About The Book

Epidural Without GuiltIn EPIDURAL WITHOUT GUILT: CHILDBIRTH WITHOUT PAIN,Dr. Grant explains in an easy-to-read, understandable format everything that an expectant mother needs to know about the state-of-the-art options for pain relief for labor and delivery.In EPIDURAL WITHOUT GUILT: CHILDBIRTH WITHOUT PAIN,Dr Grant redresses the lack of accurate information available on modern pain relief techniques, and the unnecessary anxiety that the fear of the unknown creates for mothers-to-be.In EPIDURAL WITHOUT GUILT: CHILDBIRTH WITHOUT PAIN, Dr. Grant develops his premise that the administration of medication to relieve labor pain is a sensible approach, and that it is pointless to suffer though labor and delivery.

In EPIDURAL WITHOUT GUILT: CHILDBIRTH WITHOUT PAIN, Dr. Grant presents a common-sense approach to childbirth pain relief. He explains the reasons why women can and should get an epidural before the severe pain of labor starts – if they decide you want one. Dr. Grant’s refreshing view on when the epidural should be given challenges the ‘conventional wisdom,’ and is a radical departure from current approaches, where women typically delay getting an epidural for as long as possible – until the pain becomes unbearable.

In EPIDURAL WITHOUT GUILT: CHILDBIRTH WITHOUT PAIN, Dr. Grant encourages readers to advocate for themselves, and to carefully consider and discuss the management of their labor and delivery pain with their health care providers before they go into labor. He encourages women to empower themselves by learning the facts about modern pain relief for childbirth. After reading the book, mothers-to-be will be able to make decisions based on facts, not on rumors and hearsay and they will have a thorough understanding of their options for the best pain relief known to woman – the ‘walking’ epidural and/or spinal.


Preface: Why I Wrote This Book—and Why You Should Read It
  1. Why Is Childbirth Pain Viewed Differently from All Other Types of Pain?
  2. Causes of Childbirth Pain and Strategies for Its Relief
  3. From Better to Best: Childbirth Pain ReliefThen and Now
  4. Leaps and Bounds: The Walking Epidural and Other Advances
  5. The Timing of Labor Pain Relief
  6. Epidurals and Spinals: A Guided Tour
  7. If Your Delivery Is Cesarean
  8. It Ain’t Over Till It’s Over: Postpartum Pain Relief
  9. The Risks of Epidurals and Spinals
  10. Unrelieved Pain: The Risks of Not Using an Epidural or Spinal
  11. Childbirth Pain Relief: Myths and Realities
  12. Time for Some New Thinking
  13. Notes
  14. Glossary
  15. Index
  16. About the Author
  17. List of Proprietary Pharmaceuticals

Sample book excerpt:

Why I Wrote This Book and
Why You Should Read It

As an anesthesiologist, I have been caring for women during childbirth for twenty-five years. I specialize in relieving the pain of labor and delivery using the most effective and reliable means

available: epidurals and/or spinals. The most frustrating aspect of my job is watching fear, guilt, and misinformation make up women’s minds on childbirth pain relief before they’ve had a chance to do so for themselves.

Many mothers-to-be are quite concerned about the safety of labor pain relief techniques. The thought of receiving an epidural, which involves inserting a needle into the lower back, can be unsettling. And mere mention of the term “spinal” can heighten the dread, compounded by frightening stories women may have heard about anesthesia. So this double-edged fear—

of labor pain itself and of the techniques used to treat it—can cause anxiety for months before delivery.

In addition, women attending childbirth education classes, predominantly first-time mothers-to-be, often report that instructors put a negative spin on epidurals and spinals, dismissing them as “unnatural” or even harmful interventions. If some women worry that their request for labor pain relief will be interpreted as a sign of weakness, others fear it will harm their baby, a fallacy you will come to understand after reading this book.

During my wife’s first pregnancy, back in 1993, I browsed through the materials she was reading and found that although many of them discussed a variety of ways to manage the pain of childbirth, none presented the full picture of epidurals/spinals, even though these techniques are used by nearly three in four of women who give birth in the United States. Worse still, the information presented was often incorrect.

So in 1996, to better inform and educate patients about epidurals and spinals, I began offering a monthly seminar at New York University Langone Medical Center, where I work and teach. The success of this program persuaded me to extend its reach by writing Enjoy Your Labor, published in 2005.

Based on the questions expectant mothers have asked me over the years, Enjoy Your Labor was designed to demystify epidural/spinal techniques by detailing what to expect in easy to-understand terms. I find that once women have a thorough understanding of what’s involved, they are much less anxious about receiving pain relief, and perhaps about the process of delivery itself.

Another key point I sought to convey—and one not emphasized in any book I came across—was the advantage of getting epidurals/spinals early in the course of labor. My philosophy is common sense: If you choose to have the best pain relief possible for labor and delivery, get it before severe pain begins. All too frequently, women receive their epidural after labor pain becomes unbearable, the way childbirth pain traditionally has been handled.

To foster informed decision-making about childbirth pain relief, it was also critical to debunk the many myths surrounding epidurals/ spinals. Without doubt, these misconceptions color the ability to judge whether labor pain relief is right for you. Five years later, however, I am disheartened to report that myths regarding pain relief for childbirth remain entrenched and continue to be communicated in subtle and not-so-subtle ways.

Recently, a woman whose epidural turned agony into a comfortable birth experience told me afterward that her yoga teacher had warned the class about the dangers of epidurals. This new mother lamented that other students may have been dissuaded from taking advantage of what she discovered was a very good thing indeed.

Also, since Enjoy Your Labor was published, more research has come to light that shows a connection between unrelieved pain during and immediately after childbirth and the development of serious long-term problems for mother and child. These problems include psychiatric disorders such as post-partum depression and post-traumatic stress disorder, as well as chronic pain.

To inform expectant mothers about these important new findings, and debunk the still-present myths surrounding epidurals/spinals, I decided to write Epidural Without Guilt. As you will learn from reading this book, rather than harming you or your baby, an epidural/spinal can actually benefit you both. But since most women—and men—are not aware of this, needless trepidation continues to inject an unhealthy dose of guilt into pain relief decision-making.

This new edition was also fueled by the women who told me they found Enjoy Your Labor informative, that it helped them to cope with some of the uncertainties of childbirth. Like them, you will see the logic behind getting an epidural as soon as it is clear you are truly in labor, and before the pain becomes severe. You’ll learn the benefits of relieving pain not only during labor, but also after delivery, during the postpartum period. And you’ll come to understand that you should feel no guilt about choosing the best type of pain relief available.

This book is written from my perspective as an obstetric anesthesiologist practicing in a major teaching hospital where medical advances are introduced, and where my colleagues and I provide full-time coverage in the labor and delivery suite. At smaller facilities, anesthesiologists may serve obstetric patients on an as-needed basis, so certain techniques I describe may not be available. Learn which options you will have long before labor commences.

A clear understanding of the process of labor pain relief will reduce fear about your upcoming delivery. Empower yourself with knowledge so you can make an informed choice. Knowing what to expect in terms of pain management will help to focus your thoughts on the one that is most important: joyful anticipation of your new baby.


This slim paperback should be required reading for pregnant women. Few books get this detailed about epidural pain relief, and it is such important information for women to have as they consider their options during childbirth. —Library Journal, Oct 1, 2010