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.

[PenguinsHatchedAnEgg]

I had one with DD1. Bar life threatening emergency, never again (and indeed I haven't for no. 2 or 3). For me:

• It didn't bloody work. I mean, it didn't 'fail' (as they can), but there was still an internal nerve or something that was feeling sensation. At the end, despite being so numb I could feel nothing from the waist down, I was still in terrible pain and mainlining gas and air;

• I think the epidural, and being flat on my back, contributed to DD1 not turning from back to back and the resultant forceps. I couldn't let it wear off because the pain from being flat on my back with a back to back baby was so intense. It also meant I couldn't feel to push.

-Catheter. Nuff said

• That canula they have to put in your hand for the ivf. Itchy. Couldn't press down with that hand. Horrid.

• I have a 'minor scoliosis', so they had trouble getting it in and there were fountains of blood and a very queasy looking DH. Plus scared the shit out of me when no one bothered to explain what a scoliosis was.

-Took 12 hours to regain sensation in one leg. I missed breakfast ( you had to collect it from the trolley ). I couldn't go to the breastfeeding workshop (no one to help me). I nearly had to stay in overnight (cue inspirational music as I limped, dragging my dead leg behind me, to the showers and loo to pass the test of them being willing to discharge me instead of it being 'against advice').

With both subsequent pregnancies there were moments where the pain was so intense I can't even begin to articulate it, but at no moment did I ever feel that going there again was a good idea.

[ohthegoats]

I don't want to not be able to feel anything from my waist down.

I don't want to labour on my back on a bed.

I don't want to have to be told when to push.

I don't want an increased risk of an assisted birth.

I want to be in control of my body and try to listen to it as best I can.

I don't want a fuck off gigantic needle in my back.


That is the perfect explanation.

[ShineSmile]

I didn't have an epi, just used gas and air, but felt really off my head and really out of it. I really felt out of control, and this wasn't helpful because I didn't think of squatting or doing the things I thought that may help. To me it felt like gas and air prolonged the labour (I could be completely wrong of course). Would an epi make me feel the same way? (I've never drank alcohol or taken drugs - don't know if that is relevant)

[Deverethemuzzler]

I had an epidural for DC1
not for DCs 2, 4 & 5.

I would have if I really felt the need but I didn't for DC2.
Had DCs 4 & 5 at home so it wasn't available.

I don't think there is anything wrong with them but I wanted to avoid them unless I really needed one. Its like being induced. Nothing wrong with it if you want it but something I would avoid unless I had no choice.

Nothing to do with being a hippy or wanting to win at birth.
Personal choice.
Something hard won when it comes to childbirth.

[DinoSnores]

ohthegoats, I'm guessing from the way you've written that you've not actually given birth before.

I'd really suggest that you keep an open mind about pain relief, otherwise, if you do decide to have an epidural, you are just going to be very disappointed in yourself when you don't really need to be.

With an epidural, you often CAN feel below your waist, you often DON'T NEED to labour on your back (examples above of people who didn't), you often DON'T need to be told when to push, the risk of assisted birth might have nothing to do with the epidural itself but be a risk of bad positioning that meant you wanted the epidural for pain relief, you can still be in control of your body, and the needle isn't that big and doesn't stay in your back.

[ohthegoats]

I'll probably end up begging for one. Ah well.

[ImogenQuy]

I really didn't want a needle in my back - had a friend who had a terrible spinal headache after epidural, and I have a long history of back problems too. My birth plan basically said if I could do it on gas and air and water without complications, great, otherwise at the first hint of problems I wanted to go straight to CS. I was lucky: I spent most of my labour in the pool (MLU) and although I had a long second stage it was all straightforward and the pain never became unbearable. I actually found early labour the hardest bit (the part when the midwives laugh at you and tell you to come back later): it never got any more painful than that and getting into the pool really eased everything.

And, critically, I could go home without spending a night on the post-natal ward: I was more scared of that than I was of labour!

[CottonbudCatastrophe]

I didn't want one as I knew that forceps are more likely to be needed if there is an epidural, & I didnt want the necessary episiotomy that comes with. Didn't go my way though, & I had the epidural as I unfortunately had a bladder infection immediately prior to labour, so after 20 hours & not much progress, I gave in & asked for one. I had a pretty long labour & I think due to my inability to push properly, it was longer than it would have been, if I'd not had the epidural, IYSWIM, DD didn't breathe independently for several minutes after she came out.

[guineapig1]

Ohthegoats and the earlier poster you quoted, I entirely get what your saying and I honestly shared your view. However, it is a personal choice, epidurals have a time and a place.

Sometimes, as in my case and due to the positioning of the baby you reach a stage where your choices are either drip and epi (and tbf a good chance of an instrumental delivery) or an emcs. Again, its a personal thing for you, your dh and your medical team. Every case will vary according to the circumstances. Personally I was terrified of a csection (though would of course have gone that way if the medical team insisted as clearly getting the baby out safely is the priority with minimal damage to mum!), and the horror stories surrounding these and the possible implications in future pregnancies etc. I wanted to avoid a scar in my womb if poss.

So, for ME, an epi was the best of a bad lot but the recovery even from a kiellands forceps and episiotomy was I would imagine far quicker than for an emcs. Once again though its a personal choice.

In an ideal world we would all have sneeze births with a mere puff of g&a, but this doesn't happen. I honestly think you have to go with the flow so to speak.

Out of interest, of those of you who say "never" to an epidural what would you do if you reached 9cm on gas and air with a back to baby and the consultant either says, we'll try epidural and drip to get you fully dilated (with of course a risk of instrumental) or an emcs? Obviously there's the risk of an emcs after an epi anyway but how many would go with an epi if faced with that choice?

[orangepudding]

The first time I had one it worked on only one side, also my labour progressed very quickly so by the time the dr completed it I was ready to push.

Didn't seem worth the bother for the next two labours.

[ImogenQuy]

guineapig1, in that scenario I'd go for the EMCS. My personal order of preference went (1) straightforward natural delivery (2) ELCS (3) EMCS (4) instrumental delivery. I think it's much easier to recover from a CS than from Keillands forceps, and I was utterly petrified of being left incontinent if I had an instrumental delivery. But as you say it's personal - other people are more worried about major abdominal surgery.

[MrsCripps]

I had an epidural with DC1 bronya same reason
She had her hand in her mouth and was stuck . She had to be hauled out which required an epidural.

Interestingly I had a similar level of pain at the birth of DC2 ( no epidural) that I had with DC 1 after the epidural.

Both rapid labours and both EBF babies ( no issues)
If there had been no epidural available with DC1, I doubt I would have gone on to have DC2.

[ImogenQuy]

It may be relevant that I didn't plan to have any more children, so there were no risks for me in having scarring in my uterus.

[DinoSnores]

ohthegoats, if you do "end up begging for one", don't feel guilty about it. We make the best decisions based on things at the time. Hopefully you'll just sneeze and out pops a baby but if not, see how it goes, decide at the time, don't have any fixed ideas. Important thing is that at the end of it all, you are going to get a baby!

[herethereandeverywhere]

I had one and ended up with an instrumental delivery but this was NOT cause and effect. DD was back to back and got stuck trying to right herself. The pain was horrific and terrifying (no gaps between contractions). The epidural actually sped my labour up as I was no longer wracked with pain and fear. Frankly I'd have shot myself ahead of remaining without pain relief so a 'big fk off needle in my back' seemed like a very minor inconvenience by comparison.

I was very worried about the urge to push so I let it wear off.....stupidly as I STILL had no urge to push anyway as she was malpositioned so not pushing on the right bits. All that did was make me endure horrendous pain before the spinal block man came and prepped me for a CS in the event the forceps didn't work.

If you labour naturally with baby in optimum position and things progress as quickly as they should then I'm sure women can easily do without an epidural. Where labour is slow and or particularly painful an epidural can have a really positive and lasting effect on the mental wellbeing of the birthing woman.

[whereisshe]

I didn't want one because to have one would involve being in hospital, which I wanted to avoid. I get horrible white coat syndrome (verging on panic attacks sometimes) so I wanted to have my baby at home.

The hospital is only 5 minutes up the road so if anything went wrong I was ok with going in for a c-section but not for other interventions. As it turned out the pool plus g&a were enough and DD was a straightforward birth at home.

[Hakluyt]

I wanted very much to see whether I could manage without pain relief. I don't know why - it was just important to me.

[JaneParker]

I had one out of 5 births and the only one I felt it necessary. If you are managing without why go to all that hassle of being paralysed etc.?

It's more complex.
I am very into being natural. I have never even been on the pill. I eat paleo etc etc etc I adored the power and force of labour and birth and the pain in 4 of the 5 births was copable with so I was glad I did not have one.
They cost more, can lead to complications and use up NHS resources too.

[MrsCripps]

I didn't want an epidural but a stuck and distressed baby - gave me 2 options - epidural and instrumental delivery or EMCS.


I really don't think that women choose an epidural to just go with "all the hassle of being paralysed " unless they are in extreme and unrelenting pain or their child is at risk
Im into very natural but my DD would be dead if I had insisted upon it

[guineapig1]

Mrs Cripps, sounds like you had a similar experience to me! Like I said, in a perfect world all births would be quick and straightforward. That doesn't happen. I also agree with what herethereandeverywhere says about cause and effect with regard position of the baby.

[MrsCripps]

Gp1 - yes she was completely stuck and born with her fist in her mouth eventually !

DC2 was a doddle " shelling peas" springs to mind !

[PenguinsHatchedAnEgg]

I think the whole cause and effect can be complex. The reason I had an epidural was needing synto, which was probably itself caused by poor positioning. But once I was flat on my back with my waters broken, poor DD1 stood little chance of turning.

[clareyfarey]

after 32 hours in labour with no pain relief, I got to the point where I needed to take control of the situation!

I ended up having pethidine, codeine and gas and air. None of which worked.

At 39 hours I was given cytocin, and I was bloody shattered so had an epidural to help me cope.

Still didn't work and ended up having EMCS at 46 hours, but that's cos the brim of my cervix didn't efface so no deal on the pushing.

By that point, I didn't care what they did to me, and the needles etc didn't bother me in the slightest.

sorry for the horror story. can't believe it only happened 9 days ago!

[weebairn]

MrsCripps some women DO choose an epidural beforehand, write it in their birth plan etc, regardless of the length or intensity of the labour - a few of my friends did, most/all of them got it - nothing wrong with that either.

[weebairn]

I agree the cause and effect thing is complex.

I had a long but straightforward labour and they were dithering about whether I needed to be sped up. I think if anything had lengthened it things would not have remained straightforward. But that is just guessing...