Epidurals are a miracle technology

There's a very strong podcast series about the common failure of Epidurals: "The retrievals" season 2, by serial productions. I found it rather eye-opening. The series includes reporting on a conference of the Society for Obstetric Anesthesia and Perinatology (SOAP) where the professionals in this field also found it eye opening. (mostly episode 2)

I don't bring this up to say that actually Epidurals suck, just to bring attention to the fact that they can fail, and that the system has historically handled such failure really poorly, and that the system itself isn't very well aware of this issue. This isn't just opinion from some podcast, but also admitted by the professionals working within this field.

It's also something valuable to be aware of when you or your partner is planning to have an epidural, because there is real space (and even a need) for advocacy for the patient when an epidural fails and the woman giving birth is in excruciating pain.

Male scheduled for my 3rd epidural with steroids next week for on-going spinal stenosis, relieves pain for a few days, then back to pain.

Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause.

In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg.

Success rates of better than 70%, it's a gamble. But willing to accept that rather than end up on addictive pain pills for life.

3 to 6 months recovery period before active lifestyle again, cannot risk disturbing the "fix". Giving up flip turns in lap swimming for quite a while. Supplemental covers the other 20% that medicare won't pay.

Cash paying patients suffer $35k to $45 K for the procedure.

Medicare pony's up only about $6,500, which the surgeon must accept, no extra cash changes hands.

Supplemental covers the 20% that medicare will not pay.

I've heard a few times now that giving birth while lying on the back is a relatively modern invention and that for most of history women adopted squatting or leaning forward positions.[1] And that the back position is actually much more painful. How much does laying on the back increase the pain to the point where an epidural is necessary? Is it still necessary in the other positions?

disclaimer: I know nothing about this

[1] https://www.bbc.com/future/article/20260401-women-were-never...

Here in Argentina the nurses discourage you to seek it, then they blame the anesthesiologist is not available. We have had 2 with cesarian and one friend was in so much pain that she had to ask for a cesarian too.

Interesting to find out that the contents of epidurals are not standardized across facilities. If that is the case, then how can one definitely opine on the safety of them when the contents are locally designed cocktails?

It was surprising to see incidence of death by cesarean is almost 13 per 100k. It is commonly thought as the safest way and half of all births in my country are via cesarean.

I've woken up from surgery with an epidural that had a leak. That wasn't fun.

It made it emotionally difficult to get surgery again.

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HARD disagree. Watch “the business of being born”. We’ve turned a fairly routine extremely biologically conserved process into this insanely traumatic experience.