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Epidural Without Guilt: Childbirth Without Pain Paperback – November 25, 2010
| Gilbert J. Grant MD (Author) Find all the books, read about the author, and more. See search results for this author |
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- Print length126 pages
- LanguageEnglish
- Publication dateNovember 25, 2010
- Dimensions6 x 0.29 x 9 inches
- ISBN-100975993933
- ISBN-13978-0975993934
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About the Author
Product details
- Publisher : Russell Hastings Press; First edition (November 25, 2010)
- Language : English
- Paperback : 126 pages
- ISBN-10 : 0975993933
- ISBN-13 : 978-0975993934
- Item Weight : 6.6 ounces
- Dimensions : 6 x 0.29 x 9 inches
- Best Sellers Rank: #2,638,154 in Books (See Top 100 in Books)
- #812 in Anesthesiology (Books)
- #4,010 in Pregnancy & Childbirth (Books)
- Customer Reviews:
About the author

I have been practicing anesthesiology for 25 years, and I've been the Director of Obstetric Anesthesia at NYU Langone Medical Center in New York City for nearly 20 years, providing pain relief to women having babies. I have found that many women are quite concerned both about the pain that will accompany delivery and the methods used to relieve the pain. But it's not so simple to find accurate, up-to-date information about epidurals and spinals. I wrote "Epidural Without Guilt" to make important information about state-of-the-art pain relief techniques for childbirth available to the public.
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After reading the book, it seems to me that Dr Grant is doing the best he can as an Anesthesiologist to help the women he comes in contact with. He recommends epidural as soon as the care provider verifies mother is in labor (for convenience sake since she will get one anyway, but at who's convenience really) and even goes as far as saying that mothers should consider continuing the epidural beyond labor to improve breast feeding chances. There is an entire chapter on the risks of NOT having an epidural, his examples primarily being decreased risk of PTSD and Postpartum Depression which is questionable at best. He takes every opportunity to slam those that believe that birth is a normal, physiological event and uses the word "natural" as if it were a bad word.
I love it when he compares birth to appendicitis, necessary dental work and pneumonia and asks whether one would refuse pain meds or antibiotics in those situations. Fortunately, birth is not a dysfunction of the body (as the author describes it many times in the book) but for most women a normal bodily function. Appendicitis on the other hand is a dysfunction and the body is not able to correct the problem on it's own.
The author claims he is informing women on the benefits and risks of epidural use during birth. On page 97, he talks about the use of low-dose epidural vs traditional epidural with respect to forceps and vacuum extraction births. He claims low-dose epidural is the "way to go" since there isn't an increased risk for mechanical delivery, however the author neglects to show that in the same study those same low dose babies were more likely to have APGAR scores 7 or less at 5 minutes. In fact, the book insinuates that any side effects for baby and mother are "associated with" not caused by epidural use.
The author discusses the "walking epidural" several times in this book. Even suggesting that most women "choose to stay in bed and rest". I don't personally know of a hospital that allows women in labor with a "walking epidural" to leave her bed. There is no mention of the constant monitoring required once an epidural is administered. How can a woman walk if she is tethered to her bed with an IV, a blood pressure cuff, a pulse ox, an external or internal fetal heartbeat monitor, an external or internal contraction monitor and urine catheter? All standard procedures in most American hospitals. This is very misleading.
As far as cesareans go, he recognizes that they are on the rise (nothing due to epidural use according to Dr Grant) and goes as far as saying that cesareans by choice are "gaining acceptance" and points out that China has a 50% C-section rate and Brazil an 80% rate as examples.
Dr Grant wrote this book not to inform women about epidural but rather train them and scare them into being good patients on his L&D floor. He does not understand that birth is normal for the majority of women and from the looks of it he must be interacting with more women who want normal birth (those pesky natural birth patients) and getting in the way of his daily routine. I can see how for him, birth is scary. He has no control of the birthing woman (he points that out as a risk in his chapter about risks of not getting an epidural). He can't alleviate her pain, but he also doesn't understand it. He classifies all women who birth normally as women who have something to prove and birth people as those who cause guilt to women who choose medicated birth.
Women should be well informed. This book does not do that. Women, RUN away from this book!
I reviewed this book as a birth professional. I'm a doula and it's important to me to fully understand all the choices laboring women might make, so I can support them come hell or high water. This book delivers solid information and Dr. Grant very obviously cares about his patients, which goes a long way with me. Epidurals definitely can be amazing, wonderful miracles of modern medicine(they are the very model!), and since the majority of laboring women choose to have them, both mothers-to-be and birth professionals should know the facts about them. Bravo, Dr. Grant!
That being said, I felt that he overlooked the fact that natural childbirth is a valid choice for many women. Labor is such a different thing for different people that his comparisons of contractions to having teeth drilled or having surgery is really meaningless. Although he emphasized that it was a woman's choice, I felt that the whole tone of the book lent itself to "Sure, you COULD have a natural birth- but why would you ever want to??" I appreciate his emphasis on the safety of epidurals for both mother and baby, but it's not just about safety and it's not just about pain.
More importantly, his terminology regarding delivery really bothered me. He consistently described laboring women as "assisting" the obstetrician or midwife, and as "participating" in their birth. This language is not appropriate, even when a woman is numb from the waist down. It reduces the mother, when, in fact, she is the one whom the obstetrician is assisting. Not participating in the birth is not a choice for her, although not complying with a doctor's requests is. I would hope that there would be a second, expanded edition of this book, and that this language would be changed.
On parenting forums, I see a lot of the things I believed about epidurals before having one being repeated: that they stall labor, increase C-section rates, negatively affect breastfeeding, drug the baby, and on and on. Natural childbirth advocates use outright lies and scare tactics to dissuade women from getting them. The author discusses these myths and breaks them down based on recent research as well as his experience as an anesthesiologist. The book is not technical or aimed at medical professionals; the author's intended audience is laypeople. As an anesthesiologist he has a professional interest and duty in controlling and easing his patients' pain, and believes childbirth doesn't need to be painful if a woman doesn't want it to be. It was an easy read but informative nonetheless.
This book has given me the confidence to decide that in a future delivery I won't bother waiting to get the epidural, especially if I'm induced. Any woman still deciding whether to get an epidural, or one who knows she wants one but wants some reassurance that it's a totally reasonable and appropriate decision, should read this book.



