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Epidural? Make an Informed Choice

 
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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.

Sources:
U.S. Department of Health and Human Services
The Healing Center On-Line
Birthsource.com
Drugs.com

Add a Comment10 Comments

EmpowHER Guest
Anonymous

The title of this article is perfect I was just talking to a friend of mine (28 weeks in) and she asked me about epidurals. I honestly told her that I don't want her to be persuded by me at all. This is something that she has to decide herself.
http://natural-labour-pain-relief.blogspot.com

July 16, 2013 - 1:17am

In HypnoBirthing one of the things they teach is to change the word contractions to surge. There is a big difference in how the subconscious mind perceives surge vs. contractions. The subconscious mind listens literally & responds as such.

April 14, 2011 - 3:40am

Thanks for this article. When the on-call anaesthesiologist came into my labor room to introduce himself "for later - just in case", he seems surprised when I said "thank you, but I won't be needing your services". I knew that there are situations where an epidural may be necessary (just as there are fully-justified c-sections), but I also knew that my partner and I had spent weeks preparing ourselves for labor and delivery both physically and mentally (I can't say there was anyway to prepare emotionally!). We took a Birthing from Within class, studied pain management, talked over how we would handle emergency situations - in a word, we "practiced" as best we could. We wanted to be as prepared as possible for whatever would arise. The end result was a pain-medication-free labor and delivery, though my over-24-hour labor was augmented - after trying every trick in the book to regulate contractions, much thought and with my full consent - with Pitocin, magnesium and IV fluid as I had HELLP sydrome (and the only cure for that is delivery).

From speaking with other women about their labors/deliveries (some new mothers, some who are now grandmothers), it seems that some turn to the epidural simply because they do not have the tools to comfortably approach "getting through" childbirth. As pregnant women, we must take the matter into our own hands and educate ourselves on what pain management will work best for us before we find ourselves timing contractions. We don't live in a society where we are surrounded by our mothers, sisters and aunties during our labor - they are not there to breath with us (as my midwife did as I struggled to move from 8cm to 9cm), to tell us when to bear down, to encourage us to "get animal" and let our inhibitions go in order to allow our bodies to do what they were built to do. Ina May Gaskin's Guide to Childbirth was a great resource for me - both in helping me to overcome my (I think natural) fear of impending childbirth and also to see that babes are born in many ways...but the miracle is not in the getting there, but in the little life itself.

April 14, 2011 - 12:38am
(reply to ShayGuevara)

Thank you for sharing so candidly. I personally am a big fan of both Birthing from Within and Ina May Gaskin (everything she does!). I believe that any tool that helps a woman feel prepared and informed before labor begins is a wonderful resource. Our bodies are made for birthing, and our bodies know what to do. If we can educate our minds to follow suit, the whole process is so much more empowering, whichever path we take!

April 18, 2011 - 10:19pm
EmpowHER Guest
Anonymous

I believe completely in informed choices regarding epidurals. Many people are not aware of one of the terribly debilitating side effects of an epidural called an epidural headache. I suffered from the excruciating pain of an epidural headache for three months before being finally fixed with a blood patch. If I can save just one woman going through what I did then it makes it a little more worth the extreme pain that I went through as a new mother. Epidurals certainly have their place for childbirth and other pain relief but knowing the very real side effects that can happen is very important BEFORE having an epidural. Please read my story at http://www.epidural.net/epiduralheadache.htm

April 13, 2011 - 11:21pm
(reply to Anonymous)

Thank you for sharing your story!

April 18, 2011 - 10:16pm
(reply to Anonymous)

As a Nurse Anesthetist, my one very big question is why did they wait 3 months. Never should have been that long.

April 14, 2011 - 3:37am

Thanks, Seth-Deborah, for your comment. I absolutely agree that choosing an epidural is not a "failure," nor is it a weaker option. While I am a huge proponent of drug-free birthing, I recognize that it is not always the best choice for every woman in every situation. A friend who had an emergency C-section was upset because she was unable to give birth "naturally." What put her mind and heart at ease was a comment from her midwife reminding her that women get pregnant to have a baby, not to have a birth. This has always stuck with me: a healthy baby is the main goal of a birth, and whatever needs to be done to reach that end is, in my opinion, the best choice!

April 13, 2011 - 7:31pm
(reply to Hillary Easom)

Hi Hillary, just noticed we are across the bay from each other. I am in the East Bay. I love the saying from the midwife. I shall have to remember that one.

April 13, 2011 - 10:42pm

I am a Nurse Anesthetist and a Clinical Hypnotherapist.
I totally believe to try natural first and use Hypnosis for Childbirth or the tradmarked technique called "HypnoBirthing" It works !!
However, sometimes things can go wrong or get tricky. Epidurals are relatively safe. They can help a woman in distress who is beginning to have the stress show up in the fetus as fetal distress. However, sometimes in can stop or slow the progress of labor. If you choose to have an epidural it isn't because you "failed".
Nothing is worse than getting into a situation so tricky and life threatening that things go quickly into horrible situations that you have to live with for a lifetime.

The best thing, in my opinion after YEARS of working in L&D is to learn hypnosis for childbirth at least 6 weeks before delivery. Let me be clear...it is NOT Lamaze. It is much better and it works!!

Seth-Deborah Roth CRNA,CCHT,CI
http://www.HypnotherapyForHealth.com

April 12, 2011 - 6:46pm
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