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To epidural or not to epidural

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The question of the day was “What do you think about epidurals?” I don’t believe much in universal answers to questions like this, so I’ll go over the grey areas and you can come to your own conclusions! (That’s the great thing about information – it gives you fuel to make an informed decision for yourself.) Most labor interventions bring you closer to a cesarean section. A select few might say that a cesarean section or C-section is no big deal and they wouldn’t have a baby any other way. However, if you ask the majority of women who have had both a vaginal delivery and a C-section, most will say they would have a vaginal delivery 10 times before having another C-section. There are traumatic vaginal deliveries and there are traumatic C-sections, this is baby’s way of teaching you early that there are no guaranties, baby is in charge, and life is a bit of luck of the draw. Sorry…. I strayed. Some interventions, like being on the fetal monitor or having an IV will not have an effect on having a C-section or vaginal delivery. However, interventions like epidurals, pitocin (a medication administered by IV to increase contractions), and internal monitoring can bring you closer to a C-section (MAJOR surgery). I’m not trying to scare anyone who is already terrified of a C-section, I’m just letting you know that there are more risks to your health associated with a C-section than with a vaginal delivery, along with an increased recovery period. If you want a painless childbirth experience you’re in the wrong business. It’s hard, painful, and a pain in the butt. It’s part of the preparation for motherhood!

Epidural or not, there is pressure (which an epidural doesn’t take away). If you think a C-section will prevent you from having the pain of labor you may be right. You will however have pain with recovery at your incision site. Having a baby is almost never painless. (I told you I don’t believe in universals!) An epidural can be a great tool. There are some labors that drag on for days. Sometimes when a mother tenses up and is unable to relax between contractions it can stall labors progress. This is why natural birthing methods focus on getting mom to relax through labor. In these cases, an epidural can give enough pain relief to allow mom to relax and progress to the final stages of labor. (See stages of labor here.)

There are other cases when an epidural can stall labor. Labor is generally assisted by movement such as walking, rocking, etc. Many women find their labor goes by faster by walking or sitting on a birthing ball. Getting in the shower and letting warm water run on the laboring mother’s back or getting in a warm jacuzzi tub can also provide some pain relief. If you have an epidural, you are confined to bed rest because your legs feel like they are heavy and “asleep”. You will also have an IV, frequent blood pressure monitoring, and fetal monitoring. If your epidural prevents you from feeling your contractions completely and the contraction monitor isn’t reading your contractions well, your doctor may also want to place a thin tube along baby’s head in your uterus to monitor the strength and frequency of your contractions. So, if you were planning an active labor process you might want to hold off on the epidural.

These are just some basic positives and negatives regarding Epidurals. Do you have other questions or comments regarding epidurals? Please comment on this post and share!

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7 Responses to “To epidural or not to epidural”

  1. Ivy S says:

    I had hoped to skip an epidural and have a natural birth, but things don’t always go as you plan. My water started leaking as my first signs of labor, and then broke completely about 8 hours later. After 30 hours in labor (and only dilated to 3) I was exhausted and having double and triple peaking contractions that wouldn’t allow me to relax in order to progress. I got the epidural, because I knew it would help me to relax. Things still didn’t progress as fast as I would have liked, but 52 hours after the start of my labor, my son was in my arms. If I had skipped it, I would most likely have needed a c-section due to my failure to progress, and it gave me much needed rest, to give me the energy to push.

    • janice says:

      Ivy S.,
      Perfect example of when an epidural helps labor progress! Thank you for sharing!

    • Rachel Cano says:

      30 hours! Good job. I don’t think I could have gone that long. This is a perfect example of a situation where an epidural is totally beneficial and appropriate.

  2. Rachel Cano says:

    Very well put. Thank you for this. I totally agree that this is not a black or white issue – there are several grey areas and it’s not always a matter of “pain vs. no pain”. It also bugs me that so many people assume that if you don’t want an epidural, you’re some kind of crazy masochist that has something to prove, or think you’re superior to those who’ve chosen to have one. Or the others who think that if you’ve had one, then you must not be fully informed. It may also be true that in some instances, getting an epidural may help prevent a csection, like after a long, exhausting labor with little progress, as it allows the mother to relax. It just varies so much from situation to situation. My decision to go without was based mainly on my intense fear of needles (I know. What’s with all the tattoos then? LOL.) Joking aside, the more I did my homework, the scarier epidurals and other interventions sounded, and normal labor sounded a lot safer, and, well, normal. I didn’t rule out the option entirely, but also felt confident in my body to do what it’s supposed to do. I think culturally we’re taught to fear childbirth, and that fear translates into more pain. If there’s anything I learned from unmedicated childbirth, it’s that labor is not all that awful if you can get up, move around, and listen to what the pain is telling you to do. I loved the hospital shower so much I wanted to marry it. Transition felt like I was going to die! But it was short and clearly I am still here :) Pushing was only painful when the the nurses were trying to coach it, but once I reminded them that I COULD FEEL EVERYTHING (as nicely as possible, of course) I let my body take over and it actually felt like relief (yep, like a poo). After all was said and done, I’d do it again in a heartbeat.

    • Rachel Cano says:

      I’d like to add that my total labor and delivery, start to finish was (relatively) quick – 7 hours. Any longer than that and I might have a different story to tell.

  3. Hi Janice:
    There are a few points in your post that caught my eye. The part about walking, rocking and sitting on a birthing ball being helpful to labor. I’d be curious to see the evidence for those statements, if you have any. Also, rememebr that the “walking epidural” (that I’ve been administering for the past 20 years) alllows women to retain use of thier legs and to actually walk if they want to (most have no interest in that though, they would rather rest comfortable in bed as their cervix dilates).

    • janice says:

      Dr. Grant,
      I didn’t mention a “walking epidural” because the hospitals in my area don’t offer them. I’m not sure what the ratio of “walking epidural” to epidurals which render you bedridden are…. I have heard of their use before but don’t have any personal experience with them. This was just a general article to give women an idea of what to expect. A friend of mine was disappointed to learn that she wouldn’t be able to get up and move around after her epidural was administered and I wanted other women to avoid that experience. Through this article I hope to open communication between patients and their doctors!
      As far as evidence supporting the fact that movement generally helps progress labor, the only evidence I used was my personal experience working as a labor and delivery nurse. I have seen women stay in “the only position that’s comfortable” for them for hours and make little to no progress. Then after being turned into a new position they suddenly progress. The natural way to labor is with movement. It’s the same with pushing. You can’t argue with a woman when she states “I have to push!”. Yes, in her labor, it’s time for her to push, that’s what gives her some form of relief from her labor discomfort. You just don’t hear of women (without an epidural) laying still, on their back, and progressing quickly through labor.
      I’m shocked to hear that a medical professional that has been administering epidurals for 20 years might even suggest that walking, rocking, or sitting on a birthing ball, might not progress labor. I didn’t believe I needed to site references for these statements because it was just common labor room knowledge. Are you really suggesting that movement doesn’t aid in labor’s progress or did you simply want this article to be more evidence based, siting statistics? This is more of a casual blog based on experience. I do base the posts in “fact”, but as I’m sure you are well aware, “facts” can change with discovery of new evidence and I am always open to new evidence.

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