When you experience pregnancy for the first time, one of the first things you’ll notice is how many choices you are faced with — should you choose an OB/GYN or a midwife? Should you have an epidural? Breastfeeding or bottle feeding? All of these choices are personal, and there is no wrong answer for a healthy, low risk mom. Many moms wonder about epidurals for pain relief in labor and whether or not they should opt for one versus a natural birth. Here are some great reasons for both sides to help you determine which choice is best for you and your baby.
What is An Epidural?
First, what is an epidural? Quite simply, epidural anesthesia is a popular pain relief method during labor. Over 50% of women who labor in the hospital setting opt for an epidural. It is a form of regional anesthesia, which eliminates pain by blocking nerve impulses from the lower spinal segments. This leads to a decreased sensation in the lower part of the body, where the pain of labor and delivery is felt (American Pregnancy Association, 2018).
Epidurals are administered via a small tube or catheter that is threaded through the needle and into the epidural space. The needle is then removed, which keeps the catheter in place. The catheter administers medication through either periodic injections or continuous infusion (American Pregnancy Association, 2018).
Did you know that there are two types of epidurals commonly used by hospitals? Typically, a hospital will administer either a regular epidural or a walking epidural. A regular epidural combines a narcotic and anesthesia by either periodic injections or through a pump into the epidural space (American Pregnancy Association, 2018). Moms with this type of epidural typically need to stay in the hospital bed and might have stronger restrictions on eating and drinking. A “walking epidural” injects a dose of anesthetic, narcotic, or a combination of the two beneath the outermost membrane covering the spinal cord and into the epidural space. This type of epidural allows a mom a greater range of motion in bed, as well as the ability to easily change positions. Again, it’s important to ask about your hospital’s policy in regards to movement and eating (American Pregnancy Association, 2018).
Why Might You Opt for An Epidural?
An epidural can provide some benefits to mom and baby during labor. Here are the most common ones:
- Rest. When an epidural is administered and a mom experiences pain relief, she is better able to rest. This is especially beneficial if a mom is anxious and exhausted during labor.
- Relief with mental state intact. The great thing about epidurals is that they not only provide pain relief, but they do so without altering your mental state. This again allows exhausted or anxious moms to be able to breathe and relax.
- They can sometimes speed up labor. If a mom is very tense and anxious, she might not progress as quickly as she could. Stress can trigger the production of norepinephrine and epinephrine, which can actually slow contractions (Rohs, 2016). Therefore, an epidural administered to an anxious mom might allow her to relax, thus allowing labor to progress faster.
- Allows participation from mom during cesarean births. If a mom opts for or needs a cesarean section, epidurals allow her to be awake and alert during her baby’s birth. Epidurals also carry much less risk than general anesthesia (Rohs, 2016).
Why Might You Skip An Epidural?
An epidural can also come with potential risks and side effects. Here are some of them:
- Inadequate pain relief. There is the risk of an epidural completely or partially failing to give adequate pain relief. Some women report that their epidural did not relieve pain in labor.
- Blood pressure changes. Sometimes epidurals can cause a mother’s blood pressure to quickly decrease, which could lead to treatment with IV fluids, oxygen, and other medications to help increase it during labor.
- Potential postpartum backache, both short or long term. Statistics show that long term backaches are almost twice as likely to occur with an epidural than in moms who opted to skip one (Rohs, 2016).
- Spinal headache. This requires several days of bed rest, as well as a blood patch. A blood patch is an injection of your blood into the epidural space to clot and seal the hole that caused the leak.
- Skin itching and shaking. These symptoms can be mild to severe depending on the epidural and are often the result of narcotics (Rohs, 2016). Moms will sometimes experience shivering, nausea, and ear ringing in addition to itching (American Pregnancy Association, 2018).
- Retention of urine. Many hospitals will require you to have a urinary catheter during labor with an epidural placement because you will not feel the sensation to urinate. You might retain urine postpartum, resulting in the need of intermittent catheterization until you are able to urinate on your own after the medication has fully worn off.
- Additional interventions. An epidural decreases your ability to feel the pushing sensation. Since you are also limited in your positions during delivery, this could increase the risk of necessary interventions such as forceps or a cesarean section (American Pregnancy Association, 2018).
- Permanent nerve damage. Though very rare, it’s important to note that permanent nerve damage may result in the area where the catheter was inserted (American Pregnancy Association, 2018).
Is An Epidural Right for You?
Sometimes women have underlying health conditions which warrant them to skip an epidural, but for a healthy mom, it often depends on personal preference. There are pros and cons to choosing an epidural, so make sure to speak with your provider to determine which decision is best for you and your baby.
Jessica Rockowitz is a former OB/GYN Health Educator. She obtained her undergraduate degree in Biotechnology with a minor in Marketing from Endicott College. Upon graduation, Jessica worked in stem cell research at Harvard University and simultaneously volunteered with teen parents and disadvantaged women. Being a former teen parent herself, she has always been passionate about serving young moms and helping empower them to achieve their goals. Itching to pursue a field with more patient interaction, Jessica left the research field and attended a second degree nursing program at The University of Pennsylvania. She then worked in the field of OB/GYN Health Education at a women’s health clinic in downtown Philadelphia. Jessica is also a mother of three and has experienced both a traditional hospital birth with an epidural, followed by two unmedicated birth center births. She likes to think of herself as the perfect balance between holistic and pro-science. When Jessica’s second child was a little over a year, she turned her passion for serving others into a marketing and photography career in Austin, TX where she lives with her husband, three children, and rescue fur baby.