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To epi or not to epi?

(35 Posts)
iamwhaticallpregnant Sun 20-Jan-13 16:24:18

i am nearing the end (36 wks) and need to prepare for the birth. My question is - should I have an epidural?

All I would really like is either "you should have an epidural because ........" or "you should not have an epidural because ........" in 2 sentences or less.

Please please please no stories of horror and pain - i am a first timer and completely terrified of what to expect and dont need anyone else telling me how extrutiatingly awful it is :-(

Flisspaps Sun 20-Jan-13 16:26:11

I say no, they increase your likelihood of intervention. I had one with DD. Chose not to with DS.

I had 4.5hours and 2hour labours. No epidural needed but had things been different I would have had one, I would be open to having one if needed. In my case there was nearly no time for g&a.

Good luck!

Seachelle Sun 20-Jan-13 16:29:54

I have never had an epidural. However I would say that you should remain flexible on the idea. Not sure why you want to make a decision now. See how you feel in labour.

oldebaglady Sun 20-Jan-13 16:34:06

I've had an epidural with one and not with the other

I don't think many people plan an epidural here, it is "done" abroad but here most people who have them its more of a case of that's how it the chain of events went

I had an epidural with my smallest baby, and couldn't push him out because I'd been on my back due to the epidural and had a cs in the end. Pushed much larger baby out when I had no epidural as I was upright for most of my labour and the baby and my pelvis got into a better position for birth

if you want to prepare to have a less painful birth, IMO the best way is to really familiarise yourself with baby's positioning in labour and labour positions and try to optimise this to avoid babk to back labour (see spinning babies website), plus look into hypnobirthing

then if you end up with an epidural then thats fine, but you might not need one so why risk increased chance of needing forcepts/cs withut finding out how you might manage without?

You should have an epidural because the relief is amazing and you get no prizes for suffering more than you need to. I have had one, and it did not lead to further interventions. No forceps, episiotomy, stitches. It also meant that I didn't have to be put out to have the placenta manually removed, because I was already numb. It was a fantastic experience.

You should not have an epidural because it may lead to further interventions and it will prevent you from having an active labour without constant monitoring. If I had not remained active I would have had great difficulty delivering my 11lb ds at home with just a little gas and air. It was an amazing experience.

My advice would be to just go with the flow. Start with some gas and air and If you feel like you're not managing, don't be worried about asking for an epidural!

Good luck. Please don't be scared. It's not awful. Intense, powerful, emotional, painful, but not awful. The days I delivered my 4dc were the best of my life. I'm expecting dc5 and am looking forward to giving birth again. It makes me feel like I can do anything-I feel like super woman for days after, (Until sleep deprivation kicks insmile

rrreow Sun 20-Jan-13 16:58:05

You should have one if you personally find the pain unbearable. I found that was the case for me and asked for one, but in my case labour was actually so fast that by the time the anaesthetist came into the room I was already at the pushing stage.

I think it's good to know for yourself if its something you would consider having, and then make the actual decision during labour.

Eletheomel Sun 20-Jan-13 17:00:44

I agree with other posters, by all means have an interim decision on whether you'd like an epidural or not, but be aware that things change in the labour ward and it's perfectly acceptable to change your mind about anything and everything!

I didn't want one with my son (and didn't have one) and I don't want one this time. It can lead to more intervention but to be honest, my issue wasn't related to that, just a fear of having an injection in my spine.

Doesn't mean I won't ask for one this time though, depending on hw it goes, I'd keep an open mind and just be aware that what you want to happen might not happen and vice versa.

And try and stay positive, you're having a baby, it has to come out, women have given birth for millennia, you're probably stronger than you think, and anything you need to do to get a healthy outcome for you and your baby is the right decision.

Lots of luck!

VivaLeBeaver Sun 20-Jan-13 17:02:58

I say go with An open mind and no pre set ideas. Concentrate on each contraction and don't think about the next one until its the current one. Don't think about how much longer might labour be, etc or you'll be a bit disheartened.

You might find you manage without just fine. You might be asking for one when you walk in the door. Either of those things are fine but you just won't know how you find it until you're there. If you need it then you need it.

Good luck.

Mylittlepuds Sun 20-Jan-13 17:29:47

Have one if the pain gets too much.

oldebaglady Sun 20-Jan-13 17:33:00

Just to add, I don't regret the epidural I had, even though it did lead to interventions - I wasn't coping with the pain that time, baby was in a crap position and I wasn't able to get in good labour positions anyway and I did need the epi that time IMO. Had I prepared for labour better (not planted myself on the sofa so much etc etc) I might not have got to that stage, but by the time I did have the epidural by god I needed it and it made the birth much more of a positive experience from then on, had a lovely CS in the end smile

prepare for a normal birth (stay active, bounce on birth ball, keep off your back, learn about the stages of labour so you don't feel to out of control once it starts happening..) but also stay open minded

Sirzy Sun 20-Jan-13 17:38:07

I was lucky enough to be able to speak to an anethatist while waiting to be induced. He was very matter of fact which helped me decide I didnt want an epidural at all.

It's a very personal decision though so you do what you feel is best

TondelayoSchwarzkopf Sun 20-Jan-13 17:39:15

Wait til you are in labour and then decide. And decide quickly.

There is no good evidence for epidurals increasing risk of cs.

ladymia Sun 20-Jan-13 17:42:44

I am trying to decide the same at the moment and unsure. I have been reading up too much about it I think and have read too many stories about people needing intervention after having an epidural which is scaring me a little!

I just don't think youcan plan for these things sorry. You can't plan for anything during childbirth so need to have an open mind. All births are different and I feel strongly that if you have for heart set on something in particular eg to do without pain relief or to want a water birth or whatever then you are setting yourself up for disappointment if it doesn't go to your plans. Which it probably won't. Particularly if its your first. It's the great unknown!

What I will say is that you will definitely know when you need an epidural just like you will know if you feel you are managing fine without. Honestly I think you should just see how it goes when the time comes. First time mothers in my experience often tend to have this idealistic way of how they want it to be and just don't realise how different each birth can be.

oldebaglady Sun 20-Jan-13 17:48:40

"I have been reading up too much about it I think and have read too many stories about people needing intervention after having an epidural which is scaring me a little!"

well yeah but it can be a bit chicken and egg
the epidural meant I couldn't push effectively on my back
but I had the epidural because the baby was back to back anyway, which is why I wasn't coping with the pain and why I couldn't get my body into good positions.. and with a back to back baby you're more likely to need interventions anyway...
The epidural was the nail in the coffin so far as DC1 comming out vaginally.. but by the time I had it the labour wasn't going great anyway - I couldn't bear to be upright, and I had had pethedine which meant the baby was less likely to turn into a better position.
I was also shattered as it had been going on for hours, and with the epidural I at least got to enjoy the latter end of the labour

I'ld never rule it out, but I'ld never plan on in advance either

oldebaglady Sun 20-Jan-13 17:50:30

anyway if you have a fast labour you can't have one anyway, so you can never 100% plan to have one even if you want to

ladymia Sun 20-Jan-13 18:04:48

I do think it's still a good idea to research these things before getting there but agree you can't 100% plan for these things. i don't want to be googling the pros and cons of and epidural when I am in labour smile .... which is what i think the OP is doing too?

noblegiraffe Sun 20-Jan-13 18:11:23

Don't rule it out.

And don't think you can prepare for birth by making a plan with firm decisions in advance. At best you can come up with a wish list that you need to be prepared to throw out of the window when the time comes.

iamwhaticallpregnant Sun 20-Jan-13 18:34:53

Hi all - thanks for your responses. I read one book which was a jokey look at "what to expect when expecting" and the author said more or less HAVE AN EPIDURAL. and its the best thing to do. She also said that midwives will fob you off by saying wait and see how u feel and we will see how u r in a bit etc. the reason being so that itll then b too late for one and u cant have one - which theyve been told to do as epidurals cost so much.
other than this i have not googled or researched anything because i am so worried abt how bad its going to be and 'birth horror stories".

VivaLeBeaver Sun 20-Jan-13 18:39:48

Well I'm a midwife and I don't fob women off. If a woman asks for one kid contraction ill ask her if she's sure once the contractions finished but that's as much fobbing off as I do!

noblegiraffe Sun 20-Jan-13 18:43:42

It might be awful, it might be great. It'll probably be somewhere in between. You will cope best if you are flexible, and if you ask for drugs if you need them, and accept that you might need them. It's not a sign of failure, some women have more painful labours than others and it's not their fault. Some women need a C-Section, that's not their fault either. It's a wonder of medicine that we have these things available to help us give birth safely to a healthy baby. That's the important bit, not how you got there.

I had one with both DC. Positive experiences both times.
DD1 was 7 hrs start to finish. Got my epidural at around 5cm and was able to get some sleep before I got to the pushing stage. DD2 was 5 hours. Got the epidural at 8cm, basically as soon as I arrived in. Both were back to back and I never had any issues pushing them out. With DD2 I had a retained placenta. The epidural meant that my gynae could remove it all manually while I held DD2 in my arms. Though that was seriously grim (and v messy, super-shocking for DH) my epidural meant she could get straight to work rather than knocking me out and wheeling me off to theatre.
I found the pain of labour to be unbearable and was greatful for pain relief that didn't affect the rest of how I was feeling. I was in bed for a few hours afterwards, which seems pretty normal, then a bit bambi legs, then all fine.
Not being in any pain, and not having had prolonged labours, I wasn't inconvenienced by not being able to walk around.
It worked well for me and contributed to me having positive birth experiences. I agree it is is a choice, but I think there are a lot of horror stories and women are often scared off having one. Where I was (continental Europe) it's quite standard. Midwives v much supported my choice to have one and immediately called the anethsetist (sp??).

LexyMa Sun 20-Jan-13 18:52:38

I've just started watching OBEM from the beginning and saw a couple of times what you might say was being fobbed off. One that stuck out was that "someone else is having one so we can't get to you until..." - to which I thought, I couldn't give a stuff how someone else's birth is going, do me the courtesy of answering in terms of the clinical need right here, and the pain presented.

FWIW I have given birth once, vaginally using G&A in a MLU. I was keen to avoid types/ levels of pain relief which would disconnect me from the process i.e. not be able to be in control. However once I got to hospital (a Friday evening) I had been contracting for 36 hours at home and had not had a lot of sleep at all. The consideration changed to "if I can see this through I will, if it goes on too long I know I will need help." Anyway it went to active labour about midnight after I furiously wiggled around on a birthing ball for some hours, then I spent the night drunk on entonox, then he was born at 9am.

oldebaglady Sun 20-Jan-13 18:57:13

well they do fob you off during contractions when you say all kindsa stuff, but in between contractions I would take it all back, so I'm glad the MWs knew the difference between the contraction talking and what I actually wanted and needed

wanderingcloud Sun 20-Jan-13 19:21:37

Best advice ever for a positive birth experience is to let go and realise you just CAN'T plan it.

I was never adverse to having an epidural with my DS1. I'd asked everyone I knew, done loads of research, read all the books and weighed it up and decided if I needed it in labour, I'd have it.

In the end I was in labour for all of about 3hrs. No time for an epidural, no need for gas and air or pethidine. Barely time for me to realise what was happening.

It's total pot luck. Unfortunately, all you can do is go along with things as happen.

Remember, giving birth is only a very short amount of time in the whole of the rest of your child's life!

I would, however, highly recommend Natal Hypnotherapy to help calm your worries about birth. It helped to chill me out no end in the final month of pregnancy. That and a great Aromatherapist. Good luck x

VivaLeBeaver Sun 20-Jan-13 19:36:10

Lexy, I don't watch obem but that doesn't sound exactly like what I'd call fobbing off, though I can appreciate if you're the woman been told that it might feel like it. There's only one anaesthetist on the ward so if someone else is having an epidural then anyone else will have to wait for the dr to finish the first person.

iamwhaticallpregnant Sun 20-Jan-13 19:54:35

thanks every1. just to clarify - its not my opinion that midwives fob u off when it comes to epidurals - just the very very strong opinion of one author.

oldebaglady Sun 20-Jan-13 20:09:34

what viva said, you can't just grab any old doctor from the hallway!

VivaLeBeaver Sun 20-Jan-13 20:28:23

Yes, I just didn't want you to think that all midwives would fob you off, as if you did you might ask for an epidural before you felt you needed one as you'd be expecting it to take a few hours from asking to getting one!

Though I suppose some midwives might. If I were you I'd tell the midwife right at the start that if and when you ask for an epidural it means that you really want one. Not that you want encouragement for another few hours. grin

LexyMa Sun 20-Jan-13 20:30:00

I get that. But what seemed to happen in that clip was that they didn't take her request at all seriously, and were saying 'ask later' - but she should have had the right to ask then, and get in the queue - how was she to know when 'later' was a convenient time to ask? I know they don't show everything on those programmes, so I guess it was written in her notes as 'first asked for epidural at xx:xx time' but they could have said any number of more positive, empowering things like "you're doing well, it may not feel like it but you are coping, try breathing through a few more" or something factual like how dilated she needed to be.

The point is it wasn't a straight answer

LexyMa Sun 20-Jan-13 20:31:42

aha - spectacular cross post! every situation is different.

iwillsleepagainsomeday Sun 20-Jan-13 20:31:53

i wanted one for dc1 and dc2 as was not in the uk so could have a walking epidural where you can still feel when to push. didn't get one as everybody too busy on other deliveries and/or emcs.

with dc3 now in uk didn't want one as i knew i could do it without but mainly because i did not want to increase the risk to have to go thru an assisted delivery.

Eletheomel Sun 20-Jan-13 20:55:28

Have to say, I was induced for my DS birth and they pushed for an epidural before they even started the synotcin, advising me it's more painful than normal labour, that i'll probably ask for one later anyway so better to get it in now.

I really didn't want one, but declined, but just wanted to point out that it's going to differ from each person, and because they may encourage one woman to stick through it without an epidural doesn't mean they'll take that approach with everyone.

If you genuinely want one, ask, and you don't need to ask at the beginning, but just beware if you do progress too far, then sometimes it is too late to get one (but by then, you've generally done the hard work anyway :-)

SoYo Sun 20-Jan-13 21:11:30

Pros
Excellent pain relief
Don't slow down labour if fitted after 4cm
Don't increase risk of CS
If not coping and things not progressing quickly then can stop you from completely loosing it and getting into a real state
If you need stitches afterwards it's more comfy than local

Cons
Some evidence that slow labour at less than 4cm
Can't always feel where to push depending on the density of the block
Increase risk of instrumental delivery
Increase risk of other intervention due to need for continuous fetal monitoring
Can't be instantly mobile afterwards and just hop into the bath
Will often need intermittently catheterising during labour as the bladder needs to be emptied every 4hrs(ish) and with an epidural in you often can't feel when you need to pee (the risk of the bladder overfilling is damage to it in later life so worth having)

At the end of the day, if you're progressing quickly and everything else has been normal and you're coping well you won't need one as you'll be able to see the light at the end of the tunnel! If you've already needed other interventions, progress is slow or it's just bloody agony then go for it. Only you will know if it's the right thing and you can only really make that decision at the time with the information you have then but at least now you're fully informed! You do need to be aware though that if you decide you want one you do join a queue! Most places have 1 or 2 anaesthetists and emergency theatre cases obviously come first, followed by those needing epidurals for medical reasons followed by maternal request and these are generally first come first served!

Hope that helps

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