The amount of options available to families during the labor and delivery process is phenomenal. Now, more than ever, you have the ability to really delve into how you hope to see this process unfolding and have access to various options when it comes to how you have your baby.
Do I want an epidural?
What are the benefits and risks of an epidural?
Are epidurals bad?
Many, when thinking about their options in birth, start with pain relief. There are two categories when it comes to pain relief: medicated pain relief and unmedicated pain relief. Deciding between the two is a very personal choice that no one can make but yourself. However, if you’re currently exploring the techniques and medications that are available to you, this blog can help! Let’s first talk about the benefits and risks of an epidural.
This method of pain relief is, by far, the most common seen in hospital births. It’s inundated within our culture, specifically in media, tv, and movies. This pain medication is a type of anesthesia (yes, like what you get for surgeries), however, it is isolated to one region of the body and intended to block the pain in that region.
Getting the Epidural
The process of receiving an epidural tends to be the same wherever you deliver but keep in mind you may see slight variations of this. Your medical team will ensure you’re hydrated by giving you a couple bags of fluids. Then your skilled anesthesiologist will come in to provide the epidural. During this time you will be sitting up right on the side of your bed, facing either your partner, doula, or nurse. They’ll ask you to sit still, drop your shoulders, drop your head, and hunch your back like a cat, almost curling around your belly to help the space between your vertebrae become more prominent.
They’ll clean your back, provide local anesthetic to numb the skin, and then insert a needle into the appropriate space. Once that needle is in (which you mostly likely won’t feel thanks to the local anesthetic), a flexible catheter is threaded through to the space and the needle is removed. This is the key part to remember: the needle is not left in your back; just the flexible catheter!
Once the catheter is in, a test dose is administered and your doctor carefully examines how your body reacts. They’ll ask you a few questions, continue to monitor your blood pressure, temperature, and heart rate, ensure the placement of the epidural is just right, and then either give you your full dose or set up a pump to continuously provide medication. You may even receive a button that, if you feel the pain intensifying, you can press to provide you with an additional dose of medication. No worries as it has settings on it that prevent you from getting too much. Following this, depending on how dilated you are or how soon they expect you to deliver, your nurse may insert a urinary catheter to ensure your bladder stays empty.
Benefits
The benefits varies from individual to individual. The most common reason for getting an epidural is having nearly immediate pain relief (often within 20 minutes of receiving it).
Often when the pain relief has set in clients find they then have the ability to sleep, and therefore the ability to relax. Sometimes we see patients who experience prolonged labors with little cervical progress, full body tension, fatigue after hours and hours of laboring, and then decide to get an epidural. They find they are able to get some rest, release the tension in their body, mentally reset, and in just a couple hours see huge cervical changes, leading to complete dilation and pushing. Sometimes an epidural can provide that hour or two of rest someone needs for their body to progress further. So one benefit of the epidural, for some, can include actually helping labor move along faster.
For someone who is experiencing high blood pressure, whether it be due to preeclampsia or some other medical concern, some doctors will opt to use an epidural since one of the side effects can include lowered blood pressure.
Risks
As mentioned above, lowered blood pressure is something that may happen, and therefore your medical team will continue to keep an eye on it. They may decide to prescribe a blood pressure medication during the rest of your delivery should it get too low.
Lack of movement is often the risk most are concerned about. Once you receive your epidural you will be asked to stay in bed. However, with the help of your doula or nurse, you’ll be able to switch the sides you lay on and even completely change positions with the help of the bed settings, a peanut ball, or even pillows. This helps keep your body moving, which helps your labor progress, as well as keeps the medication equally distributed throughout your body.
Sometimes the epidural doesn’t work quite as planned. Some may experience hot spots, where they can feel the sensations of the contractions in specific areas. Others may experience pain relief on one side of the body and not the other. Your anesthesiologist will want to know about any of these concerns so they can make adjustments to your epidural placement. More often than not this can be rectified, but if it can’t be, utilizing your partner, nurse or doula for pain relief techniques can be vital to help you physically and mentally get through this unexpected hurdle.
The pelvic numbness can be frustrating for some as they feel it can lengthen the pushing stage. This also means the epidural can also increase the need for a instrument assisted delivery.You can request guidance from your care provider during pushing to give you feedback about your effectiveness in pushing. Many will also request for anesthesia to turn down the epidural so they regain some feeling for this part of labor.
Risks postpartum can include spinal headaches, infection at the site of the injection, and the need to stay in bed for a few hours after delivery until your legs have regained feeling and you are capable of walking.
Your Choice
Only you can decide if the risks outweigh the benefits, or the benefits outweigh the risks. You will hear stories on all sides of the spectrum, from parents who loved their epidural and felt it helped to make it a positive experience, to others who dealt with some of the negative side effects and felt it hindered their labor.
Remember, procedures and interventions on their own aren’t inherently good or bad. It’s how they’re used and how effective they are at fixing original issue that often dictates how you felt about your experience. It’s just another tool in your birth toolbox that you have the option of using.
This post is not meant to replace the guidance of your medical care team. This article is not a full list of the risks and benefits of this procedure. Please consult your doctor for a full outline of the benefits and risks of receiving a epidural. Experiences vary from patient to patient.