epidural - does it really cause complications? epidural vs waterbirth...

[Thirstysomething]

I have two choices -- waterbirth or epidural (choice btw two different places to give birth, so can't have both).

Had two waterbirths before -- if I have to go into proper hospital this time I am definitely asking for epidural... but I know there is some evidence that epidurals cause complications more often than not, eg forceps, ventouse, slowing down of labour, etc etc.... Is that true? What do you think?! Friends say epidurals best things ever.

They don't cause complications, but they do increase the likelihood of them or the need for further intervention.

For pain relief, mine really was lovely (midwife suggested it when I was going to be approximately another 12hrs on synto drip) but I had no urge to push and had a forceps delivery after 2 hours of pushing. I had an episiotomy which extended to a 3rd degree tear and had a retained placenta and minor PPH.

Intervention generally (not always) leads to further intervention, so epidural means a catheter and continuous monitoring and also increases your chance of needing forceps or ventouse. Forceps or ventouse mean you will most likely need an episiotomy (which then can extend into a serious tear) and also increases your chance of PPH and retained placenta, which happened in my case. I also had a synto drip before the epidural (and if I'd not had the drip, I wouldn't have had an epidural, so again, cascade of intervention!)

Some women have an epidural and no other intervention of course :)

Loved my epidural with DS1, made the whole thing bearable.

And actually I seemed to speed up once it was in place - before I had it, it took me 18 hours to get to 3cm dilated; after it was placed it was only(!) another 4-5 hours before I was fully dilated. Although I needed to be told when to push, I pushed without difficulty (15m pushing stage) and came out of it with a 2nd degree tear but no further intervention.

I think I was panicked before I had it, and fighting my body, but as soon as I had it I relaxed and my body got on with things.

Completely anecdotal of course and Flisspaps is absolutely right that, statistically, it is associated with further intervention. But that's not always the case (and I would hazard a very unscientific guess that if your body has gone through birth twice already, it's more likely to "remember" what it needs to do, epidural or otherwise).

I've had both epidural and waterbirth, and I would chose waterbirth over epi any day.

With the epidural I had to fight hard to get the midwife to accept my refusal of further interventions. She wanted to break my waters and put me on a drip to augment my contractions as soon as the epi was in place. It was, according to her, 'protocol'. . The epi only worked partially, so I was still in a lot of pain, yet sufficiently benumbed not to be able to be mobile or feel to push. I ended up labouring and pushing on my back. Even though I was able to move around on the bed, I ended up on my back needing the midwife's guidance when and how to push, because I couldn't feel enough to cope upright. I tore badly. I also had problems with balance due a numb leg for several days afterwards.

The waterbirth OTOH was relaxed and empowering. I could feel what was going on inside me, and was able to respond appropriately. I stayed upright, and chose not to push, so ds2 was born without damaging me at all.

I had an epidural as I wasn't progressing fast enough so I was advised to when they put the drip up. Before that I had been in the water and got to 9cm relatively comfortably.

Had my epidural, great pain relief however it gave me the shakes which was awful. I literally couldn't stop shaking which was annoying me and making me feel sick. I ended up with forceps and ventouse but I did have large baby.

I'm pregnant again now and will be avoiding an epidural at all costs!

If you've had 2 birth epidural-less already its unlikely you'd need it for the 3rd- they are usually just for 1st time mums

stuffedaubergine, I'm not sure about that... I just about got through waterbirth with DD2, but if I hadn't had the bath I would have been YELLING for an epidural, and technically it was actually my third labour. (sorry, lost second baby v late in pregnancy and gave birth with masses of pethidine - not something I want to experience again as made me feel totally sick and woozy).

i had a water birth with DS, i was in soooo much pain. Spoke to my consultant on friday as due DS2 in 4 weeks. He said as my body had done it before a second labour should be easier in terms of pushing and time taken (as in epidural shouldnt slow the labor down ) but the pain wouldnt be any less. So he recommended an epidural.

I asked about the increased risk of forceps etc but he thought the risk was low for a second birth.

So think i am going for the epidural.

When are you due? I can try an come back in 4 weeks and let you know if the epidural was a good idea.

I would be asking exactly what the rate of assisted birth forceps/ventouse was for women who have epidurals in whichever unit you're going to. Sounds like the consultant fobbed you off a bit tbh.

In our three nearest hospitals (big London teaching hosps) the epidural/intervention rate varies between 85% - 100% (obviously there are a few women in that 100% hospital who have epidurals but not forceps/ventouse, but they are so few as to be statistically insignificant).

I would say epidurals do cause interventions, because of the impact the drug has on the internal muscles used for turning/positioning the baby, as well as the ones used for pushing the baby out - it makes them floppy & much less effective. Not to mention the catheter, the increased chance of syntocinon, fetal scalp monitoring, post birth infection and so on. I've had 3 epidurals and two babies without - I'd go without every time, just because of the after effects and complications.

I had epidural as was induced on the drip which (I am told) is more painful than natural labour. I pushed the baby out with no need for forceps/ventouse/episiotomy but it did take me nearly an hour to push her out during which time they threatened me with the forceps if I didn't hurry up!!! I would have it again as it did kill the really unbearable pain. moojie I also was shaking a bit but it only lasted a short time I thought it was just nerves!! No back pain or bad after effects at all.

I had an epidural and it was great.

1st baby - overdue, worried about level of amniotic fluid, so was induced. Nothing worked until they upped the oxytocin. Contractions came on so hard I nearly passed out, blacked out, threw up. Reduced the oxytocin but was still in so much pain they gave me an epidural. MW kept the dosage low, it still effing hurt, but was bearable. Could still move around, walk etc, felt all contractions and gave birth with no further intervention. Didn't tear (although MW was busy with gel, massage and stretching to make sure I didn't). No side effects, and was able to walk to toilet by myself to pee a few hours later.

Actually, on reflection, I think my MW was bloody brilliant. She even finished her shift before I delivered but stayed on. When her colleague tried to send her home she laughed and said that this was her hobby so she was staying put. However, I live abroad and our hospital care works totally differently over here.

However, I think misssimac makes some valid points. I live abroad and the way the healthcare system works, means that I was essentially in a private hospital with at least one-on-one care at all times. I think that may have also had a huge impact on everything. There were plenty of staff and they had the time and resources to focus on me and what was needed at the time.

Whoops. Didn't edit that quite right. Should be in bed.......

I have epi first time, it stopped some (alot) of the pain but gave me back ache (which lasted months after). I tore badly and still felt the pushing stage. 2nd time no pain relief, no tears, felt pretty much normal (just tired) straight away. Water helped me 2nd time (was in bath right up to pushing stage)

Two epidurals here and no intervention on the second but a venteuse on the first due to being too tired to push any more.

My theory is that a lot of people have epidurals after labouring a long time and have become very tired and actually it's the tiredness that leads to the intervention rather than the epidural. That's a very simplistic explanation but I am sure it has a lot to do with it.

SantasNewToy - it also has a lot to do with the fact that most women who have had an epi will be pushing flat on their back or semi reclined - so not only is there a good chance they are exhausted, they are pushing against gravity and round the U bend!

My epidural was vile. I only accepted it because i was advised to go on syntocinon. First they had difficulty siting it and there were fountains of blood. Then, although it 'worked', due to DD1's position I was still in a lot of pain in my spine. So I couldn't move or feel my legs but my back still hurt a lot and I needed gas and air. I couldn't feel to push and ended up with forceps.

DD2 was a water birth at home. Best decision I have ever made.

Of course, mine is just one anecdote, but it's my two pence worth. I'd go for the MLU/home and water birth any day.

Secondtimelucky, yes that may be part of it too although more labour wards are offering mobile epidurals now so that you are able to move. Mine weren't mobile but not sure they worked completely as I was able to feel the contractions (I just wasn't in agony with them!) and knew when to push.

I actually think the best thing for helping cope with pain is being calm and having calming people around you. Being left on your own in a side ward is horrible .

Sorry, the last part of that point in someways supports the waterbirth / home birth as you always have someone with you and you are in anenvironment that you have chosen to make you feel comfortable.

Secondtimelucky That's exactly what happened with DD - and it's only now that I realise it having seen your post. The MW kept on and on about how DD needed to come round the bend but that she wasn't getting round - perhaps if they'd have got me into another position then she might have shifted. I did get up on my knees and leaned on the back of the bed for about a minute, but was in absolutely agony - they'd let it wear off to push but I just had one solid pain rather than a break between contractions, and no feeling of pressure or needing to push.

If they'd have given me the G&A and left me there for a bit longer, I wonder if a lot of the issues I had could have been avoided :(

SantasNewToy - I agree. Sadly mobile epidurals are still not that common, but I'd be interested in whether there are any stats on whether mobile epidurals reduce intervention rates. At a common sense level, I could see that maybe they would, but I don't know if anyone has ever collected the data.

Fliss - sorry to hear that. My back was so bad that there was no chance of getting upright at all - the epi was topped up to max. It's so hard to think how things might have turned out differently isn't it? I had to do a lot of preparation for doing it all again with DD2 (although it turns out I'm a bloody good pusher in the right circumstances. She shot out like a speeding bullet. If anything, it makes me more sad about DD1).

I have had four epidurals (mobile) and no interventions, ever. I think if your body has done it before the chances of forceps etc must be much lower?

I have read so many times how people did it without an epidural second time round and believe that's what made it easier. My guess is it would have been easier anyway.

Had waterbirth in the end... Just went with gut reaction and told DH to turn left out of our gate rather than right...
Half way through I obviously changed my mind! But too late... just had to grin (?!) and bear it.
With hindsight I am glad, yet again another massively painful but perfectly straightforward birth (6 hrs of awful contractions, thank god quicker pushing time this time though) in lovely calm MLU environment. and I was worried about the 'unknown' quantity for me of epidural. And now we have gorgeous healthy baby boy.
If i ever go through that again, sorry, but I am going to give epidural a try - labour is just Too Hard! You teally do forget how much it hurts... Have paid my dues in the natural birth world now, it is drugs all the way from here on if we have dc4!!!! Xx

Ps sorry for terrible post, exhausted typing on phone!!

Congratulations!

Epidural was fantastic for pain relief in an already very slow labour (24 hours to get to 4cm) up to the pushing stage where the level wasn't increased and it was no use whatsoever for pain relief. Did end up with episiotomy, forceps and extra short tear but baby does have a big head and so can't say epidural had anything to do with the end result. What I can say is that the epidural got me through the whole experience and I would without doubt have another one!

Whoops didn't read right down to the end! Congratulations and glad you're happy with your decision. I'm in awe of your bravery