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Is the Rise in Epidural Use Similar to the Drug Culture of the 1970’s?

November 11, 2010

Midwifery Today has an article comparing the use of epidurals, and the cultural acceptance of such powerful drugs as commonplace to the cultural norms of the 1970’s where drug use was allegedly much more commonly accepted:

Women get epidurals for one of the main reasons so many women smoked pot in the 1970s—their friends are doing it. This article examines why so many women in the Western world are compelled to take powerful drugs during their labor and exposes the risks epidurals pose to both mother and baby.

Photo by Patti Ramos
Photo by Patti Ramos pattiramos.com

This year, about two million women will get an epidural legally, but hopefully not lethally, in the US. As a result, about eight of them will never walk unassisted again. In Westernized countries, roughly 50–70% of birthing women have epidurals for pain relief. Research on who gets an epidural and why draws a profile very similar to the people who were taking drugs in the ’70s. Most women are getting epidurals because their friends are doing it.(1) In a recent, large study of epidural users, the most often cited factor in deciding to have an epidural was having heard about positive experiences from friends and family. Having already had children and having fear of the side effects of an epidural each reduced the odds of choosing one by half. In other words, the older or wiser women get, the more they avoid the epidural trip

Interestingly enough, this author points out that the older a woman gets, the less likely she is to choose the “epidural trip,” implying that age and ability to gauge risk influence a woman’s decision to have an epidural during childbirth.  This woman also speaks from the cultural experience of watching talented entertainers die at the hands of “injectable drugs,” likening the dangers of heroin and the like with dangers of the drugs used by the medical profession:

The typical epidural is a combination of two powerful opiates: fentanyl and bupivacaine. Fentanyl has 80 times the potency (and side effects) of morphine. Bupivacaine has the ability to cause tingling around the mouth, tinnitus, tremors, dizziness, blurred vision, seizures, depression, loss of consciousness, respiratory depression and/or apnea. Bupivacaine has caused several deaths by cardiac arrest when an anesthesiologist accidently inserted the epidural analgesia into a vein instead of the epidural space in the spine.

Today, health authorities tout epidural analgesia as the safest, most effective method of pain relief available for childbirth. You could not pull that off on my generation. We lost enough creative artists—Janis Joplin, John Belushi, Jim Morrison and Lenny Bruce—to injectable pain killers.

We might compare those deaths to the death of Michael Jackson:

On August 28, 2009, the Los Angeles County Coroner declared Jackson’s death a homicidecaused by the combination of drugs in his body.[3] Before his death, Jackson reportedly had been administered propofol, along with two anti-anxiety benzodiazepineslorazepam andmidazolam.[4] Law enforcement officials investigated Jackson’s personal physician, who told investigators that he had been trying to wean him off propofol. On February 8, 2010, Murray pleaded not guilty to charges of involuntary manslaughter, and was released after posting a US$75,000 bail.[5]

death of Heath Ledger:

After two weeks of intense media speculation about possible causes of Ledger’s death, on 6 February 2008, the Office of the Chief Medical Examiner of New York released its conclusions, based on an initial autopsy of 23 January 2008, and a subsequent complete toxicological analysis.[9][10][101] The report concludes, in part, “Mr. Heath Ledger died as the result of acute intoxication by the combined effects ofoxycodonehydrocodonediazepamtemazepamalprazolam and doxylamine.”[9][11] It states definitively: “We have concluded that the manner of death is accident, resulting from the abuse of prescription medications.”[9][11] The medications found in the toxicological analysis are commonly prescribed in the United States for insomniaanxietydepressionpain, and/or common cold symptoms.[9][11] Although theAssociated Press and other media reported that “police estimate Ledger’s time of death between 1 p.m. and 2:45 p.m.” (on 22 January 2008),[102] the Medical Examiner’s Office announced that it would not be publicly disclosing the official estimated time of death.[103][104] The official announcement of the cause and manner of Ledger’s death heightened concerns about the growing problems of prescription drug abuse or misuse and Combined Drug Intoxication (CDI).[10][101][105]

or Brittney Murphy:

“On February 25, 2010, the coroner released a report stating that Murphy had been taking a range of over-the-counter and prescription medications, with the most likely reason being to treat a cold or respiratory infection. These included “elevated levels” of hydrocodoneacetaminophenL-methamphetamine and chlorpheniramine. All of the drugs were legal and the death was ruled to be an accident, but the report observed: “the possible adverse physiological effects of elevated levels of these medications cannot be discounted, especially in her weakened state”.[36]

This death by drugs, whether prescription, over the counter, or delivered under the guidance of a health care practitioner, is an all-too-real phenomenon.  It would be foolish to state that somehow women in childbirth would be immune to the effects of prescription drugs, to the point that the action of the drugs would also no be afflicted with the risk of death. “Tripping” is no longer considered a societally form of self expression or exploration, just as “twilight sleep” and “twilight birth” are no longer considered the medical norm for giving birth.  The Midwifery Today article highlights the impact of cultural acceptance on childbirth practices, even down to questioning “why so many women are tripping during labor”?  I

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2 Comments leave one →
  1. B. Isaac permalink
    December 29, 2010 5:30 am

    Did a man write this or possibly a woman who has nevered experienced childbirth? `The choices during childbirth are taking the chance of the epideral, c-section, cutting through the flesh, or natural, feeling like you’re being ripped apart and then the nice slice of assistance from the one assisting in the delivery…..yes there is meditation and other methods of calm, but in reality; childbirth is not a picnic!

    • brokeharvardgrad permalink*
      January 3, 2011 4:58 pm

      The article from which this post was generated was posted on Mothering.com. You can always click on the link in the article to find the source. I don’t think anyone is saying childbirth is “a picnic,” but there are some who worry about the effects of the levels of drugs imparted by epidurals.

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