or Connect
Mothering › Groups ›  January 2014 Due Date Club › Discussions › epidural or no

epidural or no

post #1 of 18
Thread Starter 

hi,  i'm due w/ my first jan 23rd. i'm a body worker and sometimes meditator (have done a couple of 10-day vipissanas - intensive silent meditations) and did a 2 day/6 hour hypnobirthing class w/ my bf.  i'm going into this with the 'less intervention, the better. unmedicated unless it gets gnarly, then gimme the shot' mindset. anyone have any experience w/ epidurals? sometimes it seems like women feel like they need to prove to themselves or someone they can 'do it.' i hear about women feeling 'empowered' and don't think i need that. i just don't want chronic back pain or... what are the cons again?  thanks!

post #2 of 18
I had one with my first and didn't really like the feeling. It was good because I needed the rest-I was in labor almost 2 days and she was posterior. If I had not had it, I most likely would have ended up with a c section.

I did not have any pain medication with my second and found the recovery to be much easier. I'm planning on not having any pain medication for my third due in January.
post #3 of 18

I had a natural labor until the last 3 hours, when I had an epidural.  From talking with other mothers, it sounds like - as with everything birthy - experiences are very individual.  My epidural was amazing.  For me, it allowed me to rest after 9 hours of labor, 6 of which were pretty intense.  I was able to feel contractions, feel the baby moving, squat while pushing - all without pain.  The epidural made me feel more present and more in control - the pain was no longer clouding my head, I could interact with my husband and with the staff.  I could enjoy the experience of labor instead of laboring through it.  My baby was not at all groggy and he nursed right away.

 

The downsides for me were that the adhesive made my skin itchy/sensitive for a day or two after.  At one point I had to pee and the nurse had to use a catheter to help with that.  I didn't have a catheter inserted the whole time though - it's just kind of embarrassing.  Oh, and it took a second try to get the epidural right.  I was sitting a little crooked to begin with and it only worked on one side first. 

post #4 of 18

I'm replying first then I'll go back and read other responses. I thought long and hard about this. I suffered greatly being sick for over 7 months of my pregnancy. The only thing that brought me back to life was knowing the end was near. I went into it deciding I wanted to do natural/no medications but after being beaten up with sickness for so long I decided to allow myself to decide in the moment. If I feel like I'm truly suffering at any moment I MOST CERTAINLY deserve some help. And so do you! Also, an ultrasound tech said something that resonated with me. Something along the lines of wanting to experience this moment in a good way, rather than suffering and not able to relax. Some women don't have as much pain. Some have high pain tolerances. I decided not to compare myself to anyone and do what I need to do in the moment, after a very long, hard pregnancy. Do what you feel you need to do in the moment! :)  (I also learned there is no medal for doing it either way.... )

post #5 of 18
Rosamus and others, I'm going in with the same "decide in the moment" approach. With my daughter, I held off until 7 cm but like others here, I was just so tired--had been up all the night before and frankly, I didn't see the point in persisting with the pain. The epidural was absolutely the right decision for me at the time--it allowed me to relax and rest, and my doula suggested that it may have actually helped keep my pushing period shorter (a little under an hour) because the baby was able to labor down further--my doula said without an epidural, you often get the urge to push earlier.

I didn't feel the contractions very strongly and had to be coached on when to push, but I didn't mind. Overall, I think I had a more relaxed birth this way.

This time, I will be at the same hospital but with midwives (whom my previous insurance didn't cover) and with the option of waterbirth. The midwife will be there from active labor on, and I think the tub will help a lot, so I want to see how far I get--but I am definitely not ruling out an epidural again.

What scared me last time was I was puking, shaking, etc. from pain (the no sleep didn't help) yet everyone kept commenting on how well I was handling it! I was so miserable--if this was "handling it well" and I felt so terrible, I couldn't imagine what unmedicated transition might be like.

Hopefully labor will be a little shorter this time and we'll see how it goes, but I don't feel a strong moral imperative to avoid the epidural. I invested so much in worrying aobut the labor itself last time, and this time I just see it as something to get through on the way to meeting my baby.
post #6 of 18

I guess I am a tad disappointed that no one so far actually answered what the real risks are, despite Rosaling ASKING about that....and there are real risks to epidural. 

 

No, as others have said, birthing is not a contest & no one offers a medal no matter what happens...but frankly, last week, we had a major ice storm...no power for 4 days, my kids got a stomach virus right as it hit, I am 36 weeks prego, no heat, no lights, no laundry & had to muddle through, because the effected area was so large, we couldn't even get a hotel room or stay with anyone (as no one had power...) and guess what?  I got no medal for that either.  Bummer, I guess that is why they say motherhood is a thankless job.  If you do ANYTHING hoping to get any kudos or acknowledgment or prove anything to someone...you are looking at it all wrong...and to imply that someone who is proud of what they have gotten through (such as a med free birth) IS looking for it is condescending & rude.  I have had a med free birth.  I AM proud.  Just like I would hope Rosalind is proud she did a 10-day vipissana.  Anything you get through that is challenging should be a source of pride.  If you aren't going to proud of those types of things, then what can you safely be proud of, if anything?

 

Back to the topic though...risks...

 

Here is a pretty good article with lots of additional links: http://chriskresser.com/natural-childbirth-v-epidural-side-effects-and-risks

 

Quote:

Epidurals have been shown to have the following effects on labor and laboring mothers:

 

 If you decide to get one, then get it.  I don't personally have a dog in anyone else's fight.  I am not going to pretend though that they aren't without risk & are probably the reason the US has the highest C-section rate...as we also have the highest epi rate & the two are absolutely associated.

 

You also NEED to talk to YOUR Dr about this since it varies.  In many places the use of walking epis is still not common place & for many women once you take the epi you are automatically cathed & stuck in bed for the remainder of labor.  This is NOT always the case, as in other places you are allowed to move, etc.  It really depends & the best person to tell you what your options will be where you intend to deliver is the Dr or hospital that is involved.

 

And I am baffled by your comment of "not needing empowerment".... I am truly taken back that someone who practices being in touch with one's body & mind would comment that they do not need to find that connection at the single most primal moment of your life.  There is no greater opportunity to know one's self than when you are standing on that edge.  Empowerment is not "I am woman hear me roar"...it is a quiet amazing transformative inner strength that allows you a look into the absolute stripped down depth of who you are.  I can promise you, you can't get there from meditation alone...there really is nothing on the planet like birthing when you are fully connected to your own body, your own spirit, your baby & the process...no matter how much pain is involved....and this is coming from a woman that went through 3 straight days of no sleep due to posterior position & delivering a face up baby.  It was absolutely immensely difficult & taxed every fiber of my being & I wouldn't trade that experience for anything.  Pain is not inherently bad or to be avoided, sometimes it is we who are re-birthed in those moments along with our infants.  Like I said, do what you want, but don't allow yourself to be fooled into thinking there is no trade off in shutting down an entire facet of the NORMAL biological part of birth, especially when you have been through the kind of training you have & you have to know that yourself.

post #7 of 18
Opheliajoy,
You make me feel bad for not chiming in on this thread! Lol. I am glad that you did. I keep silent on this subject, bc much like breastfeeding and vaccines, there is tons of info available, and it is a personal choice. Anyone who really cares can find what they want to know online!

It seems to me based on my research that there are plenty of risks to getting the Epi. I also can see that in some cases (few, imo) there can be benefits to having one.

My experience with women who decide to decide "in the moment" is that they usually end up with drugs. The hospital pushes them, i think. They make more money and the birth is more manageable for them. I think it is not in the best interest of mother or baby. But everyone is capable of reading the literature and making that decision.

I have had two natural births. The "pain" is strange. It comes and goes in a natural birth, you have breaks. Your body was made to birth babies. It is not like the pain of breaking a leg where it feels sharp and forever. The fear culture in our society is what holds most women back from an amazing experience. Birth is transformative for the mother. I was amazing and powerful and primal. I dont want a medal. It was the single most important experience in my life. I hate that others get cheated of that chance for personal growth.
post #8 of 18
My experience with women who decide to decide "in the moment" is that they usually end up with drugs. The hospital pushes them, i think. They make more money and the birth is more manageable for them. I think it is not in the best interest of mother or baby. But everyone is capable of reading the literature and making that decision.

I have had two natural births. The "pain" is strange. It comes and goes in a natural birth, you have breaks. Your body was made to birth babies. It is not like the pain of breaking a leg where it feels sharp and forever. The fear culture in our society is what holds most women back from an amazing experience. Birth is transformative for the mother. I was amazing and powerful and primal. I dont want a medal. It was the single most important experience in my life. I hate that others get cheated of that chance for personal growth.[/quote]

I know a lot of people have felt pushed by doctors or hospitals. I think it depends on the hospital. I wasn't pushed. And i don't feel cheated of any chance for personal growth. I had plenty of personal growth from experiencing labor as I did, and more importantly, from having and parenting a baby. I'm glad you had a powerful experience and are advocating for it, but I guess I feel people find personal growth in different ways, and to imply that women who get epidurals or who don't do it the same way you did are somehow missing out on something is a little presumptive. I'll see if I feel differently this time, if I do end up having a natural birth. I personally didn't feel like I was getting any breaks from the pain--my contractions were 1-2 minutes apart from the start, for over 24 hours.
post #9 of 18

Ophelialove, I don't think anyone here meant to offend you in any way or take anything away from your personal experience. You actually should get a medal for dealing with sick kids during late pregnancy AND an ice storm without power! To epi or not is a pretty personal choice and many women have different opinions for sure. I do think there are women who are made to feel guilty if they decide to have an epidural, as if they failed during child birth, and that I feel is wrong. Everyone's pregnancy & birth experience is so different. True women have been birthing children squatting in the jungle for centuries but we live in a country who unfortunately instills in our minds that medication/intervention is the way to go and a lot of women have so much FEAR around childbirth that the default is to go for the meds. (myself included at one point until I read  A LOT)

 

I had the mindset that I would decide in the moment but my mom said something that made me think. I am fearing that being sick the entire time (even now, at 37 weeks) will leave me without the energy needed for labor and birth. I was thinking 'how could I possibly add on dealing with contractions in addition to not being able to breath, nausea/sickness and severe acid reflux along with all the other late pregnancy symptoms??'. But she reminded me that our bodies were designed for this and what would probably happen is that all those other things would fade to be able to deal with labor. Shaking and puking and being completely out of your mind in pain doesn't sound like a pleasant way to bring a child into the world for mother or baby, but if you don't have a doula or midwife helping to coach you it could be rough. Some women don't have the mental capacity to guide themselves through it. Or worse, do not have a pleasant experience with hospital staff and are made to feel anxious and scared while in the hospital. Nothing closes up sphincters (cervix) faster than fear!

 

I've read the risks in a couple books and would love to NOT go this route, and ideally have that orgasmic birth you hear about, BUT I do know quite a few women around me that did have an epidural and all was super well. I've seen their babies and they are healthy and happy. All in all, tough choice for a women!

post #10 of 18
I hadn't replied to this because I haven't had an epidural nor ever discussed the risks of one with a doctor... but I'm feeling like throwing in my two cents now.

Yes, of course there are risks, as with any medication or medical procedure, and yes, the research shows increased interventions/complications associated with epidurals during childbirth. Personally I'd try not to... I try to avoid pretty much all medications and medical procedures that I can! My husband had an epidural once and had a bad experience with excruciating headache and backache in the days after... ever since he has refused it and requested general anesthesia when surgery was necessary. That doesn't happen to most people though, and no one can tell you if it will happen to you or not.

I think more woman could give birth without epidurals if they were better prepared for and supported during labor... and if they were perhaps better in touch with their bodies and inner strength. I know my own experience of meditation, prayer and yoga helped me in labor, as I was for a long phase of labor able to truly relax into the contractions, feel the energy and draw strength from the strong, sometimes painful sensations. (Which, for me, there didn't seem to be any break between...) And then, honestly, the last couple hours, it got really really hard. And I remember thinking at one point "I can see why women get epidurals!" I still didn't want one, no. But if I had had more than a couple hours left at that point? If I hadn't been at home, in a birthing pool? If I had been poked and prodded and interrupted and offered relief I might have accepted it. That said, I have several friends who have said to me that they wish they had held out a bit longer, that they chose the epidural because it seemed like labor was never going to end and they couldn't hold out any longer - but in fact, as is often the case when it starts to feel impossible, they were nearly at the finish line and if they had just known how close it was they might have been able to do it. Of course, no one can tell you how much longer labor will be and it can feel like even one more contraction is too much. I think that's where a doula can be invaluable, to remind you that the end will come, that it's closer with every contraction, that you are strong, various ways of coping of course, etc.

I can also say from friends' experience in another part of the world (Korea) where we used to live, and "western" type intervention in childbirth is practiced (induction, etc.) but pain relief is not offered for non-surgical birth.... women suffer greatly sometimes. There is a culture of stoicism and it's not bad to accept some parts of life are going to hurt. BUT if you are giving birth in a hospital and having chemical or instrumental interventions that cause unnaturally strong contractions or increased pain... it's not the same thing. It's not going to be the same experience I had in my bedroom, in my birthing pool.

For me, birth was "empowering". I do think it helped make me a better and stronger mother to have gone through the experience of labor and birth and come out saying "I am woman, hear me roar!" (And roar I did at the end there....!) But I can't say I wouldn't have been as good and strong mother if I hadn't had that experience. Having a baby transforms you, however it happens. Right now I'm waiting for test results which may tell us that a scheduled cesarean is the only way for this baby to be born safely.... and I am absolutely prepared to accept that and everything it entails, despite my desire to have another quiet, private waterbirth in my home. Everyone's situation is, indeed different, whether it is a matter of personal resolve or risk assessment or the random assignment of a l&d nurse who may or may not support you or a health situation which you have no control over... we simply cannot judge another.
post #11 of 18
Oh, and I second the motion to award ophelialove a medal for parenting sick kids in an ice storm while pregnant!! Ugh... but that's life sometimes, eh.
post #12 of 18
Quote:
Originally Posted by Blanca78 View Post

I know a lot of people have felt pushed by doctors or hospitals. I think it depends on the hospital. I wasn't pushed. And i don't feel cheated of any chance for personal growth. I had plenty of personal growth from experiencing labor as I did, and more importantly, from having and parenting a baby. I'm glad you had a powerful experience and are advocating for it, but I guess I feel people find personal growth in different ways, and to imply that women who get epidurals or who don't do it the same way you did are somehow missing out on something is a little presumptive. I'll see if I feel differently this time, if I do end up having a natural birth. I personally didn't feel like I was getting any breaks from the pain--my contractions were 1-2 minutes apart from the start, for over 24 hours.

 

 

This, pretty much exactly. 

 

Birth for me was amazing, transformative, empowering, primal... I felt connected to myself, my body, my baby.  I was on a high for days afterwards.  To suggest that pain is a necessary part of the process is a little silly.  In fact, given how much better I felt with the epidural, I would say that the pain detracted from my experience and my ability to be present.

 

I was also not pushed to get the epidural.  In fact, when I requested it, the nurse suggested that I had probably hit transition and didn't have much time left.  And I got the epidural after hours of non-stop feeling like my body was being ripped in two.  So yeah, no breaks for me.  It also doesn't make sense that if you accept that epidurals lead to all these increased problems that they are easier births to manage.  How are instrument deliveries, c-sections, more severe tears, floppy babies, etc., etc... easier for anyone?  My nurse was free to do other stuff until I got the epidural, at which point I needed an IV, CFM, increased monitoring in general, a catheter, etc. 

 

I think having an open mind is the best way to go about it so that you don't end up feeling like you're not a true woman or that you somehow didn't give birth to your baby or become a mother or some other nonsense if you end up using medication for pain.

 

As far as risks, the reason I didn't bring them up is because it's crazy complicated to talk about on a message board.  Studies have found results in both directions and with no effects for all outcomes - labor length, c-section risk, surgical vaginal delivery risk, etc.  (If you click on the articles that Ophelialove provided, you can see this firsthand - a study that found a longer pushing stage (15 minutes, btw) also found no effect on 1st stage length, c-section rates, instrument delivery, breastfeeding rates or a number of other things)  Or here is another example, this study found that women who got epidurals had shorter labors and lower incidence of PPD than women who did not receive epidurals for pain: http://onlinelibrary.wiley.com/doi/10.1111/j.0001-6349.2004.0302.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false  Short answer: it's complicated and correlation is usually interesting, but is also not causation.

post #13 of 18
Quote:
Originally Posted by cwill View Post




As far as risks, the reason I didn't bring them up is because it's crazy complicated to talk about on a message board.  Studies have found results in both directions and with no effects for all outcomes - labor length, c-section risk, surgical vaginal delivery risk, etc.  (If you click on the articles that Ophelialove provided, you can see this firsthand - a study that found a longer pushing stage (15 minutes, btw) also found no effect on 1st stage length, c-section rates, instrument delivery, breastfeeding rates or a number of other things)  Or here is another example, this study found that women who got epidurals had shorter labors and lower incidence of PPD than women who did not receive epidurals for pain: http://onlinelibrary.wiley.com/doi/10.1111/j.0001-6349.2004.0302.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false  Short answer: it's complicated and correlation is usually interesting, but is also not causation.

I also didn't feel comfortable discussing risks because I am not a medical professional nor am I trained in interpreting studies. Anecdotally, my doula told me sometimes pushing lasts longer without an epidural because you feel the urge to push earlier (with the epidural, I was able to let baby descend on her own to +2 station, and ended up pushing for less than an hour with one small tear). BUT, of course, that is just anecdotal.
post #14 of 18
My first was med-free with (the devil) pitocin. This time I'm going to birth center that doesn't offer pain meds. Med-free for me is not a "prove it" thing, I know I can. And honestly, I wish I had had fewer medical interventions with my first. Interventions tends to snowball into further interventions, and for me that meant a horribly painful recovery. I'm hoping to have a pain-limited recovery by having the least amount of interventions possible.
post #15 of 18

I also have not wanted to comment because I don't want anyone to feel that I am judging them. I went med-free with my first, and the pain I felt from having a posterior baby made me leave my birth saying that I would never look down on anyone who got an epidural.

 

(By the way, I was able to request sterile water injections into my back and they were AMAZING at stopping the back pain. The injections felt like a mild bee sting for a sec and the back pain vanished! Many places can do this - it is worth asking in advance to your midwife/ob/hospital if they can provide sterile water injections if needed.)

 

Anyway, just wanted to share this abstract (below). This is just one of the more recent studies showing epidurals to have a negative effect on how breastfeeding ends up going. There are many reasons that might factor into this but one is definitely that the anaesthesia does drug newborns, depresses their reflexes and makes them have a harder time getting breastfeeding.

 

When the researchers did the main "breast-crawl" study that I have heard about, they found that that babies of moms with epidurals would still crawl to the breast in the first hour but were a lot less likely to successfully latch and suck (and what happens in that first hour affects how things go later). 

 

Epidurals are hard to study bc they are very unique cocktails according to the preferences of each anaesthesiologist. However, at least one med used in a lot of epidurals (fentanyl maybe?) has been proven to stay in the baby's system for **30 days**. 

 

I come across a lot of moms and babies in my work and I will say that anecdotally I see a difference in the babies of moms who had epidurals versus those who didn't - these babies just are not as with it and have a harder time overcoming any breastfeeding challenges that may arise. 

 

With my first, I decided against an epidural because I did not want the cascade of interventions that any one intervention so often brings. (I was in a birth center. I really don't know that if I had had a pitocin induction in a hospital I would have been able to stand that kind of overly-intense pain without medication.) However, through my later education, I ended up meeting a very smart midwife who shared with me a theory (it is still theoretical, no studies that I know of, but it made a lot of sense to me) that when a mom receives an epidural, which disables her own body's ability to hormonally mediate some of the pain, it stops that natural pain relief from getting to the baby, and for the baby it can make labor a more painful and traumatic experience. Again, this isn't proven, but it makes sense to me, and I suspect it also is part of why those babies I see are a little more dazed than the drug-free babies. 

 

No judgment to anyone for whatever you end up needing to do, but just some food for thought. 

 

----

 

Labor epidural anesthesia, obstetric factors and breastfeeding cessation.

 

Matern Child Health J. 2013 May;17(4):689-98. doi: 10.1007/s10995-012-1045-4.

 

Breastfeeding benefits both infant and maternal health. Use of epidural anesthesia during labor is increasingly common and may interfere with breastfeeding. Studies analyzing epidural anesthesia's association with breastfeeding outcomes show mixed results; many have methodological flaws. We analyzed potential associations between epidural anesthesia and overall breast-feeding cessation within 30 days postpartum while adjusting for standard and novel covariates and uniquely accounting for labor induction. A pooled analysis using Kaplan-Meier curves and modified Cox Proportional Hazard models included 772 breastfeeding mothers from upstate New York who had vaginal term births of healthy singleton infants. Subjects were drawn from two cohort studies (recruited postpartum between 2005 and 2008) and included maternal self-report and maternal and infant medical record data. Analyses of potential associations between epidural anesthesia and overall breastfeeding cessation within 1 month included additional covariates and uniquely accounted for labor induction. After adjusting for standard demographics and intrapartum factors, epidural anesthesia significantly predicted breastfeeding cessation (hazard ratio 1.26 [95% confidence interval 1.10, 1.44], p < 0.01) as did hospital type, maternal age, income, education, planned breastfeeding goal, and breastfeeding confidence. In post hoc analyses stratified by Baby Friendly Hospital (BFH) status, epidural anesthesia significantly predicted breastfeeding cessation (BFH: 1.19 [1.01, 1.41], p < 0.04; non-BFH: 1.65 [1.31, 2.08], p < 0.01). A relationship between epidural anesthesia and breastfeeding was found but is complex and involves institutional, clinical, maternal and infant factors. These findings have implications for clinical care and hospital policies and point to the need for prospective studies.

post #16 of 18

PS...it seems like DOULAS may be one of the best forms of pain relief!! Very much looking forward to using one this time.

post #17 of 18
I've had my baby since I last wrote and wanted to share. Sometimes things don't go as planned! I ended up having to be induced after 12 hrs of nothing happening after water broke. I was anxious but they started me off on lowest dose. Within two hours contractions started and escalated nicely for 8 hrs, until I was 7cm. I held out that long with Pitocin contractions using deep breathing until it was too deep and intense and realized I needed help. Went with a walking epidural which took the edge off but by no means was I numb. I experienced transition in full effect which was out of this world painful (with severe shaking) but beautiful. After reaching 10 cm I pushed hard for four hours straight and would NOT have had the strength to push my 8.8 lb baby out without some help from pain relief.

My baby is healthy, gorgeous and alert. I'm fine except for some tearing. My birth experience was beautiful even with these interventions and I have respect for them now, not fear. No matter what, it's ok.
post #18 of 18
Glad to hear it, Sparatikness!
Mothering › Groups ›  January 2014 Due Date Club › Discussions › epidural or no