Dear Rebbetzin Heller: Epidural, Yes or No?

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Rebbetzin Heller has VERY strong feelings about pain relief during labor. Please share your reactions to this controversial Naaleh.com video in the comments below…(A huge thanks to JewishMOM Sharona for sending me this link)

forward to 16:58 to watch…

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Dear Rebbetzin Heller: Epidural, Yes or No?, posted with vodpod


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19 comments

  1. Go Rebbetzin Heller! Spoken as the wonderful teacher she is. All Jews have a responsibility to learn and to exercise bechira hofshit, to choose wisely. Within halachic boundaries, we don’t all need to choose the same way.

    Women with experience as health professionals and / or experience mothers can offer information and even perspective, but without being judgemental and pushy. Maybe research does support the premises that non-medicated births are more likely to result in babies who breastfeed better, in better mother-baby bonding, in speedier physical recovery for the mother, in lower hospitalization costs. Maybe some women even develop a more positive Jewish sense of their role as mothers and their partnership with Hashem through experiencing non-medicated births. All of that is important. But that is not the only legitimate or good Jewish way and we have to have an “ayin tova” on Jewish moms who choose other routes.

    I think Rebbetzin Heller’s perspective is an important contribution to discussion of this subject. Thanks so much for posting it.

  2. Mrs Belogski

    Absolutely. Rebbetzin Heller gives the only sensible perspective – each woman should make her own informed choice. I have had a variety of labours, including no pain relief at all, gas and air, epidural followed by forceps delivery and emergency c-section following a spinal for a 2nd twin. I have been blessed that my labours have gone quite quickly and so didn’t feel a need for an epidural apart from the first time when a) i was induced and b) i had no idea how it would go. Whilst personally i prefer as little medication as possible, given that the pain of labour can traumatize the mother, affect her relationship with her baby and discourage her from having more children, then women should be offered what ever support either emotional or medical will help them through the delivery as easily as possible.

  3. JewishMOM.com

    I recently met a woman who didn’t want to have any more children because she was so terrified of the pain of labor. This is a woman who has had several natural labors without pain medication.

    In my eyes, one of the most important points that Rebbetzin Heller makes is that it’s a shame not to have another baby because you are afraid of birth but are unwilling to take pain medication/an epidural.

    Imagine the child you choose not to have because of the pain of labor. And now imagine telling that child that you didn’t bring him/her into the world because you were too embarrassed of what your friends/doula/mother would think if you took an epidural. Or you are too ideologically pro-natural-birth to take an epidural. Or you are too afraid of needles to take an epidural. Or you are too “spiritual” to take an epidural.

    A woman with her priorities in order should choose a few hours of embarrassment/compromised ideology/other discomfort in order to give another human being, her child, an entire life.

    With that said, contradictory to what the Rebbetzin says, I have met women who do seem to find labor fulfilling. I have known several woman who after a home birth have told me that the birth was “amaaaaazing!” or “I really felt Hashem.”

    Another point : I had one birth with an epidural (my first) and the rest have been with no medication (in most cases, I asked for an epidural, but for technical reasons wasn’t able to get one).

    With that said, while I am ideologically very pro-epidural and totally in agreement with Rebbetzin Heller on most of her points, on a personal level I feel like my 5 unmedicated births were incredibly difficult, but also the most intensely G-d focused experiences of my life. Each birth felt like Yom Kippur times a thousand, in terms of feeling Hashem so close to me and helping me through. The epidural birth wasn’t like that. In terms of the spiritual connection I felt, you can’t even compare the two experiences.

    Again, I’m pro-epidural. I think that if a woman wants, she should get one. And the top priority of course is a healthy baby and mother, and all the rest is just the cherry on top.

    But, unlike the rebbetzin, I do feel that in many cases natural childbirth ends up being a more G-d focused experience.

  4. Thank you for posting this, although I must say that I find it puzzling that there is a need to clarify this point. It is shocking that women feel empowered to tell other women how they should go through one of the most intimate, personal experiences that exist. Pregnancy, birth and motherhood are intrinsically hard enough; there is no reason for women to have to contend with the emotional violence of other women’s judgments. I have come to feel that most of what I was told pre-birth about the importance of having the most natural, spiritual birth possible was just a load of hooey.

  5. Rebecca (comment above) took the words right out of my mouth! Let’s stop attacking our holy sisters and focus on the joy that more Jewish babies are being born! However a yiddishe baby gets here does not matter, he or she is here and we will welcome with love!

  6. Women are so careful for 9 months about what they put in their mouths. Then, at the last minute, they put a lot of medication into their bodies, that crosses the placenta immediately. Yet the doctors say it doesn’t affect the baby.

    Despite my strong feelings I completely agree with R. Heller. It must be the mother’s choice. When outlining risks there mustn’t be any emotional or religious pressure. Especially if the person telling the mom is not in charge of her medical care.

    • This isn’t just about pain relief- it’s about the compromise to a woman’s body – but MOST importantly to the baby’s body. To subject a newborn child at his most delicate time to unnecessary medications that DO have side effects on MANY baby (contrary to what R. Heller seems to feel) is irresponsible just in the name of “free choice”.

      There is also the issue of emotional bonding – anyone who knows anything about how anelgesia works biologically would be able to see that they DO affect the mind, and therefore the emotions…. of both the mother and the baby. Directly after birth is a very important (perhaps one of THE most important times) in a baby/mother bond. A lot of thought needs to be put into this decision as is can have real and serious consequences on the bonding and therefore the feeding, behaviour, and even the chances of a mother having PPD or PPA,

      I respect R, Heller, but i am disappointed in this response. If this were only an issue of pain relief vs. no pain relief I could see it… but she is missing the entire other side of the issue.

      So I think a women should be ashamed to have an epidural? No, not if it’s a necessary thing – and I can’t give the exact specifications on every situation – but what I can say is that this IS more than just a choice between pain and not pain. this is a choice that has many factors involved. Yes is it up to the mother – and I have seen epidurals helps some… and hinder many. all in all it is the women’s choice, but they must be aware of ALL of the facts. not just the handful presented in this video.

      Speaking as a mother who has had a highly medicated c/s, a mostly natural VBAC, and an unassisted home birth… and I am also a doula who has worked on staff as a hospital for a few years and at homebirths. I find this response very limited and therefore concerning.

  7. I had two babies in wonderful, empowering, completely drug-free births at a homebirth midwife’s cabin. Each birth changed my life and was a total turning point in terms of my attitude towards myself, towards life and towards motherhood.

    And I don’t think there’s anything controversial about what Rebbetzin Heller said.

    The problem us “natural birth crazies” have with the widespread use of epidural is NOT that there is something inherently evil about it, or wrong with women who choose it. The problem we have is exactly the one Rebbetzin Heller raises: choice. We feel that many women are not able to make an informed choice when they choose an epidural or other interventions like labor induction, because the medical establishment tends to gloss over the risks and disadvantages of these procedures.

    I believe that with deep, thorough emotional and mental preparation, childbirth can be an extremely spiritual and empowering experience… with or without pain relief. I also believe that birth does not necessarily have to be painful (for more on this, read “Childbirth without Fear” by Grantly Dick-Read, or search for “Hypnobirthing” or “The Mongan Method”). I think it’s a shame that many women miss out on the amazing experience of childbirth because they are so afraid of it, and I think that deeply ingrained fear is what needs to be worked on in society. Ironically, the presence of epidurals do not reduce women’s fears about birth; in fact, I would argue that they increase it. To observe this phenomenon, read a thread about childbirth and pain in any average pregnancy forum; then read one on a natural birth forum. Women who have natural births or at least consider having them tend to have a much more positive attitude towards birth. You might even hear phrases like “I can’t wait to give birth!” or “I love giving birth!” I myself am “guilty” of saying such things. 🙂

    As per Chava’s curse, notice that the Tanach does NOT say “in pain you shall bear sons”. It says, “b’etzev teldi banim”. The word “etzev” is never used to mean “pain”, not in the Tanach, not in the Gemara, not anywhere. “Etzev” means either “sadness” or……. “labor”. “In labor you shall bear sons.”

    For more on natural birth, homebirth and informed choices (if anyone is interested), you are welcome to read this:

    http://gimme-that-baby.livejournal.com/26190.html

  8. I think that Rebbetzin Heller’s point that epidural or drug-free – neither is considered more spiritual – is a good one. One can have a spiritual experience with any situation. And like Jenny above, I beg to differ with Rebbetzin Heller’s exposure to women’s birth stories – I have also met many women who’ve had engaging, grounding, spiritually connected drug-free labors – and many who were shocked that this was actually possible.

    What’s missing from Rebbetzin Heller’s discussion is some of the wide variations of types of labors – those of us who do not take epidurals ARE NOT GIBOROT (WE’RE NOT HEROINS who can endure excruciating pain for hours on end). Rather, can avoid epidurals BECAUSE OF ALL OF THE EXISTING MEANS OF COPING, which make it so that we DON’T REALLY FEEL THE PAIN – JUST PRESSURE/INTENSITY. These methods keep the body physically relaxed through, for example, massage, hot water shower, mental imagery, davening, keeping the shoulders & jaw low, and limbs loose (until one is fully dilated AND feels an urge to push), and allowing the woman to be in her most comfortable positions at all times.

    Many situations are not supportive of the woman to have all of the above, so it’s no wonder many request the drugs. And many women aren’t interested in the natural approach. So, for those who are interested, or who can’t have an epidural (e.g. low blood pressure), these methods of coping, existing since Eve, are available – they just require utmost support for the woman in this journey towards birthing her baby.

    B’sha’ah tovah,
    Chaya Valier
    Doula, Jerusalem

  9. I never found that pain traumatized a relationship between the mother and the baby. What I have found is that the level of positive support a mother gets surrounding her pregnancy, labor, breastfeeding and the baby’s first year, especially when it is a first baby, are each and all critical subjects in their own right.

    I always tell new mothers that the best thing they can do for themselves is be their own best friends and respect themselves and to stay away from criticism to the point of even cutting off relationships and avoiding negative nasty people as much as humanly possible.

    I haven’t had any medicated births aside from the first one, and it was the first child with whom I have suffered endlessly to this day.

  10. I have very strong opinions about medicated birth, and I have made choices in having my children accordingly. However, what is right for me is not right for everyone. Each woman has the right to make the choice for herself. I do think, however, that it is each woman’s responsibility to educate herself about the pros and cons of all birthing options, so that her decision is an informed one, instead of one made out of fear or ignorance.

  11. This topic is right up there with letting your kids cry themselves to sleep. hehehe…

    My first birth was completely natural, smooth and so “good” that it inspired my doula to renew her commitment to birthing (she had been feeling burnt out). For me, it wasn’t an amazing experience, I didn’t feel empowered or strong. Mainly I just thought that transition hurt a lot. I hadn’t wanted an epidural because I was afraid of potential complications and the ensuing interventions.

    For my second birth I got the epidural. I figured that I would try it and see what my preference was for subsequent children (IY”H). It was great. I plan on getting epidurals with all my deliveries from here on out. And my baby? He’s a great nurser. He’s a great baby. Waaay easier than the first one.

    So what’s my point? Do your research, try out your options, see what works for you. In ten years, research might show something completely different, and there will be a different trend.

  12. Rivki, so-called medical “research” and trends are not the way to make potentially life-changing decisions. Look at history, ask the great-grandmothers and consult your own common sense and your gut instinct.

    Chana Jenny, you say: “A woman with her priorities in order should choose a few hours of embarrassment/compromised ideology/other discomfort in order to give another human being, her child, an entire life.” I agree with you – in fact I take it a step further, and say: A woman with her priorities in order should choose a few hours of physical pain in order to give another human being, her child, the best possible start in terms of bonding and avoiding potential drug side effects.”

    Elle, you say: “There is no reason for women to have to contend with the emotional violence of other women’s judgments.”

    Emotional violence? The reason I speak out against epidurals is not chas v’sholom to pass judgment on anyone or to do any kind of violence, emotional or otherwise. It is because many women are uninformed and ignorant (deliberately redundant) and I feel responsible to try to help them avoid needless suffering.

    Rebbetzin Heller… I love you and respect you, and all you are accomplishing. I love your videos. I listen to them and learn from them. And I understand that you had 14 children without epidurals. But I do disagree with some of your statements:

    “Anything you can do to make labor easier – do it. … The pain is romanticized… ; women say birth was a positive transformative experience…’ women say it is because they were brainwashed beforehand that it would be, so they find it so. … Am I weaker [for taking epidurals]? … Rav encourages women to have epidurals because it is the pain of labor that is stopping them from having a baby every year. … No inherent spiritual value in feeling the pain of labor.”

    There is something so simple, so ancient, yet so effective in easing the pain of labor. It is a good midwife who provides true old-fashioned competent labor support. It works – and it never, ever gives you headaches, backaches, or paralysis lasting weeks or month (like epidurals sometimes do). It never affects the baby adversely. And it works!

    You are right that if we had a magic button to make labor shorter, we would press it. But since there is no magic button… the truth is that there is inherent spiritual value in going through labor (with proper support) drug-free.

    • Rishe —

      I think you may have mistaken – I didn’t say that quote you gave. Perhaps you mistakenly quoted someone else here?? I am unsure. please go back and read my actual response however, because you will see that I 110% agree with you! 🙂

      though, perhaps I think you said it a little better than I did.. hehe I was nervous about responding my disagreement with R’ Heller, but I couldn’t not say something. As a doula and mother it is a topic I am knowledgeable, experienced and passionate about. This is understandably a heated topic and it is something that should be given MUCH thought to by each woman and no decision should ever be second guess by anyone other than that women… but it should never be passed off as a decision as simple as “to have pain or not to have pain” – as that is but ONE facet of the decision.

      -FYI I HATE pain and if I could figure out a way that I personally could have a pain-free birth with no side effects, and no consequences – I would in a heartbeat lol. Natural labour isn’t something that only brave women do… and it’s not something that brave women aren’t afraid of! I am scared of birth. but i am scared of lots of things… being scared, alone, is not a reason to make any decision.

  13. Elle, I apologize. It was Rebecca who said “there is no reason for women to have to contend with the emotional violence of other women’s judgments.”

  14. i am pg about to have my 3rd child and feel extremely validated in hearing what the rebetzen says. i was made to feel less by choosing an epidural and feel that i suferred extensively both physically and emotionally as a result. i expected very spiritual experiences at birth and have actually never felt as abandoned by Gd as i did during my 1st birth. the beauty of giving birth is not the pain. the wonder of giving birth is not the suffering. and yes – it hurts and i did suffer. and i dont want to be made to feel guilty for feeling that pain and suffering. dont deny women the necessary acknowledgement that birth is tough. Recognising it as such will create a more emotionally healthy mother, equipped with the tools so badly needed for the task of motherhood.

    • I feel like you could be me. I’ve had 3 children – the first a 29 hour labor where I contracted pneumonia from my visiting sister, and had to have an emergency C-section after being fully dilated. I had had an epidural after about 15 hours of what felt like pure agony. The next baby I thought I would really try harder – but after 40 hours with no progress, I caved and got an “elective” C-section. This after a therapeutic rest I regret. The last baby I labored 40 hours, and suddenly went from 2cm to 5cm in 45 minutes; it was the worst pain of my life and the hospital had to call the security team in because I was tearing out my hair begging for an epidural, and prior to the last exam they were not fully convinced I was in labor because I had been at 2cm for so long. That one, finally, 20 hours later, resulted in my first vaginal birth.

      I feel it was by the glory of God that I even managed the last vaginal delivery, because once again I had to fight the doctors for admission, and once again they wanted to do a C-section. So I am grateful to God for that.

      However I do feel just like you – very crappy about myself. My first baby, despite being born at 41 weeks, had to spend 3 days away from me in the level 3 nursery. He breastfed for 4 weeks, I had oversupply and he fought me and I didn’t stick with it so I wound up pumping for 14 months. He also later developed night terrors and apparently has a bit of extra tooth material above one tooth. All of that could be from the pain relief they used in the emergency C section I think, and every time he had a night terror I would blame myself.

      The second one seemed to totally alleviate these fears – until at 2 years old he started having problems too. He fell from 50% to 9% height, and for a while even in weight, even though he went back up to 33% (his Dad is 6’3, and I am 66% for height). He also developed intermittent exotropia at the age of 2, and 12 cavities (supposedly from extended breastfeeding). He has something similar to high functioning autism – but not really that – his skin is very sensitive and he loves to smear things and isn’t as advanced at math or language as his brother (but I think he’s still intelligent in other ways – physical ways, and I think his emotions are fully in tact). Oh yes and they always wonder if his testes have fully descended. So you can imagine what regrets I have there.

      I always wonder if these things happened to my children because I could not tough out the pain.

      I fear what may come for even the last one with the vaginal delivery. They gave me a brief, non functioning therapeutic rest with her too, to no avail. But other than that just the epidural.

      I still hope to have one last child, and I am hoping perhaps in that I will be able to endure to the final end. I know now 60 hours of labor is normal for me.

      I remember begging to die and thinking clearly that I would end things myself if pain relief would not happen there at 5 cm. I do not understand how other women are able to handle the pain. It does result in self hate. I feel for you.

      • Thanks for writing this. I know this is an old thread but I find there is too much pressure on women to have these natural births that are supposed to be amazing and scaremongering about what the epidural does to the baby and the mother-baby bond (can you post any actual research on this that is actually validated? I’ve never seen ANY, just a lot of beliefs that don’t stand up to any scientific scrutiny. I’m prepared to be shown wrong though but would need to see some proper evidence before jumping to these conclusions). Having said this, I am all for natural births with water as pain relief etc and that is what I choose personally as able, because of the spiritual aspect, HOWEVER I feel like this pressure on women to not get pain relief is SO SO SO wrong and yes emotional violence. A best mum is one who is supported, not vilified because she chose certain type of pain relief or is not breastfeeding or whatever the current “must-do” is.

  15. Sandra Hess

    dear sisters. I am not Jewish, but respect and love the Jewish people. I can not help but respond by sharing my experience which ranges over 30 years – 27 in active practice as a traditional midwife. Also, my four children were born at home without drugs, fear, uncertainty or doubt. Providing comfort, encouragement, and being involved with the parents in preserving a private and peaceful birthing space that inspires confidence and offers a deep relaxed state ~ I find the mothers (and babies and fathers) enjoy a good experience. By far, the majority of them exclaim what a treasured peak life experience they had. Many are people of faith and exclaim their childbearing year (including childbirth) as peak time feeling closer to G_d.

    As a midwife, I have seen pain that is of suffering quality. It is not often I see that. Where a baby has lined up nicely in the pelvis and a healthy mother is humble and submissive, free of uncertainties and fear, receiving love and care by those devoted to baby and her… there lies a path to a calm and peaceful birth. A medical setting with a medical plan with routines, etc., tends to make the passage challenging and a gentle childbirth experience difficult to obtain.

    Much (not everything, but much) is determined by how we think and live our lives day to day. I say this with love to you, meaning to be helpful by sharing what I have learned from a 1000 mothers in labor. G_d creates us, has a beautiful design…..

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