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.

[guineapig1]

Mrs Cripps glad to hear that your dc2 was much easier. We are currently ttc#2 so hoping for a similar experience to yours

On a separate note, one reason frequently given for refusing an epidural is wanting a "natural birth". That's fine as long as the delivery is straightforward. Where its not a straightforward situation medicine can and does intervene. The way I look at it is that We are lucky to live in a time and a place where if you have been in labour a long time and thing are starting to go a bit pearshaped there are options available. All well and good wanting natural but where there is a danger to the baby and or you you either take the intevention (subject to its risks) or risk it naturally. When it comes to the line, I suspect most would choose intervention. Similarly, in terms of pain thresholds and experiences this is a very personal thing and we are luck to have choices and usually to be able to make informed decisions.

All well and good wanting "strictly natural" and I am generally pro natural myself but remember when the options we are talking about didn't exist and everyone had a " natural birth" there were far higher mortality levels both for babies and mothers.

[wispaxmas]

I've got "give me an epidural" practically written into my birth plan

I mean unless I show up already in transition, which would only happen if for me the pain isn't bad.

And I know it'll be a patient controlled mobile epidural, so with help I should be able to adopt better positions for labour and birth than lying on my back.

[PenguinsHatchedAnEgg]

Wispa - Is mobile available in your hospital? ?I wish it had been for me. It was full epidural or nothing. Do bear in mind though that things like the monitor and the canula can limit how mobile you can be, even if your legs are physically able IYSWIM.

[waterlego6064]

I wasn't frightened of it, but was keen to avoid it. Like a couple of others have said- I wanted to feel the full experience. I was lucky to get my wish, I had 2 quick and straighforward labours. In the first one, I had a couple of paracetamol and a couple of tokes on G&A towards the end. With DC2, I didn't need any drugs. I feel very lucky to have had those experiences, and to have been able to fully experience the pain. I know some people think that's martyrdom, but it isn't. I don't know how to explain it really, but I think some women feel that curiousity and others don't. Either is fine, of course.

[MrsCripps]

GP1 DC 2 practically fell out and was 9lb 5 oz !

Yes weebairn and I respect their choices .

[TortoiseUpATreeAgain]

I didn't want to first time because my mother had one and it only worked on half her body, which she said was worse than before she got the epidural because it was painful AND freaky. Also I wanted to stay mobile and didn't like the idea of being catheterised.

I didn't want to second or third time because I had one first time, and it took two doctors an entire hour to get it in. So that was an hour of contractions where I had to lie curled up and motionless as people jabbed needles in the general direction of my spine, attached to a syntocinon drip, while (it transpited immediately they'd got the sodding thing in) I dilated from 5cm to 10cm so was going through transition. So once it was in we had to wait around for it to wear off so that I could push. Apparently my epidural cavity isn't in the normal place, so I had approximately zero confidence that I wouldn't have exactly the same problem again in subsequent births if opting for an epidural.

DC2 and DC3 were both quick and easy VBACs with just TENS and a bit of gas & air at transition, as it happens.

[TortoiseUpATreeAgain]

And what PenguinsHatchedAnEgg said, except definitely caused by poor positioning in my case.

[Hazchem]

guineapig1 While I understand what you are saying about natural being the only choice previously it doesn't mean medical is always safer. Mortality rates for birthing women in the US are rising. The medicalization isn't prevent those deaths.

For me it's a bit like antibiotics - amazing and great that they are here and so useful when needed but that doesn't mean I shouldn't try to stop getting bacterial infections by washing my hand.

[Bumpsadaisie]

I had an epi with my eldest - early induction so it was quite full on and I couldn't cope. The actual putting it in wasn't pleasant (trying to keep still through big contractions) but it was OK. The whole thing went on for ages, pushing for nearly 3 hrs, in the end she needed a couple of pulls with the forceps. I was on my back the whole time and she was a bit stuck.

It was an OK experience and I really trusted the midwives and felt comfortable, but I didn't feel chuffed or exhilarated about it after, more like DD and I had survived it in the end (it was a three day process all told).

The birth of my second was quite different. Spontaneous start, water birth, upright rocking in the water the whole time, very quick pushing stage on birthing stool, 6 hours from established labour to birth. Of course it hurt but I felt really strong and confident. I look back and feel really proud of that birth and I felt exhilarated afterwards about it.

So I would say epis are fine if you need one, but if you can manage without you might have a better experience in the end with less intervention.

[wispaxmas]

Penguin, yes, they do mobile! I was thrilled to find out . As for the monitor and everything, I'm happy so long as they'll let me push as I'm kneeling on the bed proper up against the raised head of the bed with pillows. I'm not so fussed about walking around, just want to be able to (awkwardly) change positions now and then. Also, as they're patient controlled I should be able to taper it off if I feel I can handle it and still feel the urge to push. FX anyways.

[PenguinsHatchedAnEgg]

Sounds like a realistic starting plan and hope it goes the way you want

[ToffeeMoon]

Wow, there have been some really unpleasant, judgemental, ignorant things written on this thread. It has gone exactly as I knew it would when I first spotted the OP. People with no experience of epidural piling in to spout some ill-informed anecdote.

Loads of women choose epidural. It is very safe. They are normal mothers like you who want the best for themselves and their babies. It is lovely to give birth in control and without pain. It doesn't affect your baby and you do know when to push. If done well, you can feel the pressure of the contraction or you can watch the monitor to see when the peak is coming.

It's A Good Thing.

If you don't want one, don't have one. No need to get all bent out of shape over another women's choice. You are not better than her. We are incredible fortunate, all of us, to live in a country where we do not have to suffer in childbirth if we don't want to.

[PenguinsHatchedAnEgg]

Toffee - I see where you are coming from and agree that it is great we have choice. But your account is one-sided too. I wasn't in control. I wasn't without pain. I didn't know when to push. None of those things were my 'fault' or an epidural done badly, just the way the chips fall sometimes and the reason I would try never to have one again.

[AltogetherAndrews]

I didn't want one second time around, having had a bad reaction to the first time. Whatever is in the medication made me spasm and shake really badly, so much so that I couldn't hold Ds until they had injected me with something to stop it.

I also found it scary - I was in intense pain, utter exhaustion, and someone harassed turned up and explained that this could leave me paralysed for life, and then insisted that I sit absolutely still whilst in the middle of horrific pain. Not for me.

[Aleksandra034]

With DD I had an epidural. It worked like a dream for about 2 hours, no pain, I had a sleep and a rest, something to eat. Then, the tube somehow fell out of its place (not the needle itself, but the tube that connected to it). No one realised until I started asking why I was in so much pain again and my husband (!!) noticed a puddle under the bed, where the epidural had been leaking for a while (this is not a joke - this really happened, at the Women's Hospital in Liverpool, where we lived at the time). They couldn't reconnect the epidural or more precisely they said that the baby had by then moved further down and the epidural needed a different place of insertion etc. I proceeded for the next 12 hours without it, and it was a hard and extremely painful labour. In the end I gave birth naturally and without stitches, but had to have catheter as I couldn't wee (from the epidural - it sometimes happens). The pain of having a bursting bladder and being unable to push wee out was tremendous. It took me weeks to recover from the birth, I felt like I had been in 10 rounds with Mike Tyson and I even felt a bit traumatised.

With DS I had a quicker, natural birth with no pain relief. I didn't have any problems afterwards and found the whole experience to be mesmerising.

If I have any more children, I would be scared to go for an epidural in case it slows things down and causes further complications, as in my first birth. But - never say never, as you just don't know how you'll feel on the day. And I'd never judge anyone for having it, you just do whatever feels right for yourself.

[Tranquilitybaby]

Because of the intervention (forceps/ventouse/episiotomy/c section) that ends up being needed in many cases (upto 50%) after having an epidural. I think the NHS needs to make women more aware of these stats when considering an epidural, so that they can make an informed choice.

[MostWicked]

What has put me off an epidural in the past is how it may be harder to push the baby out as you don't have the "urge"

I found it SO much easier to push when I didn't have the pain holding me back.
I've had one birth with and one without. The epidural was a godsend and I would highly recommend it.

[DinoSnores]

Aargh, tranquility, it is fine to have an opinion but please give accurate facts!

As loads of people have mentioned above, it may not be the epidural's fault that there is possibly an increased association of intervention! It may be that the difficult labours that require more intervention are the difficult labours that require more pain relief. Studies really aren't clear on this.

With an epidural, you do not have a higher chance of needing a Caesarean section.

With an epidural, the chance of the obstetrician having to use a ventouse or forceps to deliver your baby is 14%. Without an epidural it is 7%.

I agree with you that women need to be more informed about pain relief options to make an informed choice (how informed is consent in the middle of an agonising contraction!) and I think that this leaflet should be given to all pregnant women as it gives the facts, rather than conjecture, about ALL the pain relief options:

Pain Relief in Labour by the Obstetric Anaesthetists' Association

[steppemum]

toffeemoon, just to reply to something you said to me:

Steppemum "I also wanted a natural birth...I wanted to push the baby out myself etc."

Do you not think women who have epidurals push the baby out?

To me, if it comes out of your vagina, it's natural.

What I meant was I wanted an all natural, no intervention, lovely music and candles earth mother type experience.
Ended up with quite a high tech experience with drip epidural etc. If you read the end of my post, you will see that I concluded that safe delivery was the only important thing in the end, whether epidural, no pain relief or CS.

[steppemum]

Oh and the point about pushing, is that if the epidural hasn't worn off you can't be in control of the pushing as you can't feel it properly.

[livingzuid]

Just in hospital still after having dd1. I didn't want an epidural and wanted to try as natural as possible. Also hate needles etc. Waters broke with no contractions but with meconium and I was induced with already 3cm dilated. This was 13 hours after initial admission waiting for something to happen after my waters went. A few hours later my contractions were so bad I was shaking and incoherent and vomiting but dilation was nowhere near what it should have been for the level of pain I was experiencing. There was no way I could have gone on with that pain.

I live in a country where you have to be on deaths door to get medicine so for my doctor to tell me I should have an epidural I listened. The anaesthiologist was there already, and it took her five minutes tops to do. It was the best decision I could have made. It turned my birth experience into such a positive event. I was able to sleep while the drip dilated me, and then my own contractions took over. I could feel the contractions but they didn't hurt and ended up with a cone head baby but that was because her head was too big and they were about to get me in for c section anyway. They cut and I didn't feel it and it was such a small area and better to have that than a tear. I'm healing nicely and it isn't that sore. I was able to tell when to push and when to stop and I had a clicker so I could control when I received the drug. From 10cms to birth was am hour and a half and I was so exhausted by then anything would have taken a while. She had a thing on her head so we could always hear her heartbeat and that was wonderful. I also had the pressure sensor on to monitor contractions.

My baby is still on icu but because of a strep b infection that she would have had anyway and was nothing to do with the mode of delivery or pain relief. She's doing brilliantly.

I am glad I got to experience both in a way. I woke up around 6am to a gorgeous sunrise, feeling so relaxed and ready to bring my beautiful daughter into the world, feeling a positivity and calm I did not have with no pain meds.

Epidurals don't affect the baby it is pethidine that does.

I completely understand why people want to go natural and if you can deal with that, great. But don't be put off it an as an option. There are horror stories but you don't often hear about the good ones. And this comes from someone who was so anti epidural she had it several times in bold in her birth plan!

[livingzuid]

Oh and they used catheters. Couldn't feel a thing and was glad that I wasn't peeing all over the floor. Someone is there fishing around in your vagina so I am not bothered by them helping me go to the loo two hours after it wore off I was able to walk etc. I never lost all sensation in my legs or body either. Was itchy though all over which is a side effect of the epidural.

[PacificDogwood]

livingzuid, congratulations [sniffs baby's head]

I never really understand why threads about 'natural' delivery vs 'medicalised' or epidural vs no epidural often turn so personal .

It is about information and feeling in control.
Epidurals have their place.
They have their risks.
Having a natural, non-interventional VB which leaves a woman with PTSD that makes her hope to never be pregnant again is surely not a desirable outcome.

It's not a competition.
We all have out ideas of how we'd like our labour and delivery to be like and then we have to deal with whatever we have to deal with on the day/s.

I was v grateful for my epidural when I needed one (oh, and as an aside, I SO could feel in what direction I was to push, even though I did not have the 'urge to push') and equally happy when I did not need one in later VBACs.
My 'epiduralled' and 'non-epiduralled' babies seem all very unfussed about what method of pain relief I chose at the time. Admittedly, my youngest is now 4...