From Mij Ferrett
Your correspondent John Crowhurst, commenting on the connection between
impaired mother-child bonding and epidural anaesthesia, has mixed up unrelated
issues
(21 April, p 54).
It is true that analgesics can be immensely effective in women who have
particular health issues that affect their ability to cope with pain. But these
women are in a small minority.
The increase in the use of anaesthetic is linked more to the increase in
induced births, which are associated with stronger contractions and more pain.
Induced births are being scheduled for the convenience of medical staff rather
than the mother and baby. Giving birth is not a pathological process but a
natural one.
It is also true that even low doses of epidural painkillers affect the
bonding process. Epidural anaesthesia reduces the cooperation between mother and
baby that can sometimes happen during birth, which is not always recognised by
medical staff. Long-term effects of epidural often include headaches and loss of
vitality for the mother—complaints which are frequently ignored when
reported.
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The increasing use of Caesarean section as an obstetric procedure holds even
greater psychological risks. Obviously Caesareans can save lives, but the trend
towards performing more of them is for the convenience of medical staff (and in
the US to avoid lawsuits) rather than to benefit mother or child. Caesareans
increase the risk of postnatal depression in mothers. Bonding is also often
adversely affected. Babies born by Caesarean are more likely to have
difficulties sleeping or feeding. They are also slower to develop some motor and
social interaction skills.
Your correspondent Angela Graham points out that women should be able to make
informed choices, but is unclear about what the choice is. Lack of bonding can
lead to a variety of asocial conditions in society as a whole as well as within
the family. This needs to be weighed against the benefits of reduced pain when
giving birth. Graham suggests that because we live in a “far-from-optimal
society” the net effect of bonding is somehow less important. I suggest the
opposite.
Rieux-en-Val, Carcassonne France
