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...

i had an epidural
pain wise, great, you feel the birth and doesn't hurt
now, most people is all they tell you but i'll go on

• there are risk, i had to have 2 dosis, and it has been consecuences to it, nothing major, but, consequences: back pain for a long time, difficulty breastfeeding due to the drugs, actually i could only mixed feed

-you'll need to be in bed with a drip and a cateter, not nice i can tell you, especially after the effects have worn off

• there are risks to the baby too, heartbeat dropping and so on, i had that and we nearly ended up on c-sec.
• really difficult to administer between strong contractions, and you ahve to be 4 cm dilated, takes about 15 min to admin, if succesful first time, most aren't, so you do the maths how many contractions you'll be in an difficult position unable to move.
• you'll have to stay longer in the hospital, they can't let you go until they know you have no damage to your spine, even if you feel perfectly fine
• could damage your spine, in rare cases, but another risk
• not to me, but my friend had one and they didn't let her hold her baby until 4 h after the birth, i put skin to skin inmediately as a condition to get one, not nice, not nice at all.

i know how close you are to labour and you must be wondering how it will be, just enjoy the end of your pregnancy, no matter how much you plan, what will be will be, i learnt that too late...

i think it is a medical decisssion, if they think you need one, they will say, they came to me to say, we think this is the best option, bla, bla.... it is not paracetamol.

I had an epidural with both dds, first time I was induced and after 2 nights without sleep and very painful contractions it was such a relief for the pain to go and to get some sleep. Dd1 was a forceps birth but she got stuck - we'll never know whether that was because I couldn't push effectively due to the epidural, then again I might have been too exhausted to push effectively without it.
With dd2 I was induced again, they offered me the epidural and said it would be better to do it before I went on the synt drip. dd2 ended up being born by emergency cs under GA but that was because the cord was round her neck, nothing to do with the epi.
Tbh I think the only thing you can do is see how you get on. You may be able to manage without, in which case, great, you may not in which case for many people they are very effective pain relief, although there are risks.

i am with picca, my laboour was 3 days long, i wiould have never been able to push without it, so the best choice in my circunstances, i would tell you to wait and see how you get on, but if you are anything like you can't...

Wouldliketoknow, a couple of other posters have mentioned the Obstetric Anaesthetists Association website www.oaa-anaes.ac.uk/assets/_managed/editor/File/Info%20for%20Mothers/EIC/2008_eic_english.pdf. This has got accurate and detailed information of the true risks and many of those that worry people are so vanishingly rare that you would never go out of your door if risks this small scared you. There is an awful lot of misinformation about epidurals - for instance they definitely don't cause caesareans. You are absolutely right to say there are risks but the alternative - which can sometimes be gut wrenching unendurable pain that can leave you traumatised and a mental wreck - is not without risks.

sorry, ushy i was just speaking about myself , i needed a second dose of epidural, they thought i had more than 3 hours till delivery, but the hb drop after 30 min, they don't know why, but it is possible too much opiaciums did it, anaestecist explanation for my case, she did say she was careful not to add certain drugs because delivery was close. a hiher percentage of labour with epi end up on c-sec that those on other pain relief, that is not a reason not to have one.

i didn't want to scare her, she reminds me of myself at that stage, people told me about epidurals they had, they just left out the not so nice bits, nice of them but not helping.

have to say i had an unusually challenging labour, and i did welcome the epidural even knowing all the risk and side effects, my point is it is a medical procedure not a lifestyle choice.

thanks for the link, i think information is the best you can have a this stage and decide for yourself depending on your circunstances.

I had one every time - loved them! But I never gave birth in the UK. The anaesthetist was always 2 mins away, so they gave a little dose and came back to check every 15 mins whether a top up was needed. That meant I could choose whether or not to let the epi wear off before stage 2. I had babies in 3 different countries, at clinics where there was no notion that not having pain relief was somehow better than having it, and the anaesthetist came straight in when you checked in to discuss your pain relief preference. (All the doctors I've dealt with also found it extraordinary that G&A was still administered in the UK.)

I wonder whether some of the problems cited are because the anaesthetist gives a massive dose then goes away for hours? My experience was of long labours, but which were not tiring as they weren't particularly painful, once I'd had the epidural. Not to mention that I was advised to have the epi every time to speed things up as I wasn't progressing well, and it did speed things up. I could always feel to push. I'd definitely have an epi another time.

2 of my friends have had specific negative experiences: one had spinal tap for a few days afterwards, and another had a reaction where you get prolonged (hours/days, not forever) severe pins and needles all over your body. I think these are very rare.

Wouldliketoknow - REALLY sorry I did not mean to cause !!! SORRY

don't worry ushy, i just wanted to clarify that epi does not cause c-sec, it is all complicated in labour, i was just happy to go home with a healthy baby, after a week in hospital, but hey, with a healthy baby.

romanarama- i am surprised that uk doctors are not up to date on painreleif

Trouble with anecdotes is there are so many variables with different women, from 1 labour to the next, and in different hospitals. It's hard to know what would've happened anyway, what was bad luck, etc., so you do need to read some hard data. It can work just fine, but obviously not every time for everyone. My own exp of the epidural itself was positive.

After much reading, my 'birth plan' (ha!) was for a water birth with optional gas/morphine, but this was rapidly rendered impossible by muddy waters and baby's heartrate repeatedly dropping throughout labour (turned out he had his cord round neck 3 times; if I'd known this, I'd've gone for an immediate elec CS, but that's another story?).

I agreed to an epidural 32hrs into a 39hr labour, when they put me on an oxytocin drip. Anaesthetist was great, got it right first time, was sensitive to fitting it around contractions, it worked, no weird after effects. Delivered DS without ventouse/forceps after very intensive 45mins pushing. Hardest work I've ever done in my life. I think I'd've ended up with a crash CS or at least forceps without it, as it let me sleep a little when first administered. After 2 nights w/out sleep I really doubt I'd've had the strength to deal with pushing PLUS pain. I could recognize the contractions, subtly but clearly, after a few promptings from MWs; in fact I could tell they were instructing me to push a bit too late and started following my own feelings instead. Was allowed immediate skin contact with baby after the birth (and resusc team callout?). They left the drip in for the many stitches; didn't feel a thing until the next day. Had an unwanted catheter but didn't feel it go in or out. Couldn't move lower half for several hours after drip removed but too tired to particularly want to anyway. Only negative was bi**hy nursing assistant who refused to believe I couldn't move and accused me of not cooperating when I couldn't lift my bum to be washed 2hrs after the drip was removed.

Whatever you decide, good luck!

I had to have an epidural with my first labour in preparation for an emergency section. My second delivery was vaginal and I had a epidural again. I was keen to have it and the hospital were keen for me to have it too in case I needed a section again. It worked brilliantly, slowed the labour down which allowed me to get some rest, I could still feel when to push and was up and about within 30 minutes of labour.

But it took two anaesthetists, a search for my first labour notes and over an hour to get the epidural in which was incredibly distressing and uncomfortable. Under any other circumstances I think they would have given up.

Having had a 'normal' delivery, if I have a 3rd I would be tempted to go without but not for any of the reasons I've stated, just to fully experience the labour. That said, as my midwife said "Having a painful birth doesn't make you a better mother". Do what feels right for you and, if you decide not to have one, don't chastise yourself if you change your mind on the day.

I have 2 DC; both times I had an epidural. My DS, who is my eldest, arrived after a long, painful labour. Had an epidural which only worked down one side, to accompany the hormone thing because my contractions were going nowhere but my waters had gone the morning before. I think I'm one of those women for whom things would have gone somewhat badly without intervention. DS's heartbeat dropped with every contraction and I ended up having a ventouse delivery, as they were worried about him. It turned out the cord was round his neck. My right leg was totally numb and limp (had to be strapped into the stirrups at the end), while my left was fine, but my abdomen was pure agony from the contractions. Mind you, I was numb all around my vagina - I didn't register until I was told later that I'd been given a local anaesthetic for my episiotomy and stitches. So that was okay.

Labour two, I had an epidural again due to fairly intense pain and no other options (due to unrelated medical issues). The worst bit was having it set up - the local didn't work the first time, and apparently that was the loudest DP has ever eard me scream. But once it was in, I could move my legs though they had slight pins and needles and a numb patch on my thigh, and I felt only the tightness of the contractions, not the pain. Had the hormone drip again to speed things along (my body seems to be utter shite at labour) but I pushed DD out with no other intervention. The only downside was that this time I could feel the entrance to my vagina, and therefore DD's large head crowning. Jesus Christ, ow. Still, the pain of that combined with slightly lessened pushing urges meant she came out slowly enough that I didn't tear.

So for myself at least, I would say that epidurals have been a positive. There are negative aspects, but then pethedine can make you feel horrendous, G&A can make you hyperventilate and/or not do much, and paracetamol won't do a huge amount for everyone. At the end of the day, every birth is different, and sometimes you have to play it by ear. As long as you walk away with a healthy baby, it doesn't matter how you delivered them.

I'm sorry to bring this up and this is not aimed at anyone in particular on this thread but...the issue of a cord being wrapped around the baby's neck has been brought up several times and I just wanted to say that I don't think this is necessarily an emergency situation. As far as I'm aware, 1/3 of babies are born with their cord around them and most times it is not dangerous, unless, perhaps, the cord is very short.

My son was born in a pool at home, with the cord wrapped around his neck. The midwives quickly unravelled it and there was no issue.

Apologies if I've misunderstood or offended anyone with this. I'm just failing to see how it might be an automatic reason for having an epidural.

Bearing in mind, of course, that anyone is entitled to have an epidural when they're in labour...I wouldn't begrudge it anyone but it might not be strictly necessary, is all I'm saying. I find some women will say 'I had to have an epidural', when that is not often the case. It is, surely, perfectly ok to say 'I chose to have an epidural'

To clear up some misconceptions (but probably not all), epidurals definitely cause a drop in the mother's blood pressure. They also are a cause of ineffective pushing (from lack of sensation) which leads to needing a ventouse or forceps delivery. They are not a cause of emergency c/s - if bubs comes out via the sunroof then he/she was always going to need that.

Occasionally we will suggest to mothers that for various reasons (medical history, past labours, current pregnancy eg large baby) they would be better off with an early epidural, mostly so it can be topped up in a hurry if required. So some women may well say they had to have an epidural.

Oh and cord round neck - this is often the case but it can be the cause for emergency c/s. If the cord is squeezed during contractions it makes the heart rate drop. If it recovers each time then fine, but if it goes too low or takes too long to recover then a c/s will be on the cards. A fair few of the c/s in labour I've been involved with recently have had cord compression signs and bubs has arrived with the cord round the neck a few times.

Re 1:10 failure rate - that's the often quoted rate for requiring a resite. It will be higher or lower depending on the experience of your anaesthetist!

three kids, three epidurals, fantastic each time

if the pain gets too much, ask for an epidural, there is o reason to suffer, even if it is not medically necessary.

I had a very good labour, just taking a couple of peracetamol and a bath before going to hospital and was shocked to be told I was fully dilated. I had g&a whilst pushing, although it took 2 3/4 hours, I wasn't in pain.
However, I couldn't deliver the placenta and got transferred to our nearest city, where I had a spinal. I had no feeling at all from the waist down, although the pushing/tugging took my breath away. It took quite a few hours to wear off, had a catheter inserted, and a drip point in one hand. It actually took 3 nurses to sit me up in bed - and I'm a bit of a skelf!
I intend to have another child if possible, and would prefer not to be numbed. I think I was very lucky with my labour/birth though, and as others have rightly pointed out, every experience is different. Good luck with yours lucybrad!

I've had one birth without an epidural, and one birth with one (four weeks ago). Epidural enabled me to have a great birth - I pushed out my 10lb 6oz baby slowly and calmly with no tears, not even a graze, and was up and wandering about after 8 hours (went home after 12 hours).

Move move move, walk around, sit on the toilet, kneel,squat, sit on a birth ball, use a pool and change position for each contraction...go for an active birth if you possibly can! An epidural will rule out all of these things. I would not consider it if things are progressing well. If not, maybe think again. Good luck.

Personal experience here.

Have 2 DCs. DS1 with epidural. Long labour. Still had a patch of pain, which went after they repositioned needle and topped up. Managed to push from remembering how it would feel to do a 'massive poo'. Stage 2 took an hour.

Felt todally spaced for 2 days, but of course that could have been due to sudden motherhood (DS1 born at 36 weeks)

DD2 - a swift labour. G&A only. And a massive urge to push. Stage 2 took 3 mins! Appara I was told to stop pushing, but I dont recall hearing that!

Felt fine and less drugged.

So depends on so many things, and how you're feeling in that moment.

If I were to have another child I wold still have an open mind about pain relief.

Does that help?