Opting for the epidural trip often looks rosy, shiny, and so very enticing. But, even though floating through arguably one of the most painful medical instances in a woman's life seems like the easy choice, it's often not easy at all. First, there are personal convictions and preferences to consider: medicated or unmedicated birth? Hospital or home birth? Doctor or midwife? Second, there are the medical risks to examine. And lastly, if you're giving birth overseas you might wonder, are epidurals illegal in other countries?
Epidurals in the United States are pretty common. As many as 60 percent of American women opt for an epidural during labor and delivery time according to Fit Pregnancy. But rates of epidurals can vary country to country depending on various factors including social norms, customs, and affordability of healthcare and medications. In France the number of epidurals is higher than the U.S. at an estimated that 80 percent, according to online news outlet The Local: France. The article cited the fact that anesthesiologists are so readily available in the country as a possible reason for the higher rates, as well as French medical staff being more "active" than other countries. In Italy about 20 percent of women get an epidural because of old beliefs that women needed to endure the pain and go through the self-sacrifice of labor in order to prepare for motherhood, according to an article in Slate.
No matter where you get an epidural, it is administered the same way. The patient will get a pain-blocking medication injected into the space between their vertebrae and spinal fluid as described on the website for Fit Pregnancy. The effects take about 15 minutes to work and lasts as long as needed (with necessary or requested top offs). The catheter inserted into the spinal area delivers the drugs to the body continuously.
An epidural is a local anesthesia that numbs the lower half of your body. The medications injected into the epidural determine how numb you are, how mobile you are, and how possibly sleepy you get. An epidural is generally a mix of anesthesia and opiods or narcotics. It's the type of drugs that go into the epidurals that sometimes vary country to country depending on what is medically approved or not.
According to available research, Romper did not find any place where epidurals were illegal or banned. However, there are places where certain drugs commonly used in epidurals were banned because of high risks associated with them. The Depo-Medrol steroid produced by Pfizer is banned in Australia and New Zealand
right now according to the Pain News Network because of several serious potential risks including a life-long debilitating condition called arachnoiditis. Arachnoiditis is described by Web MD as a pain disorder that is caused by the arachnoid membrane (membrane surrounding the spinal cord) being inadvertently punctured (presumably by a doctor giving steroid injections or epidurals) which results in severe inflammation and adhesive scar tissue.
Additional warnings about the common epidural drug depo-medrol include risk of paralysis, blindness, stroke and even death according to the Federal Drug Administration in the US. The other drug that is commonly used in epidurals (even though according to it's warning label, should not be used in epidurals) is Kenalog made by Bristol-Myers Squibb. According to a report in Bloomberg, the company changed its label back in 2012 warning physicians that Kenalog is "not recommended" for injection in the epidural space near the spine because of "reports of serious medical events, including death," associated with administering the steroids in that way.
The drug is not currently banned or illegal anywhere in the U.S., according to available sources. However, if you're considering an epidural it might be a good idea to ask your provider what drugs will be used in your epidural. That way you can research all of the possible risks and benefits before getting one.
Deciding on an epidural is a tough decision for some people, and one that should be examined closely before you have your baby. There are plenty of facts and misconceptions about epidurals, and it's hardly black and white. The information touted about epidurals can also vary widely country to country. The best thing to do if you're interested in how other countries handle epidurals or if you plan on having a baby in another country, is to research the common types of drugs used and dosages in that particular country, and decide from there if it will be a right fit for you and your baby.