Epidural - positive and negatives please

[lucybrad]

Hi All

I am currently pg 30 weeks, and previously had twins by elcs.

I am getting worried about labour now, but have been assured I can have an epidural if wanted.

Now I was wondering, if an epidural takes away all the pain, why doesnt everyone have one? I take paracetamol for a headache so why not get rid of the pain of this? Can anyone give me real life experience of the good and the bad points please...

lucybrad - I thought that was the case, it would be worth finding out for sure whether medically this would be considered your first birth as that does make a difference in my experience.
If it counts as your second, you'll barely have time to get your knickers off

lucybrad - I thought that was the case, it would be worth finding out for sure whether medically this would be considered your first birth as that does make a difference in my experience.
If it counts as your second, you'll barely have time to get your knickers off

Biggest positive for me was that it took the pain away without making me feel at all out of it and without clouding my memories of the birth (which is something people sometimes experience with opiates).

Mamatomamy - rest assured I'm under no illusions that an epidural is guaranteed, HOWEVER an epidural will be part of my birth plan. While I'm sure I can handle a birth without pain relief, I'm also pretty sure that I can handle a week in the jungle on a diet of bugs and leaves. But that doesn't mean I'm chomping at the bits to give it a go! :)

(I'm not entirely sure what "everyone" was doing in the late 70s btw but my mother was giving birth without pain medication and breast feeding...maybe that's why she felt like a martyr... and my brothers and nieces were all born in the 1990s/2000s)

I hope it goes well for you, exciting times :)
I shall never do it again and am a bit sad and a bit happy about that lol

To answer the OP in a nutshell: any invasive medical procedure carries with it some element of risk. If you read up the information on epidurals (there is a section on MN actually) you'll see that while it's very effective in blocking pain, it carries some risks, such as increasing the likelihood of instrumental delivery, which in turn, carries some risk to the baby. Unlike most situations, which affect only the person having the procedure, anything that you have done during pregnancy or labour is also going to affect the baby - so many mothers factor this into their thinking, when considering pain relief options, such as epidural, pethidine...

That's probably the most simple explanation of why many women plan to try to get through labour without certain types of drug.

Of course, the best laid plans can go wrong: I had to have a csection for one of mine, which meant having to have either a general anaesthetic, epidural or spinal. All of those carry some risk, but for that particular baby, a vaginal delivery carried a greater risk.

The comparison with taking a pill for a headache is a bit flawed, because if it's your headache, it only affect you. If that pill was going to affect the baby you were carrying, you'd probably view it slightly differently.

Having said that, many people would try to avoid medication for headaches, and would try other things to clear it first.

Bottom line is - it's weighing up the advantages and the disadvantages and coming to your own decision.

The cultural norms of different countries are interesting too - in some parts of the world it would be absolutely standard to be given an epidural, even with no medical need, whereas in other countries it would be unheard of. I find that fact in itself quite informative, ie: there is no 'set' level of pain which means that an individual 'needs' an epidural. A lot of it will be about the culture you live in, along with your own particular pain threshold, and your own views on the pain relief options.

I had a low level epidural first due to problems, this was ok as didn't feel completely numb and could still kind of feel contractions etc. But when they had to up it to a full CS level one (thought might need EMCS but forceps did it) I didn't like that. COuldn't move below my boob level.

Had a weird labour: got to 8 cms no problem then was admitted to hospital and put on monitor and messed with (baby was a bit prem) and it screwed up my labour. After 12 hours of strong, regular contractions was examined again and was.... 9 cms.

Bugger.

Had ARM.

Contractions vastly more painful.

2 hours later.... still 9 cm.

They put me on synto drip, contractions agonising, I thought 'sod this for a laugh' and had 'light' epidural (as was described to me, did not care).

Was brilliant!

Could move legs though not walk; could feel contractions as tightenings though no pain; my labour SPEEDED UP (according to midwife who was watching monitor). Had fabulous, realxed, speedy delivery when eventually bloody got to 10 cms (another 2 hours later.) Had a doula with me who had never seen epidural before but who has subsequently said she now sees point of them and was very impressed.

Downer: got left with numb patch on thigh. This is now starting to fade after 6 months. May not go completely though. Oh also had extreme shakes as espidural wore off but did not care as had gorgeous divine beautiful baby to take mind off.

violethill you're right that some cultures epidurals are more common than others.

I have yet to encounter any research that shows babies born in cultures where epidural is common suffer any more than babies born in cultures where epidurals are not.
If you know of any such research please do share.

I didn't suggest there was any such research transatlantic. And apart from anything else, what would be the purpose of making comparisons between cultures about b just one aspect of giving birth? It would be invalid. It's like taking the US, where epidurals are routinely given, without medical need, and comparing the outcomes for babies in a third world country where epidurals aren't available, but antenatal care isn't as sophisticated as in the States.

I was just making the point that the cultural 'norm' of the environment in which you're giving birth will be part of your decision making. Epidurals are not routinely given in the UK. I believe the rate is for about 50% of first births, and 33% of births overall. It's not the case that most women have them; therefore, a woman is more likely to not opt for it than she would be if she lived in the US. Of course, you then have to go down in decreasing circles and look at the stats for individual hospitals: some have vastly higher rates of natural birth than others. So again, that may influence the woman. If the doctors see epidural as pretty much the norm in their work environment, they are more likely to suggest/offer it.

My overall point is that there is no universal 'standard' for when an epidural is 'needed', as it were. The OP was asking why all women don't opt for one, as they usually block the pain very effectively, and I think a major part of the reason is that in the UK it isn't a standard procedure, so many women will weigh up the pros and cons and try to do without.

P.S the pregnancy section on MN goes summarises the pros and cons or various pain relief very concisely. If the OP has a read, it may go some way to explaining why a lot of women try to avoid the heavy duty pain relief options.

It's so interesting to me how strongly people feel about pain relief in labour, one way or the other! I do agree that since epidurals aren't routinely given in the UK, women manage without them more frequently, as you would expect. However, having given birth in both the US and the UK, I think there's an expectation here to have a natural birth and a stigma associated with having an epidural.

I had a planned cs with DC1 due to her having a medical condition. Had a VBAC for DC2 with epidural and thought it was the best thing ever. However, my labour was quick and I didn't have it until 8cm. ANd it was fab! Could think clearly, chat with my dh, and had no complications. I couldn't feel the contractions strongly enough to know when to push, but was being monitored due to vbac and was told when to. Really great experience. I think the problem with the epidural that needs to be taken into account is that many women don't go for it until they are already experiencing issues- long labour, failure to make progress, etc and need the epidural to keep going. Or they get it too early and labour slows too much for them. When it's right, though, it is fantastic!

BTW, DC3 was natural- no pain relief at all- and while that was fine, it doesn't compare with a good epidural experience.

I had one when things got too much (although was warned I would need one due to the particular circumstances of the birth) and it was fantastic as I was almost unconcious with pain at that point (in fact I had to wait too long for it which I am still unhappy about). It also meant that my body suddenly relaxed, I actually slept a little, and I dilated very quickly and was very calm.

It was also tricky to site as I have scoliosis and was a bit patchy (had to be topped up a lot) and I felt I couldn't properly push (but I did manage to). My recovery was super quick too.

My thoughts now are that they are a very important part of your pain relief arsenal... and I wouldn't have been able to carry on otherwise.

Next time I will try and do the same thing and go without it for as long as possible with the hope of a natural birth (but if it gets too much will have no qualms in having one again).

I had an epidural, first time mum and initially I did NOT want one. However when the time came I had been labouring for 14 hours and couldnt take it any more. I had the epidural and wished I had it sooner!

Almost instantly I felt sooooo much better! I did end up having an ECS but that was due to my DS's heart-rate dropping. And if I'm honest I was really pleased to get him out and finally meet the little fella.

I'd def have one again!!

I had an epidural when induced. The great thing was that the pains vanished once the dosage was found. The negatives were that I wasn't able to feel the contractions anymore (but as I was monitored the MV were telling me when to push (i ended up having an emcs anyway). Also DS had to be rushed to ICU and therefore I wasn't able to go and see him because o the epidural (but that's more a personal reason).

If I was to have another child, I'll probably have one again if I choose the VBAC option.

PS: Get lots of prunes for after as it may create a bit of constipation (tmi)

Hi there
This is a link to an information card from the Obstetric Anaesthetists Association about epidurals- i.e. the doctors who actually put epidurals in, all about the advantages, disadvantages and risks:
www.oaa-anaes.ac.uk/assets/_managed/editor/File/Info%20for%20Mothers/EIC/2008_eic_english.pdf
The website also has lots of other leaflets about pain relief in labour, caesarian sections and other information for mothers.
It is all written by doctors, so will be factual.
Hope that is some help
Liz

I had a mobile epidural and it was absolutely fantastic. No after effects whatsoever, very slight scratch when they put in the local anaesthetic, otherwise totally pain free having it put in (although by that time I wouldn't have been worried about the epidural hurting as every contraction made me feel like I was about to split in two.....), and I could move my legs etc. I only had it because I was being induced and the pain became unmanageable from all the induction drugs, but if I had another child I would have one regardless - great stuff! Plus, I ended up with a crash section so it was extremely handy that the epidural was already in place, and I knew it was working, which made me less worried about feeling pain whilst they did the section, which I didn't.

I think it is also important to remember that unendurable pain is not risk free - you can get flashbacks, nightmares not be able to bond with the baby etc. (There is a lot of research on this so it is not anecdotal). Speaking personally, I have had a birth with an epidural (lovely, peaceful, perfect) and a birth without one that ended with complications without any epidural - horrific beyond words. I certainly regretted not having an epidural for both but we are all different so I guess it is a matter of going with what feels right for you. Good luck whatever you decide:)

I've had one with, one without. Epidural was such a relief with first as labour was taking too long, but then DS1 got stuck and ended with forceps.

Without was much quicker, I had meptid instead which got me through. It hurt and the last bit where the head crowned felt shockingly weird, but the recovery after was amazing compared to after the epidural. No catheter, no 12 hour paralysis, no blood clot socks...

I had WONDERFUL experience with my epidural.

It actually sped my labour up as I had stalled (Midwife thought my body was able relax more once the pain went). Baby was born one hour later.

I had no intervention and could feel enough to push my DD out. I could walk around afterwards.

All in all, I am adamant that the epidural contributed to me having a fantastic birth experience. I actually enjoyed it and was so happy afterwards and not so completely exhausted and traumatised that I could actually enjoy being with my baby.

If I hadn't had one I would have been in labour for so much longer (it took me 24 hours to get to 4cm and after the epidural 45 mins to get to 10cm!).

I really don't understand why people resist them to be honest, especially for first labour.

Sorry, just realised my maths is wrong. Baby was born 1.5 hours after epidural.

I HAD to have one - I was induced and after 30 hours of half arsed labour which got me to a stunning 4cm dilated they had to whack up the syntocin drip (sp?) to maximum to get things moving properly. They said that in these circumstances they would always provide an epidural because, although contractions are bad enough when they are natural, induced ones can be excruciating - beyond what the body is designed to handle and I would need all the help I could get (paraphrasing here).

Thank god I did - it made the final 12 hours of labour tolerable. I started off with a small dose and also had gas and air. They kept topping it up as I needed it, until I was numb from chest down, but I know that this was for the best.

The baby was born at 3.30am and I had feeling back in my legs enough to walk to the loo (albeit decidedly shakily) by 8.30am.

I was unable to push him out because I couldn't feel what I was doing so he was eventually delivered by forceps. Mind you, the baby's cord was wrapped round his neck and his head was in a slightly awkward position so it may not have been due to the epidural affecting my ability to push.

i had a mobile epidural, not all hospitals offer them, i was dead agaist one vut it was fab, i had a mw with me for the rest of the labour, i could top it up when i wanted to, even on highest top up i could feel when it was time to push, i could feel pressure of contraction but not the pain, i couldnt weight bare but could still move my legs, i was standing up within 45 mins of birth and back on ward within the hour, got my legs in stirrups and my biggest fear was them damaging a dodgy hip i have but weirdly when they opened legs i knew how far was far enough before it started to hurt!! not the natural birth i wanted but was a fantastic experience!

I had one for my 2nd birth and it was amazing and made to birth totally enjoyable..less stressful for me, hubby and baby. Im totally for them...altho....I do suffer from backache a bit since and ds is now 4.