Most moms-to-be have thought about their birth plan and what they’d like to experience in labor.
If you’re an expectant mom and you haven’t heard about all your options, I’d highly encourage you to attend a local childbirth class to learn more.
When it comes to controlling the discomfort of labor, moms have to make important decisions ahead of time.
We’ve talked about several of these concepts in previous posts and we’ve also looked at the many different ways to get through labor—the TENS unit, nitrous oxide, music, and other relaxation options.
Most pregnant women have heard about epidurals, often through someone who had an epidural in labor.
What do we know about this option for pain control in labor? How does it work?
In short, it dampens pain signals in a particular body region.
The American Pregnancy Association describes it like this: “The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body.”
To have an epidural, you’ll need to have an IV in place. IV fluids need to be administered before starting the epidural.
The anesthesiologist will have you sit and push your back out like a mad cat. They then place a needle with a catheter into the epidural space. This is all done by feel. The needle is removed and the catheter will remain and carry the medicine to the area.
The medication provides numbing to the area.
Because epidurals can affect your blood pressure, a nurse will check your blood pressure often during labor. You won’t be able to get up and use the bathroom.
An epidural is a great option for pain management for a number of reasons:
- It’s an effective pain reliever during labor. Studies show a decrease of at least 3 points on the pain scale after an epidural.
- It can provide an opportunity for much-needed rest. If a mom is experiencing a long labor and she hasn’t rested, an epidural will give her the chance to rest—allowing for more energy to birth her baby.
- If a mom is stressed or unable to relax, an epidural can help ease the tension. I’ve seen moms who are so tense their body can’t relax enough to let her dilate well. An epidural can help with that.
An epidural isn’t the end-all, be-all solution for pain management. It does carry some downsides and risks:
- Epidurals aren’t always effective at pain management. Studies in the early 2000s indicate a 9-12% failure rate. I mention this to remind moms they’ll need a plan in place, just in case their epidural doesn’t work. How will you handle your contractions if the epidural doesn’t help ease pain? Certain techniques learned ahead of time can help you when labor arrives.
- Epidurals can have a higher incidence of a vacuum or other assistance during delivery. Prior to 2005 this was the case, although now the studies vary on thoughts about this.
- The medication in epidurals can affect the release of the natural hormone oxytocin, also called the love hormone.
- Epidurals can can lower a mom’s blood pressure, as well as cause itching and fever.
- An epidural can potentially prolong the pushing phase of labor.
Pain—or something else?
A few reasons you can’t have an epidural:
- You’re on certain medications, such as blood thinners
- You have low platelets
- You’ve previously had back surgery
So where does this leave you? It’s up to you—it’s entirely your choice.
I do like to remind moms that even if you want an epidural, you should have alternative ideas ready. Your labor could move too fast for an epidural, or maybe it’s too early to have it as a form of pain medication.
Penny Simkin, PT, DONA doula trainer, has a great YouTube video about pain versus suffering.
If pain is the issue, pain medications can help. If the issue arises from suffering, however—emotional or otherwise—pain medications usually don’t help with that.
So you have to ask yourself: Do you think it’s pain management you’ll need, or might you need support for something else?
These are important questions to ask before labor arrives.