Human placenta tastes very similar to beef, with a springy texture similar to the heart.

In short: there won’t be nearly enough lidocaine in the placenta to actually numb your tastebuds.

I’m also pretty certain that the lidocaine ampullae they use for an epidural do not contain the artificial flavor they use in lidocaine spray, otherwise it would taste like bananas.

I’m only sorry you got here so late that your views won’t be read by many of the original participants.

And I like your final conclusion, sc. giving women the choices they want.

But do you make any provision for people who like to eat placentas that have been marinated in lidocaine first?

As it happens, I have had to research this question during my gynaecology co-schap (clerkship or what have you). And I know very well what is better: natural or painless. And there have been quite a few studies where mothers have been asked all the relevant questions, both shortly after giving birth and, say, a year later.

And the amount of pain is not a big factor in gauging customer satisfaction. The literature is quite clear on this. So what is it (apologies for the wingnutty allcaps):

WHEN WOMEN GET THE TYPE OF DELIVERY THEY WANT, THEY’RE MORE SATISFIED WITH THE EXPERIENCE.

That’s it.

Women who want all-natural, fully painful, eat the placenta type-births, getting rushed to a hospital is the biggest turndown. And for sensible women it’s having unnecessary pain because an epidural is unavailable or refused.

The obvious lesson here is that BOTH modes of delivery should be readily available, and neither should be frowned upon (at least not by a midwife or gynaecologist face to face with a patient).

The midwife responded by rattling off her little list of horrors and by saying my wife could always wait-and-see during the delivery.

We told her I was a doctor, we were well informed and that we were quite adamant nonetheless.

She went “Oh” and said we could still always wait-and-see, but she would make arrangements to transfer care to the gynaecologists in the last trimester.

Because midwives work in shifts and you never get to see the same one twice, we had this same conversation during every check-up. At the end of the second trimester my wife’s chart was filled to the brim with “wants epidural” notes, but each midwife still decided to try one last pitch for good ole’ natural birth at home. Maybe they can write but not read.

Then the gynaecologists took over.

“You know there is a higher chance of adverse outcomes with epidurals?”

Every gynaecologist we saw (and it was always a different one), right up to the delivery, was a card-carrying member of the VPINEGC. My wife was brought to tears several times because the gynaecologists were peddling the same lines as the midwives, and time was running out. Mind you, this was in the hospital where I work. (A big university hospital so they don’t know me personnally, but still.)

In the end they got the message and relented.

Unfortunately, a big car crash prevented the anaesthesiologist on duty to administer the epidural. For the entire night. So my wife only had her epidural for the second half of the delivery. And, of course, she got an episiotomy with a vacuum even though our son started life with a 9/10 Apgar score.

That is why, for the second pregnancy, my wife knew what to do. Instead of crying in the car after seeing the doctor, she started crying during the first visit. The doctor didn’t even have the chance to tell her the second delivery usually goes smoother than the first. My wife got herself an elective caesarian on “psychological grounds”.

My advice for pregnant women trapped in the Dutch VPINEGC: get what you want and don’t accept anything less.

My wife and I have two young children, and I can attest from personal experience (as well as my experience as a medical student) that, yes, the vast-pain-is-natural-ergo-good-conspiracy (VPSNEGC) does exist, and it thrives here in the Netherlands. And it includes the gynaecologists as well.

The arguments used by the VPSNEGC are bollocks:

1.Yes, the pain is natural. So is the pain associated with acute appendicitis. I have never, in my life, encountered unnatural pain.
2.Yes, an epidural is associated with more adverse outcomes, at least here in the Netherlands. That’s because the “adverse outcomes” they measure are not, by and large, actual outcomes (such as dead or damaged babies), but their own medical interventions: assisted deliveries (i.e. with the help of vacuum or forceps), episiotomies, emergency caesarians, etc. So if the same gynaecologists who almost never allow women to have their epidural freak out when they’re in the unfamiliar situation that the mother is not in great pain, it’s the epidural’s fault. I am quite confident that if epidurals were causing subpar babies or even subpar deliveries then they would have been litigated out of existence long ago.
3.Yes, you can always wait and see if you really need an epidural. Except in the real world, that is. And what about those women who do not want to find out?

First some medical background:

The problem with epidurals is not the epidural itself. It is the rare complication where the dura is punctured and the anaesthetic gets directly into the cerebrospinal fluid. When this happens, the paralysis (and anaesthesia) is more complete, and there is a chance that the lidocaine creeps upwards blocking the nerves that activate the muscles we need to breathe. This can even happen with a correctly placed epidural.

Scary stuff, but luckily quite rare (and, for those of you who want to know, the heart doesn’t need input from the nervous system to keep beating). But it does mean that it is necessary to monitor the mother for at least half an hour in a place where you can immediately intubate and ventilate her should things go wrong.

The most obvious place is the recovery room of the OR. The necessary skills and equipment are already there. Except at night. Then the necessary skill may very well be busy. Or at home, sleeping.

To get an epidural for every woman who wants one requires that the gynaecologists learn how to do them. And learn how to intubate (with frequent refresher courses as they will only have to do this in rare emergencies). And have all this expensive equipment on stand-by in the delivery room. I know there are hospitals in the US which have this arrangement, but they tend to have an epidural delivery rate of >80%, making it more worthwhile.

Another course is to have fewer, but much larger, ob-gyn wards (or even dedicated women’s hospitals), so the anaesthesiologists know they have to stay at night just for procedures that aren’t a strict medical necessity. This might become a reality in the future (gynaecology is really night-shift intensive work, so most starting gynaecologists prefer large hospitals with lots of colleagues to share the burden). On the other hand, it might be incompatible with home deliveries supervised by midwives if it means the difference between getting to a hospital just in time or getting there too late, so midwives will probably be opposed. Also, the pediatricians may not like it, as having fewer, bigger ob-gyn wards means having fewer-bigger incubator wards.

Well, my wife found breastfeeding impossible, but she was able to pump more than enough breast milk for our daughter to be bottle-fed 100 percent breast milk for the first three months. Nevertheless, she was repeatedly told—based on what evidence I have no idea—that our baby would be better off if she switched back to breastfeeding. (I think one argument had something to do with facial muscle development.)

“Industry ” may not be the right word, but “cult” may be closer to the mark.

If the first, or even the second it seems to be setting the bar too high. Surely, the baby gets all those good antibodies if you just breast feed some of the time, and that isn’t such a big deal. Not arguing, just wondering what’s at stake in this discussion.

The breastfeeding advocates I knew all acknowledged that it’s not for everyone, though they were definitely advocates. If ypou disagree with them, you can walk away, and as I understand, that’s what you did.

The animus here seems highly excessive.

Have you ever used a lactation consultant? It is an industry, and they make money by selling their services.