Your Medical Answer Questioned!
Re: Epidurals, by J. B. Leibman, M.D.
I am responding to the letter written by Mrs. Goldstein
on epidurals. After speaking with department heads and
specialists in three hospitals, I was unable to
substantiate her statistics. Her claim of 400% increase
in posterior babies could not be verified, and even if
it could be, it says nothing, as absolute numbers are
necessary to prove anything. In other words, five in a
million is also a 400% increase over 1 in a million,
but is still meaningless.
Labor may be up to an hour longer in someone fully
dilated, but epidurals also cause full dilation faster.
Epidurals do not cause any increases in the use of
pitocin (ziruz-inducement), they cause a
negligible increase in vacuum births (less than 1%) and
do not lead to more C-sections.
Babies are not at any increased risk. The procedure is
safe, and in 15 years and over 100,000 epidurals,
temporary backache was the only side effect seen at
Ichilov Hospital by Dr. Halpern who was my contact
there. In professional hands, this remains a safe
procedure, and the risk of death is less than taking
penicillin.
The pain of childbirth is significant, and while I have
never been through it, I certainly would not want to
substitute beanbags, massages and showers for, let's
say, an amputation, instead of an epidural.
I feel that it remains a woman's choice. I have checked
with three of the hospitals with the most active
obstetrics departments and none pressure women into
having epidurals. It makes sense, too. Usually,
anesthesiologists are too busy and hate being called to
do these procedures, so I can't imagine who is forcing
women into these.
In conclusion, I stand by my words that epidurals are
safe and that women who want them should not be
dissuaded out of them. Informed consent extends beyond
what we believe in and must be given in the most
objective form. Natural, Lamaze, birth coaches are
great for the women who want them. If we agree on free
choice, let's not deprive those who don't want them.
And please, let us not make them feel guilty for their
safe and positive (epidural) birth experience, if that
is their choice.
*
ON BURNS: A talk with Mrs. B., the mother of burn
victims.
As a mother of a large family, I have experienced
several occasions of burns by my children, some
difficult, others even more so. I don't think that any
burn heals without a great deal of pain and suffering,
since the nerve endings in the skin, which protects and
envelops the body, are always affected.
Q. What is it, Mrs. B., that you would like to tell the
readers?
My great disappointment with the treatment given in
hospitals. When our Shabbos kettle tipped over and
scalded my son, the first thing we did was to put cold
water on it and order a taxi. Throughout the trip, the
boy screamed with pain and I was sorry I had removed
the leg from the water, where he hadn't felt any pain.
I comforted myself with the thought that as soon as we
reached the hospital, he would receive proper
treatment...
No compresses were given, no sedatives, and the boy
screamed with pain. In fact, they did not treat him for
the first two days of hospitalization, since they
wanted to see the degree of the burn!
My son was hospitalized for many weeks, had to have a
skin graft, suffered terribly throughout when the burn
was daily washed and scraped to help the new skin form.
I am sorry I didn't know better at the time.
Q. What have you learned about burns, since?
I had a daughter who was put into a tub of very hot
water. This time we were luckier; we used hydrotherapy.
Q. What is that?
As soon as it happened, I began screaming. Luckily, the
neighbor who came running had her wits about her. She
grabbed the child and carried her over to her bathtub
and let cold water run in. She didn't even bother to
remove the child's clothing, to save time and avoid
stripping any skin. After a while, she added some
lukewarm water to prevent shock, which is also
dangerous.
After an hour, the child had calmed down and I thanked
my neighbor. She asked me what I intended to do. It
seemed to me that everything was fine, but she said
that as soon as I removed her from the water, the pain
would return. I should keep her in a lukewarm tub for
several more hours until all pain, or even a tingling
sensation, was gone upon removal from the water.
Q. How long must one keep a burn victim in water, then?
It depends.
If one can get to the water within seven seconds, no
damage will occur since the body will not have absorbed
the heat yet and no tissues will have been damaged.
This is very important, since sometimes the pain does
not even register by then! But a burn should be kept
submerged in water until there is no pain upon
removal!
Q. What about the danger of shock in a serious burn?
It seems that the hydrotherapy is also an excellent
means of treating shock, and that water can soothe the
body internally as well as externally.
However, there is always an added risk when treating
a serious injury on your own. Medical professionals
still do not recommend doing it by yourself, even though
it usually works out ok.
Mrs. B. can be contacted at 03-6182688.
