photo of an epidural procedure from Shutterstock
To epidural, or not to epidural – that is the question I have been asking myself as I try to get ready for the second go-round of popping out a baby. I didn’t have an epidural with baby #1 and generally found it to be a positive experience to go drug-free – certainly an empowering experience if not exactly pleasant, but I can’t help wondering; What would it be like to have a relaxed, calm and pain-free delivery – free of screaming, cursing, and the overwhelming fear that one’s body is going to rip in half? There are pros and cons to going both au natural and numbed from the waist down:
Pain, sometimes very intense pain
Can be scary
Sometimes the exertion of dealing with labor can wear you out and make you too exhausted to push, slowing labor
After you’re done you feel amazing – like ‘OMG I just did that?’
No drugs will get into your baby’s system
Labor generally goes faster
Less risk of stalling labor and needing vacuum, forceps, C-section
You can walk around, work with gravity and take a more active role in the birth of your baby
Can delay labor, leading to further medical interventions like Pitocin, Forceps, or C-Section
Risk of C-section is significantly higher with epidural
Someone is sticking a big needle IN YOUR SPINE
You are hooked up to an IV and confined to bed afterwards
You can have complications with the epidural like nausea, itching, headaches, fever, problems breathing, or pain/nerve damange at injection site afterwards
Drugs can get into your baby’s system
Sometimes nursing is adversely affected (most often from babies being sleepy when they come out)
You can relax and actually enjoy your labor
Pushing can be easier when you’ve had some time to rest
While I know the pros and cons for both, and the rational reasons to consider both options, I wanted to hear some of the opinions and experiences of fellow mothers about their labor experiences, so I asked around to some friends and family and the Inhabitots crew, and here’s what I found…
Photo courtesy of Aaron Fulkerson
To epidural, or not to epidural, that is the question
I got an epidural with the birth of my daughter, and I would do it again. I wanted to give natural labor a shot, but I completely overestimated my threshold for pain. To make matters worse, I had back labor, meaning that the pressure of my baby’s head against my tailbone caused severe pain in my lower back. I asked for an epidural as soon as I arrived at the hospital. Although it slowed down the labor process—I didn’t feel the urge to push as much—the birthing process was a great deal more relaxed because of it. Aside from a slight headache the morning after, I experienced no ill effects, and had the complication-free birth that I wanted, so all-in-all, it was a good decision. I would do it again!
I planned to have a natural, midwife attended, drug-free birth experience. Ha. I ended up with a doctor and an epidural. Labor doesn’t always go like you expect. I had some unexpected pregnancy complications, plus I was one of those rare mamas-to-be whose water broke before I went into labor. All the above was bad news for my natural birth plans. My midwife sent me to the hospital for a couple of hours to see if my labor would start naturally. It didn’t, so I was given the dreaded pitocin drip. Rumor has it that pitocin increases contractions and labor pain significantly. I’ve only had the one birth, so while I can’t say labor without pitocin is easier, I found one mama online who did have both a pitocin birth and a regular birth and she notes, pitocin is way harsher and puts you into “Hard rockin’ labor.” My labor with pitocin was insanely painful. There were no ebbs and flows like regular contractions. My contractions got hard quick and offered little rest between.
photo courtesy of George Ruiz
Still, harsh contractions or not, I’d spent NINE months planning a drug-free birth, and I wasn’t giving up because of pitocin. This may have worked, but my labor wasn’t going anywhere and the nurses kept increasing the pitocin drip, which made my contractions worse. After 5 hours the nurses starting offering pain medications. I refused. After 10 hours they gave me the epidural speech. I refused. After 18 hours of excruciating contractions, I was ready to crash and burn, my yet-to-be-seen son’s heartbeat was sketchy and the staff got anxious. They said I needed to sleep or I’d be too tired to push. I couldn’t sleep through pit labor, which they knew, so they added, “It’s a c-section OR an epidural and maybe you can still have a vaginal birth.” That’s why I give in. Well, that and I was so tired and in so much pain, what could I do? All I remember was falling in love with the guy who came to give me the epidural. I specifically remember thinking, “Oh, man, he’s so cute… sigh.” That’s what epidural pain relief in serious situations is like; a bit like love. The epidural worked fast, relieved ALL my pain so I could sleep for two hours and when I woke up, I had enough fleeting energy to push my son into the world, which thanks to the epidural so late in labor, was 100% pain free, but also less efficient. Because I couldn’t feel much, I was a poor pusher, and the doctor who had been called in in case of c-section, ended up having to use forceps. Still, although my birth didn’t go as planned. I’d get the epidural again. I was very relieved I had that option over a c-section, which is more serious in my opinion.
photo courtesy of Nadia Santoyo
PRE-BIRTH (SEPTEMBER 2012)
I’m a more open to epidural having been through a birth without one. I had my daughter at a birthing center with no epidural. When it was time to push, I’d been awake for 31 hours and was exhausted. My contractions basically stopped, and I ended up pushing for 3.5 grueling, miserable hours. For my next daughter, who is due any day now, I’m hoping to get an epidural so I can get some rest, then hopefully have an easier time pushing and be more alert and present at the moment of birth. Maybe because this is my second child, I’m less worried about the potential downside of an epidural (slowing down labor to the point that I need Pitocin and/or a C-section) and more optimistic that it will make this birth a better experience than the first.
POST-BIRTH (OCTOBER 2012):
I can tell you the epidural was AWESOME and I’m so glad I got it! I would do it again in a heartbeat!
Based on my experience switching from traditional MD to midwife at the end of my pregnancy when I found out my MD was not supportive of my natural birth plan, and then having a successful home birth but lots of complications after the fact, I would never tell anyone what they *should* do with their birth. Each situation is just so different, and I believe that most moms try to be well-informed and have good instincts about which choices are right for their babies and themselves. With that being said, I wholeheartedly recommend that women check out the options for birthing tubs, as I think this relaxing environment for laboring eliminated any need for me to have an epidural. Doctors in hospitals often will only let you labor in a whirlpool tub until your water breaks, which doesn’t do you much good if your water breaks early in the process. Midwives attending home births and labors at birthing centers tend to allow women to labor there for more extended periods, so if you’re interested in this option it’s worth doing your homework. I’m all for a relaxed, pain-free birth, but based on my experience, epidurals don’t seem to be the only way to achieve this. When I got out of my tub to finish laboring, the pain shot up three-fold, where before that I experienced contractions as intense but not very painful. Epidurals also can cause babies to be born a bit drugged, and this can cause problems with starting breastfeeding or bonding with mom, so like I said, every mom who really does her homework probably knows best what choice to make. But based on my experience, I would plan to make the birthing tub the center of my birth plan next time around, and everything else can be in flux. They’re that great.
Having experienced a completely natural delivery for the birth of my first child, I wouldn’t plan on having an epidural for my second; however, there are a lot of things I would change about the experience. At no point in my pregnancy did I have a precise birth plan, rather in an exercise of either pragmatism of naivety, I simply maintained a vague notion that I wanted as little by way of medical intervention as possible.
I did have some grounds for this: for completely non-pregnancy related issues, I’ve experienced spinal anesthesia multiple times in my life—and I’m terrified of it. This is not to say that epidurals are a bad thing, but I personally find the administration of them deeply unsettling. Additionally, I was fairly clear that I didn’t want to be incapacitated in that way during, or after childbirth.
I grew up in the UK had always assumed gas and air (this is a UK only thing, US folks) would be the method of pain management I would use while in labor. My mum likes to describe it as similar to having a martini next to the bed that one can simply sip from, which sounds delightfully (and perhaps unrealistically) classy, but does emphasize the notion that one can have control over ones pain management. And unlike a martini, it has little to no unpleasant after-effects.
But that option was unavailable to me in the hospital I was to deliver at and as such opted to have a natural birth. An exceptionally sassy on-call doctor whose technique was one of goading me through delivery and around four residents, plus nursing staff all trying to coach me made the whole process incredibly disorienting. There was one nurse who was a complete saving grace through the whole dizzying experience, who took me seriously when I told (yelled at) everyone, in very clear terms, to shut up, and who helped me to focus and, as far as possible, relax.
What I came away from childbirth realizing was that the physical process is one that my body is perfectly well-equipped to handle—but emotionally it can be extraordinarily unsettling. For my next childbirth my plan is to, well, have a plan; to find a midwife, and perhaps a doula, with whom I can develop a good rapport, and to find a more calming, controlled environment in which—as far as I can have any expectation to—to know what is going to happen and who will be there.