Considering an epidural this time round

[terf]

Am 38 weeks and been thinking this round and round. Last time I had to be induced due to medical reasons but I wanted to go au naturel - had hypnobirthing, a doula, did lots of prenatal yoga beforehand - the lot. And I did it. But - and it's a big but - it was agony! I was hypercontracting and it took all night of agony to push the baby out. And the pushing - God I remember the pain of pushing her out. Ended up getting 2nd degree quite extensive tearing that took an hour and a half to stitch up. Initially the local anaesthetic didn't work and I could feel the needle - they actually ended up having to strap me into stirrups. The doula said that was the first time she'd seen that being done to anyone.

So here I am considering possibly getting an epidural but - and again this is a big but - I don't want the labour to end up getting complicated. I know, as it has been drummed into me, as soon as you start messing with labour it increases the chances of further intervention.
Anyone have any thoughts? Thanks

I had epidural twice and it was great. Usually they will only give it to you when the labour is well established (hence less chances of it stopping) and they cut it off/down for the pushing stage so you can actually feel what you're doing (but with less pain). Both my births pretty straightforward, no complications. With DD I had the epidural literally at the last possible moment and the relief was amazing. I went from writhing on the bed, screaming and trying to break DP's hand to laying happily and chatting with him. If you're set to give birth in a reputable hospital, I would go for epidural if you get to the point where you need it.

I think that labour is sopposed to be more painful if you are induced and 2nd labours are often quicker - so if you are not induced it may not be so much of an issue - I would in your circumstances be somewhere where you can get one if you need one - you may not
I did have an epidural with my 1st and ended up with an EMCS - couldn't feel to push - had a VBAC 2nd time round and didn't have one - but everyone's experience is different and every labour is different too
i would also consider some kind of debreif from your previous labour as it sounds pretty bad - most hosptials will go through your note with you in some detail and it can be quite healing

I'm under obstetrician care this time and my Dr loves epidurals. She had both her children delivered with epidurals and doesn't understand why women put themselves through so much pain. She said modern epidurals apparently don't prolong labour. I think I'll have the option in my back pocket. This time round I think I'm more chilled out about things. If I can manage then I will do so without resorting to having an epi.

I had an epidural for first child. I didn't want one originally, but I was stuck at 9 cm for 4 hours; they gave it to me and after 10 minutes I was ready to push. it was great.

I have had 2 naturals and then an epidural for an emergency cs for a breach and then had my fourth naturally.So my advice would be just wait and see how it goes and ask for one if you think you need it.
The epidural was certainly pain free but it was only because I needed it.
It is true 2nd births in general tend to be much quicker and certainly was for me.It will be over before you know it with any luck!

I'm not having an opinion on epidurals, but I'd love to see research about whether they (still) prolong labour or not.

I second peacemoon and see how it goes. Second labours can be totally different.

I had an epidural with my 1st, and it was AMAZING, I had been in labour for a long long time and my contractions weren't getting us anywhere, so I couldn't have managed without it. However I ended up with ventouse and forceps, and the fact I couldn't feel where to push I don't think helped (but they had topped it up just as I got to fully dilated, so that was probably silly!).

Because of the forceps, I was determined to try and have my 2nd without an epidural. My birth experience with DS2 was totally different to DS1, I only had 45 mins where I couldn't manage just with breathing, and the pushing stage was only 5 minutes (11 minutes official established labour vs 28 hours with DS1!). I did regret not having an epidural when it came to pushing, but when it was over I was glad not to have done (great to shower straight away and generally feel OK).

But the thing that really helped was knowing I could have an epidural at any time I wanted - with DS1 I had to wait 2 hours after requesting (begging!) for it, whereas with DS2 the midwife said I could have one as soon as I wanted it (maybe she was lying, but hey ho I believed her!) which meant I could get through it one contraction at a time.

Good luck whatever you decide!

If you have a low enough dose epidural you can shower straight away - I did with no. 3 which was the perfect dosage - I was sitting upright throughout labour on a ball and could feel a bit but not in great pain.

I have had four epidurals. My rationale is that my body knows what it's doing by now, so it's unlikely to be too fazed by an epidural. Also, having had a very quick and shocking labour in which the epidural didn't work, I would personally prefer a longer, less painful one!

oh yes sorry, on the showering thing, with DS1 my epidural was taken to the max because they were about to possibly c-section (venteuse was last chance saloon) so my experience after not the same as if you have a lower dose

Do it! My first delivery was in a birthing pool and the pain was excruciating. The second time around, i had to be induced and had an epidural sited even before contractions started. I slept through much of the labour, got topped up every time I asked, and despite a top up just minutes before starting to push, I got on my knees as I had wanted to, pushed for only two minutes and the baby was out. Pushing was totally pain free. I would definitely recommend it to a friend! Yes my labour was longer, but I spent it either sleeping, chatting with DH or listening to music. The difference with my first labour was like day and night. My recovery was also much quicker, I was immediately up and running and felt alert.

Hiya, I have had x2 natural births and x2 with an epidural and all were so so different.

I do have to say though that inductions are more painful (especially if they break your water) as firstly your body doesn't get the chance to get used to the gradual progression of contractions and especially as you are often linked to a drip which helps to mechanically make contractions more effective.

I have been a birth doula for quite a few years now and from my experience it is always best to go in with an open mind... see how you cope with a natural labour but if you cant and would like some pain refief then go for it. At the end of the day as long as the outcome is a happy and healthy mum and baby it doesn't matter how it happened.

If you would like more info on any aspect of labour or tips to make the 1st and 2nd stages of labour more effective naturally, please feel free to get in touch. [email protected] www.northlondondoulas.co.uk

Good luck and congrats.x

Thanks everyone. Doesn't make the choice easy. Victoria I had a doula with my first birth and she was so against having an epidural which is why I persisted without one. I do think that my fast postnatal recovery was due to this and oddly many midwives came over and congratulated me for having a straight vaginal delivery. It was so odd but later in the ward all the ladies recovering were paid a visit by the anaesthetist - I think I must've been one of the few that didn't have one. This was at Chelsea and Westminster hospital. I don't have any desire to be any kind of hero during labour - just want it to be an experience that I can look back on with some kind of fondness. I delivered my daughter two years ago and I'm still likely to remember labour as a bit traumatic. I do think though that there's no way to avoid pain during it. I'm just going to have to see how I go.

Sorry I haven't read the rest of the thread so apologies. But there are a couple of things...

Firstly, messing with labour doesn't necessarily lead to intervention. It's just as likely that those labours which end up being long, drawn out and extremely painful are always going to require intervention anyway - a case of the epidural being another inteverntion rather than causing the other interventions.

My epidural saved my life - I'd been in labour for 27 hours, contracting every 60 secs, but with zero dilation. I don't think i would have made it if I hadn't had that pain relief.

Having said that, I went into my labour with an open mind, ready to "do" childbirth with as little pain relief that I could get by with. Turns out I needed a lot, but a different person and different pregnancy needs less.

Instead of making the decision now, why don't you go into labour with your eyes open - you know what happened last time, you know what pain level you want to avoid, so you will certainly be able to judge what pain relief you need. Your labour may be much harder this time, and you may feel you need the epidural. On the flip side, it could be much easier in which case you may regret getting the epidural unnecessarily.

HTH!

I was determined to have an epidural for dc2 but she was born 15mins after arriving at the hospital so there wasn't time.Dc1 was back to back and the pain was so bad that when I was in labour with dc2 i thought it was just Braxton Hicks.You may be in for a nice surprise.

I think it is fantastic that you did manage a natural labour, i know that they are not easy in the slightest and the pain of my first was indescribable! I have to say i have been lucky and regardless of having an epidural or not, i had no intervention with any of them and had quick recovery afterwards - but i 100% put it down to the herbal extracts i take in late pregnancy. With regards to your Doula... i think its great that she helped you to stick with your origional wish of a natural labour, however i have to say that i dont like the sound of the way she was sooo anti pain refief that you felt that you couldnt have any! A Doula should be supportive of the parents wishes and feelings and pain levels and not impress their own opinions on a couple, as it is YOUR birthing experience and one that you will remember forever and hopefully in a good way! i really do hope that whatever you choose it is a wonderful occasion for you and your family.
Victoria.x

i had the 8cm rule with DS2

try and do it on gas for as long as possible, and keep moving
when you can bear it, see how dilated you are . 7cm plus, then hang on in there as baby nearly there
less than 7cm, go for an epi

i was 8cm and then he came half an hour later

HTH xx

"It's just as likely that those labours which end up being long, drawn out and extremely painful are always going to require intervention anyway - a case of the epidural being another inteverntion rather than causing the other interventions."

I find this a bit difficult to get my head around. Some labours are going to be much, much, much longer than others - usually because of the way the baby is presenting. In the long distant past these mothers would have been beefed up with chicken soup and brandy, and just encouraged to keep going. Most of them would have gone on to deliver without help. When you read the birth stories from The Farm you see a good number of women progress like this and go on to deliver naturally.

But in our system of maternity care women generally aren't 'allowed' to labour that long - we have a partogram and if your labour doesn't conform to the expected pattern you're going to end up with syntocinon/ARM/continuous fetal monitoring - all of which can make an operative/instrumental birth more of a likelihood. And almost all women having long labours will end up opting for an epidural - at least if they're labouring in hospital. In other words, there's no control group of women having untypically long labours who don't have syntocinon and/or an epidural to compare with. Hence impossible to say with confidence what the relationship is between the interventions and the outcomes. What we don't know is that low risk women who have restricted access to epidurals (ie, those who have opted to labour at home) who as group are surely just as likely to have long, difficult labours as low risk mothers in hospital, are about half as likely to end up with an operative or assisted birth.

I had two colossally long labours (by which I mean that the ACTIVE part of the labour was very, very long - not just the latent stage. With my third I had over 12 hours stuck at 8cm), one with an epidural and one without. I do wonder whether my third birth would have ended up as a 'failure to progress' c/s or forceps had I not been cared for throughout by an independent midwife who wasn't under pressure to accelerate the labour artificially fairly early on in the process.

"What we don't know is that low risk women" - whoops, meant, 'what we know'.

I had an epidural and thought it was great. I was given it at 4cm dilated, slept for a few hours, then dilated at the (I think usual) 1 cm per hour after the sleep. Yes, it's harder to push with an epidural, but you can do it, especially if you are prepared for it / think hard about it. As others have said you can tone down / not top up the epidural for the pushing stage. My baby did need the help of a ventouse at the end - I don't know if the reason for this was the epidural making pushing less effective or whether I would have needed help anyway. I thought overall the epidural made my experience of birth better and more manageable.