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Considering an Epidural? What You Should Know First

Posted by Sandy Caetano | Thursday March 3, 20119 comments

When I gave birth to my son, I chose not to have an epidural.  This is not a common choice: after all, if it means a free pass on the pain of labour and delivery, why wouldn't I jump at the chance?

No, I wanted to try giving birth naturally.  My mother gave birth four times without an epidural, I reasoned.  How hard could it be?  So I stood my ground and declined it, though there were many moments I wished I hadn't.

What is an epidural? 

“An epidural is a catheter that goes into one of the spaces in your spine - the epidural space - [releasing] constant, continued local anesthetic for the spinal nerves during labour,” explains Dr. Grace Liu, an OBGYN at Toronto’s Sunnybrook Hospital.

You can have the epidural at any point during labour, but most women choose to have it administered when their contractions are getting stronger, often when their cervix has dilated to about 5 or 6cm.  The effects begin to wear off shortly after the medication has been stopped.

Once your epidural is in place, it should stay in until after your baby is born and your placenta delivered. It takes about 20 minutes to insert and then about 20 minutes until it begins to take effect.  Possible side effects include paralysis, though according to Dr. Liu the chances of this happening are less than 1 in 100,000.

“It’s really unlikely for paralysis, permanent damage, or muscle weakness to occur when having an epidural,” she says.

One of the most common risks with the epidural is that it can cause a spinal headache. This happens if the epidural needle punctures the bag of fluid which surrounds the spinal cord, causing a leak of fluid. The chance of this happening is about 1 in 100.

“It’ll cause this crazy headache and it’s most often positional, so if she lies down the headache’s gone and if she sits up it comes back,” says Dr. Liu.

The biggest baby-related risk is that it could decrease your blood pressure, so to counter this, women are given fluid via IV before the epidural is administered.

Why should you choose an epidural?  Some might argue that the birthing process is more enjoyable without the pains and stress, but others insist going natural is a powerful experience that shouldn't be missed.

Speak to your doctor about your options.  You might be surprised at the number of choices available to you!

Have you ever had an epidural?  What was your experience like?
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on March 03, 2011  Sassy Urbanista  248 said:

Well my first experience wasn't bad at all. I had to be induced because my son didn't want to come out. He was late, and I was also leaking amniotic fluid. Basically my water broke, but it was a slow leak and I didn't notice anything then peeing frequently which I had already been doing throughout the pregnancy. So they brought me into the labour ward hooked me up to IV and started giving me oxytocin to induce labour. The pain was fine, it was the same strength throughout the entire time I was in labour which was a total of 15 hours. They gave me a bit of morphine to help with the pain and to help me sleep, but it didn't do anything. The pushing didn't hurt much either, not enough for me to want more pain relief.

For my second, my water broke while I was at home and the pain progressed naturally getting stronger and stronger. This was much harder than the first. I couldn't believe how quick - when I was actually walking around and not sitting down relaxing - and strong the contractions kept coming. That was when I had really considered the epidural, but I guess my fear of something going wrong with the epidural was strong enough for me to go without. Even still, the pain wasn't excruciating. I would do it again in a heartbeat!

Mind you there was a woman in the next room the first time around screaming like crazy! That freaked me out. But I was ok. Doing it naturally isn't as bad as some may think. I would try it. If you really feel you can't do it, then you can have the epidural.

on March 03, 2011  mamaluv  STAFF said:

@mela You know, now that you mention it, I had a "dead" spot right near my epidural injection point for about a year after my last baby. It was numb but kind of tickly at the same time (sort of like it had fallen asleep but without any surface sensation). But it did eventually go away. I have no idea if that was related or even if it was the exact spot, but it could have been.

on March 03, 2011  savingpallas  155 said:

The hospital in my city doesn't do epidurals. If you want an epidural you have to drive to London ON, about an hour away! For that reason alone, I will be opting for natural childbirth. I'd much rather be in pain and safely surrounded by medical professionals than be in pain and driving down the highway hoping for the best lol

on March 03, 2011  mela86  2,943 said:

I was adamant at first about not getting the epidural. But as the labour pains increased, my mind was changing. I mean I am a small girl with a baby that eventually came out weighing 9 pounds. So as the pain increased I asked for some alternatives and they mentioned a morphine needle. This was injected on my rear end and it did absolutely nothing.
So the nurse came in and told me that it was my last chance at getting the epidural and if I said no, I couldn't ask for it at all. So I gave in. She made me sit up and sit still. She inserted the catheter and I don't think it hurt because I can't remember feeling any pain. It helped tremendously. Before I got it, I was writhing in pain, but that was because my labour pains were really bad, lower back pains too. Once I took the epidural I was smiling at my hubby like he was my friend again. I delivered my son and everything was fine.
Now the only thing is, and I'm not sure if this is in my mind, but sometimes I feel a weird pressure type feeling in my back where I had the catheter put in. I believe it's a long term side effect, it doesn't really hurt, it's just more of an annoying, nagging feeling. I wouldn't mind if it went away permanently but I guess I've become accustomed to it and it only shows up once in a while.

Overall, it would be great to not take the epidural, but I guess if the pain becomes too unbearable, as it does for some women, I don't see anything wrong with getting some relief.

on March 03, 2011  LaurenBlair  128 said:

@mumaluv - that sounds much more reasonable!

on March 03, 2011  mamaluv  STAFF said:

@Lauren Inserting the epidural needle might take 20 minutes from the time the doctor comes in to the point when it's all hooked up and going. It takes about 20 minutes after that for the anesthetic to kick in and ease the pains.

The actual process is like this: they swab you clean on the insertion point, then when they're just about ready they wait for you to be between contractions (because you should try to not move or tense up while they're pushing in the needle). There's a little prick - a little more of a pinch than your standard blood test but not much. After that the catheter insertion doesn't hurt, though you can feel it going in. They pull the needle out leaving the cath in and that's pretty much it! So maybe a 30 second process? After that they start the meds and fiddle with the dosage a little. That's where the extra time comes into play.

on March 03, 2011  mamaluv  STAFF said:

I tried to go natural for each of my deliveries, but just couldn't make it. I found that in anticipation of the labour pain I'd clench up so the contractions weren't as effective, prolonging the process. As soon as I took the epidural, my labour progressed much faster.

In the case of my first, I had the normal dose so when I was in labour with #2 I asked for a lighter amount because I wanted to still have the experience with just the edge taken off. I should have gone for the full dose... let's leave it at that :) My last baby ended up coming via C-section, so that time they really pumped me full. It took longer to wear off and that time I did get the spinal headache. It wasn't that bad though, as headaches go.

I think it's really important to make this a positive experience - whatever that definition means to each person. Some people are so married to their birth plan that they refuse to reconsider when they are in the situation. A friend of mine had a really bad experience with baby #1 because she was so stuck on her plan, and when baby finally arrived she was exhausted and so emotional she didn't even really want to hold him.

So now I advise anyone who asks to know what your options are, be prepared for any eventuality, and don't worry so much about being brave and toughing it out. We all have different pain thresholds and there are women out there who are lucky enough to experience relatively little birth pains (but don't go bragging - the rest of us will gang up on you). The next woman might not make it past 2 cm dilation before asking for meds. It really differs.

on March 03, 2011  LaurenBlair  128 said:

What exactly takes 20 minutes? Does the needle goes in that slowly, wouldn't that be pretty painful as well or are their other steps to inserting? I'm pretty clueless when it comes to this!

on March 03, 2011  Ali de Bold  STAFF said:

I'm curious, Sandy what was your experience like without one? Was it as bad as everyone says?

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