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Epidurals are a miracle technology

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Re: Epidurals are a miracle technology

#61

Post by advisedwang »

atrus wrote: post #54
wl wrote: post #40

Earlier quoted context omitted.

The problem that The Retrievals deals with is epidurals failing during cesarians, which, they're quick to emphasize, is painful, open abdominal surgery. The not-so-simple solution is to convert to general anesthesia (anesthetic gas, IV propofol, etc). This isn't without its risks to the mother and the child, so there's reluctance on the part of anesthesiologists to go that route if there's other options. The result i…

> This isn't without its risks to the mother and the child > The result is unnecessary birth trauma. Not trying to be snarky, but which is it? This is definitely a situation in which having a midwife there to advocate for you is an absolute plus.

The "risk to mother and child" is referring to using general anesthesia. The "unnecessary birth trauma" is referring to C-section without any anesthesia.

Re: Epidurals are a miracle technology

#62

Post by advisedwang »

economistbob wrote: post #33

Interesting to find out that the contents of epidurals are not standardized across facilities. If that is the case, then how can one definitely opine on the safety of them when the contents are locally designed cocktails?

> how can one definitely opine on the safety of them

Because the statistics still include all those variations. The variations are also not that huge, and are also independently studied.

You might as well ask how we can talk about the risk/safety of general anesthesia, given that different hospitals and even different anesthesiologists use different drugs.

Re: Epidurals are a miracle technology

#63

Post by Fire-Dragon-DoL »

rocqua wrote: post #36

There's a very strong podcast series about the common failure of Epidurals: "The retrievals" season 2, by serial productions. I found it rather eye-opening. The series includes reporting on a conference of the Society for Obstetric Anesthesia and Perinatology (SOAP) where the professionals in this field also found it eye opening. (mostly episode 2) I don't bring this up to say that actually Epidurals suck, just to br…

I was shocked to discover that if a woman gets an epidural, it stops producing oxytocin that mitigates the pain for the baby (and mom).

That sounds absolutely horrible for that little creature. Yet I am a man, so I really am not allowed to speak on the matter and I absolutely let my wife decide entirely on the matter by herself (we had absolutely no time for an epidural, my wife delivered both kids way too fast)

Re: Epidurals are a miracle technology

#64

Post by KaiserPro »

kshahkshah wrote: post #45

HARD disagree. Watch “the business of being born”. We’ve turned a fairly routine extremely biologically conserved process into this insanely traumatic experience.

Husband of a UK doctor here.

first, childbirth is fucking dangerous. Its also unnecessarily painful. In terms of risk[1], the epidural is not the thing thats going to cause "morbidity", its the baby coming out breech or massive internal bleeding.

A non insignificant number of women literally tear themselves a new arsehole when delivering a baby. Yes elective caesarians can carry higher risks, but also might be required to actually deliver a live baby, or save the mother.

THe problem for the statisics is that there is a difference between elective caesarians and emergency once. If you group them together, then you're going to get a higher mortality/morbidity rate, because there’s a reason why it was an emergency

Personally I have no fucking clue why people wouldn't want an epidural. My wife didn't want one the second time because "she wanted to get home quicker" (by a fucking day) it turns out by her own words: "it was way way more painful without the epidural" bear in mind shes a fucking doctor, and a paediatric one at that.

[1] Women of African origin in the UK have worse outcomes in child birth, partly because of the lower uptake in pain relief.

Re: Epidurals are a miracle technology

#65

Post by kasey_junk »

Calavar wrote: post #25
tptacek wrote: post #18

Earlier quoted context omitted.

Medical professionals in the US make multiples of what the same professionals make in Europe.

This gets said a lot and it kind of irks me. (I am a physician.) US software devs also make 2x what their European colleagues do, but that never gets called out as bloat. Plus US software devs make that 2x pay without taking our additional loans for medical school at the rate of $75k per year or doing years of low pay residency where their salary doesn’t give them the means to pay off those loans.

> US software devs also make 2x what their European colleagues do, but that never gets called out as bloat.

Of course it does. And it gets acted on. Every major corporation in America has explored or implemented moving to European or other foreign developers to save costs.

Developers also don’t have the advantage of a trade group that prevents this practice, requires particular education or limits the number of people allowed to get that education.

Re: Epidurals are a miracle technology

#66

Post by nikolay »

... Except when they injure your spine, like with one of my friends. I'm not sure why women choose painless childbirth, which is not only potentially bad for them, but for their newborns as well. My wife gave birth to 3 children, two in the US, and doctors were shocked she didn't want them. Yes, it hurts. The moment your child is born, all pain is gone, and you're in the most beautiful state ever, and this creates even a stronger bond, knowing what you had to go through to bring a child to life! Men, women - we're all weaklings today. When I think about our ancestors and the sword-and-spear bloodbath battles they fought in to protect their families, we don't have such men and women anymore! Pain is an essential part of life. Chronic pain is a different story, of course.

Re: Epidurals are a miracle technology

#67

Post by EliRivers »

kshahkshah wrote: post #45

HARD disagree. Watch “the business of being born”. We’ve turned a fairly routine extremely biologically conserved process into this insanely traumatic experience.

extremely biologically conserved process

This seems just plain wrong. It is not at all extremely biologically conserved.

Pregnancy and birth varies wildly across species. Not conserved. For primates, it's got problems; in humans, pregnancy is an absolute mess. The birth itself is historically one of the most dangerous things a woman can do, and remains not exactly a walk in the park even with the best of modern interventions.

Re: Epidurals are a miracle technology

#68

Post by biggc »

nikolay wrote: post #66

... Except when they injure your spine, like with one of my friends. I'm not sure why women choose painless childbirth, which is not only potentially bad for them, but for their newborns as well. My wife gave birth to 3 children, two in the US, and doctors were shocked she didn't want them. Yes, it hurts. The moment your child is born, all pain is gone, and you're in the most beautiful state ever, and this creates ev…

Suffering is not a virtue

Re: Epidurals are a miracle technology

#70

Post by adyer07 »

Fire-Dragon-DoL wrote: post #63
rocqua wrote: post #36

There's a very strong podcast series about the common failure of Epidurals: "The retrievals" season 2, by serial productions. I found it rather eye-opening. The series includes reporting on a conference of the Society for Obstetric Anesthesia and Perinatology (SOAP) where the professionals in this field also found it eye opening. (mostly episode 2) I don't bring this up to say that actually Epidurals suck, just to br…

I was shocked to discover that if a woman gets an epidural, it stops producing oxytocin that mitigates the pain for the baby (and mom). That sounds absolutely horrible for that little creature. Yet I am a man, so I really am not allowed to speak on the matter and I absolutely let my wife decide entirely on the matter by herself (we had absolutely no time for an epidural, my wife delivered both kids way too fast)

I looked for a source for this, and found the opposite:

> Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.

In other words, the fetus makes its own oxytocin during labor. It does not come from the mother.

[1] https://link.springer.com/article/10.1186/s12884-022-05221-w

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