Would you sign this Epidural Release Form?

[Guest guest]

Hey all!

I am perfecting my release form to hand out to expectant moms. (This

is to answer some past posts when people say " What can we do when

all moms want epidurals? " )

I think women need the truth. If a women HAD the information that

most of you had about birth, they may not choose an epidural as

their FIRST choice.

I would really like to " perfect it "

Let me know what you think- Gloria - especially!

Barbara

Epidural Release Form

I choose that my own pain be removed with the epidural, and that my

baby feels the pain of labor more intensely.

I understand that the pain from labor causes my brain to release

beta- endorphins. These are natural pain killers which can be

likened to natural morphine or heroin. These opioids are so

powerful that they can cause women to have an " out of this world " ,

or " high " feelings in between contractions, and they also have been

known to cause euphoria after the birth.

When I receive an epidural, I understand that my baby will feel the

pain of labor more intensely because my body will stop producing and

circulating these pain killing hormones mentioned above.

I choose to use the epidural medications even though I am aware that

use of these drugs will depress my baby's breathing and they will

most likely lead to the need for resuscitation and breathing

assistance for my baby at birth.

I understand that having an epidural can lead to maternal fever in

90% of the cases. A fever in the mother can cause the baby to have a

fever, which leads to a " work up " in the neonatal unit. A neonatal

work up includes a spinal tap, which is a very painful procedure.

I understand that once I have an epidural, I must have a fetal

monitor screwed into my baby's head without pain relief for my baby.

I am aware that this screw in my baby's head will be pulled with

every contraction, and tugged at when I move around.

I understand that all epidural drugs currently used during birth

where never studied for their long term effects on the development

of the fetus, and I choose to use them anyway.

I understand that having an epidural increases my risks of needing

Pitocin. Pitocin is a synthetic form of oxytocin, which is a hormone

that causes uterine contractions (among other things). The side

effects from this drug can be increased uterine contractions,

multiple unrelenting contractions, and contractions powerful enough

to tear my uterus.

I understand that Pitocin use during birth has been associated with

autistic disorders. Autism is developmental / brain disorder which

is characterized many times by a lack of attachment.

I understand that the use of epidural and especially pitocin has

been related with decreased maternal-infant bonding. Pitocin use

causes the brain to stop producing its own Oxytocin (in the Mother

and baby). Oxytocin is the hormone of love and attachment.

I understand that after receiving the epidural, my baby may

experience, " an increased heart rate " and " fetal distress " which may

mean that my unseen baby is panicking, crying in my womb and

suffering from the increased pain.

I understand that my baby's liver, which is the organ that will have

to clean the drugs from my baby's system and that because the liver

is immature, the use of epidural drugs will most likely will cause

effects such as: increased incidence of jaundice, behavioral

problems, drowsiness at birth, poor sucking reflex and poor muscle

strength and tone in the first hours of my baby's life.

I understand that the use of epidural anesthesia leads to more

cesarean sections.

Most likely, I will have a headache after the birth of my baby

because of leaking spinal fluid. This will necessitate that I lay

flat on my back so the spinal casing can heal. I understand that

this could affect my ability to breastfeed, hold and care for my

baby. Decreased touching, holding and not breastfeeding, may

decrease the body's natural bonding hormones which may cause " post-

partum depression " and failure to attach to my baby.

By signing this release, I have been told of the risks and the

possible affects of this drug on my baby and I agree to hold

harmless this hospital and my society for any problems related to

using the epidural now or in the future.

Mommas To Be- please sign here

X_________________________________________