Epidurals: a look at one of the most popular labor and delivery interventions.
So popular in the US that nearly three quarters of all births here use some form of it. A study in 2008 found epidural use at 61%, with more women getting one during their labor than not. Let’s look at what makes this such a popular choice among so many.
While it is the most-used form of pain management in a hospital setting, it’s not one’s only choice for substantial pain relief to help better manage their contractions. For example, nitrous oxide is a non-invasive alternative, a good first step for many. Just like you see at the dentist’s, one inhales nitrous through a mask that covers both the mouth and nose. Just before a contraction begins, the laboring person puts it over their nose and mouth and slowly inhales and exhales throughout the entire contraction. For many, it doesn’t take the pain or sensation of the contraction away, it merely distracts them by helping to make them less aware of the pain. You don’t like the way it makes your head feel after a contraction, you don’t have to use it again. Done.
An epidural, on the other hand, involves much more invasive procedures just to get the medicine in you, and it’s not even guaranteed to work. There are various combinations that they can give you as well, but are typically an anesthetic, such as Lidocaine, mixed with a narcotic, such as morphine or fentanyl, which is then injected into your lower spinal cavity. The goal is to have you numb or without any feeling of pain from the waste down (bellybutton high or so). Many feel pressure only during a contraction, but no pain. Others feel pain but it’s less and tolerable, while still others don’t go numb at all, have hot spots, or have it wear off quickly.
Many hospitals have stipulations before you can get one. For example, most prefer your labor to be progressing nicely and for you to be at least 4cm along. You have to get at least a good part of a whole bag of saline in you before they’ll place the epidural as well. Once the procedure is over, and the epidural catheter is placed and working well, you’ll be given a catheter for urine, and settled into your bed nicely to try and relax and let the medicine work.
It’s important, though, with epidurals, that you’re moved around in various positions AT MINIMUM every hour, so that the medicine doesn’t sink and sit in one spot, leaving you feeling everything on the opposite side.
You will also, from that point on, be continuously monitored with a Blood Pressure cuff, oxygen sensor, and baby monitors that keep track of baby’s heart rate and your contractions. No more getting out of bed for you until well after baby comes.
Let’s look at the benefits and risks of an epidural:
Provide relief of or reduction in labor pain
Helps an exhausted birth person to get some rest, possibly sleep
Calms a person who’s anxious or too tense
Some long labors speed up with epidurals
If pitocin is needed to help with labor progression, epidurals help it to be less intense on the body
Can help lower BP which can come from pregnancy-related hypertension
When used during c-sections, they help the birth person to stay awake and alert
Many can still move their legs and help change positions
Many still feel when their contraction is happening
Not enough pain relief or even none at all
Can raise birth person’s body temp
Can Lower the BP in the birth person
Can cause lower back pain that doesn’t subside for weeks and months
Can cause a severe headache
Retention of urine
May cause labor to slow
Can affect baby’s heart rate, as well as breathing, once Earthside
Just as there are horror stories with birth itself, there are horror stories with epidurals. On the flip side, they were life-changing tools that made labor better for so many others. Weighing those risks and benefits is something only YOU can do, and whether you choose an epidural, other pain medications, or nothing during your labor, you’re still having a natural birth.
MedlinePlus. Epidural Block – Pregnancy. (https://medlineplus.gov/ency/patientinstructions/000484.htm) Accessed 10/14/2021.
NHS. Epidural. (https://www.nhs.uk/conditions/epidural/) Accessed 10/14/2021.