An epidural anesthesia may be presented as a substitute for the natural opiates (endorphins) a woman is supposed to release when giving birth. The need for epidurals is a symptom of an inappropriate hormonal balance. It is therefore highly dependent on environmental factors. It is related to the degree of privacy.
While the effects of an epidural on maternal behaviour are easily demonstrated at an individual level among non-human mammals (e.g. ewes don’t take care of their lambs after such an intervention), it is difficult to demonstrate specific short-term and long-term effects among humans. In our species the effects of a disturbed hormonal balance are attenuated by the influence of the cultural milieu. For obvious reasons randomised controlled studies are not feasible. We have to rely on anecdotes and observations by practitioners.
The most convincing hard data we have at our disposal are related to foetal position during labour. A prospective study of 1562 women has evaluated changes in foetal position during labour by using serial ultrasound examinations. A strong association of epidural with foetal occiput posterior position was clearly demonstrated.(1) One of the main effects on statistics has been an increased rate of c-sections.
- Lieberman E, Davidson K, Lee-Paritz A, Shearer E. Changes in fetal positioning during labor and their association with epidural anesthesia. Obstet Gynecol 2005; 105: 974-82