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What You Need to Know About the Epidural

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by Elise Bowerman

Discomfort during childbirth is a common fear among birth-givers.

[Sweet Momma's Prenatal Yoga classes provide techniques and methods to help birthers choose their pain management options wisely.]

Childbirth is called labor. Not walk-in-a-park. Not chill-and-wait. Not let's-hang-out-with-a-bunch-of-people-staring-waiting-for-me-to-birth.

This will be the hardest and most focused the person will work in their life... which is why gathering information to make informed decisions is important.

What is an epidural used for?

An epidural is an invasive option provided at a hospital birth in an effort to control the discomfort of the uterus pulsating while baby(ies) move and shift downward. 

What is an epidural?

An epidural is when a catheter is injected into the lower back beneath where the spinal cord ends. (It does not look like the stock photo image above.)

Typically, an anesthesiologist is the provider who uses a small needle covered by a plastic catheter tube to puncture into the low back. The needle guides the plastic tube into the epidural space below the spinal cord. Pharmaceutical drugs are provided through the tube to decrease sensation in the lower half of the body.

This tube stays in place in case more drugs are needed, or other interventions are required, like cesarean section.

Benefits of using an epidural in labor

  • Enables rest if birther is dealing with exhaustion, irritability and/or fatigue.
  • May improve the birther's outlook as a more positive childbirth experience.

Risks and side effects of using an epidural in labor

Once the birther chooses an epidural, then the birth becomes a medical procedure; rather than a primal trust of the body and baby's ability to be free to move, eat, drink, and clearly focus to get through the work at their own time.

Knowing this all too well, Evidence Based Birth's PhD Nurse and Founder, Rebecca Dekker has shares, "There will likely be continuous blood pressure monitoring, oxygen monitoring with a probe on your finger. Additionally, you’ll have a cuff on your arm to measure your blood pressure... You may need extra IV fluids. In fact, probably most people will have extra IV fluid through the IV in your arm. You’ll likely need Pitocin to help augment or speed up your labor. There is a likelyhood you’d have a catheter in your bladder. Also, you would probably need to stay on a continuous fetal monitor and contraction monitor, and you’ll have several belts strapped around your abdomen. Then you have a higher risk of needing a vacuum delivery at the end of the second stage to help get your baby out." 

A 2018 Cochrane review found an increase in needing further interventions when an epidural is administered:

  • Forceps or vacuum in the pushing phase. Both types of delivery are very likely to cause grades 3 - 4 lacerations in the perineal area.
  • Additional IV fluids or drugs, or even a cesarean section due to the birther's high risk of low blood pressure which may cause fetal distress.
  • Urinary catheter due to lack of ability to move lower body, or fever causing the loss of bladder control.
  • Pitocin will be administered to speed up labor since epidurals usually slow it down, and cause weaker contractions. This creates a domino effect, like:
    • longer second stage of labor
    • longer pushing stage
    • an overall longer labor

Other common anecdotal side effects include:

  • Not being able to tell when to 'push'
  • Itchy skin, or feeling itchy
  • Nausea
  • Shivering
  • Ringing in the ears
  • Not receiving the pain relief hoped for:
    • Epidural didn't work at all
    • Numbed one side over the other
  • Spinal headaches
  • Slowed breathing and sleepiness of birther
  • Temporary sore back at injection site (or may last longer)
  • Trouble with baby 'latching on' in breastfeeding due to lethargy from medications

Severe, rare complications include:

  • Permanent nerve damage
  • Seizures
  • Severe breathing difficulty
  • Death

Knowledge is Power

Childbirth is an experience where prior education is needed. And education does exist! Search your local listings of childbirth educators to reserve your (and your birthing partner's spot) in your second trimester or very early third trimester.

We live in a society where people often run away from uncomfortable conversations, situations, and feelings. The more we face our fears, become educated in options of how to handle them, then we will be a more empowered - and empowering group of humans.

But if we live in a state of fear and birth with fear - then we will continue to live on a planet of distrust. We must birth our babies with love and trust - even when medical intervention is necessary... and you will only know if it is necessary - for you - by educating yourself.