Pregnancy, Parenthood & Playtime

Doula, Birth Advocate, Aspiring Midwife, Mother, and Wife

Epidurals

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Many women today are under the impression that Epidurals are perfectly safe with no risks or side effects on mom or babies, and there are many providers out there who will not take the time to help educate mothers to the contrary. So I thought I would put together a post about epidurals and the risks and benefits for mothers and their babies. Now before I start, I just want to get it out there that with both of my children, I had an epidural. The first time I was not aware of any of the risks or side effects, and the second time I labored naturally for around 24 hours before getting the epidural to help allow me to sleep. Being a benefit to me. I needed to “re charge” so I could again focus on what was important and that was getting my baby here. Unfortunately the experience ended in a cesarean section, but I did not have to go through getting an epidural, waiting for it to work, and then possibly having it not work once we were in the operating room.

If I could do it all over again, I wouldn’t have had an epidural either time, but third time is a charm right?

Epidural

Epidural

According to the website for the American Pregnancy Association, some of the benefits of epidural anesthesia include :

  • Allows for rest in prolonged labored (As was my case)
  • Relieving the discomfort of childbirth can help some woman have a more positive birth experience
  • When other types of coping mechanisms are not helping any longer, an epidural may be what you need to move through exhaustion, irritability, and fatigue. An epidural may allow you to rest, relax, get focused and give you the strength to move forward as an active participant in your birth experience.
  • If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery
  • And in most cases, when using epidural anesthesia compared to other types of pain relief, you will remain more alert and aware of what is going on.

But like everything in life, there are risks. According to the website for the American Pregnancy Association, some of the risks of epidural anesthesia include :

  • Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache
  • After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop
  • You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating
  • You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary
  • For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
  • Though research is somewhat ambiguous, most studies suggest some babies will have trouble “latching on” which can lead to breastfeeding difficulties. Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.

There are also some things that their website does not touch on such as the increased risk of cesarean section due to stalled labor, or epidurals causing labors to become prolonged. The problem with this is, today in most hospitals there are strict time limits on the amount of hours a woman can labor. If you exceed, 12, 18, or even 24 hours in some cases, you are looking at a vaccum assisted delivery or even a cesarean section for something that has become very common called ‘failure to progress” which is what lead to my first cesarean section, after a short 6 hours in labor. Yup, you heard it folks, I was induced for 6 hours before being wheeled off to the operating room.

Some of the other commonly untold risks, taken from Kim James Website, birth doula, include…

  • Prolonged 1st stage of labor
  • Increase of malpresentation of baby’s head
  • Increase in the need for pitocin augmentation
  • Prolonged 2nd stage of labor
  • Decrease in the ability to push effectively.
  • Increased likelihood of an episiotomy
  • Increase in cesarean section delivery
    • 50% Increase at 2cm
    • 33% Increase at 3cm
    • 26% Increase at 4cm
    • After 5cm there was no difference
  • Urinary Retention that can lead to postpartum bladder dysfunction
  • Hyprotension (drop in blood pressure as earlier stated)
  • Itching of the face, neck and throat
  • Postpartum headaches (which I experienced very badly after the birth of my second child. I could not leave my bedroom with the curtains drawn without my head pounding uncontrollably.)
  • Maternal Fever (Sometimes blamed on the woman’s waters being broken too long instead of the epidural itself)
  • Feeling of emotional detachment
  • Inability to move freely on your own

There are also more serious risks as maternal death, but these are in extreme cases, and are not as common as the others already discussed.

Then we cannot forget the risks to your baby… which include :

  • Fetal Distress also known as an abnormal fetal heart rate
  • Drowsiness at birth
  • Poor sucking reflex due to the anesthesia (which can directly impact breastfeeding)
  • Poor muscle tone or strength in the first hours of life
  • Low Apgar scores

Be sure to become educated yourself before consenting to any kind of medical intervention during labor, you may not get all of the information that is available to you!

Information for this blog have come from the following websites :

American Pregnancy Association
Medical Risks of Epidurals

Kim James

Categories: General
Danielle Elwood

20 Responses

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  2. [...] for those who choose to use them for labor can be the right fit, but they are not risk free. Epidurals can slow labor, or pose other risks to mothers and babies. There are various ways to [...]

  3. [...] Science & Sensibility – Her Survival Was a “Christmas Miracle”, but the Disaster was Man-Made: Henci Goer calls a spade a spade on the high-profile story of one mother’s death and recovery during childbirth. Also check out Danielle’s post on the risks of epidurals. [...]

  4. I had my first son in 1995. I read “What to Expect When You’re Expecting” (didn’t know there were other, much better books) and took Lamaze. It was required that I meet with the anesthesiologist 3 full weeks before my EDD to review the LONG page of risks(including DEATH)and sign the waiver, or I would NOT be a candidate for the epidural. Had a horrible labor (which I will not go into), did get the epidural though (although I remember feeling every pain), had a vaginal birth.
    Fast forward 3 years:
    Same hospital, same doctor, different protocol. I chose ahead of time to get the epidural again (yeh, I was a sheep following the herd) and asked about when I needed to meet with the anesthesiologist to review and sign off on all of the risks. The nurse told me that that no one needed to do that, she actually didn’t know I had been required to 3 years before, and told me that everyone gets it, all you have to do is ask.
    At least I knew from my first birth what my risks were. I am thankful that both births were vaginal and my kids are healthy, but I knew then that something was horribly wrong with the hospital system.
    I am now a doula and believe in giving all my clients the information about all the risks, because I believe those risks are significant.
    Also, as a massage therapist, I have worked with several clients who had received epidurals in the past and have to cope with ongoing back pain from it, and even a lump on one of them.
    Women need to know. Thanks for posting this!

  5. Desiree says:

    Does anybody who throws that phrase around even know what martyr means?

    Merriam- Webster definition: Main Entry: 1mar·tyr
    Pronunciation: \ˈmär-tər\
    Function: noun
    1 : a person who voluntarily suffers death as the penalty of witnessing to and refusing to renounce a religion
    2 : a person who sacrifices something of great value and especially life itself for the sake of principle

    Now generally that refers to someone who chooses death to make a point, generally religious in nature. How in the world is a woman who does not get an epidural martyring herself? If anything it is just a simple smart choice when you look at the research and studies conclusions of epidural use. Does the benefit of mom being relieved of a temporary pain outweigh the risks of an epidural to mom and baby? Maybe, maybe not. Not for me.

  6. michele says:

    A “martyr”? No. Just someone who prefers to not have an epidural. It really is as simple as that.

    I also had an epidural with #1–hated it. Horrible experience. Ended up in a cesarean. Baby #2, at home, no meds and birthed vaginally.

    Yes, my natural birth was painful, but it was much better for me and my baby. And I would do it again.

  7. Tina says:

    Like most here I have more than 1 child. With my 1st I had an epidural. With my 2nd I didn’t have the chance to get one. Even though it was very painful for me (still talking about my second), the end result for both of my deliveries was the same. Both babies went into respiratory distress and had to stay in the NICU. If I had to do my 2nd again the only part that I would change is not getting an epidural.

  8. Here is a great analogy, would you stand at the sidelines of a marathon yelling at the runners “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Read the rest here:
    http://www.raisingmyboychick.com/2009/08/just-like-athletics-exploring-a-childbirth-analogy/ (Not my blog, but very well done)

  9. Lisa says:

    I don’t get the “martyr” thing, and I never will. I’d much rather go through labour pain than have someone put a needle in my spine. My babies have all been by c-section (which I never wanted, and wouldn’t wish on my worst enemy). The surgery was awful. The spinal anesthetic I had with three of them was every bit as awful. My desire to avoid the pain “relief” of having a needle put in my spine has nothing to do with being a martyr. It has to do with wanting to avoid something I find traumatic. Being awake and knowing that things are happening to my body that I can’t feel is freaky. I’m no more being a “martyr” by wanting to avoid that than someone else is being a “martyr” through her willingness to go through my own personal hell in order to avoid something (labour) that just isn’t that big a deal to me.

  10. toni says:

    I actually enjoyed my unmedicated out-of-hospital birth. I didn’t want an epidural, not because I was a “martyr” or wanted to prove I could go through the “horrible” pain of child birth. I didn’t want an epidural because I didn’t think I needed one, and I was right. My labor was only 7 hours long, from the time my water broke to when I gave birth. It wasn’t bad at all, I call it manageable. I never wanted pain relief till I hit transition, which is typical. 20 minutes after uttering the words “I can’t do this anymore” I was holding my baby. Everyone is different, and for me, an epidural, which can lead to other interventions (pitocin, episiotomy, c-section) sounded much worse to me than natural childbirth

  11. Claire says:

    Before I had my first baby, I would probably have said something like Beth, I didn’t see why anyone would want to be in pain if there was an alternative.

    Then I gave birth, and had a bad epi experience. It failed to work properly, and there were some horrible side effects.

    So my second child was born unmedicated aside from gas and air. My decision was made simply because of my past experience and also because it is undisputably better for baby if you can manage without medications. Epidurals are not without their risks and downsides, and to say that women that don’t have them are being “martyrs” is incredibly dismissive. It’s a choice like any other. Want one, have one, but don’t knock those that choose not to.

  12. heartsandhandss says:

    Wanting to labor without medication does not mean your a martyr. It is a choice women have that they are free to make. Just because you loved yours and couldn’t imagine laboring without doesn’t mean you should say things like that.

    It is a woman’s choice. She can choose to use meds or not, but being a martyr has nothing to do with it.

  13. Beth says:

    Elwood-I see where you are coming from too. It is a choice that you made that was best for you…no one else. No one else should have an opinion about your experience except for you.

  14. Beth says:

    Thanks Who’s the Boss for the backing! Birthperson-Having given birth twice gives me the experience to say I made the best choice for ME! Not you or anyone else. And not everyone should make their choices based off of mine-it is my opinion and my choice. I choose NOT to be a martyr and to enjoy the birth process. My choice-not yours. So who is copping out? And what is the cop out? Only a man would say it is a cop out….and a man cannot give birth and therefore, should not have an opinion.

  15. elwood says:

    I can see where they are coming from. I chose to be in pain during the majority of my second labor, at least 24 hours of it because I didn’t want an epidural. In reality, it wasn’t that bad.

  16. Who's the Boss? says:

    Birthperson-what do you mean? What’s a copout? Sounds like a legitimate comment. Why would a woman choose to be in pain if she didn’t have to? You don’t see MEN lining up to give birth and probably wouldn’t if they could (do not site the “man” who gave birth because he was a she)

  17. Birthperson says:

    I think that too many women think they need to be martyrs when having a baby when they shouldn’t.

    I hate this copout answer. But I guess that’ my problem.

  18. elwood says:

    I also think it depends greatly on the woman and her pain threshold.
    With my second, I labored naturally for a very long time, and it didn’t bother me. Things would have been much different had I actually given birth instead of having a c-section.
    I would do it all over again a million times, especially over pitocin contractions!

  19. Beth says:

    Having had two children, both with an epidural, I can say that I am SO glad that I had one. If I didn’t, the experience wouldn’t have been as positive. I love to look back at the experience and think of it as a good thing, not the pain. I think that too many women think they need to be martyrs when having a baby when they shouldn’t. When in doubt, get one!!!!

  20. Erin says:

    Six hours? How awful for you, I am so sorry.
    Great post. Very few women look at the dark side of epidurals, unfortunately. It seems like getting an epidural in labor is equal to taking an aspirin for a headache with many women, and it’s something I’ve never understood. The risks aside, childbirth is something that you so rarely get to experience, I can’t imagine wanting to sleep through it. I loved it all–even the pain. Aside from all that, I’m so thankful I made the decision to use a midwife and doula with my first labor. My water broke at the start of labor, my son was still very high (even at 9cm, he only descended to a +2 station when I’d have a contraction) and posterior, so I was in labor for close to 24 hours. With the help of my midwife and doula getting me into positions, walking, doing partner squats and so on, I was able to birth him vaginally. After he was born, my midwife and doula both said that had I had an epidural and been flat on my back, I would most likely have had a c-section.