Wilson and other anesthesiologists contend these ideas are based on speculation and not rigorous research. Dr. William Camann, head of obstetric anesthesiology at Brigham and Women's Hospital in Boston and co-author of "Easy Labor," calls the idea that epidural medications could affect a baby weeks later "completely ridiculous."
"If epidurals were dangerous or had downsides, three-fourths of women would not be getting them. The babies come out screaming, crying, and vigorous," he says.
Anesthesiologists and natural childbirth advocates do agree on some points, however:
Narcotic injections, delivered intravenously or into muscle, are riskier for a baby's health and successful breast-feeding than epidurals. "Narcotics are not good for baby and breast-feeding; they affect baby's initial alertness and ability to breast-feed," Camann says.
Adds Pitman: "With good help, most moms and babies can overcome any difficulties with breast-feeding and be successful."
Making personal decisions
Choices about sex, alcohol and labor pain relief are made within each woman's personal and cultural context. Kelly, Wilson and others say they hope their research has added valuable information that will enable women to make the best informed decisions during pregnancy.
Moore-Davis says that women should be asking their healthcare providers a series of questions about choices during pregnancy: "Can you tell me what the risk of that is? What are the benefits? What evidence supports your decisions in practice?"
And Kelly notes that a medically paternalistic view of pregnancy still exists that relies heavily on the precautionary principle, or the 'when in doubt, leave it out' approach. But, she says, "women are capable of making informed decisions based on the available evidence — it's fairly insulting to assume they cannot."