Is there such thing as a "light" epidural?

[plantnerd]

I am not pregnant and not sure if I will be again, but am kind of re-evaluating my beliefs on birth and such.  My first birth was natural in a birth center, attended by CPM's.  I will not go into details, but there were a few issues with my care that in hindsight really concern me, so next time I am planning a hospital birth with either a CNM or OB. 

I found the pain of labor to be horrific, and feel that pain and exhaustion affected bonding with my son.  I am exploring the idea of getting an epidural/pain relief for the next time.  The concern I have over epidural is the inability to move if I need/want to.  I love the idea of pain releif, but am weirded out by the idea that I would be stuck and not even able to go pee if I wanted to (not that I could pee with my natural birth, but that's another story).

Are they able to administer just enough anisthetic to take the edge off, while still allowing movement?

[WifeofAnt]

I'm sure a good anesthesiologist would be able to but you'd still be restricted by having a tube coming out of your back.  IV medication might be a little more mobile but you can't get any more after 8 cm.

[womenswisdom]

Some anesthetists administer an epidural where you still have movement, but the pain is greatly reduced or eliminated.  There is no standard for how much or type of drug is in epidurals, and each anesthetist has their own "cocktail".  It also depends somewhat on how your body reacts to the meds.  However, even if you get a "light" epidural, you will not be allowed out of the bed for liability and legitimate safety reasons.  You are not likely to be able to actually support your weight and you will not be able to voluntarily void your bladder and will need to be catheterized if you need to do so.  You may be able to still move your legs and help turn yourself in bed, but your mobility will be reduced.

[plantnerd]

The cath doesn't bother me.  I ended up with an atonic bladder after my first and the cath was a wonderful thing after holding pee for 14 hours.  I don't really even want to walk around, chilling and watching tv while laboring would be funny indeed.  I just want to be able to sit up and shift my weight around, maybe get in a chair, and somewhat be able to care for myself after the birth.

[MegBoz]

I bet someone is going to suggest hypnobabies. Have you considered it? One poster here is an instructor & says with her first, she had the epidural, but didn't like the lack of sensation & inability to move, but she didn't want to deal with the pain. Hypnobabies worked wonderfully for her for 3 or 4 subsequent births to really help reduce (or nearly eliminate in her case) the pain.

Since you were at a birth center, I'm guessing you had the option of hydrotherapy - tub or shower?

I don't know that I've heard there's a way to make sure you can still pee. I just heard a woman say she had trouble peeing even with a natural birth, so I think that's a potential side-effect you can't do much to eliminate. (not sure).

I do believe it IS possible to turn it down low enough that you can feel a lot. Friend of mine said she felt her DS moving all the way through her body, whereas with my NCB, I don't even remember being cognizant of feeling him descend! I was surprised when I was told he was nearly crowning! So her sensations were almost more 'clear' than mine.

I've also heard of women, with assistance, getting up onto hands & knees. This is from a story my doula told, but I have the impression this is rare. And I think no one actually "walks" around with a "walking epidural" - even if it were physiologically possible (I have the impression it is not), the hospital would be too worried about the liability of you falling.

So I guess it depends how much movement you want. Getting up onto H&K or a supported squat? Possible. Actually walking? I don't think possible. Probably best to talk with the nurses at the hospital you're considering. I remember my doula saying the nurses were uncomfortable with her client getting onto H&K, but the doula pushed for it.

[plantnerd]

Hydrotherapy I tried.  Shower was good, not really a reduction of pain, but it did make me warm and not quite as pathetic feeling.  The tub made me want to crawl out of my skin.  Too floaty, too out of control, I was in and out in two contractions.

[cileag]

We use a patient controlled analgesic (PCA) system where I work and it seems to give a lighter epidural.  After the initial first bolus of pain medication, each patient is hooked up to a pump that runs a continuous flow of medication, with the option of pressing a button to give yourself additional doses.  In this case you could ask that the pump be turned down until it's at an acceptable level for you.  The hard part is that honestly everyone reacts so differently.  And we definitely move our patients side to side, help them sit up, but would not let them in a chair.

[jeminijad]

Some places give a one time dose- you aren't cathed thru the whole labor. It may be called something different, but falls under the "I want my epidural now" category. This is what I had w/DD, and honestly, it was a good thing. I was able to move around the room (not cruise the halls or anything,) albeit in a shuffling, clutching things kind of way.

I still felt contractions, they just didn't hurt; and it was mostly gone by pushing. You still feel the ring of fire (and can push effectively) if the anesthesiologist does a great job.

[AlexisT]

It is possible to adjust the mix and dosage. I don't know how low it's possible to go. When I had my anesthesia consult for #1 (OB didn't like the look of my spine) I was told that they did the "mobile" epidural but "no one gets out of bed; your legs turn to jelly." (This was not in the US and liability wasn't as much of a concern.) I think a lot of docs are calling it "low dose" now because "mobile" or "walking" is a misnomer.  That was okay, I just didn't want to be dead from the waist down, unable to move at all, if I wound up choosing one. As it turned out, I had a CS. For whatever reason, they did an epidural instead of a spinal, and they did give me a huge dose of anaesthetic--I was dead from the mid-back down.

It's all going to depend on your anesthesiologist. Some like to give a heavier epi and you won't know till it's in. I don't think a chair will be possible but you should be able to sit up comfortably on the bed. Also, with an epi, continuous monitoring is non-negotiable, which also restricts movement.

[frugalmum]

I had a similar experience to you-- my 4th unmedicated birth was so horrifically painful that I ended up with PTSD.  I had an epidural with my 5th and 6th and quite frankly it was fantastic.  After what I had gone through, in terms of sheer agony and the trauma it caused me, it seemed like a miracle to give birth without pain. 

My first epidural I could still feel and move slightly-- I just didn't feel any pain.  I still felt contractions but they felt like "light" early contractions even during transition.  I was able to move my legs within minutes of giving birth and could walk easily within 20 minutes.  I don't know if I was given a "light" epi or not, maybe it's just how it affected me.

Epi #2 was "heavier" but I gave birth within 30-40 minutes of getting it so it was not a big deal.

Both my epi babies were born pink, eyes wide open, nursed well.

The best advice I can give you for an epi is to get it put in as late as possible-- 5cm or later-- this is tricky as it can take them 45 minutes-1hr to have the anesthesiologist show up, insert it, make sure it's working, and they generally will not give you an epi after 8cm-- so don't request it too early or too late.

There are risks with epis but there are also risks with trauma from birth pain or prolonged births that are excruciatingly painful, including PTSD and bonding problems.