You’re Feelings/ Thoughts on Transferring for an Epidural?

[MegBoz]

Sorry, this is so long, but I’ve given it a lot of thought & I think my viewpoint now is healthy & realistic & I’d love your input.

So my sister emailed me about my HB MW’s website:

Loved the web site – love reading birth stories. Also love that they included a story about a hospital transfer for an epi… shows they aren’t extremists and take a more realistic approach in dealing with each individual woman/situation. Not that I think in a million years you would ever transfer for an epi!!!

I agree, it’s good that she included a transfer story. & ya know, I don’t expect to transfer for an epidural either, BUT, I feel that I’m accepting of it as a possibility. Before I had DS, it was a big unknown. I expected I’d be able to cope with the pain & it would stay manageable (& it did – it was an AWESOME, quick, hospital NCB.), but I DIDN’T KNOW – and I had SO MANY PEOPLE telling me, “Oh, you’re going to be begging for that epidural!” I didn’t want to feel STUPID & hear “I TOLD YOU SO!” afterwards, so I felt so stubborn & adamant that I wouldn’t “cave.” It’s a shame I had to feel that way, but that’s how I felt.

Well, I have nothing to prove now! There’s less pressure. I’ve also read enough birth stories to respect the fact that birth is unpredictable, each birth is unique, & #2 could be an entirely different experience. I don’t EXPECT it to be that way, I think the odds are slim that it’ll be anything but quick & fantastic, but I know there IS that chance.

& I’ve read birth stories of women who said the pain was so horrific & traumatic, that they had PTSD from it. If I end up in excruciating pain for a long period of time (like maybe from an OP baby, so no break between ctrx), I think I SHOULD go & get that epidural!

The first 6 weeks of DS’ life, I suffered through agonizing pain 24/7 with cracked nipples, but in that case there were no options to escape. Well, only options were nipple shield or cut back & supplement with formula – and those would have very likely damaged my supply, so I would have been “trading one problem for another” (supply was fantastic) & I just didn’t want to do that. So I sucked it up. But there were times I was thinking, “WHAT IS WRONG WITH ME? Why am I putting myself through this hell? Am I totally crazy?” B/c it really was so awful.

Thankfully my transfer hospital is where I had DS & they are very NCB-friendly & my MW knows the midwives there! So there’s less concern & fear about transferring (i.e. no fear of being met with hostility & punished.)

Point being, if I’m faced with, “suffer horrific pain, suck it up & deal with a traumatic experience” or “go get the epi” I’m prepared to do the latter cuz I think that would be the best move for me. I think the epi WOULD be the smart decision if it reached that “horrific/traumatic” level.

I’m also thankful that my DH has SUCH an amazing sense of common sense. He is just so practical & smart about making good decisions. He saw me birth once before & if it’s much different – much more painful for much longer, if HE agrees, “You’re suffering too much, let’s go & get that epi,” I will feel confident in knowing that’s the right decision. It’s a decision he wouldn’t make lightly, (he’s not crazy about the idea of a needle in my spine!) but if HE thinks it’s the right choice, then it would be.

So, point being, while I appreciate my sister’s confidence in me & do think it’s a very slim chance for me to transfer for an epi, I ALSO realize it is within the realm of possibility & I’m OK with that. & I’m HAPPY that I’m OK with that because I think I’m approaching birth from a healthy standpoint.

I’ve given it a lot of thought over these past couple years & I think this is a healthy viewpoint & I’m happy to be ‘at this place’ where I feel this way. So I wanted to share & get your views.
Thanks if you made it this far.

[2ID_Wife]

If I labor with this one like my sister did with her 2nd I might think about it to be honest. 18 hours after going to the hospital with cx every 2-3mins being at almost 6cm when getting there and her water breaking on the way in the door she was only at 8cm. She got one at that point(went natural with her 1st who was 9lbs 3ozs), and 8 hours later she had her baby. People have told her the epi stalled her labor but as slow as it was going she felt like was not going to make it. The epi helped relax her enough to calm and refocus. She had advers reaction to the iv meds they offer in the past(and a history of drug addition) so it was basically epi or nothing.

[MegBoz]

Originally Posted by 2ID_Wife

so it was basically epi or nothing.

Oh, yeah, I guess I should add, injected narcotics (nubain & stadol) are totally off the table for me personally. UGH, I took oxycodone once for a tooth abscess & the nausea was horrific. Such an unpleasant feeling & not worth it. Plus, some horror stories I've read about stadol, I'm not interested.

I believe I've read sterile water injections in the back have been proven effective pain relief (I think especially for back labor), so I'll ask my MW if she's familiar with that technique.

[Twinklefae]

I had what I'd call a medically necessary epi. I was at 5cm, had been in labour for 36 hours, and was having involuntary pushing contractions. I could not control or stop them. My cervix was swelling. If I hadn't got the epi, I would have ended up with a c-section. Instead, I got the epi, slept for 6 hours, woke up refreshed and fully dilated and pushed out my DS in less than an hour.

It can happen.

[angelachristin]

I was in labor for over 20 hours in an attempted homebirth with an OP baby that was not recognized by my midwife, so there were no attempts to change her position, etc. I had a swelling cervix and seemed to be stuck at 8 cm with contractions that were coming 3 at a time before a break, then I'd get like a 1-2 minute break before another 3 contrax. It was living hell, the worst pain I could ever imagine, and my midwife just kept telling me to stop being afraid of the pain. I transferred for an epi, but I never got my epi because I was complete and pushing on arrival at the ER and had my baby within 20 minutes of hitting the ER doors. My baby never did turn and was born stargazing.

[micah_mae_]

The only time I would consider it is if I had been in labor for so long that I was sleep deprived. I did have a traumatic first birth (unmedicated) and suffered from PTSD because of it...but I would do it all again the same way. I don't know, the epi just isn't an option for me. Not that I think they're evil or that no one should get them. If you feel like you need one then obviously that's the best thing for you so you should do it, you know?

[peainthepod]

I wouldn't ever judge another mama for needing or even just wanting medication. The birth freedom movement, to me, means respecting a mother's choice to have a hospital birth with epis and monitors if she wants one, or an unmedicated homebirth if she doesn't. For me, it would have to be a medical emergency situation or just so sheerly exhausting and painful that the only alternative was being sectioned. But then I hate hospitals and will do just about anything to avoid them.

[homemademom]

Originally Posted by peainthepod

I wouldn't ever judge another mama for needing or even just wanting medication. The birth freedom movement, to me, means respecting a mother's choice to have a hospital birth with epis and monitors if she wants one, or an unmedicated homebirth if she doesn't.

I agree with this. For me, I could see transferring for a combination of sleep deprivation and extreme pain (by which, I mean contractions that are coming on top of each other with no break). Sometimes, the tension caused by those factors keeps a mom from progressing, and an epi frequently helps a woman's body to relax enough to dilate.

[micah_mae_]

Originally Posted by peainthepod

I wouldn't ever judge another mama for needing or even just wanting medication. The birth freedom movement, to me, means respecting a mother's choice to have a hospital birth with epis and monitors if she wants one, or an unmedicated homebirth if she doesn't. For me, it would have to be a medical emergency situation or just so sheerly exhausting and painful that the only alternative was being sectioned. But then I hate hospitals and will do just about anything to avoid them.

You said it better than I.

[Peony]

It happens. My longest birth was just under 20 hours, and that was totally fine doing it natural. My shortest was 4 hours and had that labor lasted even 8 hours I just might of transferred. Sometimes we can do everything right and still have massive amounts of pain that you can not get on top of or under control. Labor hurts, but that labor seriously threw me over the edge, he was posterior and I had no idea. I never got the birth high, just exhaustion and 4 hours of pain that never stopped or eased off. And not the normal birth pain I had experienced before but more like someone hitting me in the back with a sledgehammer the entire time while having the normal contraction pain. I do have a high pain tolerance from all of my injuries, etc... over the years but this was insane. When I look back on his birth day, I don't think about my DS, but what felt like never ending pain, that is all I remember. Would an epi be preferable to that? I actually do know one mom who had two successful natural births, and went on the have an early elective epi for the 3rd, she told me that for once she wanted to remember that day instead of it just being a haze in her mind. I wouldn't birth in the hospital just for an epi if I ever had another but I can tell you that after not being afraid of natural child birth for so many years, if I did get pg again, I would be dreading the birth instead of looking forward to it. I don't ever want to experience that again.

[micah_mae_]

Originally Posted by Peony

It happens. My longest birth was just under 20 hours, and that was totally fine doing it natural. My shortest was 4 hours and had that labor lasted even 8 hours I just might of transferred. Sometimes we can do everything right and still have massive amounts of pain that you can not get on top of or under control. Labor hurts, but that labor seriously threw me over the edge, he was posterior and I had no idea. I never got the birth high, just exhaustion and 4 hours of pain that never stopped or eased off. And not the normal birth pain I had experienced before but more like someone hitting me in the back with a sledgehammer the entire time while having the normal contraction pain. I do have a high pain tolerance from all of my injuries, etc... over the years but this was insane. When I look back on his birth day, I don't think about my DS, but what felt like never ending pain, that is all I remember. Would an epi be preferable to that? I actually do know one mom who had two successful natural births, and went on the have an early elective epi for the 3rd, she told me that for once she wanted to remember that day instead of it just being a haze in her mind. I wouldn't birth in the hospital just for an epi if I ever had another but I can tell you that after not being afraid of natural child birth for so many years, if I did get pg again, I would be dreading the birth instead of looking forward to it. I don't ever want to experience that again.

That sounds like my DS's birth. I had back labor due to his size and compound presentation (acynclitic with a nuchal hand). It was 4 hours. 2 hours of the worst pain you can imagine and 2 hours of exhausting pushing. I just have to be optimistic that it was a freak occurrence or else I'll have an anxiety attack before October!

[BlackSheepPDX]

I think the concept of "compassionate use of the epidural" is really important.

I find that at times the "natural birth" movement becomes so obsessed with a zero-intervention birth as the end-all-be-all that anything less is a failure, leaving women feeling horrible about themselves when perfectly reasonable things have happened.

There are absolutely justifiable reasons for wanting/needing/receiving interventions, including an epidural. And the only person who needs to be satisfied with the reason is the mama. She might be exhausted. She might be terrified. She might just not want to feel what she's feeling. That's up to her.

[grumpybear]

Originally Posted by MegBoz

So, point being, while I appreciate my sister’s confidence in me & do think it’s a very slim chance for me to transfer for an epi, I ALSO realize it is within the realm of possibility & I’m OK with that. & I’m HAPPY that I’m OK with that because I think I’m approaching birth from a healthy standpoint.

I think it's great that you have this attitude when it comes to birth.
I've noticed that for the most part, the more inflexible one is with their birth plans, the harder it is for them to accept every little thing that does not go as planned and they end up with somewhat traumatic births.
While others who are more open to whatever lies ahead (birth is very, very unpredictable anyhow) are happier with the births no matter how the baby was birthed (natural, with drugs or c-section).
So kudos to you for being in such a healthy place wrt to attitudes about birth. It will serve you well when you are giving birth to your baby.

[HeatherB]

I do think there are times where an epidural is prudent. Some OPs have described such situations. For me, it would certainly need to be down to epidural (which I'm really not a candidate for) or c/s. And I'd go for the epi over a c/s with a general without question. My first was born by c/s with general and THAT caused PTSD for me. Then again, with two home births following that with a supportive midwife, enough rest, and similar labor patterns, I had two successful HBACs.

I think starting out at home (especially if you have a very good midwife) gives you a good step up on being able to avoid interventions like an epidural. But, it's a far better option than heading straight for a c/s, and for some women, it'll be exactly what they need. The danger comes in the overuse, and that's the issue we're all most familiar with.

[MegBoz]

Originally Posted by BlackSheepPDX

I find that at times the "natural birth" movement becomes so obsessed with a zero-intervention birth as the end-all-be-all that anything less is a failure, leaving women feeling horrible about themselves when perfectly reasonable things have happened.

I think you hit the nail on the head here! I think if I did not feel the way that I do, if I DID end up transferring (for any reason) I would feel like a failure & be absolutely devastated. I think my viewpoint now is much more healthy.

Originally Posted by grumpybear

I think it's great that you have this attitude when it comes to birth.
I've noticed that for the most part, the more inflexible one is with their birth plans, the harder it is for them to accept every little thing that does not go as planned and they end up with somewhat traumatic births.
While others who are more open to whatever lies ahead (birth is very, very unpredictable anyhow) are happier with the births no matter how the baby was birthed (natural, with drugs or c-section)

Thanks! Yes, that's exactly what I was thinking. I've read that on MDC before - that "traumatic" can sometimes have more to do with feeling that we didn't get what we wanted & needed - like our needs & wishes weren't honored & we were therefore totally out of control. While of course I would be upset if I needed to transfer, I think it wouldn't be quite as devastating to me now with this new attitude as it would have been with DS' birth had I needed a CS or epidural.

I feel like I'm having a hard time articulating this, but I think you all know what I mean. I think it boils down to this: Realizing you can't 100% control it, birth is unpredictable, and there may be circumstances that could warrant epidural as well as CS makes you more accepting if you are faced with that situation, which makes you less likely to be devastated & traumatized if you are in that situation.

[Banana731]

I think for most women the decision to have an unmedicated birth is about more than having "something to prove." An unmedicated birth is best for both mom and baby. Epidurals have side effects.

That being said, it is better have a vaginal birth than a surgical birth, and if an epidural is the only way for that to happen, than so be it. But it is important to remember that they come with their own set of risks.

[AmieV]

I was one of those who always said I would never transfer unless for emergency purposes, which is really easy to say until you've been in a situation that is not an emergency but warrants a transfer.

I had 2 easy peasy glorious OOH births and my third was planned as a homebirth. I went 42+ weeks overdue, got to 9cm, water broke, and everything petered out. I then started getting pain I'd never felt before in labor that was excruciating and between contractions and impossible to deal with. I decided to go to the hospital and I talked about epidurals the whole way there. And remember...I'm a crunchy lady.

I am in the same boat as you. I suppose I could have stuck it out at home and maybe she would have been born eventually. She was asynclitic and I ended up getting one dose of fentanyl and pushing her out 15 minutes later, I think I just needed to relax enough for my pelvis to let her through (she was also overdone and over 9lbs....which isn't that big, but much bigger than my previous kids, and I do think her head sutures being more firm might have had something to do with her getting stuck.) I beat myself up over it for weeks about maybe I should have just stuck it out at home since neither of us were in physical distress or an "emergency" situation. But in the end I came to the same conclusion as you. As traumatic as the transfer was, I do believe it was less so than what staying home would have been like. I also think there was a good potential for me to have become exhausted and end up needing a csection. My doula/friend who was there thought it was 50/50 that I'd be getting sectioned anyway, and so did my midwife's partner who was there. So, I am very proud of throwing the towel in when I did and possibly saving my vaginal birth.

Anyway. Hope that helped.

[gemasita]

I'm glad I saw this post. I'm planning on having a homebirth with my first so there is a big unknown around what labor feels like.

To add to it, I've been a doula for almost 5 years so I've seen everything on the spectrum from PTSD from the pain to painless childbirths.

My midwife said that yes, more first-time moms transfer because of prolonged labors or pain medication. At first, I was terrified of that.

But now, I've come to the conclusion that my experience as a doula tells me that childbirth can be unexpected - plan for the best and be ok with a different direction. My backup family practice and hospital is wonderful so I am ok with a transfer if I need it. I am making the decisions that are setting me up for the best outcome and I am willing to surrender to what I can't control. I am confident that no matter what the actual events are, it will be ok because I have caring, trusted, and experienced care providers to offer help if I need it.

[Peony]

Originally Posted by micah_mae_

That sounds like my DS's birth. I had back labor due to his size and compound presentation (acynclitic with a nuchal hand). It was 4 hours. 2 hours of the worst pain you can imagine and 2 hours of exhausting pushing. I just have to be optimistic that it was a freak occurrence or else I'll have an anxiety attack before October!

Sending normal birth pain wishes your way for Oct. I think DS's size played a role in it as well, he was a full 2 lbs larger then any of my other kids, and definitely at the very max for what I could safely birth.

[Friday13th]

We transferred for an epi because DS's heartrate was dropping and not recovering well every time I pushed and he wasn't descending. We were hoping the epi would relieve the urge to push (it did) and give him a chance to descend at his own pace without the stress my pushing was causing. (he didn't due to what I'm guessing was a cord issue or something we may never understand) we ended up opting for a csection after an hour or two with the epi and his heart tones getting worse and him not moving down past 0 station.

But yeah, had the epi worked the way we'd hoped I would have been thrilled and we had certainly exhausted everything we could do at home at that point.