Thinking about getting an Epidural? Great! I’m glad you are taking the time to research your options. Remember, giving birth to your baby is so much more than a medical procedure, and having a doula is a wonderful idea for moms who want natural childbirth or epidurals!
Here is some information to get you started:
Myth: Painless Childbirth
Although good to excellent pain relief is obtained in 90% of epidurals, few epidurals take away all the pain. You will still be required to use some other forms of comfort measures at times. Some hospitals advertise “painless childbirth,” but few women experience it that way.
Avoiding the use of the epidural until you are 5cm reduces your chances of needing a cesarean. A doula will be invaluable in helping you use relaxation techniques, suggesting position changes, and using non-medical comfort measures.
Help in coping with pain is only one small part of your doula’s role. Epidurals do not hold your hand, rub your shoulders, explain what is happening or help you make decisions. Epidurals do not get ice chips or remind you to urinate. Epidurals cannot suggest position changes to help labor progress. Epidurals will never advocate for you or help you get what you need from hospital staff.
What if…
Below is a list of situations or experiences that may require you to delay or skip the epidural altogether. It is good to know about these ahead of time, so that you aren’t caught off guard in the middle of hard labor.
- Your labor may progress too quickly for you to receive an epidural.
- A pre-existing medical condition, low blood pressure, low hemoglobin levels, previous spinal injuries, or prior bad reactions to anesthesia may contraindicate epidural usage.
- Medications that you take can effect how likely you are to be able to get an epidural. The biggest culprits are blood thinners.
- If you are bleeding heavily or are suffering from shock, you will not be given an epidural for safety reasons. Since many women tend to have lower blood pressure with an epidural, this may be made even more dangerous with the lowered blood pressure of some of these problems.
- Often you must wait for the anesthesiologist to become available.
- You may need to wait while you receive 1-2 liters of I.V. fluid.
- If your cervix is almost completely dilated and the baby has descended well in your pelvis, sitting up for an epidural can make monitoring the baby difficult.
Also remember, the procedure itself can take up to 30 minutes to perform, and you may not have complete pain relief for another 20-30 minutes.
Side Effects
Over 70% of the time, epidurals come with mild side effects. Although not considered medically serious, these side effects can be very unpleasant.
- All over the body itching, nausea, shaking (“epidural shakes”).
- Confused nerves may send feelings of intense heat in the lower extremities.
- Many women find the deadened nerve sensation in their entire lower body to be very distracting and disconcerting (like having your jaw numbed for a filling).
- Mothers experience a drop in blood pressure 30% to 35% of the time.
- The loss of control over the legs is often distressing to some mothers.
- Some mothers report feeling “detached” from the experience of childbirth as a result of the full effects of epidural anesthesia and may not feel like participants in their births which may affect mother-baby bonding.
- Epidurals increase the likelihood of other painful interventions, such as: IVs, urinary catheters, continuous fetal monitoring either externally or internally, frequent blood pressure monitoring, maternal fever requiring use of antibiotics & tests on baby (complete blood count, spinal taps), pitocin, forceps, vacuum extractors, episiotomy and cesarean section.
Other, very serious, but rare risks include:
- Convulsions
- Respitory paralysis
- Cardiac arrest
- Allergic shock
- Nerve injury
- Epidural abscess
- Maternal death
Benefits?
Ok, so what about all the good things you hear about epidurals? What are the benefits of epidural anesthesia?
- Allows you to rest if your labor is prolonged.
- Relieving the discomfort of childbirth can help some woman have a more positive birth experience.
- Most of the time an epidural will allow you to remain alert and be an active participant in your birth.
- If you deliver by cesarean, epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.
- When other types of coping mechanisms are not helping any longer, an epidural may be what you need to move through exhaustion, irritability, and fatigue.
- An epidural may help you to rest, relax, get focused and give you the strength to move forward as an active participant in your birth experience.
The use of epidural anesthesia during childbirth is continually being perfected and much of its success depends on the care in which it is administered.
Things to Remember
Again, an epidural can be great, or it can be not so great. As with all pain coping techniques, including IV medication and epidurals, there are advantages and disadvantages.
Sometimes the epidural gives only patchy pain relief, or doesn’t give pain relief at all.
Some women experience epidural induced pains after the birth, like epidural/spinal headaches, postpartum backaches.
Epidurals do not provide complete relief for back labor but now confine the mother and prevent her from doing many of the positions that relieve the pain of back labor.
A doula will stay at your side, help you cope with any side effects you have and give you information about your options.
One more thing…
An epidural does not affect your need for reassurance. You might expect that with pain relief, all your worries would go away. Interestingly, this does not seem to happen. Women experience the same emotions during labor whether they use epidurals or not. Many times, the medical staff or the mother’s partner may feel that if a woman has pain relief, she doesn’t need the same type of gentle emotional support. Women often feel even more frightened and worried when they sense this emotional withdrawal. A doula will continue to focus on what you are feeling, and will give you the reassurance and comfort you need.