Letter: Childbirth: heaven at home and hell at the hospital, or vice versa?

Sir: We read with interest, then horror, Maggie Brown's article on choices in childbirth (6 August). As anaesthetists, we agree entirely that, regarding pain relief in labour, 'one of the greatest recent advances has been the spread of the epidural'. We also agree that this procedure does indeed require a highly skilled anaesthetist, and such a service is available in most British obstetric units.

While the procedure is not a 'magic wand' and can have some side-effects, such as failure to achieve 100 per cent pain relief or, rarely, the development of a headache or backache, we were most perturbed to read that 'if the injection goes wrong, it can leave you paralysed'.

To our knowledge, there have been an exceedingly small number of cases of paralysis secondary to epidural anaesthesia, usually from drug contamination or incorrect drug administration. The procedure itself is extremely safe, and we would not like our patients to gain the impression from this article that there is a significant risk of paralysis. This sort of sweeping statement is a very unfortunate piece of reporting, and can only help to pour doubt on an exceedingly valuable technique which has benefited millions of mothers worldwide.

Yours faithfully,

Dr C. R. MARSH, Dr S. P. SMITH, Dr J. DeCOURCY, Dr S. HUGHES

Department of Anaesthesia

Cheltenham General Hospital

Cheltenham

6 August