Some suggested questions for television and radio interviews:

• Why do so many women think epidurals are dangerous for them and their babies?
• Why bother with an epidural when a woman in labor can simply get a morphine injection?
• My mother didn’t get an epidural. Are women today not as tough as the last generation?
• What’s with that big needle used for getting the epidural? Doesn’t that really hurt going in?
• If a woman rigorously practices Lamaze, why does she need an epidural?
• Don’t epidurals slow down labor?
• Doesn’t the epidural deprive the mother of full participation in the birth experience?
• I’ve heard that it’s not easy to push when the epidural is working – true?
• Don’t epidurals lead to c-sections?
• I’ve heard that women who get a “walking epidural” are not allowed to walk. So what’s the point?
• Don’t epidurals make it more difficult to breast-feed the newborn?
• What’s the window of time when an epidural can be given? When is it too early? When is it too late?
• What’s the connection between an epidural and postpartum depression?

Interview discussion topics:
Childbirth is one of the most profound life-changing experiences. For most women, it is a very stressful time – and many women spend months worried about the pain of their upcoming labor and delivery, and the techniques used to relieve the pain. Pervasive myths about epidurals and spinals contribute to this anxiety. In EPIDURAL WITHOUT GUILT Dr. Grant answers the questions that mothers-to-be have asked him during his 25 years of practice.

The natural childbirth myth
From time immemorial, women have suffered the pain of childbirth. Although consistently downplayed by “natural childbirth” advocates, this pain has been documented through the ages in literature, drawings, etc. One of the wonders of modern medicine is the epidural, for it has that has radically transformed the childbirth experience. Techniques of pain relief that are available to women in 2011 can make childbirth nearly, if not completely, painless.

The subject of labor pain relief is very controversial
Interestingly (and unfortunately for women), labor pain is viewed differently than all other types of pain. Although we know that it is the most severe pain that most women will ever experience in their lives, it is still seen by many as a “natural” pain that should not be meddled with. Some proponents of “natural childbirth” are fervently opposed to the modern epidural and spinal, which are indisputably the most reliable ways to effectively relieve the pain of childbirth. As has been observed, there is no situation for men in which pain is not relieved because it is viewed as “natural.”

The guilt trip
Although 70% of American women use epidurals and spinals to relieve the pain of childbirth, many feel very guilty about their choice, as they are told by opponents of pain relief that they are depriving themselves of a life-defining experience and that the procedures are dangerous for their babies. For other women, the guilt is so intense that it dissuades them from asking for an epidural or spinal.

“This is not your mother’s epidural”
Today’s “walking epidural” would not be recognizable to a woman who delivered 20 years ago, when epidurals were so strong they prevented the mother-to-be from moving her legs. They certainly would not be recognizable to 20th century women who received injections of narcotics, as this type of treatment typically caused drowsiness and amnesia, not to mention nausea and vomiting. The epidurals of 2011 enable women to be pain free, awake, alert and mobile throughout their labor and delivery. Although most women don’t actually walk around much during labor, they have the muscle strength they need to push effectively when the time comes.

The “window of opportunity” myth
Many women (and obstetric practitioners, for that matter) still believe that there is a window of time during which an epidural or spinal may be administered. The myth, which is more than 50 years old, is that if epidurals or spinals are given before 4 centimeters cervical dilation, they will slow down labor. In fact, recent studies have shown that if given early, epidurals and spinals can actually speed up labor. The bottom line: if a woman wants pain relief she should get it, regardless of her cervical dilation.

The psychological consequences of unrelieved pain
Many people have the attitude that pain is a just “natural” part of childbirth –something that should simply be accepted. The story goes something like this: Labor pain, although it may be quite severe, is at worst only a temporary nuisance. Tolerate it – it will pass. After all, until modern times, before medications like morphine and procedures like epidurals were around, didn’t women always experience painful childbirth? But it turns out that pain may have many harmful effects on the mother and even on the baby that can last long after delivery. Serious psychological illness such as post-partum depression and even post-traumatic stress disorder (PTSD) may be more likely to occur in women who experience painful labors and painful deliveries.

Unrelieved pain after delivery and breast-feeding
Pain doesn’t end the moment of delivery. Unrelieved pain after delivery can make breast-feeding more difficult. There are a couple of reasons for this: The pain itself may reduce the amount of milk the new mother produces. Also, if a new mom is in pain, she may find it more difficult to interact with her baby than a mother who is comfortable. This can interfere with bonding, and bonding is very important for the well-being of the baby. There is a role for continued epidural pain relief after delivery, but this option is rarely considered.

The information gap
There is a lack of accurate information about state-of-the-art pain relief techniques for childbirth. Most expectant mothers make their pain relief decisions based on myths, rumors and hearsay – and decades-old information. Epidural Without Guilt provides mothers-to-be with the information they need to make an informed choice about what type of pain relief, if any, they would like for their labor and delivery.

Broadcast Segment Proposal: Pain relief versus natural childbirth
Silly as it seems, the notion of providing women with pain relief during labor and delivery is controversial, emotionally charged, and polarizing. Natural childbirth enthusiasts typically insist that the pain of childbirth really isn’t that bad, and, anyway, it’s only “natural.” In fact, many natural childbirth enthusiasts react strongly to suggestions that women should use medication to ease the pain.

Here’s an example of a visceral reaction from a natural childbirth person who took the time to write an Amazon review of EPIDURAL WITHOUT GUILT, even though it unlikely that she read the book (there is certainly nothing in her “review” to suggest that she did read it):
“The information presented in this book is totally inaccurate and does not reflect current research. Although I support a woman’s right to choose what is best for her during labor, she should be able to make those choices based on accurate information. Absolutely do not recommend this book.”
Tiffany Hoffman, Doula

Contrast this with a note Dr. Grant received from a woman who heads up an organization dedicated to assisting women who have experienced traumatic childbirth:
“Progressive physicians, such as you, keep me optimistic that transformational change is possible in obstetrics. I applaud your efforts to highlight the obvious link between inhumanity and trauma in childbirth with depression and post traumatic stress in mothers. Extreme and prolonged pain, lack of control and a lack of privacy and dignity are well recognized in society as causes of depression and PTSD yet, somehow, when it happens to women it is swept under the rug…Other medical specialties have long since considered the alleviation of both suffering and morbidity as quality indicators. I struggle to understand why obstetrics remains the only medical specialty that believes these things are normal and acceptable…Thank you for your extraordinary efforts for mothers everywhere – now and in the future. I wish we could clone you! The world needs more Dr. Grants!”
Penny Christensen, Birth Trauma Canada

Dr. Grant will be happy to discuss this controversy with a natural childbirth advocate. Could be “interesting.”