An epidural is just one form of pain relief during labor. While many women will joke about getting one on TV, it’s not the first considered form of pain relief. There are other options building up to it. And while some women do choose it, there are risks to the mother and baby due to it.
It’s worth considering all the pros and cons before choosing any form of pain relief during labor. You need to know as much as possible to keep yourself happy and your baby safe. Here’s everything you could possibly need to know about epidurals to make an informed decision.
What Exactly Are Epidurals?
Epidurals are a type of anesthetic injection given to you, usually during labor. It can be used for other health and surgical reasons but the most common is during labor. The anesthetic will number from the waist down, preventing you from feeling any pain in the lower limbs. Since you can’t feel pain, you no longer feel the discomfort of childbirth.
There is a belief that epidurals will completely remove the feeling from the legs. However, it will depend on the type and amount of drug you are given for this use. Most of the time you will be given enough to completely numb the waist and legs, which can cause some problems if you want to give birth naturally.
There are three types of epidurals available. One of those involves top-up injections after the initial one. You’ll have a tube in your back, where your top up injections are given throughout the course of the labor. You need a refill every one or two hours, or you will feel the effects completely wear off. This has become one of the most preferred options for women giving birth.
A second option is where you get a continuous stream of the drug into your body, keeping your waist and legs completely numb the whole time. If you do need stronger pain relief, top-ups and stronger forms are available.
In some cases, the second option is available to allow patients to control the amount of the drug they get. The total amount will be managed by doctors, but a patient has a button that they can press to add more to their body when necessary.
A “spinal” is the third form of epidural. This is delivered to the back and you get enough to last for a few hours. The painkillers work almost immediately, unlike other forms of the drug. You will also need a catheter placed after the administration of the drug, as you won’t be able to walk or know when you need to use the toilet. It is possible to have top-ups of this delivered if you need more at a later hour.
There’s No Need to Fear the Needle
Many people worry about what it will be like to receive the epidural. There’s this fear of a large needle being stuck in your back and that you’ll feel the pain. This is certainly not the case.
Most of the time you won’t feel pain. There may be a pinch from the feel of the needle entering and many women experience a feeling of warmth in their back as the drugs are sent into the body. You will usually be conscious throughout the time of the epidural, whichever type you have. It can feel odd having no feeling in the legs, which can make it difficult to move around. You can’t use your core muscles, which can make it difficult to even just pull yourself into a seated position.
As the epidural effects start to develop or wear off, you can start to feel some tingling sensations in your legs. They start to feel heavy and lethargic. However, your body and mind aren’t affected. You won’t lack energy, making the pain relief very different from most others.
Most of the time, the two types of epidurals take 10-20 minutes to take effect. The spinal can take just a few minutes to settle in.
Why Get an Epidural During Labor?
The pain relief is one of the biggest benefits of getting epidurals. Because you’re the whole lower body is numbed, it can be the preferred option for many women who want a natural birth. You get to have your baby without feeling the force of your baby working its way out of your body. You also won’t feel any tears that can happen during birth.
Epidurals are also good for lowering the blood pressure during labor. The lack of pain means you’re not as stressed during the birth of your baby. You can experience a more positive time, being more involved and happier about the whole situation. Other forms of pain relief can make you foggy and clumsy, meaning you forget about the whole time. Instead, you’re completely aware of the things that are happening, making it easier to make choices for you and your baby.
When you suffer from pain, your body goes into a fight or flight response. Your heart rate increases, as do the stress hormones. This can cause hyperventilating and other health problems if you don’t get them under control. There are natural ways to help prevent some of this, but the epidural is often more calming as it gets rid of the sensation of the pain.
This is also an excellent option if you have a C-section. You remain awake throughout the process, which is a positive for you, your baby, and the doctors. You get to meet your baby as soon as you’ve given birth. Your partner can also be in the room to meet the baby right away. Doctors are also able to monitor your vitals easier. It’s possible for you to share if you’re dizzy, sick, or struggling to breathe or stay awake. This can help doctors take steps to keep you safe while delivering your baby.
By having a more positive experience when giving birth, you will help to decrease regrets and the risk of developing postnatal depression. It’s easier to feel more connected to your baby since the birth isn’t a foggy mess and you haven’t felt like you’ve missed something important.
There Are Downsides to Epidurals
Unfortunately, there are downsides to this type of pain relief. One of the biggest issues is that you don’t feel any pain at all. Sure, this can be a good thing, but you lose the feeling in your waist and legs. It can be extremely difficult to give birth naturally since you don’t feel the pain and discomfort of contractions. While you may feel a little pressure, you don’t know the exact timings to push to help deliver your baby.
You’ll have to rely on others around you, which can make the whole situation seem surreal. You’re not necessarily going to be as connected to the birth as you would hope.
You’re more likely to need ventouse or forceps for the delivery since you can’t time the pushing properly. Your baby will struggle to get into the right birthing position too, which increases the need for other help to give birth. Sure, you won’t feel the forceps or vacuum device, but there are more risks to your baby.
Those who have epidurals are also more likely to need C-sections. Forceps and ventouse deliveries aren’t always effective, especially if your baby hasn’t been able to get into the right position.
Your blood pressure will drop to epidurals. While this can be good, it can drop too much. You’ll initially feel sick and lightheaded, but this can be extremely dangerous for both you and your baby if it continues. You will be closely monitored by doctors throughout the time of having the epidural active.
You will likely need a catheter in place. This is a necessity with a spinal, but you can need it with other types of epidurals. It’s impossible to walk around when you are giving birth, which can affect your birthing experience. You’re confined to a bed, which can seem like you’re trapped and unable to have full control. Walking around helps the baby get into position, which leads back to the risks of needing other help to deliver your baby.
And don’t expect to feel the pain relief immediately. It can take up to 30 minutes for the epidural to set in, depending on the type. Your anesthetist will need to adjust the amount to give you throughout your labor to make sure you keep the pain relief active. This is especially the case with the first two types of epidurals available.
Many women will also experience other problems when having epidurals. Some have shivering or fever while suffering from nausea and headaches. It’s also possible to suffer from ringing in the ears and backache, especially where the epidural was administered. Some women struggle to urinate properly after the catheter has been removed.
It’s not the perfect form of pain relief. Around 10% of women will still feel pain when they give birth. This could be due to the drug’s inability to take effect or it may be due to low pain tolerance.
Getting the Epidural Timing Is Essential
It’s important to make the choice to get the epidural earlier on in your pregnancy. When the contractions get around two minutes apart, there won’t be enough time to safely put the epidural in. This can be done in emergency situations, but doctors would prefer everything set up. You can ask for the epidural to be set up ready for you, just in case you decide you want it. It’s possible to set up the tube for the epidural to be given later.
However, it’s not impossible. You do need to stay as still as possible during the placement of the epidural. This is one of the biggest reasons not to wait until the last minute to choose an epidural as your form of pain relief.
The anesthetist needs to find the right place in your spine to avoid hitting the spinal cord or nerves. This is done through experience and can take just a minute to accomplish. There’s a compartment within the back that the nerves pass through, and this is where the epidural needle is placed. Sometimes the spinal bones will be bumped, as they surround the space. However, you’ll barely notice and will not do any damage to your body.
You will need to avoid getting the epidural too soon. It is possible to slow down your contractions and even stop them entirely. This can put you and your baby at risk, so your doctor will want to make sure you’re using the right type of pain relief. If you stop contractions, doctors may need to carry out a C-section and you may need to go under full anesthetic to make sure you and the baby are kept safe.
There are extremely minimal risks of permanent damage to your spinal cords. Anesthetists are trained extremely well to make sure this doesn’t happen!
Closing Points on an Epidural
An epidural isn’t the first type of pain relief offered in a hospital. There are many other, less invasive options, including gas & air. Doctors will prefer that you work your way up to an epidural. Once you’ve started to numb the pain through an epidural, your body will get used to this.
It’s an excellent option if you need a C-section and wants to remain awake the whole time. The epidural will numb your waist and legs, so the doctors can perform surgery without you realizing. It can be used for vaginal births, but there are risks of needing medical help to deliver your baby. There are also some risks to your overall health.
The good thing about epidurals is the pain relief. It’s not immediate, but you will experience a calmer and more relaxed birth. There isn’t the same fogginess as other pain relief, but you’ll have to weigh up all the pros and cons of different types of pain relief during pregnancy and labor.