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If you’re pregnant and reading this, chances are you’ve either planned on getting an epidural, have been told to get one, or at the very least wondered whether you would need one in labor. Whether or not you should take an epidural can be a hotly debated topic depending on who you talk to. As a birth mentor, it’s my job to tell you to do what’s in your best interest. In this blog post, I have listed 15 things I want expectant parents to know about epidurals.

Is an epidural right for you?

Epidurals are a type of anesthetic pain relief given during labor to relieve pain. They are administered into the epidural space around the spinal cord (hence the name). A needle and tiny tube, called a catheter, are inserted into the spine in the lower back area. The needle is then removed and the catheter is left in place through which the medication is then administered.

Whether or not you should take an epidural can be a hotly debated topic depending on who you talk to. As a birth mentor, it’s my job to tell you to do what’s in your best interest. In some instances, getting an epidural can be the absolute best decision. And in others, it may not be (and there might be other alternatives that may be more suitable given your circumstances at the time). At the end of the day, as someone who will soon experience labor and subsequently the birth of your baby, it becomes of vital importance that you are adequately armed with both the positives and negatives (and yes there are some important ones!) of epidurals so that you can make an informed choice based on accurate information.

In this blog post, I have listed 15 things I want expectant parents to know about epidurals. Some of these are hard facts backed by research and some are anecdotal based on accounts given to me by my clients from my birth classes and workshops. Ultimately, I hope this list offers you a well balanced perspective of what to keep in mind when deciding whether you should ask one in labor.

  1. Epidurals are an excellent option for those times when you are exhausted and want to catch a break. Some labors can be long and intense. In such cases, an epidural can provide much needed relief and a chance to rest or sleep.
  2. They can help you relax if you’re feeling overwhelmed or unable to take the intensity of labor
  3. The pain relief from epidurals can last for as long as you need it. This is because the amount of medication administered through the epidural can be increased or decreased as necessary.
  4. Epidurals work differently for different people. Some people find a lot of relief with epidurals while it doesn’t have a helpful effect for others.
  5. Epidurals might reduce the need for a cesarean birth for some mothers.
  6. Epidurals can lead to other interventions down the path for some mothers. Since epidurals suppress the release of the hormone, oxytocin, which produces the contractions, synthetic oxytocin or pitocin may need to be administered to help labor progress and for the cervix to dilate. Research suggests that induction with pitocin also increases likelihood of birth through cesarean.
  7. Opting for an epidural will result in restricted movement for the mother. This might lead to a slower progress of labor as being upright and movement is important in helping the pelvis open and for the baby to descend.
  8. Even under the effect of an epidural and most likely restricted to the bed, there are still ways in which you can incorporate movement by practicing active rest.
  9. Epidurals lower your blood pressure, which may slow your baby’s heart rate and may require interventions or delivery through cesarean.
  10. You may still have to work at pushing the baby down and out even if under the effect of the epidural
  11. You may find it helpful or require “coaching” while pushing the baby, especially if you don’t feel the pushing urges strongly or don’t feel them at all.
  12. Epidurals, if continued to be administered through the pushing stage, may also prolong pushing significantly.
  13. Epidurals may increases the chances of an assisted birth via forceps or vacuum which in turn is accompanied by a need for an episiotomy
  14. They may affect breastfeeding in mothers who want to do so, as it affects milk production and also results in babies being drowsier and therefore less alert and active and slower to latch and feed.
  15. Some mothers may experience a sore back and/or a headache for some time after the epidural is administered.

Epidurals can be a useful tool in your labor toolkit. They definitely have their place in the pain coping and management plan of laboring women. BUT it is important for you to take all things into consideration while deciding whether you need one or not. As a birth mentor who has worked with close to two hundred couples in my antenatal programs and parentcraft workshops, my advice always remains the same: it is important for every birthing person and their partner or birth team to equip themselves with a few different pain coping tools and strategies (both for mind and body) regardless of whether or not they plan to take an epidural. As you can tell from the list, there is the odd chance that an epidural may not give you the relief you desire. Or sometimes, there might be a delay in epidural administration due to the anesthesiologist not being immediately available. In such situations, it can be very reassuring and comforting to fall back on other pain coping practices that might provide some temporary relief as you wait.

I highly recommend looking up the prenatal classes and labor and birth prep programs offered by The Nesting Heart to learn more about epidurals as well as to learn hands on skills for pain coping to add to your labor toolkit.

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Labor & Birth
Namrita Bendapudi

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