Epidural - why wouldn't you?

[lbsjob87]

I started a thread on AIBU about pain relief in childbirth yesterday that led me to wonder something. Lots of women said they didn't have an epidural because the idea scared them so much, and I just wondered why?
I am 35 weeks with No 2 and am starting to think about a birth plan (although last time has taught me they are not worth it half the time, but anyway.....)
I'm aiming for a VBAC but may yet be advised to have an ELCS. If I do have a VBAC, I will take it as it comes, if it gets too much, I'll probably have an epidural. Last time, my DD was back to back and had shoulder dystosia and an epidural couldn't come quickly enough.
I know it's personal choice/circumstances but I wondered what frightened people about it? Is it the initial needles in the back, the loss of feeling in the legs or a fear of not being "in control" of the pushing?
Last time was a blur, tbh and I really don't remember much about it.
I'm not trying to scare myself, just wondering what others experiences are.

Why wouldn't I want an epidural?

Maybe because I don't want to dramatically increase my risk of having my vagina widened with a scapel, lenthen my labour time, or have my baby delivered by vontouse or forceps perhaps.

Gas and air was fine for me- plus I was able to walk out of the hospital and go home withing 3 hours of delivery.

Because I didn't want the risks associated with it.

I had a "patient controlled" epidural where I had a tube in connected to a button which, when I pressed it, released a small amount of painkiller into my spine. It was great. This was installed after I had been experiencing painful contractions for more than 48 hours and was at the limit of my endurance. I kept it at a level where I could feel the contractions and knew when to push but wasn't being overwhelmed with the pain. I wasn't on my back for the pushing stage, I was on my side with my DH supporting my upper leg. I would absolutely recommend it - but everyone's choice is going to be different and be what is appropriate for them.

There are risks with epidurals - if the needle slips or goes in wrong you can have permanent damage to your spine, so it's not a choice to be taken lightly.

I had 3 births without epidurals. I didn't want them for a variety of reasons.
With my 1st birth -I was a nurse at the same hospital, and nurses tend to be a tiny bit distrustful of medical procedures. We are aware that things can go wrong and doctors can make mistakes.
Births 2 and 3 were very fast - the 2nd I just made it into hospital in time, the 3rd was a booked home delivery.
I would probably have an epidural if I was going to have an elective CS, but only as the lesser of 2 evils.Never 'just' for pain relief though, it wasn't an option I considered.

Thanks guys, some interesting stories there (and some horrific ones......)

As I said, I do intend to take it as it comes, last time wasn't a fair comparison, but I agree with the poster who said that epidurals are bandied about as a bit of a wonder drug - one pop of this and you get pain free childbirth - so it's good to be a bit more informed.

Thanks.

Oh, and dontevenblink EXACTLY that.
My only real memory of the pain from before was when DD was pushing on my spine. It felt like someone was standing on my back trying to snap it. All the contractions did was remind me why I was there, they were nothing compared to the back pain.
I think at that moment, if someone had suggested a spine transplant instead I'd have taken it!

There was no anaesthetist available, so an epidural wasn't an option.

I wouldnt want one. I did it both times in the birth pool and its great. Doesnt hurt that much as the water helps you. Im not having needles in my back 2 girls I know have ongoing back problems from them and its ruined their 20s, its not for me.

Water birth not an option for me, unfortunately, melissa83 as they are only available at the MLU and as I had a CS last time, my trust will only let me on the main ward.
I'm fine with that, tbh, as last time, a few people including my MWtried to talk me into the birthing centre but I opted for hospital as it was 20 miles closer and I had a feeling I'd need it.
As it turned out, the switch to EMCS came very quickly as my DD was in major distress, and had I gone to the MLU, my midwife later admitted it could have turned out very differently.

Yes lbsjob87 I have never felt pain like that before, I couldn't even feel the contractions with the awful pain of it, I definitely think it put them into perspective and made them easier to deal with for dc2.
Yes I would have seriously considered a spine transplant at that point too if it had stopped that pain!

I've never actually spoken to anybody that has had that pain too, so its a relief to hear that it wasn't just me who found it excruciating (although I'm sad for you obviously) as my midwife told me to pull myself together and not be so dramatic... . Considering I had been quiet the whole of my 30 hour labour before you'd think she might have realised something was majorly wrong. She was very apologetic afterwards though...

ibs, I think taking it at it comes is a really good attitude to have. Of course epidurals increase the risk of other interventions, but they do have their place.
It is a very personal decision only to be made at the time IMO.
Good luck

Ibs does your unit have a shower? I found the hot water from a shower just amazing in birth I could direct it onto my back.

I was terrified of the needle into my spine and risk of paralysis (actually hugely reduced compared to the early 90s when I first read about that), and it can slow Labour further and trigger more intervention later.

I managed 12 hours of labour fine with TENS, kneeling on bean bags and then pool in the MLU, but after 5 hours they like you to get out of the pool as it can slow things down. I wrangled another 2 hours, but still nothing happening and then my SPD got so bad I couldn't sit, stand or kneel without screaming. An epidural was recommended and was wonderful - it wad a 38 hour labour and thankfully I didn't get the common post-epidural headache, though the day of shivers was weird.

Second time my body skipped straight to the SPD-screaming so was given epidural within 15 minutes of reaching hospital. It made my legs very floppy that time so couldn't even try kneeling to push, but in the circs very glad it was there.

No babies here yet but I would be scared because I know someone who has been on crutches for 15 years because of her epidural. Registered disabled and really struggles.

From NICE guideline for intrapartum care- "Modern epidural solutions contain opioids and, whatever the route of administration, all opioids cross the placenta and in larger doses (greater than 100 micrograms in total) may cause short-term respiratory depression in the baby and make the baby drowsy."

had 3 epidurals with 3 induced births...high risk because of medical problems...All went well. I'd recommend them!

My epidural was brilliant. Didn't feel the needle thanks to local anaesthetic. Had full sensation in my lower half (ie touch) and could move about - I just couldn't feel any pain. I could feel all contractions and also when they changed and when I needed to push. I laboured on all fours on the bed. I pushed him out in 4 contractions and could walk to the bath within 20 minutes of birth. Wonderful stuff! Only side effect was the shakes but no biggie.

Can I just state for the record that the needles does NOT go in to the spine?
It goes into the space between 2 spinous processes of your vertebrae and enters the epidural space through a membrane.
It is only when it is place incorrectly that things can go wrong.
sketch here

To me that's going into your spine.

Having an epidural with my first birth lead to a ventouse delivery which ruined my sex life. If I had known I wouldn't have had one and wouldn't recommend them to anybody. I told them to shove it in my other births, I'd rather do the pain than strapped to a bed like that again.

Fair enuff, beatingwings - just wanted to say it does not go in bone or spinal chord.

I think the same as beatingwings, it's like saying that a jab in the back of the shoulder isn't the same as a jab in the back.

I had a lovely epidural with DC3. It was nice and light so I could still move my legs around. I don't know if I would have been able to stand as I needed to stay in bed as there was a fetal scalp monitor on her head, but I could still feel the contractions, they just weren't painful anymore until the very end.

Her delivery was far easier, with no complications, and my recovery far quicker than with my home birth.

gamerchick, when I can see that you think that about your delivery (and I wasn't there so I can't say any better!), but studies suggest that epidurals probably don't lead to increased instrumental deliveries. It may be that more difficult positioning of the baby means that women are more likely to want epidural analgesia and that difficult positioning will then need an instrumental delivery.

I had one and it was great. I did have an instrumental delivery, but that was only because he had his hand stuck up by his head and every time I stopped pushing, he was pushing himself back in!