Epidurals And Making The Best Decision For Yourself
You get pregnant everyone congratulates you and suddenly everyone has an opinion about how you should birth and how you should raise your child. And one topic that is always top of the list is pain medication in birth. Your friends who have had babies before they will immediately tell you, "Just get the epidural! Don't be a hero, there is no prize at the end of doing this without an epidural." Just the opinion of a friend shouldn't be the reason you make a decision. There are a few things you should consider so that you can make the best decision for yourself.
Advantages Of Epidurals
Epidurals have a number of benefits besides just giving you complete pain relief. And that benefit can make a long difficult labour more manageable and let you sleep so that you can have the energy necessary to push baby out at the end. As well the birthing parent can be more alert and able to ask questions and make decisions more clearly during labour.
Epidurals can also potentially speed a labour up that is stalled for whatever reason. In the case of an induction, when the care providers are trying to start a labour that the body may not be ready for it can be come a battle between the body, your mind and the medicine. This can often lead to a labour that get the cervix to a certain point in dilation and then stop or rather the dilating will stop. And you spend a number of hours stuck at a certain dilation. The medicine, Pitocin, is continuously being administered and increased but the cervix is not budging and all the while you are experiencing ever increasing intensity in the contractions, thereby creating more tension in your body. Getting an epidural can relieve that intensity of contractions, allow your body to relax, get you some sleep and thereby giving the cervix what it needs to continue dilating, relaxation.
The epidural can also help if you are experiencing symptoms of pre-eclampsia, specifically high blood pressure. Often when pre-eclampsia is diagnosed an induction is the protocol. Delivering baby, if your blood pressure can't be managed with medication, is the designated safe option for both baby and the birthing parent. Having epidural can help lower your blood pressure during the labour as that is one of characteristics of an epidural.
With an epidural in place an unplanned or emergency cesarean birth would not need general anesthesia which can have greater risks and the birthing parent can be alert to bond and feed baby after the surgery has been completed.
Disadvantages Of Epidurals
There are a number of disadvantages to getting an epidural. It will be important to weight the advantages versus the disadvantages of epidurals.
One disadvantage is that you will be less mobile. You will not be able to get up and walk around which can help to keep baby positioned properly and labour moving forward. However you can counter this disadvantage with changing sides every hour and also using a peanut ball which can help create space in the pelvis for baby to move down and good positioning of baby for pushing.
Another disadvantage of an epidural is it can inhibit your ability to push effectively. Not being able to feel the pressure in your bum in order to feel where to push down there can often result in an instrumental delivery such as a vacuum extraction or a forceps delivery. There is also a way to counter this as well. Having the epidural turned down or off during pushing can give you more feeling down there and allow for more effective pushing and even being able to attempt more pushing positions that can help bring baby out easier.
Getting an epidural very early in your labour can contribute to a longer labour and often more medical procedures such as the artificial breaking of your waters and the use of Pitocin which can increase fetal distress. Using non-medical comfort measures in early labour can reduce this risk.
There are a few side effects that can come with an epidural as well, these can often be remedied by medication or fluids. These include:
Low blood pressure
Nerve Damage (About a 1 in 250,000 chance)
You will also need to have a urinary catheter as you can not get up to pee. The good news is that it won't be administered until after the epidural is working and you won't feel it. This can increase your risk of a urinary tract infection so you will need to be aware of your urine output after the birth and get any UTI symptoms dealt with quickly. Other medical procedures that come with an epidural include:
Continuous fetal monitoring
Blood pressure cuff
Weighing the advantages and disadvantages is important to making the best decision for you and your baby. Whether you get an epidural or not is up to you and only you. Your friends, your family, your partner, nor the medical staff get to decide this option for you. When you have reached a point in your labour when you are done, then you get to choose this option.
If you would like to know more about epidurals or other medical interventions that can happen during labour, see our video workshop on Pain Management And Interventions.