Get me an epidural NOW

If you’ve had a baby, two big questions you can be sure to get from (mostly female!) family and friends are:

– what kind of delivery did you have?

– if answer to previous question is normal delivery then… did you have an epidural?

Anyone that knows me knows that I am not the biggest fan of epidurals. However, I am not writing this to give my opinion or tell you what to do or what not to do. In fact, whether you have an epidural or not is your business and you should not feel the need to justify your decision. I want to just give you the information so you know the full story about epidurals – the good, the bad and the ugly!

What Exactly Is An Epidural?

Surprisingly to some people, an epidural is not an obstetric procedure. It is carried out by an anaesthetist. This is why, although available in all maternity hospitals in Ireland, you may have to wait if there is an emergency in theatre for an anaesthetist to become available to do it. I found this video of an anaesthetist explaining the epidural procedure on youtube that it far better than I could type it!
Video copyright of http://www.StreamingWell.tv

History

A brief history of the epidural. They first started to exist as far back as the 1890’s. They were first used in childbirth in the 1940’s but only became commonly used in childbirth in the 1970’s. Some of the reasons for this are that epidurals commonly slowed down labour and in the 1970’s the medicalisation of birth really took hold with increased hospital births, the use of oxytocin to speed up contractions, continuous fetal monitoring and improved safety and competence in Caesarian Sections. Can you see the cascade of interventions there in that last sentence? Advances in medical science can help and hinder us; undoubtedly lives have been saved thanks to Caesarian Sections and other interventions in normal birth. Equally, many women have undergone unnecessary interventions and procedures in birth that have left them damaged, physically and emotionally, for the rest of their lives.

Current Situation

I don’t know how many times I’ve heard the analogy “you wouldn’t get a tooth out without pain relief so why wouldn’t you have an epidural for childbirth?”  I guess it depends on your outlook though, having a tooth extracted is painful – as is childbirth. Yet, the person getting the tooth out has no involvement in the procedure, they just sit there and let the dentist pull it out. In childbirth, unless you are having a C Section, you are very active in the process; most women do not want to have the baby “pulled out”. There’s the difference.

Epidurals in labour have been researched and researched as it is such a hot topic in maternity care. Epidural rates are higher than ever, figures have doubled over the past 20 years. I think midwives need to be accountable here too. We, as professionals, can impact these figures. If we provide good one to one care and support a woman well in labour, evidence has shown that the epidural rate is reduced.  I think if women are informed more about epidurals BEFORE labour, they can make a more informed choice when the time comes.

Benefits

I have a little infographic that summarises all the risks and benefits at the end of this post if you want to save it for later use. I’ll start with the benefits of an epidural. If you are finding that you are just not coping with labour, despite trying all the other options and techniques, then an epidural will usually give you excellent pain relief. If you have an overwhelming fear of childbirth and an epidural is the difference between you having a normal birth or a C Section then an epidural may be the answer for you. An epidural is also beneficial in women with raised blood pressure – either essential hypertension, gestational hypertension or pre-eclampsia; as it lowers blood pressure. In a prolonged labour, it can give the labouring woman a rest. In an induced labour, it can help a woman cope with the more intense pains brought on by syntocinon / oxytocin. However, some women cope fine with induction so don’t presume you will need an epidural just because you are having your labour induced.

Risks

So on to the risks of an epidural. Usually in your pregnancy you will receive a little leaflet or booklet on pain relief in labour. You will more than likely add this to the big pile of other pregnancy related leaflets you acquire that you have great intentions of reading but other things get in the way. If you were to read this leaflet, you will see under the epidural part that the risks are usually listed as anaesthetic risks such as lowering of blood pressure (IV fluids can counteract this), headaches, back pain, heavy tingling legs, nerve damage (rare). Obviously these are important but the more serious risks are rare as anaesthetic techniques constantly evolve and improve. What might not get as much of a mention are the obstetric risks and side effects. The pushing stage of labour is usually slightly longer with an epidural and you are more likely to need a forceps delivery and therefore an episiotomy. You might still feel pain as sometimes it doesn’t work or it only works on one side. Your baby is more likely to be in a poor position for delivery which also increases the risk of instrumental or operative delivery. You will be confined to the bed for your labour, delivery and around 6 hours after delivery. You will need a catheter in your bladder which increases your risk of urinary retention. Epidurals lower natural production of oxytocin hormone usually resulting in the need for syntocinon infusion. Mothers are more likely to have a high temperature in labour with an epidural; this can lead to problems for the baby such as poor condition at birth. There is also recent research that links epidurals to problems with breastfeeding and higher rates of jaundice. Please contact me at theirishbabyfairy@gmail.com for further information or details of research and studies to support this. Also some hospitals over mobile epidurals which I haven’t covered here as there is limited availability, if any, in Ireland at present.

A Final Thought

As a midwife, I would never advise a woman not to have an epidural. If it is requested, I try to organise for it to happen as soon as possible. That moment is not the time to be getting into a detailed discussion about the pros and cons of epidurals. The anaesthetist performing the procedure briefly discusses it and obtains consent. What astounds me is the power of the mind. These women are in so much genuine distress with contractions that they request an epidural then manage to stay perfectly still for the 10-20 minutes it might take for the procedure to be completed. If that doesn’t demonstrate mind over matter, I don’t know what does. This brings me on to an alternative to epidural (or any other medicated pain relief) – that is hypnobirthing. I am not trained to teach hypnobirthing and I can only say how good it is from seeing women use the technique in front of my own eyes. These are the women that look like they have had an epidural; these are the women that you examine to find they are 10cm / fully dilated and are acting like they are in the very early stages of labour. It has to be seen to be believed. So I have asked a lovely lady who is an expert in this and teaches it to do a guest post on my blog about it, you can read it here. So did I have an epidural? None of your business… only messing, you can read about what happened in my labour here.

A quick overview of epidurals in labour

 

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29 thoughts on “Get me an epidural NOW

  1. Very informative. Had an epidural with my first. I’d already had pethedine and gas and air. I had intended on having just gas and air but plans change because I was so exhausted by the end. Long labour, back to back and 9lb 4oz baby. I’ve since had another two much quicker deliveries with just gas and air. I coped better afterwards having had the epidural in terms of after pains but I felt more in control of the deliveries without the epidural! I would always try to avoid an epidural but for me it was certainly the best choice when having my first baby!

    1. Thanks for reading and commenting Kate. The reason you coped better with after pains on the first is because you only really get after pains after the second and subsequent babies (they get worse the more babies you have) – nothing to do with the epidural! Every birth is different, sounds like you managed beautifully on all 3 xx

      1. Aha! That would make sense as they were much worse after third! Worst part (I found) is with epidural you obviously can’t move around, change positions but then tricky when you are on a monitor anyway! 🙂

  2. I had an epidural with BB – I was induced and literally could not bear the pain. I felt like I had failed and that there was something wrong with me because I couldn’t cope with the pain when other women can. I went into labour naturally with Little B and didn’t need any pain relief at all. His birth made me realise I hadn’t failed the first time round at all – the pain was so completely different having been induced. Popping over from #KCACOLS FB linky x
    Crummy Mummy recently posted…Things they don’t tell you about pregnancy after miscarriageMy Profile

  3. When my wife got pregnant, it was me who insisted she get an epidural. I couldn’t stand seeing her in pain. Thank God she and the baby got through okay.
    Roy Shaffer recently posted…Forex for Lunch ReviewMy Profile

  4. Very informative. I had an epidural both times – so glad I did on first as I was induced and ended up need forceps. Second time it started rising too high and they said it was up as far as if I’d had a c section , which could have been a problem if it continued to rise ! I guess I had them out of fear without contemplated the risks too much – possibly not wise but i don’t regret it . #kcacols

  5. Really informative post. I honestly think the best thing to do is to go into the whole labour and birth with an open mind, and to know that every birth is different. I’ve personally never liked the idea of having an epidural, but was always open to the idea that I might need one if the birth didn’t go the way I wanted it to! I was lucky with both my labours and managed with gas and air, but I think every woman should make the choice that’s right for her and her experience of giving birth. x #KCACOLS
    Madeline (This Glorious Life) recently posted…Coaching cards for new parents – #YouGotThis blog tourMy Profile

    1. I was exactly the same Madeline, I didn’t want one but if I needed it I would have had it! I was lucky I didn’t need it in the end. Every labour is so different though.

  6. I didn’t have chance to have an epidural it was over too fast but I know why some women want them and I do not blame them at all. If things had gone differently I can imagine I would have been screaming for one too despite saying I didn’t want one at all #kcacols
    Tracey Bowden recently posted…Getting In Shape for Summer With Chemist DirectMy Profile

  7. This is a really informative post, thanks for sharing! I was really scared of having a needle in my back (not usually scared of needles or squeemish in the slightest, but this one made me feel really uncomfortable at the thought!) and I was terrified when the woman in the bed opposite told me that because I was being induced, I’d “definitely need one”. I managed without and was very relieved but I’d never judge anyone who did have an epidural, I think they’re really brave to have that needle in their back! #KCACOLS

    1. I laughed when I read this but it actually is quite common to have this fear. A lot of people get over it in labour though 😁 Glad all went well with induction for you.

  8. Excellent post. I was adamant that I didn’t want an epidural with any of my five, it was actually my biggest fear, and I didn’t have one despite having some pretty horrific inductions. The irony is that now I have to have an epidural to treat my on-going back issues, two bulging discs, caused by my pregnancies! I’m dreading it! #kcacols

  9. So much information on the epidural! I didn’t have one as he was fairly speedy and I was quite mind over matter keen on as natural delivery as possible. All I can say is thank goodness for gas and air as it made the last pushes bare able! #kcacols

  10. Such a useful post – thank you! I was induced and couldn’t cope with the intensity and back to back contractions so had an epidural when I really hoped i’d make it through without one. Now I feel like I cheated hich is ridiculous I know!! I’d already thought about hypnobirthing for the next time around and your post has just confirmed my feelings about it 🙂 #kcacols
    Hannah (tuesdayschildblog) recently posted…Birth story – part #2My Profile

    1. Hannah, you did what you had to do and of course you didn’t cheat. I wouldn’t hesitate in getting one if I felt I needed one. There’s no prizes for being a martyr! It’s nice to have a natural birth but when interventions like induction happen, it’s not so easy.

  11. Such an informative post! I went into labour with a pretty open mind – I wasn’t opposed to an epidural, but I wanted to see how I dealt with the pain. I was doing great until my midwife broke my waters and then everything ramped up about 10 gears (I had just been told before she broke them that I was 4cm, so I felt if this was the level of pain I was in at 4cm, there was no way I was going to cope with getting to 10!) I requested an epidural pretty sharpish then, but by the time the anesthetist arrived (I think about 30 minutes later), I was bearing down and ready to push – it all happened so quickly! I think I’d take the same approach in future – just play it by ear and see how it feels at the time. #KCACOLS

    1. Katy I was the same wouldn’t let them break my waters at 4cm but let them do it at 7cm and it was like someone pressed a turbo button!!! I never felt anything like it, everything went really fast then but I did ask for an epidural also but then talked myself out of it!

  12. Hypno birthing is something I am definitely going to look up if I get pregnant again. I had to have an epidural because of severe spd, not being able to move my legs when baby’s heartbeat dropped so they had to move them to get the monitor on his head. Obviously it needed to be done but I passed out with pain (weak)! Nearly in c-section but ended up being a forceps birth. I really didn’t want the epidural but the consultant said it was a must. So want to see if hypno birthing can help if there’s a next time. Sorry that was a bit of an essay! Maybe I should just write a birthing post!!! #kcacols

  13. I had an epidural with both my girls but the second one was a programmed c-section so they have to do it regardless. For my first birth I made very clear that I wanted one as soon as possible. So when I was shouting like I couldn’t cope any more they put me one! The thing is that my 1ist birth experience wasn’t that pleasant and I ended up in an emergency c-section. 24 hrs trying to have that baby and then my baby was out after 15 mins of having a c-section. Crazy! My views regarding women having to feel the pain for childbirth is just silly. I have not much tolerance to pain so I knew that I needed epidural plus I was very scared of the whole thing. So knowing that I had that alternative calmed me down a lot. I agree with you 100% when you say that this is ‘your body, your pain, your choice”. Just perfect! It is ultimately OUR CHOICE. Great post and very informative. Thank you so much Lisa for sharing this at #KCACOLS. It is great to have you.
    A Moment With Franca recently posted…Ravensburger My First Puzzles Review & GiveawayMy Profile

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