Going Epi-Free?

[Sobranna]

I am 11 weeks and some change, and I've been seriously pondering the reasons for getting an epidural and researching the complications associated with that. I have two conflicting issues:

1. I am terrified of the epidural. My mom had some pretty bad experiences twenty years ago. She said after those experiences, she decided to go natural on the last one because, "it just couldn't be worse than the epidural." (Well, she proclaimed to me that it was, and if she had to do it again she would go ahead with the epi.)
2. I am a wimp. I'm not athletic, wouldn't really consider myself "in shape" (who really is after a month of m/s and fatigue??), and have never really accomplished anything physically hard (had to quit training for a half marathon because of shin splints, ugh!).

As I research I find my heart being pulled toward an intervention-free labor and birth. I am hoping you ladies can help me with your experiences and encouragement as well as any references and resources I can look up. I'm especially interested in reading about whether going without pain meds can shorten labor (or going with them lengthens it?) and prevent other medical interventions. Also, what things did you do in the months leading up to delivery that you felt made your natural birth more "successful"?

[Pat899]

That is a real problem with our culture. If you go without the epi you "must have a high pain tolerance" or "you must be really strong." These are all lies.

The truth is I am a wimp and I cry when I stub my toe just like most people. The truth is an epi free birth is better for my baby. So I do it med-free. Because I want the best start for MY baby. The truth is a med free birth happens whether you cry and scream through the contractions or whether you mediatate through them. The truth is I bonded to my babies better when I went epi free. The truth is birth is a lifechanging brush with the eternal. You create new life. And these reasons made my decision to never use drugs to numb my chance to touch the eternal again, easy. But the birth, that was still hard.

[~Charlie's~Angel~]

Are you kidding? Am I in shape? NO. Do I have a high threshhold for pain? Eh, it depends. My husband makes fun of my sound effects all the time. I make noise when my kids pounce on my stomach or spray me with an ice cold garden hose.

Truth is, aside from knowing not getting an epi was better for my baby, I also didnt want to be robbed of the experience of giving birth to my children. I also watched my mother not be able to hold my sister for almost the first WEEK of her life due to complications from her epi. That was AWFUL!!!! I also am not a huge fan of needles in my ARM, let alone my spinal column.

Truth be told, i spent a total of 30 seconds begging for one with my second child, but all that meant was I was in transition, fully dialated, and ready to push. He was in my arms 10 minutes later. It was AMAZING to be able to feel every morsel of that, trust me!

[Lit Chick]

Originally Posted by Pat899

That is a real problem with our culture. If you go without the epi you "must have a high pain tolerance" or "you must be really strong." These are all lies.

YES.

Let me tell you an embarrassing story. Years ago, I stepped on a piece of glass. A small one. But there was blood. My husband grabbed some tweezers and was going to pull it out, and I freaked out so much that I nearly threw up. I was shaking and crying, it was insane. He never even touched me. When I got enough courage to address the issue myself, the glass was about the size of a grain of kosher salt. And the bleeding had already stopped.
Lesson? FEAR is worse than pain. My foot never actually hurt, but I was afraid that there was a giant shard of glass in me that would be horrible to pull out. I worked myself up into a terror for no reason, and I anticipated and reacted to pain that was never really there.

Jump to me being pregnant. I also thought I was a "wimp" and that you had to be "strong" to go without meds. But my mother, my mother in law, and my best friend all had med-free births... and some were not that easy.... hmm. And I really did not like the idea of epis, especially after my aunt had one that went wonky...

So, I started to read. I ended up going with a home birth, and it was fantastic. The best book for me in the early stages was "Ina May's Guide to Childbirth". Even if you have a hospital birth, read it! It's excellent. "Birthing From Within" is another good one.

Also, I took a childbirth class that was Bradley-oriented, and it was fantastic as well. Helped us understand each intervention and the benefits and risks. There was also a pain management session where we all experimented with different techniques. We held onto an ice cube and did different things to find out what technique let us hold on the longest. I thought I'd be a "distract me with chit chat" type or person, but when I closed my eyes, and kind of chanted, I was not that uncomfortable.

By the time I had the baby, I was ready. I was prepared. I was NOT afraid of the pain.... and thus it did not really "hurt". It's not that there was no pain... but the sensations were never scary, never a "make it stop!" feeling.

And this is probably WAY too much TMI, but I thought of labor as a lot like an aggressive poop. I'm sure everyone at some point has one that comes on a little strong that is NOT comfortable. But do you freak out? No, it's only poop. You relax, and it happens. Early labor and transition was pretty much like that for me - I reminded myself not to fight the feeling, and it made the process smoother. Still not exactly comfortable, but nothing horrible.

[alegna]

I had two babies at home. No meds of any sort. If I'd been in a hospital they both would have been sections. At least with labor the pain is OVER when the baby is out. Surgery pain lasts for weeks.

Epis hugely increase the chance of ending up with a section.

-Angela

[limette]

I was given pitocin during my labor (without consent) and shortly after begged for the epidural.

The epi did not work and shortly after the baby went into fetal distress (from the pit and the epi?) and I had a c-section.

For my second, I labored the same way (back labor) except we didn't go to the hospital until 9cm. No drugs, vaginal birth.

Do I have a high pain tolerance? Hell no. Am I in shape? Absolutely not.

I'm not going to lie, my births (posterior babies) were painful. But by the time they got painful (transition) It was too late to do anything about it anyway and you are so caught up in the process that you just go with it.

[Juvysen]

I have never had an epidural ( I figured if other women had been able to do it without for thousands of years before the advent of the epi, I could too), but my best birth yet was with hypnobabies. I highly recommend it

ETA... I should say I was in the worst shape for my hypnobabies birth - hypnobabies kept me in control of the pain. It really was great - I'm still shocked at how well it went.

[Asiago]

I had a drug free birth. Laboring at home helped a lot, not even being in the hospital setting was an asset for me while laboring. Also in my birth plan I asked not to be offered pain relief, and no one offered at the hospital once we arrived. They were very respectful of my wishes.

I felt great after the birth and was glad I did it that way.

Actually laboring was harder than the birth. At least being at home was a comfort, I would not have wanted to labor at the hospital.

[ExuberantDaffodil]

it is so much easier to resist the temptation of an epidural if you know one isn't available.

I had a pitocin-induced hospital labor with my first, and 5 minutes before he was born, I was hollering for the epidural (didn't get one, not enough time).

For my second, I had an all natural (accidently unassisted) homebirth, and 5 minutes before she was born, I hollered (but not for an epidural ).

I am not athletic, in shape, or tolerant of pain.

[micah_mae_]

I had a 10.5 lb baby. No drugs. No tears. Short, intense labor. It was traumatic for me but...it was best for my baby.

My own comfort will NEVER come before my children. It started with the birth of my son and it will continue until the day I die.

ETA: That is a standard I hold to myself, not for anyone else FYI.

[Pirogi]

Originally Posted by ExuberantDaffodil

it is so much easier to resist the temptation of an epidural if you know one isn't available.

One of the things that I remember from my first labor (at home) was thinking, in early labor, "This isn't so bad. I wonder why people want epidurals?" Then later, once the contractions got stronger, I remember thinking, "Yeah, I can understand now." Now I don't remember it being painful. Intense, yes, but not painful.

Laura Shanley often asks, what do you believe about labor and birth? Do you believe that it must be painful? Do you believe that a birth with little or no pain is possible? For you? The mind is an incredibly powerful force. If you believe that you can birth your baby without pain medication, you will.

[CoBabyMaker]

I haven't had my med-free birth yet so take what you want from this.
I had a very long labor with DD and eventually decided to get an epi. I regret it so much! I know that everyone's experience will be different but for me it meant that my right leg went completely numb but even worse I couldn't feel to push and ended up with a c/s.
Looking back I know I could have avoided it if I had more support. To me, great labor support is the best pain management. Get a doula if you can! If you can't afford that try to find a well-educated (about natural birth) friend. I was pretty opposed to having a lot of people there but wish that I had just one more person. Even maybe just keeping that extra person "on-call" for if DH needs a break or you just need support from someone else.

[gcgirl]

I don't actually buy the "epi-free is better for baby" argument, EXCEPT that I believe the mother being mobile and free to move during labor can help birth progress and lead to fewer complications. That's better for both mom and baby. There are also times when an epidural is helpful. I personally had no problem avoiding the epi with both hospital births, one with pit and one without, but I had short, uncomplicated labors.

The thing about the labor pain is it's different from injury pain. It feels productive (usually), and while it hurts, it's totally possible to work with your body in a way you really can't with other types of pain. I wouldn't worry about your ability to handle it because it's such a different thing.

[luv-my-boys]

I wanted to add something in, pain relief in child birth isnt an all or nothing situation regarding the epidural. There are other forms of pain relief, everything from I.V meds to local anesthetics to things like hypnobirthing and bradley method.

Im not going to lie. Birthing my kids is the most painful thing I have ever done...over and over again But for me and how I wanted to experience my births I just positively didnt want an epi. That isnt to say that all epidurals are horrible, I've seen otherwise. Epidurals are as good as the person doing them and every person reacts differently to meds. I've seen great epidurals where mothers have been all with it and it ended up being a wonderful experience to what a lot of MDC mamas would consider traumatic.

I do definately suggest that you ask your hcp about pain control options available to you Prior to your birth. Being educated about what is and what they do is a better option than not knowing at all. It also allows you the opportunity to ask questions and decide when your not in the heat of the moment.

[laohaire]

More of the same here.

1) Do I have a high tolerance for pain? Well, not when I've stubbed my toe or gotten a papercut or bonked my head on the washing machine door when I'm switching the laundry and didn't see it start to swing shut. Also, you should hear me complain about the arthritis in my knees.

2) Am I athletic? Hon, you actually started training for a half marathon? I am excited when I run a HALF MILE, and I've only done that a handful of times in my life. If my husband grabbed my ankles I would give it my all to do 10 situps and then collapse in a wimpy heap.

That said, I also believe it's not just a case of avoiding the epidural. If I were strapped into a hospital bed with pitocin being dumped into my veins, I would have an epidural. Even though I would be terrified to. I think even the wimpiest of us could have a natural birth, but only if she is in control. When "hospital policy" is in control, that means you are prevented from coping with the pain. My midwife checked me a couple of times in labor, and laying on my back in bed so she could do it was the most excruciating part - I can't imagine having to deal with the whole birth that way. (For what it's worth, if I birthed again I'd decline the checks too).

I didn't have pitocin. It's excruciating.

I had a birthing tub, for me it was wonderful. For another mama, relief might be in a birth ball. Or in walking back and forth. Tying down an animal in labor is the worst thing you can do to her. No wonder women beg for epidural anesthesia. But it's better to make sure you're not tied up!

So, again, I think we can all get through birth - heck, women deal with back labor and so on, all natural, not that it doesn't hurt but you find ways of coping. But standard hospital management removes all your coping mechanisms and leaves you in panic. I think that the choice you are looking into making is about a lot more than the epidural but about your entire approach to your birth - and I think it's one of THE most worthwhile choices you can make in your LIFE.

[*MamaJen*]

For me, the big issue was avoiding the snowball of interventions. If you get the epidural, you're tethered to the bed, you're more likely to get pitocin, which can cause fetal distress and lead to a C-section, you're more likely to tear or get an epesiotemy because you can't feel your body's own urge to push or control your pushing, and so on.
If you are at all interested in a natural birth, I think the best thing to do is research and learn everything you can about birth. The Business of Being Born is a good place to start. Also, Your Best Birth is a pretty decent introduction. Gentle Birth Choices or Ina May's books are also good.
I just think there is such a crazy huge difference in the way OB-attended hospital births and midwife-attended homebirths are handled. For example, most midwives encourage you to use a birth tub (think a portable hot tub set up in your living room or in the birthing center). Birth tubs are really effective at relieving pain and relaxing you.
I think it is possible to have a natural birth in a hospital, but in many ways you are set up to fail, unless you get super educated and go in with good birth support, like a doula. When women go in with just a vague idea of not wanting drugs, they are not well-equipped to resist the onslaught of interventions. If you truly want a natural birth, your best bet is a midwife.
As far as the pain of a natural birth goes, I found it really manageable. For one thing, it's not like stubbing your toe or breaking your arm, where it's a sudden intense pain. The contractions start out mild and slowly build in intensity, plus you have a long break in between each one. As they get more intense, your body's natural endorphins start to kick in. In an undisturbed natural birth, it's seriously like being on drugs. I've heard it described as "laborland" or "going to Mars." For me, it was this warm, fuzzy, pain free place, and I totally forgot I was having a baby. I was actually surprised when he started crowning, because I was so in the moment. Labor was never what I would call painful. There was discomfort, but it was never unmanageable or overwhelming, and once I started pushing it honestly felt kind of good.
The other thing is, labor is a physical, physiological experience, but it's also an emotional and mental experience. If you are scared, if you feel vulnerable, if you feel unsupported, it will hurt. If you feel calm, if you feel like you're in a safe space, if you feel supported, it will hurt a lot less.
Anyway, it's a big learning curve, but there's a ton of great information out there.
This is also an interesting perspective: http://www.childbirthconnection.org/...ing_vision.pdf

[cappuccinosmom]

I've had three hospital births and no epidural. I don't love pain. Don't tolerate it well. But for me birth was very different than other types of pain. It was productive. I knew that I was going *through* it to get to a really great "prize" at the end--my baby. I had one labor that hurt like heck but I was able to tolerate it. Now, the only way I could tolerate it was to be bent over at a 90 degree angle. If I'd been required to stay in bed, on my back, I'd have been begging for the epidural. That's why watching those baby shows on TV make me cringe. I want to reach out and help those women get up and into a position that will allow them to tolerate the contractions.

Probably not good to start a massive exercise regimen now, but start walking every day, and doing recommended pregnancy exercises, especially squatting. Even moderate exercise like walking will make a big difference in your overall stamina and health. For many years, walking is pretty much the only form of exercise that's been available to me. I'm fat and definitely not in shape, but my births have all been short, even wit hthe larger babies.

[Toolip]

I think that there was an article in Mothering (I don't remember the title, something about a tiger... or something like that, it was sometime in the last year I think, anyone remember?). It addressed all of the issues that you brought up, it was a great article, I think you would find it very encouraging.

[MegBoz]

Girl, I think you're really selling yourself short! The fact that you even STARTED training for a half marathon tells me you're a lot more athletic & motivated to attack physical pursuits than the average American (bear in mind that the average American doesn't exercise at all.) Based on your sig, you're either an accountant or engineer & most people in those professions have a Bachelor's Degree - obviously that took a lot of hard work, persistence, & perseverance to achieve! I don't think you should view yourself as a wimp. Seriously.

My advice is to read "The Thinking Woman's Guide to a Better Birth" by Henci Goer. THAT will show you, without a doubt, that an epidural has risks & complications (chiefly that it slows labor, leading to a need for pitocin to speed it up, which can lead to fetal distress, etc.) The 2 things that concerned me most were that it doubled your risk of CS (which I really wanted to avoid) & quadrupled your risk of insturmental delivery (forceps or vacuum) - the latter increases your risk of bad perineal tears (although the epidural itself ALSO increases your risk of bad perineal tears.)

Personally, I read "Thinking Woman's Guide" and decided that a medicalized birth is not for me! "I'll suck it up & deal with the pain." is what I thought.

I was also emotionally freaked out at the idea of all those tubes in me (not just the epidural catheter in my spine, but the resulting necessary blood pressure cuff around my arm, fetal monitor continuously around my belly, IV in my hand, and potential need for catheter in my urethrea to empty my bladder. EWWWWW! Reminded me of the movie "The Matrix" with people plugged up. That struck me as way less appealing than learning to cope with the normal, natural process of labor.

Originally Posted by Lit Chick

FEAR is worse than pain.

& I was personally way more scared of being out of control of my own body, controlled by doctors & machines, & the whole medicalized experience, than I was of the natural pain of birth.

Then I started Bradley Training & read "Ina Mays Guide to Childbirth" by the famous midwife Ina May Gaskin. (My library had it!) Then I started thinking, "Ya know, it's probably going to hurt, but I bet it will be manageable, at least 95% of the time, and it's probably going to be an awesome experience." I started looking forward to giving birth and no longer viewing it as something I'd have to grit my teeth & suffer through until it was over.

& ya know what, that's EXACTLY what it was like. Totally manageable, AWESOME experience!

Being a very logical, rational person, this processed worked for me. Based on your career, I'm guessing you're the same way! So I recommend keeping your mind open & just getting educated. I also recommend trying to get some exercise - walking, & some upper body resistance training can be helpful - carrying a baby around gets tiring on the arms! Good luck!!!

Originally Posted by laohaire

I think that the choice you are looking into making is about a lot more than the epidural but about your entire approach to your birth - and I think it's one of THE most worthwhile choices you can make in your LIFE.

:

[listipton]

Lots of the same as already posted. Here are my birth experiences, FWIW.

I have done childbirth with both the epi and natural. With dd, I read one book about the 'evils of epidurals' and it was so slanted that I thought there was no way it could be that bad. Everyone around me told me not to be a hero, it hurts so just don't feel it, and that I couldn't do it without drugs anyway because I am the 'girly' one in the family. In my experience (and this is just my experience talking), I was not let in on the 'secret' about the epi.....If it's done 'right' you still 'feel' the end, just not the contractions. Instead of being able to work with your body, you're stuck in bed with your legs being pulled up, directed pushing and nurses and docs yelling at you because while you can feel the end result (and yes, it hurts), you can't feel WHEN to do the things they're telling you to do. And I had an 'easy' first birth (fast and no pit. The nurses kept telling me they were so surprised that I didn't need it.) And I personally didn't tolerate the epi well (fever, shakes, backache).

With ds, I went to a different practice and worked with a group of midwives. I read Ina May's Guide to Childbirth and then everything I could get my hands on regarding what my body would most likely be doing during normal birth. The end result was that while childbirth does hurt, I was able to do it. It didn't hurt nearly as bad as my epi birth. I do vaguely remember a part in transition where I said 'this was a bad idea', but within 10 minutes, I was holding baby boy. Go for the natural mama, you CAN do it .