Delegitimizing women’s need for pain relief in labor

Barely 2 weeks after I wrote the post about the invisibility of women’s needs, Science and Sensibility features guest blogger Dr. Michael Klein who has written a post about epidural anesthesia that entirely leaves out the most important benefit of epidurals, its ability to relieve the agonizing pain of childbirth.

I’ve mentioned Canadian family practice physician Michael Klein before. I wrote about Dr. Klein’s personal opinion that “a few” preventable perinatal deaths are worth it in order to lower the C-section rate.

Now Dr. Klein attempts to explain Epidural Analgesia—a delicate dance between its positive role and unwanted side effects, while rendering women’s need for pain relief utterly invisible. In a 1200 word post, Dr. Klein utterly fails to mention the excruciating pain of childbirth. There is not a single word about how women feel about pain and pain relief in labor.

He does manage to hit all the high points of the NCB campaign to render women’s pain invisible.

The “risks” of epidural anesthesia are accorded a prominent place, but apparently there was no room to include just how often these “risks” occur, thereby depriving readers of any context to evaluate these risks. He’s so desperate to vilify epidurals that he actually includes inadequate pain relief as a “risk.” There’s no mention of the fact that approximately 98.5% of women have excellent pain relief from an epidural, but we’re supposed to consider the 1.5% failure rate a reason to avoid the 98.5% chance of outstanding pain relief?

As I said above, there is not even one word devoted to how women want to manage their own pain, but Dr. Klein has plenty of words about what women should want. Apparently, Dr. Klein thinks the days before adequate pain relief were just dandy:

Prior to the ready availability of epidural analgesia in labour and delivery departments, maternity nurses used their skills to reassure, massage, breathe with the woman through contractions, and employ a range of other methods to handle labour pain.


Prior to the availability of epidural analgesia, the childbirth education movement utilized a variety of techniques that were physiologically and psychologically helpful to reduce pain, such as breathing and imagery. These methods began to take hold in the culture in the 1950s and 1960s but today are less prominent in many childbirth education classes. Some classes are more focused on teaching women compliance with particular hospital technological methods and approaches, routines and policies, rather than on teaching women coping skills.

Imagine that. Childbirth classes teach women what to expect in labor instead of how to have the labor that Dr. Klein approves. And let’s not forget one of the conspiracy theories to which NCB advocates appear addicted: childbirth classes indoctrinate women to comply with hospital policies.

What kind of labor does Dr. Klein in his wisdom approve?

Backed by randomized studies, it has become apparent that this emotional and physical continuous supportfrom a doula gives a woman more confidence and ability to work with her labour.

More confidence? To work with her labor? Sure, when women’s need for pain relief is invisible, there’s no reason to worry about whether doulas relieve pain.

Dr. Klein in his wisdom frowns upon epidurals but loves other methods of pain relief, no matter how unnatural they are:

Pain moderation by transcutaneous nerve stimulation (TNS) or intradermal water injections can be very helpful … Other non-pharmacological methods like water baths or showers or movement, including the use of birth balls, are also helpful for many women who find that partial pain relief is sufficient to help them through contractions.

That’s really funny. It’s okay to put a needle in your back and inject something that won’t provide adequate pain relief (water), but it’s not okay to inject local anesthetic that will provide complete pain relief.

Dr. Klein, I have a simple question for you: How dare you?

How dare you write a piece about epidural anesthesia that includes not one word devoted the agony of labor pain?

How dare you write a piece about epidural anesthesia that includes not one word about what women think about pain and pain relief in labor?

In short, how dare you render women’s need for pain relief in labor utterly invisble?