Introduce the word "epidural" into conversation and you'll hear vociferous arguments for and against the powerful pain meds used in the delivery of babies.
For some, epidurals represent just how medicalized giving birth has become - and the risks associated with using them, such as prolonging labour and interfering with breastfeeding.
Others will tell you that there's no glory in all that pain.
A couple of new developments are keeping the debate alive. First, a new study has shown that when women control the flow of epidural meds themselves using a button, they actually end up administering less than an anesthesiologist would.
In research presented Thursday, a patient-controlled group used 30 per cent less medication. They reported feeling comfortable, but they did describe more pain during the actual pushing stage than those given epidural doses by a doctor.
How the analgesia was delivered did not affect the length of labour, according to Time magazine. But putting women in charge of their epidural delivery did result in a slightly lower C-section rate. This suggests that some of the evils of epidurals might be lessened if women were more in charge.
At the same time, a new book is sparking spats online. Epidural Without Guilt: Childbirth Without Pain is written by New York obstetric anesthesiologist Gilbert Grant.
Not surprisingly, Dr. Grant is in favour of the practice, citing research that suggests epidurals are not as bad as critics think. He even suggests that epidurals can be used as pain relief after birth and to ease painful breastfeeding.
Babble blogger Ceridwen Morris aired her critique of Dr. Grant's book-promoting website, suggesting he had posted misleading information about such things as the effect of epidurals on breastfeeding.
A lively debate ensued in the comments section, with Dr. Grant explaining why he sees an epidural as a "wonderful alternative" to other post-partum pain meds. For painful breastfeeding, he suggests a dose (delivered by the new mom using the technique from the study above) just before a breastfeeding session.
"I am in no way advocating this for everyone, but it's a great option for some women - problem is - no one ever thinks about it - because no one has ever heard of it," reads one of his replies.
Parents out there - have you every heard of this? Is epidural guilt real?