Dr Denis Walsh, associate professor in midwifery at Nottingham University, United Kingdom, said pain was a “rite of passage” which often helped regulate childbirth. He said it helped strengthen a mother’s bond with her baby, and prepared her for the responsibility of motherhood.
But an obstetrician said epidurals were an important option for some women. Dr Walsh, who wrote on the subject in the journal Evidence Based Midwifery, agreed that in some cases epidurals were very useful.
But he said epidural rates had been rising over the last 20 years, despite the fact that alternative, less invasive ways to manage pain in labour were available. He said pain in labour was known to have positive physiological effects, such as helping to establish a rhythm to childbirth.
It also triggered the release of endorphins which helped women to adjust to pain.
Dr Walsh said epidurals were known to increase the risk that hormone treatment would be needed to boost contractions, and that devices such as forceps would be needed to complete the birth successfully.
He said: “I am concerned that if we increase epidural rates we do not know the long-term impacts of that.” But he warned that a culture had emerged where most hospitals effectively offered women epidurals on demand.
Official figures show the number of mothers receiving an epidural rose from 17% in 1989 to 1990 to 33% in 2007 to 2008. Dr Walsh said the NHS should encourage alternative ways to deal with pain such as yoga, hypnosis, massage and birthing pools.
Dr Maggie Blott, consultant obstetrician at University College London, agreed that pain could help aid the physiology of labour, and that alternative ways to manage pain were available.
She said: “There are some labours which are very prolonged, some are very complicated, and we need to have epidurals available so that women have access to them if they need them.
“Do not under-estimate the pain of having a baby – it is a very, very intense and painful experience. If it is happening hour after hour in a very prolonged labour it is very tiring and wears people down and I think epidurals are very useful in that situation.”
Dr Blott also stressed that the use of forceps, or other devices to aid birth was a relatively simple procedure, which many women would prefer to enduring pain over long periods.
Cathy Warwick, general secretary of the Royal College of Midwives, offered support for her colleague. She said: “At the moment it is very easy for most women to ask for an epidural, and if they want one they definitely should get one.
“But what Denis is saying is that we want to make sure that women get other options, and that they do get really good support from midwives.” Carrie Longton, from the parenting website Mumsnet, said her contributors had given Dr Walsh’s views short shrift.
She said: “It is very difficult to talk about this unless you have been through it. Childbirth is such a different experience to breaking a leg, or breaking an ankle, and it is different for every woman. So anybody saying you must not do anything is unwelcome.”
Ms Longton said it was vital that women who asked for an epidural were not made to feel they had failed in some way, as that was very likely to damage the bonding process with their baby.Post published in: Analysis