Wednesday, April 23, 2008

Labor on

A puzzle swirling in my head, well not all the time, but in a now on, now off mode, was precipitated while surfing my new Verizon FIOS cable service. I am a sucker for TLC-like channels and food p**n and house p**n like Food TV and HGTV. After making sure FIOS was giving me my daily dose of fat chefs, home designers with six figure budgets to decorate a backyard and fashion stylists who did unbelievable makeovers on pretty but dorky women and I turned to their other offerings. And guess what? They had another TLC-like channel. Forgot what the name is. But when I surfed, there was a show like the baby story and bringing home baby. This one was about delivering the baby. The mother-to-be was in the LDR and discussing her birth plan on the camera. She wanted to go “natural”. OK. But what amazed me was her ferocity about it. No epidural. No c-section. No intervention. I have met plenty of people like that. She is not alone. In birthing classes, at work on the parenting message board I am a part of. They are everywhere and they are growing fast.

Women who want to have babies at home, who forgo an OB-GYN for a midwife. Are these women forgetting that the leading cause of deaths in women until the turn of last century was, take a guess, childbirth? What gives? What drives them to make these stupid choices? Is it the implicit promise that if something goes horribly wrong while giving birth, they can dial 911 and get proper medical care? There are several issues than stump me and I am going to discuss them in a systematic fashion one by one. Starting from what I feel is the craziest.

Giving Birth At Home
This trend is growing. These women want to give birth in their own beds. Many times supervised only by their husbands. Or perhaps a doula, not even a trained midwife. This is insane. Things can and have been known to go wrong at the last minute. What then? Do these women stick to their principles and go all natural then? No matter what? Of course not. I am sure they are too chicken to deal with the baby trying to push his/her elbow through their cervix and call 911 putting undue stress on the emergency response system and the baby. Will they go to a remote area where there is no emergency response whatsoever and let nature take over? I don’t think so. I think it’s a sham. All that go-back-to-your-roots, lets be organic earth mothers. Yeah, right.

No intervention: No c-section, no vacuum pump, no episiotomies
When I was about 30 weeks pregnant, my OB-GYN waned to discuss my birthing plan. I had read about birthing plans and not just single paged ones but 4-6 paged long ones detailing how every step of labor and delivery must be handled. I had no birthing plan. I just wanted my baby and me to be healthy and safe. I told so to my OB-GYN and asked her if women actually put their labor and delivery plans to paper in such detail. Her answer amazed me. Most of them do, she said. Now I don’t know if this is a trend triggered by momzillas reading too many mommy-to-be books. It very well might be. She said there are a few who want to stick to it no matter what and it took a LOT of her time and energy in convincing them to go for a c-section or a vacuum pump or whatever because the baby was in distress. I trusted my doctor. Not my mother, not my husband. For my delivery I trusted my doctor. If she wanted to do an episiotomy, she would not really need my permission.

No Pain Management
This one really, really stumps me. Why do women hesitate to get an epidural? I don’t think it’s just because it’s risky to the baby, which it is NOT. They are safe. Many, many studies show that and epidurals have been around for half a century now. I think women feel guilty and selfish taking something to alleviate their labor pain. Contractions are natural, yes, but not all things natural are necessarily good. What’s wrong with alleviating pain? Epidurals were not common when my mother gave birth more than a quarter of a century ago in India. But she knew about them then. But it was assumed a woman had to suffer to give birth to her child. WHY? Why should we suffer when there is a remedy?

A long time ago, in the 1940’s when epidurals were introduced in the USA, doctors told women that labor pain what the price every woman paid for the sins of Eve. Really? Now that puts a whole new spin on no-epidural, doesn’t it? We have sinned by carrying a child? And now must atone by undergoing labor? This doesn’t even merit a response from me. BigGeek assumed I would be taking an epidural. I had told my mother I would get an epidural. She told me the contractions are not that bad and you don’t remember them. She said to wait and see if I really needed one. My contractions were very bearable and I took it at the last chance offered. Because yes, despite all opinions on the issue I felt selfish. BigGeek wanted me to get out of pain. And I am glad I took the epidural. It did not prolong my labor or delivery. Chip was out in less than thirty minutes. And yes, I still remember how the contractions felt. You don’t forget them.

So. It’s out of my system now. This post had been welling up inside for a long time and I just did a core-dump.


Rohini said...

Agree with every word you wrote. I don't know why this whole suffering business has to be such a badge of honour. If there's a way to spare yourself the pain without harming the baby, why not?! Does it make you any less of a mother if you took pain relief?! DEFINITELY NOT!

dipali said...

Sensible! No draamebaazi:)

Anonymous said...

AMEN, Dotmom! You said it!

However, I think *some* of the fears about Epidurals are because they can and do affect the mom - if not administered very exactly, they can cause temporary paralysis (happenned to my friend, here in the US), and administering the shot to a woman in pain is not very possibility of errrors do exist. That said, I very happily demanded and got an epidural as soon as I showed up at the hospital for both my deliveries - I figured there was enough pain/sleeplessness coming (second time, I KNEW there was :-D), I may as well get what enjoyment I could out of the process...

I think in general though, too many people get way too involved with the process of delivery rather than the result...maybe these women were also the kind to be bridezillas about their weddings!


DotMom said...

rohini: thankyou, thankyou and to think I was the last sane, rational woman living :)

dipali: dramebaazi..let the kids do that after they come out:

anon: every procedure has possiblity of side effects.. 1/10,000 is a small risk. the catheter is inserted by a trained anesthesiologist, so the risk is very very low. possibility of errors I think exisit more for home births and other "natural" things like getting doulas instead of doctors. Your bridezilla comment is on the mark! That exactly what I thought! these women would be bridezillas at their wedding!!!!!!

rayshma said...

ahem! i don't know what an epidural is :(
but i want any & EVERY thing that'll help me feel lesser pain WHEN i get pregnant. even if it's not eco friendly! i sound terrible, maybe... but heyy, i shall help save the earth if i save myself!

NainaAshley said...

My thoughts exactly! I had no birthing plan either. I told my doctor that her plan was my plan. That i ended up suffering through unbearable contractions for half a day is another story.

I don't understand the logic behind choosing to suffer less painful options are available. Its like choosing to travel by bullock carts when cars are available. And its not like your child is going to love you any more because you suffered during child birth. And it doesn't make anyone a better mother either. What matters is how you take care of the child after birth.

Girl Next Door (gnd) said...

If people fear the risks of an epidural (like anonymous pointed out, I know a friend who was paralyzed for quite a few weeks), that's a different story! But otherwise, I think it's the BEST thing that happened to "labor and delivery!"
My plan was to try for a natural birth if possible. But WHOA! Came my first Big contraction and I wussed out to get an Epidural :)
and everything that followed.
With T2, my ob-gyn "helped" speed things and she was born 4 hours after I reached the hospital. That's how it should be - cos of the less physical stress, my recovery was amazingly fast!

noon said...

I was ready to take the epidural a week before due date if possible! :))
Well you know what I mean..
I really didn't want to suffer pain. If I had not taken an epidural I am sure I would have had a C-sec for KB - the baby was in distress and my Ob said - push hard and if baby doesn't come out very soon, we are going for an emergency C-sec. I was able to push hard (although not feeling the pain I suffered 4th degree tearing which killed me later in a different way) only because I had taken the epidural...I wouldn't even mind if people said they are worried about back pain etc and hence didn't want an epidural...but most women I know who swore against epidural just wanted it to be all natural..
Though after having had KG without an epidural (since she came 7 min after I reached the hospital!) - I should say the pain was indeed not as unbearable as I had imagined it to be...

I just don't get this passion for home births. My American friend whose dad is a doc - she tried home delivery for her first child - but finally the mid wife gave up because after 22h the baby wasn't coming out - they ended up with a C-sec. Now she had her second - at home! She and the baby are fine, thank God, but why the risk I don't understand...

bird's eye view said...

Agree with the whole thing. I don't know why, when they have a safe option, these women would want to risk life and limb - both theirs and the child's - for some quixotic egoboost. Do they know how many poor women die in India every year for lack of medical attention during childbirth, even now?

And the pain thang - I told my doc from day one - put me under and take the baby out. She kept waffling on abt natural birth and epidurals but eventually my way was the only option( posted abt it long back) - and feel blessed not to have suffered more pain than needed.

Pixie said...

Fantastic post dotmom!
I totally agree with what you've written and I have decided too - that when I become pregnant - it's going to be one with lesser pain and discomfort...
I agree with every word...

mummyjaan said...

Just curious: what country was this taking place in, Dotmom?

Kodi's Mom said...

ouch ouch! you hit where it hurts!
when I got to the 'epidurals are harmless' part, I knew we'd be like the parallel train tracks on this one :) no point stripping each one apart. so lets just let it be.

ps: when you are down on books and feeling really bored, do read the Thinking Woman's Guide to a Better Birth. not for use in your context, but for general information. It might answer some of your 'I don't understand why....'

choxbox said...

seconding kodi's mom here!

also, recommend this book called 'birth without violence'.

everyone has a different level of tolerance to pain and i dont believe one is a lesser/greater person if one opts to use pain relief. my gripe is with how epidurals/other pain management options are promoted. my doctor told me there was no way i would be able to deliver w/o pain relief. i did and it was very do-able. had i not been able to, i would have asked for an epidural. my point is - why tell me beforehand that i *wouldnt* be able to manage w/o one? i'd expect a doctor to at least make an attempt to reassure me to not fear the pain.

noon said...

Dottie - sorry to respond here - but since this is the space to comment on this thread...
Choxbox - you hit the nail - no one is lesser/greater because they took pain relief - but so many of the naturals I have spoken to had this tone of one up because they went the natural way...and I felt like - hey I have an option to not go through that much pain, am going to take it. I take pain relief when I go to the dentist...and I don't know (I should also read those books) if it will make a difference to the baby if I take an epidural...well I have had it both ways - so I think I will read this book to see what it says!

Anonymous said...

I was on a steady diet of the Childbirth and Bringing Baby Home shows the week before Nibbles was born. It helped me calm down (strangely enough).

Totally agree with what you say about birthing plans and epidural. I took an epidural when I reached a stage where I was certain I'd have no energy left to push if I bore the entire brunt of the contractions. Still felt them, nice n' strong enough for a quick push. And Nibbles was so awake and alert when they handed him to me!

I have no idea why, but I let the guilt slip in when the natural childbirth camp questions me and makes me feel like I cheated. To each her own I suppose; no point starting Labo(u)r Wars.

Null Pointer

Tharini said...

I am not exactly for homebirths myself but I am not about to comment on people who want to have it that way. That is their decision to choose.

As for epidurals...I had one during my first labour and I went "natural" during my second. Firstly I don't see it as a 'badge of honour' that I flout around and that's not why I did it. I did it because I wanted to undergo every sensation in the journey of labour to motherhood. I wanted to be alive to every sensation and be a very active participant in birthing my child. I didn't want to simply lay back on the bed and push when they told me to push, and not listen to my own body in the process.

In fact when I speak to other mother of birth stories, I do not volunteer that I went natural the second time. I listen sympathetically and nod understandingly when they talk abt taking epidurals and how good it feels, because I know how good it feels. Ironically, its when they ask me outright, and I set the facts straight, do they give me the reaction of how 'crazy' I have been to not use an epidural. Now can I judge them for it?

That epidural during my first labour was like heaven. I had no clue what to do, I was tied down to my bed and into a single position on my side and I had no choice of moving around.

You know what is the driving rationale behind home births??? It is because of the "routineness" of medical interventions in a hospital. It is a given nowadays that everyone has an epidural the min your labour is confirmed. I remember how much I was cajoled into it the first time with Winkie. I had to say over and over again that I would ask for it if I wanted to, but could they please leave me alone till then? The attitude of the staff was quite callous. Even during the hospital tour, they waved all those fancy statistics about how many successful epidurals they ahd administered. Its as if there is no scope for one's own personal choices in the matter. I agree very much with the benefits of what medicine had done for our progress. But at the same time, it has become slightly more regimental about these set procedures that HAVE to be administered just becos you are admitted into a hospital.
Sometimes, the whole atmospehere in a hospital during birthing is hostile. So I don't blame people for choosing home births to have a safe and psycologically comforting environment in which to birth in. If hospital birthing rooms and areas were more conducive to these needs, it would reduce the incidence of home births and theh associated risk of danger to mother or baby from any untoward developments along the way. And there is nothing wrong with midwives. They are all well qualified professionals providing the additional psychological support that some of the women need.

As for pain, it really boild down to how one views pain. Pain usually has its associtations with something unpleasant and has very negative connotations. When I read the Bradley book, my concept of he "pains" of childbirth, underwent a complete change. Cos how can you describve something that works within your body to aid in a very natural process as pain?? Pain in childbirth comes from a uterine contraction, and that contraction is the biggest bag of muscles in your body stretching to open up for the emergence of a baby.

I could go on and on, but at the end of the day, labour is a very intimate experience and it stems from very intimate choices, and these choices will range from one extreme to the other, much like all our parenting and non-parenting choices of whether to cloth diaper or not, whether to sleep train or not, whether to be a "green" person or not, so there is no really right or wrong way in it and there is really no point judging the choices of others, even if it appears 'stupid' to oneself.

Poppins said...

You know I really liked reading your take on it. I always thought that I would prefer to have a natural birth, had mixed feelings about an epidural. Ofcourse I didn't have that option and was bitter for a long time about it. Now I feel Thank God for medical intervention, what is important at the end of the day is a healthy baby and mother.

I'm considering asking my Dr for a VBAC this time, but if she's against it, I'm going for a repeat C-Sec. I have decided to just totally trust my Dr.

DotMom said...

rayshma: Do what you are most comfortable with, w/o putting yourself or the baby under undue stress.

nainaashley: I wonder if all this stems from a deep mistrust we all experiece towards doctors. I don't think its a badge of anything. It doesn't make you a better anything, except perhaps at bearing pain. To me, its a non-issue. Take an epidural if you want, don't, if you don;t care for it, but just because you don't want pain meds, don't look down on me.

gnd: I agree. 4th degree tears are harder to heal than an episiotomy. I am sure a woman 100 years ago, would have loved to be in your shoes and have those options.

noon: hahaha. I think women try home births because they know tehre are doctors and 911 would save save their lives if something were to go wrong? will they go to afghanistan to have a baby the "natural" way, I don't think so. It's the hypocrisy that annoys me.

BEV: quixtoic egoboost? I like that. I think these women operate on a differnt plane that people like you and me.

pixie: I think we should all take advantage of what medicone has done for us and not try to reverse progress and turn to luddites.

mummyjaan: homebirths are a rage in the UK. USA also. Not Africa or afghanistan, where homeborths are the norm for a whole lot of different reasons!

kodi's mom: I maintin epidurals are harmless than home births. How many women and kids have died from epidurals? you have stats on that? there is no morbisiy or death associated with epidurals.. There is a LOT of death associated with home births. I'll get the book from the library and pray there are logical reasons that organis, earth-mother ones :)

DotMom said...

choxbox: they have a book with that NAME????? and it is not about birthing in afghanistan? I am sorry, don't mean to offend your sensiblities here, but the title IS pretentious. Atleast in US and the UK. But I am not going to judge a book by its cover, literally.. will read it. And yes, everybody has a different tolerance to pain. But please don't make it a badge of honor and let other women who do take an epidural feel they are less of anything.

thelastbyte: no, i am not starting a war here :) But want to know a logical, rational viewpoint in this. My point is that this is hypocrisy. These women can "afford" to go natural because help is only 911 away.

tharini: homebirths? I am usually the each to his own type. But I can't, not when there is another innocent life involved. I also have to comment on the "routiness" of medical procedures. Giving birth IS routine. It might be THE most importatn day in life for a mother-to-be not for the nurse or doctor who handles 4 births on her average shift. Their point it to have a baby safely and quickly. 3 day natural labor fest? I don't think your insurance will cover that. I am glad things work like clockwork in a hospital, that I am safe and taken care of no matter what. I don't expect the doctors and nurses to hold my hand and sing Kumbaya. They are not my family and friends but professionals whose only job is to make sure the baby and I are safe, healthy and alive. The routine-ness that you speak of? May women in many parts of the worls will give their right arm for it. Hospitals in India have had hostile birthing atmospheres, but a nurse coming in and check your progress and you hooked to a monitor that checks your baby's hearbeat is clinical but hardly hostile. I think women (and the mommy media) need to stop expecting doctors and nurses and hospitals to be their family and friends. For psychological comfort turn to your mom, partner, friend, or even a psycologist. Don't expect the OB-GYN to do it. that being said, I think hposiptals in the US are phenomenal. If you tell your labor nurse your big toe is feeling cold, they will bring you a sweater for your big toe. If that's hostile, I don't know what to say.

poppins: All the doctors I have chosen, my driving factor has been if I can trust em. Chip's pediatrician, my OB-GYN. everyone. Chip's old ped (he has retired now), an elderly gentleman, had a reputation for not having a good bedside manner. Meaning, he did not play with 3-week old babies and preferred the parent calm their own babies. I don't expect a doctor to do play with my child. He is his doctor, not nanny or a friend. The doctor always listend to my concerns. But, No baby talk. We had a great doc-patient relationship. Ditto with my OB-GYN. I did not expect her to be my friend or therapist but my doctor, someone I could trust if things went wrong. (although over the months we sorta bonded and became friends because she thought I asked interesting questions)

BangaloreMom said...

Hi Dotmom

Its uncanny how I wanted to do a post on this myself and stumbled across yours..I am soooo with you on this one. I never quite understood why so many women want to go back in time when it comes to labor and delivery and not trust modern medicine while they are so ready and willing to use other aspects of the same medicine. And ultimately, it should'nt matter whether you have a vaginal delivery or a C-Sec as long as u and the baby are healthy.

I had a C-Sec for my son because the baby was in distress. I shudder to think of all the things that could have gone wrong had it not been for that decision taken by my Ob-Gyn and do not regret it for a second. I think moms-to-be should not take such a huge decision as birthing on their heads when they have so many things going on already and just leave the doctors to do theor jobs.

the mad momma said...

okay i have plenty to say.. so will do a post on it instead of eating up your space.

DotMom said...

bangalore mom: exactly. that's why i have a feeling this is media induced. I am sure if these women asked their own grandmothers, the grandmothers will send them to the hospital. Doctors are stressed to with insurance regulations (in the US atleast) and the lawsuit happy junta. Nobody realizes they are caught between a rock and a hard place.

MM: pliss do. can't wait to read it.

B o o said...

The first thing which comes to my mind when I think of home birth is - Who will clean the house afterwards? No, seriously! And not to mention the laundry!
Anyway, I think Epidural and home births are two very different choices. I was screaming for Epidural during my labor but it did nt happen. Now that I have come out of that one alive, Im contemplating about not taking epidural this time. But thats just me. I always delay pain medication until the last minute when it becomes unbearable even during menstrual cramps. So its not for a badge or anything. Hence I can understand where the home births and all natural people are coming from. Some people love roller coaster rides and some would nt even sit on one. One calls the other a fool. Me? I ll try anything once! ;)

Anonymous said...


Back here after MM's post...I agree that the risks of epidurals are low enough to not weigh heavily enough with me, but knowing the 1/10,000th person affected adversely by it might affect some people.

Tharini, I live in TX, and my hospital, doctors and all the staff were anything but hostile. At the pre-childbirth hospital visit, we were informed about the epidural option, and were told that it would be given only if I could ask/consent to it. The hospital was rightly proud of its record for successful births, including the level of NICU available. Like Dotmom said, they were very attentive to my physical needs. I was also not confined to my bed for labor - was allowed to take a shower, walk in the corridor - do anything that I liked, until the epidural was given (at my urgent request!) - of course, you cannot walk after that - not that I wanted to by that time.

That said, I do believe that some women (and men) get intimidated by hospitals and medical professionals and may agree to something they may not want/believe in. Some docs too, especially desi ones, do have bad attitudes - I changed doctors because my previous one thought questions were a waste of her time!

In the end, I like Dipali's answer - no drama - just get the job done :-)


dipali said...

There are doctors and doctors and nurses and nurses. I've generally had experience of very kind, compassionate and patient doctors (once you get to them) who are willing to explain things to you in detail, and makes sure that the patient is comfortable with whatever is going to be done. I've dealt with all kinds of medical specialities and several patients, mostly in India.
But some nurses are often overworked, short tempered or just plain ignorant, and prisoners of routine, with no kindness at all. I've been woken up at 3.30am in a post-op ICU and made to brush my teeth so I'm good and ready for the morning shift. Bah. Same ICU, early morning, some nurse is having a screamaganza with the sweeper. Double bah. While I accept medical technology as one of modern life's greatest boons, our nursing and other attending staff needs major lessons in humanity. (Dottie, this is without wanting them to be your friend or to love you- they should at least give you the basic respect any human being deserves).

karmickids said...

Agree, agree, agree. If we had to get back to the basics, we might as well get back to living in caves with no creature comforts, and kill our daily dinner.
If there is a choice that reduces pain and makes us more comfortable, and better places to receive our children to this earth than our homes why not??? And why would anyone be so insane as to assume that they would not need zillion things can go wrong during a delivery, and they have, according to me, no right to play god with their kids, and risk them lifelong debilities should anything go horribly wrong. My two cents.

And yes, I ODed on painkillers. Call me chicken.

mummyjaan said...

Dotmom, as I understand it, your post was something of a rant. I'm afraid I don't have anything to add about the pain vs epidural argument. I had C-sections both times.

However, I have been thinking of what you said about homebirths, and , while, on the whole, I do agree with you, I think you may have overlooked a few points. For instance, having a home birth in a developed country is very different from having one in, say, India or Afghanistan.

You're saying homebirth "is the rage in the US and UK". It's not, really. A very very small percentage of women choose to have homebirths, at least as far as I know in the UK and Ireland. (Homebirth, however, much more common in Holland).

"These women are foregoing their OB-GYN for a midwife". An untrained midwife (such those found in rural India) would be a disaster indeed. A midwife in the UK or Ireland, or Holland, a case in point, is a highly trained nurse who has already spent many years in the labour wards. These women are fantastic. Dotmom, at normal deliveries in the hospitals I've worked in, no doctors or consultants were ever called if everything was progressing normally. The OB-GYN was only called in if there was some concern for the mother's or baby's health. The midwives did everything.

If you take into account this fact (that, indeed, in the majority of deliveries, no 'intervention' is needed), and if you have a trained health professional present, then indeed it would not make *much* difference if the delivery were conducted in the hospital or in the home. Much difference to anyone, that is, except the mother, who might be more relaxed.

As far as I understand, for instance, in Holland, the midwife would have been looking after the pregnant lady throughout the pregnancy. If there are any risk factors present which preclude a normal delivery, the women are sent into the hospital to have their baby.

You may be interested to know that there are units cropping up in several hospitals in Ireland, which are called 'Midwifery-Led-Units'. These units, within the Obstetrics wards, are staffed by midwives - there are no obstetricians involved here. Of course, the women who ultimately deliver in these fabulous units are carefully 'screened' on a basis of risk factors - any woman with clear risk factors goes to the Obstetrician-Led-Unit, while those who appear to have an uncomplicated pregnancy go to the midwives. The point of this long-winded paragraph is that midwives are very capable professionals :)!

Homebirth needn't be as risky an option as it appears. I can understand why some women would want it.

I admit, I am not one of those who would have opted for it, but I'm not overly concerned about the ones who do take that route. At least not when under the care of a competent midwife.

DotMom said...

b o o : hhahaha. the doula, I suppose! My problem is not with individual choices.. it is with the hypocrisy (and yes, you can say its their right to be hypocritic and I can't argue with that) and putting a life in jeopardy.

anon: exactly.. to me its a biological event.

dipali: agree. professionalism and basic courtesy should not be abondoned by any profession. nurses, doctors, sales clerks.. theere are good doctors and bad doctors and there are good nurses and bad nurses.

karmic: nah. I am not calling you chicken.

mummyjaan: excatly my point.. these women are doing it on in developed countries BECAUSE they have a fall back. that's hypocrisy, right? If you believe in au naturel, go all the way. For better or for worse. Nobody does that. There are mid wife led wings in hospitals in the US too. And yes they brag about how their births are 100% no-intervention without mentioning that the mothers-to-be are carefully screened and a whiff of a complication they are sent to an OB-GYN. Sorta gives a wrong impression that midwifery led units don't intervene whereas OB-GYNs do. They do because baby and women will be put in danger if they don't intervene.

choxbox said...

not offended at all! there is indeed a book by the name and its quite nice - in fact its by an author based in the US or UK. do check it out if/when you feel inclined to. why i recommend it is because it is against the whole forced medicalisation of birth - which is what i meant to highlight too.

ddmom said...

Took me few minutes to context switch from laughing like a maniac reading the Ouch post and then this serious post. What can I say? I would have lost the baby if I was even 5 minutes late in reaching the hospital.
As far as epidural and other pain medications, I am totally in agreement that its an individual's choice. We all have different pain tolerance. I am positive if my husband was a woman, he would have opted to go through it without medication, not because it is risky or anything, but just for the life time experience.