Most women know -- or should know -- that epidurals have risks associated with them. Epidurals can lead to the often quoted "cascade of interventions." A recent study has brought to light a surprising and amazingly common side effect of epidural intervention. This side effect brings on even more risks, including high rates of cesarean section and instrument assisted delivery.
The side effect is having a persistently posterior baby. Posterior means that your baby's spine is up against your spine and your baby is facing forward (towards your belly button). Posterior babies can and are born vaginally with no intervention. However, a posterior delivery can be much harder than an anterior delivery.
Why the Increased Risk?
The risk of having a persistently posterior baby is increased with an epidural because the epidural relaxes all of the muscles around the baby. The mother is also forced to be bed ridden. Studies have shown that many babies turn different ways during labor, but most settle into the anterior position (facing your back).
If an epidural has relaxed the back muscles the baby can more easily spin around and lounge with spine against your spine (facing your front). An epidural will most likely prevent you from moving during labor, and you will lie on your back. This position will encourage your baby to lie spine to spine.
Why Does it Matter?
Posterior babies are the most common culprit for back labor. Back labor is the term used when a laboring woman feels intense back pain during labor. Though clinical evidence does not show posterior babies increase back labor, many women who have posterior babies report intense back labor, lending anecdotal evidence.
Having a posterior baby (sometimes called "sunny side up") makes interventions much more likely because it is harder for the baby to move through the birth canal. The use of forceps and vacuum extraction is greater with posterior babies.
Cesarean section is also more likely, perhaps because of more "failure to progress" diagnoses. Cesarean surgery is a major abdominal surgery that is harder for mothers to recover from and also puts babies more at risk for breathing difficulties.
Being born from a posterior position is ok for babies. However, a baby born "sunny side up" may have swelling in the face that takes a day or so to fade, due to the baby's unusual birth presentation.
Weigh the Options Carefully
Epidurals do provide pain relief, but with many risks. You may have heard some of the risks (headache, fever, back pain, and increased chances of cesarean deliveries) -- and you should take the time to research those risks and more.
The increased risk of posterior babies when using an epidural is one reason to seriously consider other methods of pain relief. Natural pain relief options can be excellent for you and your child. Be aware of what is best for yourself and your baby, and make the choice that will benefit both of you.
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