Not long before I gave birth to my first child, my sister-in-law pointedly told me I should have an epidural during labor. No “see how you feel,” “gauge your pain” or “consider it”—hers was a more piercing comment, implying that I was crazy if I chose to birth my baby any other way.
Truthfully, I shouldn’t have been surprised, or even irritated, as I was at the time, by her unsolicited advice. The National Center for Health Statistics reported a study that showed 61 percent of women opting for epidural or spinal anesthesia during labor. Caucasian women, like my sister-in-law and me, were more likely than any other group to choose an epidural.
No doubt labor is painful. There’s no way around that—at least not entirely. Even women who choose to have an epidural experience pain at some point during their labor. But many women opt for epidural anesthesia because they think it’s what they are expected to do nowadays. Some of my prenatal yoga students have said they’d choose an epidural because it makes labor easier.
Some of these comments clearly stem from fear—of pain, of the birth process, of motherhood in general. I worry, though, that many pregnant mothers are under-informed and opt for epidural anesthesia without fully understanding the potential disadvantages of their choice.
So what are the pros and cons of epidural anesthesia during labor?
Undeniably, an epidural relieves a lot of the pain that comes with childbirth. For many women, especially those who are fearful of the birthing process, this is appealing. Epidural anesthesia also allows the mother to rest for a while during labor so that she can be awake and active during the birth.
Not feeling the pain of each contraction can cause a mother to dissociate herself from the labor, focusing less on what is happening inside her body. For some women, this is a relief; for others, it’s a disappointment.
Many physical risks are associated with the use of epidural anesthesia, and it is important to consider these before making a final decision. Sometimes an epidural slows down labor, delaying the baby’s birth. In some cases, Pitocin is needed to keep labor moving along. As with any drug, there can be negative side effects including nausea and vomiting.
In some cases after epidural anesthesia, contractions weaken to the point that the mother cannot feel them at all. When this occurs in the final stages of labor, pushing can be complicated. In these instances, other interventions such as forceps and vacuum extraction may be necessary to help the baby move through the birth canal.
After an epidural is administered, the lower body may feel numb for several hours, even after the baby is born. During labor, walking can be difficult, and the mother is therefore somewhat confined. Staying in one position too long can slow down or stop labor. It can also contribute to the high incidence of hypotension, or low blood pressure, that has been reported after epidural anesthesia. Medical interventions are often necessary to treat the hypotension, which can otherwise be a huge risk to the baby.
Other symptoms that have been associated with epidural anesthesia include headaches, backaches, nausea, shivering and soreness at the point of needle insertion.
Every mother has a different approach to her own labor and birth, and this is what makes our experiences unique and special. We are fortunate to have options that were not always available to women, even in the recent past. However, in order to truly take advantage of her ability to choose, it is important for a woman to be adequately informed in order to make an educated, responsible decision both for herself and for her baby.