally-provided access to labor support, nor to evidence based practices that most greatly benefit natural labor (such as free mobility, food and drink, birthing tubs)--the kinds of things that are well demonstrated to minimize women's experience of pain and maximize motherbaby's health as well as comfort during labor. The med system is all over having the nurses and other techies whose primary job is mind the machines, NOT the people having a birth--they utterly neglect the provision of similar staff support of natural birth.

Well, why would they? We cannot forget that Tech Medicine is Big Business indeed. Follow the money, follow the money, follow the money. If you think your 'choice' of pain med or elective csec is 'freely made', then you need to think again--because what you are told IS very much impacted by the MONEY. Hospitals make more money on hi tech. Docs make more money on surgery, and NICU and all that. The tales we are told about 'safety' of med birth, and the seductive inducements of 'no need to stay pregnant any longer, no need to experience labor, no need to feel any pain at all are ADVERTIZING, plain and simple. We don't expect any other advertizing to give us a whole, reliable picture--we are taught to be skeptical and wise about such things--why do we seem to believe the crass promotional efforts of docs and hospitals as GodsOwnTruth?

And what about the baby? What about the baby's rights??? Do I support even elective csec? Well, yes--in theory. But ONLY if families are made fully aware of the very real and even prevalent risks of that to their baby (and so, by the by, to a woman's/family's OWN well being and happiness) for being surgically removed early enough to prevent the woman's 'experience of labor'. "Late term premies" are a very real group of babies who spend otherwise needless time in the NICU with feeding and breathing problems. Now, our med brethren (and regardless of the sex of your OB or neonatologist, let's be clear that this is a MALE/PATRIARCHALLY created and dominated field) don't have to deal with this in the short or long term. They don't have to worry about the risks and the negative impact--hey, they are fully confident that they can rescue babies from the folly of elective csec (or induction); they have meds and machines to fix all that! But are parents clearly receiving the Informed Consent they need, in order to make a truly intelligent and free decision about such things? NOT.

And are women, in our rush to allow each other 'the right to self-determination', really being asked to consider the ramifications of their choices on their baby's health, now and forever? I really don't think so. This is one way in which the question, IMO, should be broadened to include the 'Democratic --self-determining-- Ideal' that one's own rights end where others' rights begin.

And what about the costs involved? Oh, you say, I have insurance! I can pay for this myself. Um, sorry, you are NOT paying for it yourself (and for the time being, let's leave aside the poor who can't). You are directly placing a burden on the entire group of insured people, and the economic ramifications are simply too far reaching to even start on here. So--if you really must have that epidural or elective induction/csec in the pursuit of personal right to choose, then maybe that is a cost that should come out of your own pocket, in the name of keeping everyone's insurance costs as low as possible. And further, required to personally cover all costs incurred if you or your baby become needful of further med care as a result of your epidural or your elective med birth

Sure, you've got rights. And your rights end where others' rights begin. This, first and foremost, means if you are going to exercise your rights most effectively on your own behalf, then you owe it to yourself to become FULLY informed about ALL the risks of medicalized birth and ALL the benefits of natural birth. Frankly I think no one should be allowed to 'choose' medicated birth, or other elective procedures of birth, without being required to know all that. Required, yes, I did say that. Because your choice is NOT just your choice, it is not just about you. It's about your baby, and it's about society on the whole...these choices do impact your whole world, after all. And which of us would really desire all the medicalization of our births if A) We really were informed about the risks to ourselves, and the benefits of natural birth to ourselves? and B) we were really fully informed about the risks to our babies in medicalization along with being informed about all the numerous benefits to our babies/families of natural birth and finally C) We really truly had the option of fully supported, fully evidence based natural birth in the hospital (labor support and all the rest)?

So....sorry for the ranty ramble, but this is why I think the question was too 'small', and cannot be answered so simply as a matter of 'pro-choice'.


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## emnic77 (Sep 12, 2009)

MsBlack -


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## Amatullah0 (Apr 7, 2009)

Quote:


Originally Posted by *MsBlack* 
This is such an interesting discussion on various levels. Mainly, though, I think that the answers (no offense to anyone in particular or to the group) are narrowed down by a question that is in itself too small and individualized in it's scope (no offense to the OP either! I think it is all too easy in this era to come to a question from a limited perspective rather than a holistic one...given the strong and pervasive influences of our medico-legalistic society).

First: as a feminist and entirely 'pro-choice' woman, I absolutely believe in women's right to self-determination and autonomy with informed consent, where that is possible.

'Where that is possible' is one of the somewhat operative phrases here, because (at least in Free Republics such as the US, Canada, UK, others) as the cliche says 'Your own rights end where others' rights begin'. That is, we are not isolated individuals making choices in a vacuum; when it comes to birth we are also making choices for our babies. And when it comes to health care in general, we are also making choices that impact--directly and indirectly--everyone else in our world as well. More on that later. For now, I want to touch upon the other operative phrase, which is 'with informed consent'.

As one pp has stated, 'informed consent' is pretty much a joke in the world of allopathic medicine. Most people utilizing medical care don't have the foggiest notion what true informed consent even is. I won't go into it here, but believe me it involves WAY more than 'taking the epidural class' at your local hospital, and WAY WAY more than signing the General Consent Form upon admission to the hospital. What I am getting at here is the reality that women choosing medicated births and csecs are very far from choosing on a basis of informed consent.

See, not only are we not given a clear picture of the real risks of medicalized birth, we are also not told about the numerous real and irreplaceable benefits to natural birth for mothers and babies, in both the short and long term. Those benefits are very much physiological as much as emo-psychological, impacting the 'whole life' of both mother and baby, and entire lifespan of both (and family also). Also, while we are promised (and generally given, after the tech-mechanical fashion of industrial medicine anyway) full staff 'support' for medicalized birth, we are certainly NOT supported in the choice to go natural.

Mind you, it is very difficult indeed to even find a medical provider who is 'ok with' natural birth, or who actually knows a freakin thing about normal birth. Beyond that, however, those who really do want a normal, natural birth in the hospital do not have institutionally-provided access to labor support, nor to evidence based practices that most greatly benefit natural labor (such as free mobility, food and drink, birthing tubs)--the kinds of things that are well demonstrated to minimize women's experience of pain and maximize motherbaby's health as well as comfort during labor. The med system is all over having the nurses and other techies whose primary job is mind the machines, NOT the people having a birth--they utterly neglect the provision of similar staff support of natural birth.

Well, why would they? We cannot forget that Tech Medicine is Big Business indeed. Follow the money, follow the money, follow the money. If you think your 'choice' of pain med or elective csec is 'freely made', then you need to think again--because what you are told IS very much impacted by the MONEY. Hospitals make more money on hi tech. Docs make more money on surgery, and NICU and all that. The tales we are told about 'safety' of med birth, and the seductive inducements of 'no need to stay pregnant any longer, no need to experience labor, no need to feel any pain at all are ADVERTIZING, plain and simple. We don't expect any other advertizing to give us a whole, reliable picture--we are taught to be skeptical and wise about such things--why do we seem to believe the crass promotional efforts of docs and hospitals as GodsOwnTruth?

And what about the baby? What about the baby's rights??? Do I support even elective csec? Well, yes--in theory. But ONLY if families are made fully aware of the very real and even prevalent risks of that to their baby (and so, by the by, to a woman's/family's OWN well being and happiness) for being surgically removed early enough to prevent the woman's 'experience of labor'. "Late term premies" are a very real group of babies who spend otherwise needless time in the NICU with feeding and breathing problems. Now, our med brethren (and regardless of the sex of your OB or neonatologist, let's be clear that this is a MALE/PATRIARCHALLY created and dominated field) don't have to deal with this in the short or long term. They don't have to worry about the risks and the negative impact--hey, they are fully confident that they can rescue babies from the folly of elective csec (or induction); they have meds and machines to fix all that! But are parents clearly receiving the Informed Consent they need, in order to make a truly intelligent and free decision about such things? NOT.

And are women, in our rush to allow each other 'the right to self-determination', really being asked to consider the ramifications of their choices on their baby's health, now and forever? I really don't think so. This is one way in which the question, IMO, should be broadened to include the 'Democratic --self-determining-- Ideal' that one's own rights end where others' rights begin.

And what about the costs involved? Oh, you say, I have insurance! I can pay for this myself. Um, sorry, you are NOT paying for it yourself (and for the time being, let's leave aside the poor who can't). You are directly placing a burden on the entire group of insured people, and the economic ramifications are simply too far reaching to even start on here. So--if you really must have that epidural or elective induction/csec in the pursuit of personal right to choose, then maybe that is a cost that should come out of your own pocket, in the name of keeping everyone's insurance costs as low as possible. And further, required to personally cover all costs incurred if you or your baby become needful of further med care as a result of your epidural or your elective med birth

Sure, you've got rights. And your rights end where others' rights begin. This, first and foremost, means if you are going to exercise your rights most effectively on your own behalf, then you owe it to yourself to become FULLY informed about ALL the risks of medicalized birth and ALL the benefits of natural birth. Frankly I think no one should be allowed to 'choose' medicated birth, or other elective procedures of birth, without being required to know all that. Required, yes, I did say that. Because your choice is NOT just your choice, it is not just about you. It's about your baby, and it's about society on the whole...these choices do impact your whole world, after all. And which of us would really desire all the medicalization of our births if A) We really were informed about the risks to ourselves, and the benefits of natural birth to ourselves? and B) we were really fully informed about the risks to our babies in medicalization along with being informed about all the numerous benefits to our babies/families of natural birth and finally C) We really truly had the option of fully supported, fully evidence based natural birth in the hospital (labor support and all the rest)?

So....sorry for the ranty ramble, but this is why I think the question was too 'small', and cannot be answered so simply as a matter of 'pro-choice'.









excellently stated


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## gcgirl (Apr 3, 2007)

Yes, of course they do. Unfortunately it's not always going to be an option. Pain relief isn't 100% foolproof, so IMO it's *foolish* to not prepare for pain relief failure. But a right? Why not?! You can talk blue in the face about the various *risks* of pain relief methods, but there are risks to Tylenol too. Women have the right to CHOICES, and if pain relief is an option then yes, it's a woman's right to choose it.


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## *MamaJen* (Apr 24, 2007)

Ha, I'm so steeped in the natural birth mindset that when I read this question I thought at first that you were asking whether women had a right to a beautiful, gentle, nearly pain free homebirth -- I was going to say that women had a right to maximize their chance of getting it through midwifery care, waterbirthing, emotional support, etc., though of course there was no guarantee.
As far as the pain-free goes, I do think that women have every right to choose the epidural, or even a scheduled elective C-section if that's what floats their boat. It's their body and their choice. BUT, I also think they have a right to good information about those choices, which I think is what is lacking in the current system.
Of course, there's no guarantee that an epidural is going to yield a pain free birth.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *babygirlie* 
Why not say you do not have a right to a novocained tooth extraction. You ate the sugar you now must suffer the consequences. Just silly.

We don't have a "right" to a novocained dental work. I actually get mine done without novocaine. The reason for that is that, after my dentist tried the _fourth_ needle of novocaine (two on one visit, and then we rescheduled), I told him to just do the filling...the tooth was really hurting, and I just wanted it dealt with. I then discovered, somewhat to my surprise, that I preferred the pain of drilling and filling to the pain of the needle...and _vastly_ preferred either to the numbness of the novocaine.

I did consent to novocaine when I had a root canal, but that was as much because I was concerned about what would happen to my mouth when I started thrashing as it was because I knew the pain would be really bad.

In any case, there is no "right" to pain-free birth in this sense, because epidurals aren't foolproof, and more than one woman has had a needle in the spine, _and_ the pain of childbirth.

I really, really dislike the "right to a pain-free birth" language, simply because the most common use of it (at least ime) is by OBs dismissing women who don't want the epi as self-hating, self-destructive martyrs and crazy women. It's not about our "right" not to feel pain. It's about their "right" to keep control of the process.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Juvysen* 
(I actually think I read something about deliveries during one of the hurricanes a few years ago where they didn't have the facilities to do all the drugs/meds/whatever so these women were stuck doing natural childbirth)

That was actually the opening of the awesome book "Pushed" by Jennifer Block! It was in Florida during a hurricane. They ended up sending women home who weren't yet in active labor (whereas they previously would have admitted them, then probably augmented). They canceled inductions (not sure if they canceled _all_ of only those deemed not medically necessary.) I think they even canceled elective RCS.

A nurse told the story & said she was amazed. Women were delivering at all hours of the day & night (whereas before the odds were stacked for daylight births), the scheduled inductions ended up coming in within a few days of that induction laboring on their own, and the CS rate plummeted to a small fraction of what it was previously.

The nurse said this was incredibly enlightening for her & she actually left the profession of L&D nursing soon after.


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## prancie (Apr 18, 2007)

IMO you cannot grant as a "right" a finite resource. We have a right to the things we can pay for. If a hospital refuses to grant procedures and medications to people who cannot pay on the spot, that is the hospital's right. If a hospital allows payment plans and government subsidies then that is their right too.


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## AlexisT (May 6, 2007)

By that logic, prancie, a woman with no resources isn't entitled to have a professionally attended childbirth. She can't pay for it. (In the real world, EMTALA says she does.) TO me, appropriate pain relief is part and parcel of maternity care. Some women need the epidural, some women don't, but it's not the hospital's choice to make on cost grounds.

I think a woman does have a right to pain relief. Whether or not this will result in a pain free birth isn't necessarily up to us. But the hospital does not have the right to decide who really needs it. (MegBoz - you may be thinking of a story I told here once, with an acquaintance whose hospital told her she could not have an epidural.)


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## Joyster (Oct 26, 2007)

I think a woman should be able to choose what sort of birth she wants. I've had one birth with an epidural, one without, and am considering a homebirth. I am in Canada, a socialist and wholeheartedly and vehemently believe that everyone should have a right to health care as well. Even though I don't agree with elective c-sections, they are here, legal and covered. I do believe strongly in education around this. My doctor who used to deliver was not partial to them either and has always advised her patients of all the risks and she believes strongly in that as well.

Some can make the arguments that pain relief can hurt the baby, but some also make the arguments that caffeine or a glass of wine or a million other things that women do during pregnancy is not good or harmful to the baby. I dunno, where does this begin and end?

I also do not believe that me thinking I or anyone superior because they've given birth one way or another is very women or family friendly.


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## FireWithin (Apr 29, 2004)

Haven't read most of the replies.

I think have the right, and responsibility, to be fully informed about birth choices. I think birth knowledge, knowledge of dangers, and potentials (both positive and negative) have been removed from women. They should understand the ramifications of their choices.
eta: looks like many others said what I wanted much more eloquently.


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## Megan73 (May 16, 2007)

Quote:


Originally Posted by *witchygrrl* 
This was an old feminist argument--that because men ddn't have to undergo such a painful experience to have a child, why should women? That led to the "twilight sleep" kinds of births, wherein teh woman would actually have a traumatic experience but because she was blacked out during it, she had no real memory. Kind of like the date rape drug, IMHO.

I don't think you can pin this on feminism. The "twilight sleep" stuff was well underway by the 1950s (and women had been using chloroform in labor since the 1850s) - before feminism's second wave hit. And it was feminists of the "Our Bodies, Ourselves" credo that helped women think about reclaiming birth from male doctors - which included questioning being so doped up you had no idea what was going on.


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## Harmony08 (Feb 4, 2009)

I wonder what kind of responses this question would get in the Birth Trauma forum? Since the wording of "rights" etc is confusing I 'll clarify that I am taking the initial question to be asking if women have a right to pain meds in birth. Taken that way YES it is absolutely a woman's right to request pain meds if she wants/needs to. Of course some true information would be very helpful and I think the natural birth movement is doing a good job encouraging women to educate themselves. When I said yes to the epidural after 30 hours of labor I knew EXACTLY what I was saying yes too but I felt that if I didn't get it and get some rest I was heading for a c-section. Sometimes a woman may need one intervention in order to avoid others. We all have different labors, different pain, different needs. How can one woman decide what another woman should or should not need?


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## Harmony08 (Feb 4, 2009)

Quote:


Originally Posted by *loveneverfails* 
I think you're misunderstanding what I'm saying. *Can every woman *survive* childbirth pain without anesthesia?* *Obviously.* That doesn't mean she can just "suck up" the pain without there being unnecessary trauma done to her. There is a tremendous amount of variability between an orgasmic birth and one that results in PTSD due to traumatic amounts of pain and suffering. The decision of how much pain is too much is something that needs to be left up to the woman. Someone else may be able to tolerate what I don't find tolerable, and I may be able to tolerate what another woman would find intolerable.

I'm not arguing about free market forces here. I'm saying that it's such a widely variable, personal decision that doesn't fall into the category "has a right to" very easily. The question is framed oddly. Women have a right to choose between options that are available for them based on their own judgment of their situation, not because of some overarching entitlement to a pain free birth or because of some lofty moral ideal where Real Women and Real Moms Don't Have Epidurals.

Are you 100% sure about this. I have heard many stories of women who labor so long hard that they need some rest in order to make it through. What do we think happened to over exhausted burnt out mamas in the past???

(I get that you didn't literally mean "survive childbirth" just adding an idea)


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## accountclosed3 (Jun 13, 2006)

in the modern area, violence and abuse leading to premature labor and birth, or the need for a c-section and one not being available that leads to poor survival rates in developing nations.

second to this, issues of nutrition and hygiene are tops on the list for not surviving. in regards to nutrition, it's really the nutrition of the mother over time and how that affects the growth of her body as she matures that is at play, adn then hygiene at birth when the time comes.

exhaustion is not a common cause of birth-related death from what i understand from my reading. this is not to say that it wouldn't cause any number of problems, but i don't think it's one of the top causes.

---

i'd also point out that i have no objection to the use of any measure of medical methods that a woman and her advisors deem as necessary.

but, dehydration may be at issue with exhaustion--they usually interplay with each other--and that coudl lead to a high risk situation.


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## choli (Jun 20, 2002)

I think every woman should have the right to birth in the way she herself chooses - whether a home birth with no pain medication, or an elective C section. Nobody's business except the mother.


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## possum (Nov 23, 2004)

Quote:

~~Quote Removed
There are lots of things we don't have rights to that are not illegal. No one has an inherent right to have a big screen TV or a veggie garden or wall to wall carpeting, but they are also not prohibited.


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## MsBlack (Apr 10, 2007)

Quote:


Originally Posted by *choli* 
I think every woman should have the right to birth in the way she herself chooses - whether a home birth with no pain medication, or an elective C section. Nobody's business except the mother.

Respectfully disagreeing here. Not sure if you read my previous post--it was very long, so maybe lots of you skipped it!







--anyway, in briefer fashion I will say that none of us lives or births in a vacuum. Our actions/choices at birth impact not just ourselves, but our babies, our families and society on the whole in numerous ways-- having both broad and enduring effects, on all of us.

It is only in 'free countries', where individualism is so highly prized, and our belonging within a group (and within Life generally) is so little acknowledged, can we have such thoughts as yours (and others here). Yet none of us would be here without that group, and without this planet. This is a complex question, I don't pretend to have THE answer--I just think we must look beyond 'personal preference' and individual freedom in exploring it.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *Harmony08* 
I wonder what kind of responses this question would get in the Birth Trauma forum?

I had the same thought. I'd like to see the response of a woman who has been ripped open to the point of incontinence, when told that she doesn't "need" an elective c-section.

Quote:

We all have different labors, different pain, different needs. How can one woman decide what another woman should or should not need?
I think many women who say that no one should have a right to pain relief just don't have painful labors. To draw a parallel-- I didn't get morning sickness with my first child, just a couple twinges of nausea. So it would be easy for me to say "Oh, stop complaining, people with HG-- you don't NEED medication, people were pregnant long before there was medication and they did just fine, just eat some crackers or something."

Quote:


Originally Posted by *MsBlack* 
Respectfully disagreeing here. Not sure if you read my previous post--it was very long, so maybe lots of you skipped it!







--anyway, in briefer fashion I will say that none of us lives or births in a vacuum. Our actions/choices at birth impact not just ourselves, but our babies, our families and society on the whole in numerous ways-- having both broad and enduring effects, on all of us.

It's still a woman's choice. Many people would point out that a UC poses unnecessary risks to the baby and so it shouldn't be allowed. Would you agree with that?


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## dinahx (Sep 17, 2005)

You can't have a 'right' to something that costs 1000. When the world's women don't have to worry about unpollouted/contaminated drinking water, then I'll start worrying about needles in the back. And what about women whose epidurals don't take? Are their rights being violated?


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## Marylizah (Jun 17, 2005)

Quote:


Originally Posted by *dinahx* 
You can't have a 'right' to something that costs 1000. When the world's women don't have to worry about unpollouted/contaminated drinking water, then I'll start worrying about needles in the back. And what about women whose epidurals don't take? Are their rights being violated?

This is a red herring. Lots of things that we have rights to cost money. Trials, for example, before a jury of our peers. Education. You know, the public kind, that all children have a right to in the US and the Western world. Just two examples that come to mind.... There are more. Clean drinking water in other parts of the world have nothing to do with how women in the rich countries of the world should be treated when they are in a hospital, or what they should be offered as part of their care.


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## dinahx (Sep 17, 2005)

Quote:


Originally Posted by *Marylizah* 
This is a red herring. Lots of things that we have rights to cost money. Trials, for example, before a jury of our peers. Education. You know, the public kind, that all children have a right to in the US and the Western world. Just two examples that come to mind.... There are more. Clean drinking water in other parts of the world have nothing to do with how women in the rich countries of the world should be treated when they are in a hospital, or what they should be offered as part of their care.

You have a right to a trial, before the state can incarcerate you. Children have a 'right' to an education so that they can comply with compulsory education laws. Once there are 'compulsory childrearing' laws, then I'll agree it is a 'right'. It is really just a priveledge tho. No one has answered the question as to who is violating your rights in the case of a delayed or ineffective Epidural? And when your baby crashes from your BP drop, do you have a whole other set of rights then? Do you have a right to immediate general anesthesia, safety be darned, should you be determined to be feeling an iota of pain?


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## dinahx (Sep 17, 2005)

I have to add that I can't see why we are even discussing this. Most women have to forcibly refuse an epidural at least once in the course of hospitalization, nevermind several times. Most hospitals have 'epidural compliance' rates that top 90%. Does anyone really feel that this priveledge is at all threatened? Why shouldn't we worry about say the rights that are threatened, like the rights of CNMs to practice independantly, the right to be free of harassment to accept elective & costly procedures, the right to choose our place of birth, VBAC rights, etc.???


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## jeminijad (Mar 27, 2009)

Quote:


Originally Posted by *dinahx* 
I have to add that I can't see why we are even discussing this. Most women have to forcibly refuse an epidural at least once in the course of hospitalization, nevermind several times. Most hospitals have 'epidural compliance' rates that top 90%. Does anyone really feel that this priveledge is at all threatened? Why shouldn't we worry about say the rights that are threatened, like the rights of CNMs to practice independantly, the right to be free of harassment to accept elective & costly procedures, the right to choose our place of birth, VBAC rights, etc.???

This site is one of the few places that DOES concern itself with everything that you listed, 90% of the time.

I hardly think a thread on pain relief as a right v a privilege is out of place or inappropriate.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *dinahx* 
No one has answered the question as to who is violating your rights in the case of a delayed or ineffective Epidural?

That's because it's a weird question. But I'll try: It depends on intent and capability. In the case of a delayed epidural, if someone is deliberately withholding pain relief from a woman in pain, yeah, I'd say that is not only cruel but a "violation of rights". If it's just circumstance that the labor goes too fast for the pain relief to get there, that isn't anyone being cruel etc., it's just unfortunate circumstance. Only a human can violate another human's rights. So of course circumstance wouldn't violate rights, that's impossible. As for an ineffective epidural, it depends on whether it's a case of negligent incompetence. If someone is truly incompetent to the point of not being able to place an effective epidural, they should not be placing epidurals. If it's just a physical idiosyncracy, again that's circumstance, not anyone at fault.

I mean, you can't prosecute "bad luck" or "nature" for violation of human rights, which is what makes that question so weird.

To kind of give a parallel to what I'm talking about, say a woman was attempting a homebirth and ended up having to transfer and have a c-section. If the situation is: the midwife's negligence caused the need for an emergency c-section, that's one thing, and in that case there IS someone at fault. If, however, there were simply complications during childbirth, out of anyone's control, no one is at fault.

Does that answer your question?

Quote:


Originally Posted by *MsBlack* 
At the very least, again, perhaps women who want their elective csec, induction or epidural need to pay for it themselves, thus minimizing the harm caused to the greater culture.

As for UC--that is a whole nother discussion with various elements. But at least UC does not impact the greater society the way med practice does.

The fact that the cost of this is even a factor for you, convinces me that no amount of discussion is going to make us agree here. I don't think that affordability has, or SHOULD EVER have, anything to do with right and wrong.

The topic of UC is VERY relevant to what you are saying, though (except, I guess, that's it's free?). Because that is something that puts a baby at risk. So does homebirth with a midwife. So does birthing at a hospital. So does c-section. There is no such thing as a risk-free birth. The risks just change with each method. That's why we, as women, should be allowed the freedom-- and yes the RIGHT-- to weigh these risks and decide which ones we PERSONALLY are comfortable with.


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## Youngfrankenstein (Jun 3, 2009)

Quote:


Originally Posted by *MsBlack* 
I can tell you that if not UNinformed, the great majority are certainly UNDERinformed. Please remember that the majority of birthing women do not come to MDC, nor do much if any independent research. They hear only what their docs tell them; and these med things are both so highly profitable for the med institution, and make women SO much easier to 'deal with' at birth, that of course women are not being told the unvarnished truth about the risks.
<snip>
I'm sorry, but women are being sold a bill of goods that does not live up to it's promise, and daily causes harm of many sorts to women and babies--not to mention having a serious economic impact on the rest of us. It is IMO simply very shortsighted to say it's none of my business, only a woman's own business, to make birth choices.










I agree totally!

FWIW, I had my first homebirth and second pain-drug free birth a few months ago. I know about 99.9% that I would have had an epidural if I were in a hospital setting. Should I have had the right? Obviously I didn't NEED the epi to give birth but pushing out a 10# 4oz baby with her shoulder behind her back making the midwife have to reach up there and unhook her hand was EXTREMEMLY PAINFUL!

I also wonder if your labor or morning sickness "weren't so bad" you can't understand what some of us complain about. My mother used to tell me my morning sickness was all in my head. I puked for 20 weeks, you tell me. I've also heard that if you had a painful birth you "didn't do it right". Oh well!









I guess my point is that Mrs. Black is right in that my informed choice of birth setting, set me up for the "best odds" to have the kind of birth I wanted that I was in control of.


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## zip27 (Aug 14, 2009)

You know, I think there are two separate issues that are getting conflated in this thread. The first is, should people be entitled to (or provided with) health care services in accordance with a generally accepted "standard of care," either because people have a fundamental right to health care services or because society decides that the services should be offered. In this context, I think pregnancy and chidlbirth should be treated in the same manner as any other health condition.

The second issue is, what should the standard of care be. In our country, I think we can all agree that the current standard of care is to offer pain management to women in labor. If some of us don't think that's appropriate, they can work to change the standard of care - obviously standards of care for all medical procedures are not static and change over time in response to a variety of factors. It is ridiculous to require true "informed consent" of the kind that's been described in this thread to any procedure rather than consent to a doctor's explanation of the current standard of care and associated risks - you would need advanced training to really be able to weigh the pros and cons of every single medical decision you make. We hire health professionals in part because we believe (sometimes wrongly) that we can rely on their judgment in determining what appropriate care may be. That's simply the nature of the beast, and we shouldn't require women to sift through all kinds of conflicting information (during labor!) as a condition of receiving an epidural.

It gives me the willies to talk about whether pain management should be a "right" of laboring women (with the unspoken corollary being that we should withhold pain management unless the woman can somehow prove she's entitled to it or "deserves" it) given the short shrift women's health care issues have historically received in this country. I'm sure insurers, which up until very recently in this country did not have to provide any coverage for pregnancy or birth expenses, would jump at the chance to deny all coverage for pain relief absent some hideous amount of paperwork "justifying" the need for it.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *zip27* 
It gives me the willies to talk about whether pain management should be a "right" of laboring women (with the unspoken corollary being that we should withhold pain management unless the woman can somehow prove she's entitled to it or "deserves" it) given the short shrift women's health care issues have historically received in this country. I'm sure insurers, which up until very recently in this country did not have to provide any coverage for pregnancy or birth expenses, would jump at the chance to deny all coverage for pain relief absent some hideous amount of paperwork "justifying" the need for it.

Yes yes yes.

I mean, that's what I'm getting from people who say that it isn't a right-- that women should have to prove that they "need" it, and who judges that?


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## dinahx (Sep 17, 2005)

The fact is: Painfree Childbirth is actually a medical fantasy. Even if you gave us all general and sections, thus removing pain from the actual birth experience, you can't get around the icreased pain during the recovery period. Even if the recovering mom takes opiate pain relief (and can we deny that this affects the baby?!?) Women also report residual back pain from Epidural injection sites, not to mention Spinal headaches, nerve damage, painful periods after sections, emotional pain from decreased fertility related to scar tissue, painful intercourse resulting from operative vaginal delivery (made more likely by epidurals), etc.

It seems since there is not an accurate way of predicting who will experience these not so rare side effects, anymore than who will find a natural birth bearable, that we ahold never be talking about 'painfree childbirth' as a right, anymore than 'side effect free 100% effective Birth Control'. The pain can be shifted around, but never entirely removed.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *dinahx* 
The fact is: Painfree Childbirth is actually a medical fantasy. Even if you gave us all general and sections, thus removing pain from the actual birth experience, you can't get around the icreased pain during the recovery period. Even if the recovering mom takes opiate pain relief (and can we deny that this affects the baby?!?) Women also report residual back pain from Epidural injection sites, not to mention Spinal headaches, nerve damage, painful periods after sections, emotional pain from decreased fertility related to scar tissue, painful intercourse resulting from operative vaginal delivery (made more likely by epidurals), etc.

It seems since there is not an accurate way of predicting who will experience these not so rare side effects, anymore than who will find a natural birth bearable, that we ahold never be talking about 'painfree childbirth' as a right, anymore than 'side effect free 100% effective Birth Control'. The pain can be shifted around, but never entirely removed.

Okay, I see where you are coming from with this post. But I think that the OP was talking about, basically, "Should women be allowed to get an epidural." I could be wrong but that was my interpretation.


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## Lolagirl (Jan 7, 2008)

Quote:


Originally Posted by *dinahx* 
You can't have a 'right' to something that costs 1000.

Woah, slow down there. I'm mystified if this is only supposed to apply to epidurals and other analgesic during childbirth or across the board, but this sort of argument could be used to deny all kinds of healthcare to all kinds of people, with all kinds of justifications used to support those arguments. Really, does anyone here think it's perfectly fine to deny healthcare to people who either don't have health insurance or the money to come out of pocket for the expense? Would you propose some kind of system whereby we let 3rd parties decide on a case by case basis what is really "necessary" care for those who aren't able to pay cash for medical care? And let's not forget that the people making these decisions would likely be men looking largely at the bottom line and who would likely have no idea what "standard of care" is even supposed to mean.

It's all well and good to look at how other countries approach childbirth, but to simply say they don't get this care in the 3rd world so we shouldn't either is the worst kind of red herring imaginable. Because the 3rd world also doesn't have access to all kinds of medical care that greatly increases quality of life for lots of people here in the U.S. and in western Europe, let alone numerous life saving medical interventions. So what, no palliative care for you in your final days because they don't get that elsewhere, or oncological care for your cancer, or heart bypass, or heck, even access to basic birth control?

I get that this place is supportive of natural childbirth options as the norm as opposed to the exception. But there are times when medical intervention does become necessary, and those decisions should always made by the patient in consulation with her health care provider. If we want to have the power to call the shots for our own unmedicated, low to no intervention births than I simply can't envision how we can try to turn around and try to narrow the personal control another mother may have to decide differently for herself.

I'll step off my soap-box now and go back to lurking...


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## mambera (Sep 29, 2009)

Quote:


Originally Posted by *MsBlack* 
And well, the fact is, the use of drugs at birth DOES put babies at risk. It is an inconvenient and uncomfortable fact, but it is a fact.

IV analgesics that cross the placenta put babies at risk. Those are given only to a very small percentage of laboring women.

The more typical epidural analgesia that remains in the mother's vertebral canal does not, as far as I know, have any effect at all on the baby based on the studies I have seen.

Do you have specific evidence to cite that indicates otherwise? I would be interested to hear.


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## Altair (May 1, 2005)

Quote:


Originally Posted by *MsBlack* 
Respectfully disagreeing here. Not sure if you read my previous post--it was very long, so maybe lots of you skipped it!







--anyway, in briefer fashion I will say that none of us lives or births in a vacuum. Our actions/choices at birth impact not just ourselves, but our babies, our families and society on the whole in numerous ways-- having both broad and enduring effects, on all of us.

It is only in 'free countries', where individualism is so highly prized, and our belonging within a group (and within Life generally) is so little acknowledged, can we have such thoughts as yours (and others here). Yet none of us would be here without that group, and without this planet. This is a complex question, I don't pretend to have THE answer--I just think we must look beyond 'personal preference' and individual freedom in exploring it.

Then I guess no one has the "right" to eat unhealthy, because they must think of the effects they are having on other's health care bills... I guess I don't have the right not to exercise either.

Insurance covers all sorts of things that are marginally elective (hello viagra), or merely reduce pain when it's entirely possible to live with that pain.


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## dinahx (Sep 17, 2005)

So we have a 'right' to everything our individual insurance plan (or lack thereof) covers? We don't have a right to everything available to
us. So many here are misunderstanding the term 'right'. Just because I scrape together the funds to go out to dinner, does not mean that I had a 'right' to that dinner, only that I enjoyed the priveledge in return for legal tender.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *babygirlie* 
"We don't have a "right" to a novocained dental work"

Then the statement would be No one has the right to a numbing agent while at the dentist. Meaning it would be illlegal. Meaning also I'm betting no one would get dental work anymore lol. I think that's an arcane and cruel thought pattern.

No - no one has the "right" to something that may not happen. I have no right to novocaine at the dentist's, because it failed to work for me. I would never argue that people don't have a right to get the needle - if they want it - at the dentist's...but nobody has a "right" to make it work. It might not. Women have had c-sections under failed anesthesia and all the talk in the world about their "right" to be pain-free won't change that.

I also disagree about "no one would get dental work done anymore". I'm _much_ less scared of the dentist now that I don't get the needle...and far less hesitant to call if there may be a problem. Everyone's different.

I really worry about the "right to pain-free birth" thing, and the ideas it sets up in women's heads. I've known many women who didn't even know that an epi _could_ fail to provide pain relief.


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## Juvysen (Apr 25, 2007)

Quote:


Originally Posted by *Storm Bride* 

I also disagree about "no one would get dental work done anymore". I'm _much_ less scared of the dentist now that I don't get the needle...and far less hesitant to call if there may be a problem. Everyone's different.


It's funny... I went to a dentist that was in his 70's a while ago... it was amazing. He didn't even offer pain relief for a simple filling - because he was extremely skilled and it completely wasn't needed. I was nervous when he started drilling on me, but it did not hurt at all, and was unnecessary. So, uh, maybe if dentists were more frequently highly skilled at drilling the pain relief issue with dentistry wouldn't be an issue? Anyway, I was shocked at that experience.

I guess that sort of goes back to the "if women were properly supported through labor, pain relief would be less of an issue" thing, too, though... hmmm Of course, i'm sure there's instance where it's necessary anyway (surgery comes to mind, at the very least...). I'm sure the dentist I went to used some sort of pain relief thing when doing a root canal or something more extreme... I don 'tknow, just something that came to mind when you mentioned the dentistry thing.


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## zip27 (Aug 14, 2009)

Dinahx, I agree with you that "right" isn't the correct term here - if we look at what we have a right to in the strictest sense, then I don't think anyone has any right to any health care services beyond self-care. Maybe the better way to frame the question is, if you are going to provide a basic level of health care to people, should pain management for laboring women be part of that package? My apologies to the OP if this isn't what she was getting at.


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## Storm Bride (Mar 2, 2005)

Oh - and could we please find some other term than "elective c-sections" when talking about how they shouldn't be allowed. "Elective", as used officially by the medical profession, simply means non-emergency and/or non-emergent. As someone who spent an entire pregnancy fighting over my right _not_ to have an "elective" c-section, and lost my next baby trying to avoid an "elective" c-section, I find the usage of it to mean "chosen by a mother, for no medical reason" absolutely creepy. I personally think the way the natural birth community uses it is more accurate, but...it is what it is, and we're not going to change the medical community's usage, yk?


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## accountclosed3 (Jun 13, 2006)

i would say that for the most part, people on this thread are rather liberal. natural birth is likely more possible for more women than we are culturally lead to believe, but it's not a problem to not have a natural child birth depending upon the individual's circumstance.

personally, i think people have a right to choose--even if they choose in a way that i consider rather foolish. but, heck, they consider UC to be bat-poop crazy, so i guess everyone is pointing a finger.


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## dinahx (Sep 17, 2005)

Is there an Epidural rationing campaign afoot? If there is I haven't heard of it. A rate of over 90% includes women who show up too late for them, so it is really very close to 100%. I would say the woman decides, unless her doctor does, and women who are willing to risk residual back pain and/or an increased need for augmentation and a possible drop in Maternal BP followed by fetal 'crash', and a possible increase of their Cesarean Risk in exchange for pain relief are the women who get them, or women who either don't know or don't care about the possible adverse effects, or believe that it won't/can't happen to them.

I know my main reasons for not signing up are threefold:
1) I don't want to precipitate any intervention
2) if I do have a section, I want a spinal, and you can't have it if you already have an epi
3) I'd rather not go to the hospital

I care more about complete pain relief (definitely not always provided by a turned up epi) during the possibility of actual surgery than partial
pain relief during a vaginal birth.


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## GoBecGo (May 14, 2008)

How about...

"women have the RIGHT to give birth in such a way that their pain is not unduly increased". I did actually have bearable pain at home, but i KNOW i would have had unbearable agony if i'd been in hospital (it's why i opted to homebirth).

Pain RELIEF is a separate issue since, as covered above, it isn't a given even where epidurals are available - they might not work, there might not be time, etc.

But there should be a RIGHT not to have one's pain added to by rough VE's, unnecessary augmentation, fear, surgery, etc...? Yes? No? As in a woman has the right to be protected from the increase in pain caused by any and all interventions which increase her pain?


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *GoBecGo* 
But there should be a RIGHT not to have one's pain added to by rough VE's, unnecessary augmentation, fear, surgery, etc...? Yes? No? As in a woman has the right to be protected from the increase in pain caused by any and all interventions which increase her pain?

I think that nothing should be done to a woman without her consent. If she consents to an intervention, she's consenting to the risk of side effect that comes with it. If it's done without her consent, whoever did it should face prosecution.


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## GoBecGo (May 14, 2008)

But should women have to endure the pain of interventions they have consented to? If a woman is told "you need a csection as your baby is in serious distress" should she endure the csection without anaesthetic because she consented in order to save her baby's life?

Or if she consents to a VE to see how her labour is progressing should she have to accept that the person doing it can be as rough as they like and cause as much damage as the feel is ok? Many women find VE's uncomfortable enough that they offer entonox for it in the UK (even if the woman wasn't already using it). If a caregiver KNOWS an intervention could increase pain are they not required to also offer something to relieve that pain? Is that a "right" the woman should have?


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *GoBecGo* 
But should women have to endure the pain of interventions they have consented to? If a woman is told "you need a csection as your baby is in serious distress" should she endure the csection without anaesthetic because she consented in order to save her baby's life?

I think she should have anaesthetic. Why wouldn't she?


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *grumpybear* 
They may make selfish choices but they have a right to them nonetheless.

How is needing pain relief selfish? What if the relief from pain is what allows a mom to rest enough to vaginally birth her baby and avoid a C/S due to exhaustion, is it still a selfish choice?


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## possum (Nov 23, 2004)

I don't see that at all. I see a lot of people who seem to have differing opinions on a subject which is apparently very touchy. Someone having a different opinion does not mean have to mean that they are judging anyone personally or generally.
It is totally possible to completely disagree with something and still think others have a right to it.
It is also possible to think something is appropriate or sometimes appropriate and not think people have a right to it. There really are lots of shades of grey out in the world and in this thread if you care to consider people's posts and opinions.


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## GoBecGo (May 14, 2008)

Quote:


Originally Posted by *possum* 
I don't see that at all. I see a lot of people who seem to have differing opinions on a subject which is apparently very touchy. Someone having a different opinion does not mean have to mean that they are judging anyone personally or generally.
It is totally possible to completely disagree with something and still think others have a right to it.
It is also possible to think something is appropriate or sometimes appropriate and not think people have a right to it. There really are lots of shades of grey out in the world and in this thread if you care to consider people's posts and opinions.











Contrary to popular belief (especially out in mainstream Life, but it seems even here on MDC) i didn't have a homebirth to make a point. I had one because 7 years of molestation, abuse and rape as a child left me somewhat touchy about where i am able to relax sufficiently to give birth and who i am able to let near my genitals without having to be sedated. I'm not sure what the limit to the pain i would be willing to endure to have complete control over those things is. I certainly didn't reach it in labour. I don't think i should have to apologise for where i am with that, considering how i got there.


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *Harmony08* 
Let's just cut to the chase about what is going on in this thread. Women who have been lucky enough to birth without pain meds are telling women who did need pain meds that they were wrong/selfish/uninformed/weak.

Women who did hope to birth without pain meds are trying to point out that is isn't as simple as the other side is making it out to be.

The natural birth movement has done amazing things for women and their families. There is, however, a very stinky undercurrent and it is alive in this thread. I must admit that I am pretty turned off. I am sure there are women out there who have natural births and believe in natural births and who truly do not judge another woman's choices. It seems that there are also many others who would read the heartbreaking tales in the Birth Trauma forum and say "See, if she had only birthed at home/done Hypnobabies/connected to her baby/allowed the "surges" to move through her/worked with her body/read more Ina May than she would have had the beautiful birth I did."


Hope you don't think I'm disagreeing with you because I'm not - I agree with you 100%. I think that it is a shame how women are sometimes treated here when they admit that they chose pain meds for their birth.

There should be no shame in birthing with pain meds. I have no problem in stating that both of my birth were with an epidural and I really hate the idea that seems to be quite prevalent here that because I chose an epidural I mush be uneducated about childbirth and uncaring for the well being of my child.


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## choli (Jun 20, 2002)

Quote:


Originally Posted by *Harmony08* 
This thread smells very strongly of "If I can ______ than everyone else can too and if they think they can't they're doing it wrong".

1000% agree.


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## Harmony08 (Feb 4, 2009)

Quote:


Originally Posted by *possum* 
I don't see that at all. I see a lot of people who seem to have differing opinions on a subject which is apparently very touchy. Someone having a different opinion does not mean have to mean that they are judging anyone personally or generally.
It is totally possible to completely disagree with something and still think others have a right to it.
It is also possible to think something is appropriate or sometimes appropriate and not think people have a right to it. There really are lots of shades of grey out in the world and in this thread if you care to consider people's posts and opinions.


Oh good! I hope I am wrong and nobody is actually judging anybody else for getting an epidural. That would be really great!


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *Harmony08* 
Oh good! I hope I am wrong and nobody is actually judging anybody else for getting an epidural. That would be really great!

I hate to say it but chances are there is some judgement on this thread.


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## prancie (Apr 18, 2007)

i'm not sure where this thread has gone but as to the original question I say, again, "no" because pain relief is not a right, it's an entitlement provided under some circumstances. Rights and entitlements are not the same thing. Receiving social security payments upon retirement is an entitlement, not a right, as is public education.


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## SeattleRain (Mar 15, 2009)

Quote:


Originally Posted by *GoBecGo* 
But should women have to endure the pain of interventions they have consented to? If a woman is told "you need a csection as your baby is in serious distress" should she endure the csection without anaesthetic because she consented in order to save her baby's life?

Or if she consents to a VE to see how her labour is progressing should she have to accept that the person doing it can be as rough as they like and cause as much damage as the feel is ok? Many women find VE's uncomfortable enough that they offer entonox for it in the UK (even if the woman wasn't already using it). If a caregiver KNOWS an intervention could increase pain are they not required to also offer something to relieve that pain? Is that a "right" the woman should have?

I don't understand why you're assuming that the person doing the exam is rough? Why can't the person who is doing it be gentle? My doctor certainly doesn't do VE's roughly...


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *prancie* 
i'm not sure where this thread has gone but as to the original question I say, again, "no" because pain relief is not a right, it's an entitlement provided under some circumstances. Rights and entitlements are not the same thing. Receiving social security payments upon retirement is an entitlement, not a right, as is public education.

If a woman chooses to give birth in a hospital she is presented with a patient bill of rights upon her arrival - adequate pain relief is listed as one of every patients rights. Your statement is accurate for those women who choose homebirth or, in some cicumstance, birth centers but not hospitals.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *SeattleRain* 
I don't understand why you're assuming that the person doing the exam is rough? Why can't the person who is doing it be gentle? My doctor certainly doesn't do VE's roughly...

She's not assuming it. She's asking if consenting to a VE means that the woman should just have to take the pain, no matter how rough and painful the VE may be. They can be pretty awful.

I'm certainly not judging anyone for taking an epi. I'm not being even slightly snarky when I say it takes a far braver woman than I am to take a needle in the spine. I've had to psych myself through the roof for it with my 3 non-emergency sections, and would have _much_ preferred to be knocked out, even if it did increase the risk to me. I actually think I'd have given up being able to see my baby right away in order to avoid that needle. Epis and spinals terrify me.


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## hollytheteacher (Mar 10, 2007)

Yes. It is a decision each woman must make for herself. However, it is imperative that the woman has complete informed consent. Meaning she needs to know all the risks/pros/cons etc in order to make that informed decision. But yes they do have the right if chosen because it is an option and therefore have the right to make that decision.

I wanted a natural childbirth but once some interventions were thrown at me I opted to get the epidrual for fear that i'd become so exhausted i'd be forced into a c-section (and it was close...I was told several times during pushing that if i didn't hurry up a c-section would be inevitable)


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## A&A (Apr 5, 2004)

My epidural was far from "pain-free."

Just sayin'.

(It gave me a massive migraine).


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## Marilyn82 (Jan 26, 2005)

Quote:


Originally Posted by *possum* 
I believe that rights, in their truest sense, are not things that others must provide for us. They are just things we can freely chose to do or not to do - speak our minds, worship as we choose, own a gun to protect ourselves, live without fear of the government invading our homes without cause. Sometimes these rights must be protected, but never provided.

I think the concept of rights gets really sketchy when we start saying that we have a right to something that someone else has to provide us.
In some cases, such as a right to a trial by jury, I consider this a right to live without people accusing you unjustly and having to prove that you did commit a crime rather than you having to prove your innocence, IYKWIM.

Exactly







100% agree. I personally feel that,as you said - we as humans do not have an inherent "right" to anything that must be provided to us. I DO think we are entitled to take advantage of the opportunities provided to us. Therefore, I would say we do not have a basic human "right" to things like public education, or medical services including pain relief during childbirth. That being said, I DO think that we have the "right" to make CHOICES including _utilizing_ the resources mentioned above when and where available.

I think it comes down to defining the word "right". I think there are people on this thread who think of it as I do, as an inherent thing. Whereas there are people to seem to think more on the lines of what it means in our current society. It all boils down to the definition of the word, IMO.

So no, I do not believe it is a basic human right to have a pain free childbirth (or be offered pain medication etc), however I do believe it is the right of every woman to make those choices. I am so glad that we live in a place where the choice is available to most women and only wish that the knowledge was given as freely so women could have more power in those choices - whatever they may be.


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## amma_mama (May 20, 2008)

Putting aside that the "right" to pain-free cannot be guaranteed (as pain meds can fail to provide 100% coverage), I strongly believe that women have a right to choose whether or not they want/need pain meds. What right does anybody on the other side of the debate have to choose *for* me? While I would have loved to have been able to give natural, med-free birth to my DD, and I gave it an honest shot, it did not turn out that way in the end. I had to decide in the moment to do what was right for me under my circumstances. And I am thankful that I had choices. I do think that all women should be better informed about their choices and the associated risks, but then should be free to choose what they feel is best for them under their personal circumstances.

My pregnancy and birth experience made it difficult for me to understand why any woman would want to risk a homebirth, or "worse", UC. It took some time for me to understand that my pregnancy/birth experience was not the same as everybody else's - I can only make choices for myself based on my own experiences, but cannot and should not project my situation and/or impose those choices on others. We don't, in fact, walk in each other's shoes and cannot fairly judge another's situation or make decisions about what medical options should or should not be available. Yes, there are many places where (or times when) these options are not available - the answer is not to take the options away where they exist but to make them more readily available where/when they do not, together with genuine informed consent. This goes equally for homebirths, UC, waterbirth, med-free birth, as well as medicated birth.


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## dinahx (Sep 17, 2005)

The problem with this debate as it takes place in the larger society is that women are often accused of choosing home and/or natural birth for the sake of their 'experience' rather than safety (either neonatal or maternal) but somehow epidurals are conferee with safety, when this is not true at all, scientifically. Epidurals RAISE risks, that is why they require a higher level of care and monitoring. They are all about the mother's 'experience'. So as long as medicated childbirth choices aren't assumed to be choices made for the sake of fetal safety, maternal experience be darned, we're all good.


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## prancie (Apr 18, 2007)

Quote:


Originally Posted by *TCMoulton* 
If a woman chooses to give birth in a hospital she is presented with a patient bill of rights upon her arrival - adequate pain relief is listed as one of every patients rights. Your statement is accurate for those women who choose homebirth or, in some cicumstance, birth centers but not hospitals.

Just because a hospital calls it a "right" does not make it so. It is an entitlement offered by the hospital. Or as my DH call it, a "small r right." Our culture does a great deal to confuse the concept of rights and entitlements.


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## GoBecGo (May 14, 2008)

The more i think about this the more i think the word "right" is no use. Do humans have a "right" to clean drinking water? Yes, but many many peoples of the world don't have access to that "right". In that context are we saying all women should have the right to ACCESS to pain relief during labour (which doesn't mean they have to have it, and isn't a should or should not about having it)?

I am not comfortable with epidural being cited the whole time as the only way to get a pain free labour. Proper support HAS been shown to significantly reduce pain for many women (and that is not a criticism of partners, doula's or labour support - sometimes epidurals ARE required no matter how much support a woman has) but of a medical system when you might or might not know your nurse or ob, and where they might or might not be in the room for much of your labour depending on what time of day it is and how many other women there are labouring. If a woman wants to have as little pain as possible WITHOUT an epidural (for whatever reason) she should have access to that proper support. I dislike the anaesthesia being made into a "right" by the hospital, because it basically amounts, in this country anyway, to women being offered drugs as soon as they are in enough discomfort that they need more input than a nurse or MW popping into the room every 40mins. Epidurals in many hospitals in the UK are used as a blunt instrument to fix staffing problems - not enough midwives to stay one on one with a woman who clearly needs that level of support during her labour? Give her an epidural and strap on the electronic nurse. Even when you state on your birth plan you REALLY don't want to have drugs (even for one woman i know due to an ALLERGY to a whole host of the drugs on offer) they are often offered as soon as you start to vocalise any discomfort during contractions.

Obviously this isn't the case in every labour in every hospital in every country. But for a large proportion of women i do think drugs are offered or even pushed by staff who simply don't have the time and resources to do anything more individualised/useful for the woman.

I think the danger of telling women that pain relief is their "right" is that many will interpret that as meaning they NEED to have it and they MUST have it. When i was a kid we lived in a house with no mains or well water - we drank burn water off the hill. It was fresh, uncontaminated and tasty. So many people i have told act like i was living in 3rd-world style poverty when i said that, because the "right" to mains water being so widespread and so over-cited as a critically necessary thing for "civilisation" means that they are all terrified of non-mains water. When actually a good bit of the water one finds running wild in Scotland (especially the highlands and islands) is perfectly safe to drink as it is.

So perhaps it's more useful to think women should have the right to medical assistance WHEN NEEDED during labour, including pain relieving drugs if necessary. But that the pain relieving drugs in and of themselves should not be isolated, since i think enough (childless) women already believe that labour is unbearable without epidurals, which is only the case for SOME women during SOME labours. And to respond to what a few others have said, yes, i think epidurals used to allow women in long labours to rest so they can go on and have the vaginal birth they wanted are very much medically indicated and one of the wonderful aspects of the existence of such procedures.

The access to pain relief in labour is something which i both hope not to need and am very grateful for the existence of.


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## Viola (Feb 1, 2002)

Quote:


Originally Posted by *zip27* 
You know, I think there are two separate issues that are getting conflated in this thread. The first is, should people be entitled to (or provided with) health care services in accordance with a generally accepted "standard of care," either because people have a fundamental right to health care services or because society decides that the services should be offered. In this context, I think pregnancy and chidlbirth should be treated in the same manner as any other health condition.

A lot of good posts here, and I like this one also. Like many others I look at it from the point of view of a legal right because I've gotten into many endless discussions of the word right and what it means, so I don't want to get hung up on that. Currently, the access to pain relief medications in labor is a standard medical practice, but I don't think it's an unconditional legal right. The doctor clearly has some say in the matter because it is medical treatment and a lot of pain relief involves the distribution of controlled subtances.

For me it comes down to the question does any human have the right to pain relief for painful conditions, and it doesn't seem like we do. Clearly human compassion and standards of medical care dictate a certain level of alleviation of suffering, but certainly there are many situations where we can't do much for pain. My father suffered a lot of pain in the last years of his life and his pain medication was a controlled substance, so he couldn't get all that he thought would help him. He also had to undergo certain medical procedures without anesthesia because his breathing was compromised enough where the doctors wouldn't anesthetize him. I think his rights in this situation were his ability to agree to or deny having the procedure.

When I suffered a ruptured disc in my back, I couldn't get up off the floor because the pain was so bad. My husband called the paramedics who got me up, and I ended up going to the ER via ambulance and I wondered what they could even do for me. They assessed me and gave me some pain medication but then told me that was all they could do for me, they would not admit me to the hospital unless it got to the point where I was having fecal incontinence from nerve damage. The prescription I got for pain medication was for a very limited amount. So even in a situation where I have access to paramedics, hospitals, healthcare workers and pain medication, there are still limits to what you can demand and receive in terms of pain relief. I was happy they gave me some pain medication, and I feel like healthcare is a service I pay for so I do have a legal right to the standard of care for which I am paying, but I was always aware that they could just have sent me home without doing anything for me other than testing.

in regards to current obstetrical practices, I think women do have certain legal rights that end up being taken away from them under the guise of medical standards. I think ultimately a woman's right to pain relief should mean that other people can't stop her from doing things to help cope with the pain, and yet it seems these things do happen, sometimes deliberately. On a philosophical level, I feel like a woman's autonomy to do things with her body during labor is more of an inalienable right, but the access to an epidural is provided as a for pay medical service and I wouldn't say that it is necessarily a legal right. It's more of an issue when a standard of care is denied to groups of people in a discriminatory fashion that I think the question has meaning.

This reminds me of a story with my mom. My mother started having babies in the 40s, and her first 3 were twilight sleep. Her 4th child was born in Hawaii in 1955 and she had no idea when she went into it that she would get nothing but oxygen. When the doctor put the mask over her face, she thought she was getting knocked out, but that didn't happen. The doctor said he didn't believe in using pain medications during birth, and she ended up having a baby naturally (other than an oxygen mask, I guess). So he had the right to practice medicine as he saw fit and he didn't think the rendering a woman unconscious was a good practice. My mom was expecting it, though, so it was rather a shock to her, but I don't think her legal rights were violated.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *lach* 
That pain was nature's way of telling me I should have been looking where I was going, and not stepped into a giant hole.

Okay, I just burst out laughing.


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## possum (Nov 23, 2004)

Certainly they are not the same, but IMO, they all generally fall into the category of things that are not necessities and which I think it is appropriate to expect people to provide for themselves.

And of course the standard of care - including on-demand c-sections and epidurals - drastically increases the cost of maternity care. I'm not sure how much this increases the overall cost of health care. There is a reason that we were able to pay in cash for a midwife assisted home birth on an income that was very near the poverty line but would never have been able to afford out of pocket a hospital birth complete with an epidural (heaven forbid a c-section) and prenatal care with multiple blood tests and ultrasounds. There is a reason that my in laws were able to pay cash for all four of their hospital births in the late 70s and early 80s despite the fact that they were below the poverty line.
Part of the reason is astronomical malpractice costs, but a big part of it is that unnecessary, recently-available options have become the standard of care while outcomes for mothers and babies have become poorer or stayed the same.


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## tndixiemom (Jul 16, 2007)

"I'm sorry,honey. I know that you are shaking from the pain and in agony. I know you have been in labor for twenty hours and are only 6 cm, but we can't afford an extra 1000.00." How is that not classist?


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## Lousli (Nov 4, 2003)

Quote:

~Quoted Removed
Do you believe this to be the case only when *you* perceive this as not a necessity? A woman should have to provide this for herself unless it is medically necessary? So who makes that judgment? Do all women who need surgical births automatically qualify? What about maternal exhaustion? Do women have to provide their own pain relief if they need the repair for a fourth degree tear? Are women who experience normal childbirth automatically disqualified from pain relief unless they can afford it? What defines normal?


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## anj_rn (Oct 1, 2009)

I think that people have the right to access medical care. I believe that the medical community has the obligation to offer options to reduce pain. That is why a hospital in the US, can not turn away an emergency (or woman in active labor), regardless of their ability to pay.

Where is this so called painless childbirth? I had a section with my DS due to cord entanglement. I did not have any contractions. The IV (all 6 attempts) hurt, the spinal hurt (and the side effects of itching were awful). There was also a heck of a lot of pain afterward. Yes, I chose to have a medical intervention to protect my son's life, yes I was medicated, yes I still felt pain.

that being said, I also think women have the right to their preference in a childbirth experience. I would never try to take away someone's right to HBAC. But I also recognize that not all women are low risk, educated on HB, or have a good enough support system to do that.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *CherryBomb* 
I don't mean to imply it's not a two way street (or that other people haven't had a different experience), because you're certainly right. But just from _personal experience_, I've gotten it _a lot_ more from the NCB side than the main stream side. I really never had any ms people talk down to me the way I've had NCB do, even when planning a HBAC. I fully admit I'm biased and unfair because of personal experience.







But, YMMV.

I have. I also haven't had any NCB people sic social services on me for endangering my baby...despite the fact that I'm sure many people thought I was (I sure did!) when I chose a c-section for my last "birth". (Totally OT, but I _still_ can't believe that I came to a low so bad that I chose a medically unnecessary c-section. *sigh*) Someone - who chose to remain safely anonymous in her judgement - did that when I chose not to go to the hospital.

And, before you point out that the NCB community wouldn't have a leg to stand on, because c-sections are considered safe and prudent and all that, I'll point out that they could lie. The anonymous mainstreamer did.

Honestly, the _only_ difference between the arrogant Monday morning quarterbacking by the mainstream community and the NCB community is the the NCB community tends to root their arrogant judgment of other women's decisions in something with a little more teeth than, "but my doctor said". Fortunately, there are plenty of women on both sides of this who don't do it at all.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *GoBecGo* 
I am not comfortable with epidural being cited the whole time as the only way to get a pain free labour.

It's no coincidence that it's being cited this way. The "right to a pain-free birth" thing is heard more often from medpros than anyone else. They don't really give a crap about that, imo. They think that selling it that way will get women to accept the needle, and then those women are _much_ more likely to be compliant.

I strongly believe some women need the epi. I don't believe that it's the best option for the all of the huge number of women who get it.


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## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *Storm Bride* 
I strongly believe some women need the epi. I don't believe that it's the best option for the all of the huge number of women who get it.

If a woman is not willing to go through training for pain management during labor (lamaze, bradley, what-have-you), and/or doesn't have a support system, I really think that the epidural IS the best option for her.

Even women who are commited to train for pain management sometimes need an epidural. Those who don't, I would say that most of the time they have no chance of being able to handle the pain. And generally an epidural is safer and more effective than other medical forms of pain relief.


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## blessedwithboys (Dec 8, 2004)

i think the babies right to be born under the best possible circumstances trumps the mothers "right" to not feel pain.


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## triscuitsmom (Jan 11, 2007)

Quote:


Originally Posted by *MegBoz* 
"Pain-free"? No. That is simply impossible! They won't admit you into the hospital as a patient in labor until you are having ctrx, so those first few ctrx may be painful. So, it's not realistic to expect to never feel any pain!

First I agree that the question is faulty...

Second in response to what I highlighted above... considering that you can find care providers who will do elective inductions or cesareans before the start of labour and you can get an epidural placed before the induction gets started having a painfree birth (assuming the epidural works) is possible for both vaginal and cesarean births... in theory at least (like I said, assuming it works).

Do I think people have the right to pain medication if they ask for it. Yes. A thousand times yes. I don't think it's wrong or that women who choose it are in any way weaker than those who don't.

I think women need to be able to be the ultimate decision makers in childbirth. From UC to elective cesarean, the whole range should be open for them to choose from.

FWIW that is coming from a student midwife, and two time homebirth planning, UC comfortable, hospital birther because of twice being induced. The first time with an epidural after a dysfunctional labour and threatened cesarean (I wanted neither a cesarean OR the epidural I got instead) and the second time unmedicated with the exception of pitocin turned up past the maximum dosage. The second time noone could believe I didn't get an epidural. I had every reason to. And I didn't want it, and I didn't get it, and I'm glad.

But I don't judge anyone who chooses differently in that situation. When I hear people say that you "can't" birth without an epidural when you have pitocin I understand why even though for me it wasn't true...


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## triscuitsmom (Jan 11, 2007)

Quote:

~Quoted removed
Who decides it's a necessity? Seriously? This is a totally offensive thought to me. Who decides when that epidural or that c-section or that homebirth is necessary... necessary for the woman either physically or mentally. ALL of them should be options, and none should be taken away because someone else has decided it's not a necessity without knowing the facts of the situation. Because you can't possibly know the facts of the situation for each individual woman. You just can't.

ETA: I live in Canada. So personal cost to me is the same whether I have a UC or whether I have an emergency cesarean under general anesthesia after labouring in the hospital for two days and getting pitocin and multiple types of pain medication. I understand that isn't the case in the US. But that doesn't mean that those who can't afford something they need while they are birthing shouldn't have access to it. Understanding it's the reality doesn't IMO make it right.

Quote:


Originally Posted by *blessedwithboys* 
i think the babies right to be born under the best possible circumstances trumps the mothers "right" to not feel pain.

And again who decides this? I am extremely pro natural birth, pro homebirth even... but I cannot say with any certainty that it is the right choice for any woman but myself. She knows that. And when I say I support both NCB and hombirth it's because I have read the studies. I know that on paper it is statistically "better" for both Mom and baby. But it is NOT better for baby to have Mom still recovering from trauma either physical or mental months after the birth that could have been prevented if people had just listened to her to begin with. It's just not.


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *blessedwithboys* 
i think the babies right to be born under the best possible circumstances trumps the mothers "right" to not feel pain.

One thing that I will never buy into is the concept that being pregnant makes me somehow less of a human being. To say that the baby trumps the mother means that pregnancy renders me somehow less human than I was before I got pregnant. That is a repulsive concept to me.


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *blessedwithboys* 
i think the babies right to be born under the best possible circumstances trumps the mothers "right" to not feel pain.

Couldn't the same thing be said about moms who choose UC - that that the baby's right to be born under the care of a medical professional (be it a doctor or midwife) trumps the mother's "right" to birth alone?


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## new2this (Feb 11, 2010)

I haven't read through all the posts yet.

But my take on it is "right" I think is the wrong word. However I believe if a woman wants to have an epi or whatnot then she should be able to. I don't think anything in the childbirth will be without total pain short of being knocked out totally but then there is pain afterwards.

Yes since the beginning of time woman have birthed without pain but technology and times have evolved. So for me as a person with low pain tolerance and a person who can not use meditation or other things to block out pain then you bet I want that epi. I believe if a woman wants to have a natural birth more power to her but that does not make her superior to anybody else.

No one not even doctors ect can tell me or anybody else just how bad something hurts ect. Some can say its a 5 and for me it will be a 10 both of us are right.


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Kelly1101* 
If a woman is not willing to go through training for pain management during labor (lamaze, bradley, what-have-you), and/or doesn't have a support system, I really think that the epidural IS the best option for her.

Willing? What if they simply don't understand that those options help with pain? What if they can't afford it? Using the term "willing" seems judgmental, all by itself. Not everyone knows the things we know. I, for instance, at 24, had no idea that Lamaze and the childbirth classes my doctor recommended weren't the same thing. I'd never even heard of Bradley.

For all that...I laboured, with really bad back labour, for about 8 hours before I even woke up my ex. I had a support system later - for all I cared - but I did the first part completely alone, without training. Does that mean that "I did it, so anyone can?". Not at all...but the epi absolutely would _not_ have been the best option for me, and I sure didn't need any "helpful" hospital staff pushing one at me, under the guise of my "right" not to feel pain.

What about my right not to have a needle stuck in my spine? IMO, there is nothing wrong with getting the epi, if the pain is that bad. There is something wrong with a culture that teaches us from the get go that we _have_ to have it, because there's no way we can handle the pain without it. There's something wrong with a culture that yammers about the "right" to an epidural, without talking about any of the potential downsides ("yes, ma'am, here's your epi, you poor thing - oops - sorry about that six month backache, but you had the _right_ to be pain-free...when we didn't want to listen to you"). Talking up the "right" to an epidural makes an epidural sound like an unmitigated blessing. I've personally never had one, so I can't say one way or the other...but if it's anything like a spinal...YUCK!


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## triscuitsmom (Jan 11, 2007)

Quote:

~Quote Removed
Yep, and along the same vein is that those unmedicated births were taking place at home with no surgical options, yet I don't think there is a single person here who would not say that hospital births and c-sections are sometimes necessary. And sometimes they are necessary not for purely physical reasons, but psychological reasons that are just as valid.

The same can be said for epidurals. There are a myriad of physical and psychological reasons they are necessary. They aren't for every woman but you can't possibly know if they are or not.

C-sections should not just be for the economically privileged, hospital births should not just be for the economically privileged, home births should not just be for the economically privileged, and epidurals should not just be for the economically privileged.

Again just because that is the reality for some now doesn't make it right...


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## Lousli (Nov 4, 2003)

Quote:

Quoted post removed
Evolution selects for survival. It doesn't have anything to do with pain tolerance, psychological trauma, or non life threatening damage to either mother or baby. Just because someone survives childbirth doesn't mean that their experience is pleasant or not traumatic. To suggest that someone experience excruciating and/or traumatizing pain because they can't afford pain relief and um, well evolution will make sure they survive the process is absolutely dehumanizing to me.

As is the comment about the baby's right to be born under the "best possible" circumstances trumping the mother's right to pain relief. Maybe the "best possible" circumstances include having a mother able to care for her child and not experiencing severe PPD and PTSD every time she thinks of her child's birth. Of course not every childbirth experience goes this way, but some do.

And I'm not even going to get into the idea that someone who is a sexual abuse survivor might be denied pain relief because she couldn't afford it or someone else decided it wasn't in the best interests of her baby. The only person making that decision should be the woman birthing the baby.


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## lach (Apr 17, 2009)

Quote:

Removed quoted post
Humans are notoriously poorly evolved for childbirth. Because we walk upright, our hipbones must be large and solid with a very small pelvis opening. Human babies come out far less developed than any other mammal, because that's the last point they can fit. Human childbirth is far more dangerous and risky than it is for any other mammal.

Most biology textbooks at the high school and college level discuss this.


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## PinkCedar (Jan 29, 2010)

Quote:


Originally Posted by *Beppie* 
I'd just love to hear what MDC mamas think of this.
My reaction is no, it's not a "right." but just mulling it over in my head and thought it'd be great to hear what other mamas think ...

I was forced to have my first child without medication. I was on medicaid, and it wasn't covered. An epidural wasn't my _'right'_ as a poor teenage mom.

For me, this turned out ok. I was scared, and it was very hard, but I did it. I had a 9lb.4oz. baby unmedicated, but with a little episiotomy.

For *me* this was awesome. Because I, thankfully, got the rush. I did not suffer PTSD from it. Instead I glorified in it, and have happily had three more unmedicated births.

But change the roles. If one of my girls were in my shoes - 18, scared an in intense pain? Begging for help the way that I did? Don't you *dare* tell me they do not have a RIGHT to pain relief. I'll tear you a new one.

Every woman should have a right to have a good birth experience. For some, that means the right to pain relief.

Of course, in a perfect world, I would rather all women had access to free education for holistic pain management. But that's just another Utopian pipe dream of mine...


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## triscuitsmom (Jan 11, 2007)

Quote:

Removed quoted post
But again, who decides necessary?

We've already covered that there is no real way to distinguish between those who "need" an epidural and those who "want" one. How do you distinguish that? A person who is terrified of giving birth with pain to the point of psychological trauma for months after the birth I'd argue needs access to safe pain relieving medication, of which an epidural seems to be the most effective. Do you say no since she has no "medical" reason? What if that same woman is a sexual assault survivor? What if she cannot disclose that because the person abusing her is her husband who comes to every appointment with her.

You can't know. Noone can know with 100% accuracy. I want homebirths, I advocate for homebirths and natural childbirth, I am a student midwife and I do labour support now. That doesn't mean I don't understand that these are not in any way shape or form the best or right choices for every situation.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *triscuitsmom* 
But again, who decides necessary?

We've already covered that there is no real way to distinguish between those who "need" an epidural and those who "want" one. How do you distinguish that? A person who is terrified of giving birth with pain to the point of psychological trauma for months after the birth I'd argue needs access to safe pain relieving medication, of which an epidural seems to be the most effective. Do you say no since she has no "medical" reason? What if that same woman is a sexual assault survivor? What if she cannot disclose that because the person abusing her is her husband who comes to every appointment with her.

You can't know. Noone can know with 100% accuracy. I want homebirths, I advocate for homebirths and natural childbirth, I am a student midwife and I do labour support now. That doesn't mean I don't understand that these are not in any way shape or form the best or right choices for every situation.

Every other surgical procedures have guidelines. For example, a woman with uterine fibroids will be able to get surgery to ahve them removed if they are painful, above a certain size or if they are causing a fertility problem (deforming the cavity). Someone can get a hip replacement if they meet the criteria for it, someone can get a fake breat if they had a mastectomy, which they will get if they either have cancer or are high risk of getting breast cancer (if they carry a certain gene, have a certain family history, etc). That's the way medicine works in all other areas but as I said, the culture surrounding birth would need to change to start applying the same norms.

As far as psychological issues, they are generally acknowledged as legitimate medical issues and can be provided for in any guideline. While the case of a sexually abusive woman who cannot speak out because her husband comes to her apointments is really horrifying, giving her an epidural is not going to make it any better. Should we make epidurals the norm for routine pap smears as well, you know, just in case? Perhaps providing good psychological care as part of standard health care plans and better laws and mechanisms to help people who are being/have been abused would be a better idea. We might be able to make that happen with all the money we could save from unnecessary procedures.


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## Storm Bride (Mar 2, 2005)

Quote:

Removed Quoted Post
Why? I don't think every woman who lacks "training" needs an epidural, either. I've most definitely been in labour...nowhere near as much labour as I'd have preferred, but definitely labour.


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## Marilyn82 (Jan 26, 2005)

I just wanted to say, I was really enjoying what was a thought provoking and interesting topic. It's interesting to me to see the different perspectives on the issue because it's truly one of those things (like most things IMO) that just isn't as simple as black and white.

...but that is going to go downhill really quickly if we resort to snarkiness. Lets refocus on making it a productive discussion


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## triscuitsmom (Jan 11, 2007)

Quote:

Quoted Post Removed
If she says it is. If she says it will help her get through her labour without having to feel the pain and pressure that frighten her who are you to say it won't make it any better? The abuse no, but there are ways to make abuse worse for people that happen all the time in the medical field, doesn't mean we shouldn't take people at their word and try and not let it happen.

My whole point is that if you are going to say that psychological reasons are just as valid as physical ones (which I obviously agree with) then how do you decide who has a valid psychological reason and who doesn't? You can't. That's the point.

Quote:


Originally Posted by *Storm Bride* 
Why? I don't think every woman who lacks "training" needs an epidural, either. I've most definitely been in labour...nowhere near as much labour as I'd have preferred, but definitely labour.

I have to agree. I have never taken a childbirth education class of any sort, and I've never had any "training". I made it through a pitocin induced labour without needing or wanting an epidural, and it certainly wasn't pain free.


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## Marilyn82 (Jan 26, 2005)

C'mon you guys, the low blows about who knows more about this because of how much they've labored/studied etc etc are totally moot and are going to get the thread shut down









I think everyone has equally relevant information, for the sole reason that discussions like this are all about exchanges of information with the idea of challenging your ideas and making you more open to other perspectives....not to reaffirm your own biases by putting other people down. Exchanging information and even debating can be constructive...it's not a bad thing, and it doesn't mean that someone who disagrees with you isn't just as smart or deserving of respect.

*sigh*


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## possum (Nov 23, 2004)

Quote:

Quoted post removed

Very good points. I agree that if a society chooses to provide birth services to women that appropriate guidelines can be made to decide who should receive any given birth related intervention just like they do for other medical procedures. Why would that be any different?
It just doesn't make sense to me to provide unnecessary (at least in a large percentage of cases) interventions to all women on the off chance that someone might fall through the cracks. No system is fail safe and without issues.


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## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *possum* 
Very good points. I agree that if a society chooses to provide birth services to women that appropriate guidelines can be made to decide who should receive any given birth related intervention just like they do for other medical procedures. Why would that be any different?

Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?


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## triscuitsmom (Jan 11, 2007)

Quote:


Originally Posted by *TCMoulton* 
Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?

Yes, this









Also, I don't think it's fair to compare obstetrics to the rest of medicine. Not the way we have it set up right now. Obstetrics is the only specialty I can think of where most of the people (way over half) probably do not NEED to be in it. Having a baby is not, in and of itself, a medical thing. It's a body thing, yes, but not a medical thing.

However considering that more that 90% of people giving birth here do so in a hospital and without a midwife that's how it's being set up. It's hard to talk about rights and choices when the deck is stacked so heavily in favour of the intervention side.

I think homebirth should be the norm, I think natural childbirth should be encouraged and supported and help given for it, I think breastfeeding should be the norm as well.

I think that there is a time and place for other options from a life saving perspective. But I also think it's a terribly slippery slope when we take away the choice for things like c-sections, epidurals, formula, pick anything that goes against the "biological normal" in the name of someone's reason being "not good enough".


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## possum (Nov 23, 2004)

Quote:


Originally Posted by *TCMoulton* 
Would you feel the same way if they decided that it was best for all women to deliver in the hospital and not cover homebirth?

Actually, I prefer a free market for health care and all other goods and services where all consumers and producers are free to buy and sell what they see fit.
I said, "if a society chooses to provide birth services to women," because the reality is that the free market is not at work in any health care system that I know of, but I think that within existing systems there is room for improvement.

ETA: The reason why I prefer a free market is because I don't think other people need to decide for me what I can and cannot have for my birth. If a system is set-up to distribute health care, I think it has to decide what is appropriate and will be covered and what is not. If I choose what is not part of the covered services, then I am paying twice for services.


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## possum (Nov 23, 2004)

Quote:


Originally Posted by *triscuitsmom* 
Yes, this









Also, I don't think it's fair to compare obstetrics to the rest of medicine. Not the way we have it set up right now. Obstetrics is the only specialty I can think of where most of the people (way over half) probably do not NEED to be in it. Having a baby is not, in and of itself, a medical thing. It's a body thing, yes, but not a medical thing.

However considering that more that 90% of people giving birth here do so in a hospital and without a midwife that's how it's being set up. It's hard to talk about rights and choices when the deck is stacked so heavily in favour of the intervention side.

I think homebirth should be the norm, I think natural childbirth should be encouraged and supported and help given for it, I think breastfeeding should be the norm as well.

I think that there is a time and place for other options from a life saving perspective. But I also think it's a terribly slippery slope when we take away the choice for things like c-sections, epidurals, formula, pick anything that goes against the "biological normal" in the name of someone's reason being "not good enough".

I am confused. I don't think we can play it both ways. Either birth is or is not generally a medical event. If it is or becomes a medical event in a society which provides care regardless of the ability to pay, then why can't as the PP suggested there be guidelines in place to decide who should get which services?


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## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *possum* 
I am confused. I don't think we can play it both ways. Either birth is or is not generally a medical event. If it is or becomes a medical event in a society which provides care regardless of the ability to pay, then why can't as the PP suggested there be guidelines in place to decide who should get which services?

There are guidelines. That's basically what the standard of care is - guidelines.

I really don't think guidelines on pain relief, of whatever kind, in childbirth make any sense. Nobody knows how much pain a woman is in except for _her_. I know that when I checked in to the hospital with ds1, I was told by the admissions nurse, the L&D nurse, and the...think it was an intern...that I was "obviously not that far along, but we'll check you out". I was 8cm, and during a contraction, I was 10cm. They called a crash section for breech on the spot. So...three medpros assumed I wasn't that far along, based on their assessment of my appearance when I approached the check-in desk. They were all wrong. I don't want them deciding whether or not I can have pain relief.

What kind of guidelines could we possibly establish for something like that? I'm inclined to think we could say "no epidural in the parking lot"...but women can't really have that, anyway.


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## possum (Nov 23, 2004)

Quote:


Originally Posted by *Storm Bride* 
There are guidelines. That's basically what the standard of care is - guidelines.

If everyone can have something that she requests, that doesn't seem like much of a guideline.


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