Anesthesiologist/Mother Shares Labor Epidural Perspective

Laura Wolf, MD

To the Editor:

Epidural

I am an anesthesiologist and the mother of 5 children. My husband is also an anesthesiologist. After reading the letter in the Fall 2006 Newsletter from Tami Maloney, wife of an “anesthesia professional,” I felt compelled to respond. Mrs. Maloney’s assertion that “anesthesiologists are at the beck and call of couples who do not prepare” adequately for childbirth is simply wrong. Mrs. Maloney extols her experience of having 4 vaginal deliveries without any pain medication. While that certainly is her right, I would not offer this “option” as being the gold standard of childbirth preparation for my patients.

I had 5 vaginal deliveries in 7 years and had a labor epidural with each one (1998, 1999, 2001, 2003, and 2005). However, the labor epidural with my first child had minimal to no effect in diminishing my labor pains. Despite preparing both physically and mentally for my delivery, the pain was intense and overwhelming. The entire experience was a blur. The other 4 deliveries were pain-free and manageable. I was able to interact with the hospital staff, my husband, and especially our new baby without the pain and fatigue to cloud my thoughts.

With so many options for pain control available today, it makes no sense to see painful, medication-free childbirth as a badge of honor. Getting physically and mentally prepared does not remove the severe pain but merely helps one deal better with it. We are lucky to have so many choices regarding pain intervention in this modern society. Most people would not consider having dental work or passing a kidney stone without some form of medication. Similarly, women requesting pain relief during childbirth should not be viewed as failures.

As an anesthesiologist who has labored 5 times, I do not think that learning to deal with labor pain is a viable option for most expectant mothers. Anesthesiologists are trained to tailor the myriad of pain relief options to each individual case. We are at the beck and call of our laboring patients to make them more comfortable if they should request our services—not to pass judgement on how well they have prepared for delivery during their pregnancies.

Laura Wolf, MD
Vero Beach, FL