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.

[BreeVDKamp]

As everyone else has said. Needle in back makes me want to puke, and the loss of control and feeling.

However after having DS with no pain relief at all, I had a spinal for stitches and the pain relief was amazing! I wasn't in labour pain after the birth of course, but I couldn't feel a thing from the waist down so it is an impressive tool!

Was extra scared of paralysis though as I was shivering so hard from shock!

[pinguina16]

Can I ask what might be a really stupid question?

Only around 25 to 30% of women have an epidural (figures slightly vary year on year). I imagine it is a personal choice for most (although I'm sure a small number of women actually need one for medical reasons other than simply for pain relief).

94% of women give birth on a labour ward (or consultant-led unit where anaesthetics are available). Again I imagine that a bigger proportion of women choose the labour ward for their labour than women who don't really have a choice.

My question is: if you do not want an epidural (I do know some women ask for one and are effectively denied one but I think it would be a minority), why choose to labour on a labour ward rather than a midwife-led unit/birth centre?

[Roseotto]

I chose obstetric-led care because I wanted the experts on hand if anything went wrong. I am comfortable with monitoring etc as I know a couple of people where midwives sadly got it wrong and made the wrong call and the consequences were awful. So I preferred to be in the hands of a doctor. I don't mind being monitored or having examination. Luckily nothing did go wrong for me and I still had very positive experiences even though I declined an epidural each time. I have had some back problems in the past and figured the less mucking about back there, the better. My labours are also quite fast and efficient so I was really only out of it with pain for 15m to 45mins tops (Longer within that range for first labour).

[bestguess23]

When it's your first child and you really have no idea how strong labour pain will be it can be reassuring to know you have pain relief available, if needed. My birth plan will probably be gas and air but the reality is I don't know if that will be ok. It's also reassuring to know a consultant will be on hand if needed. Some of the birthing centres near me would involve an ambulance ride to a consultant led unit it needed, that to me is terrifying.

[insanityscatching]

I've had four epidurals for three vaginal deliveries and an ELCS. I've never needed any assistance delivering. The epidurals were given firstly because it was a trial of labour with my first dc as I'm small and latterly because they were VBACs and it was consultants preference.
My fifth child was under a different consultant and I used gas and air only,not because I preferred it, more because an epidural wasn't offered. I'd have taken the epidural if offered even though I managed fine with G&A because I'd rather not feel anything.
I didn't feel a greater sense of achievement by not having an epidural and my favourite birth was my third where the epidural was sited before I was induced as dd was bigger and back to back and I didn't feel a thing.

[eaiand2]

IMHO the reason most women are afraid of epidurals is that there isn't a good understanding of how they work NOW. I've met so many women who think they're still like they were over a decade ago, deadening your entire lower half. Most these days are low dose combinations of drugs that allow you to still have feeling, but just dulled, numbed, and no pain. I could still move, change position, and could've stood up if I wanted to (with support) and I felt no pain, but still felt the tightenings of every contraction as well as the urge to push.

[theendoftheendoftheend]

I nearly had an epidural with DD2, even got the anaesthetist in the room before I suddenly felt very brave and decided against it. BUT then my midwife (who had issues and was 'let go' not long after) just left, she left me to it! I could feel DD2 and birthed her without a MW present. I now wouldn't have an epidural as despite the horrific pain both during and after (being stitched up feeling everything!!) there's something about the whole situation that makes me feel if I hadn't been able to feel DD coming and known to push, she might not have survived. I couldn't put the necessary trust in a midwife now to have an epidural.

[Roseotto]

I disagree that most women who don't want epidural do so because they don't understand what modern epidurals are like. I didn't want the drugs, intervention and fuss when it's not necessary and I could cope without. I wouldn't speak for "most women" myself but suspect I'm not alone.

[32percentcharged]

I also disagree with the comment that 'most' women who don't have an epidural are afraid of them and that it's because they don't understand how modern ones work.

Like I said, my view was quite simple. I didn't want to give birth in a medicalised environment with anaesthetists and doctors and I wanted to feel the experience of giving birth. Granted, modern epidurals may not numb you completely but it's bound to be a different experience than giving birth without one and like I said upthread, we're not all the same and don't all choose the same thing.

I had a spinal for my dc2 as she needed to be born by c section, and I found it great- couldnt believe I was awake and being operated on painlessly. I wasnt remotely 'afraid' of having the spinal. To me, the essential thing was, is there a medical need for drugs or not? First time round my pregnancy was normal and low risk so I booked into a MLU and delivered with just the midwife, who IME are the experts in delivering babies where there are no complicating factors. Second time the baby needed to be delivered by c section so I went the medical route gladly.

[Roseybee10]

I agree. I know how they work, I just didn't want one unless it was a medical necessity.
I didn't mind having pain during birth, for me it was part of the experience. if I had needed induced or wasn't coping with the pain for a prolonged period and needed a rest to have the energy to push then I would see that as being a medical reason. I couldn't personally have had one as pain prevention.

[Skiptonlass]

I'd prefer not to have one.

No fear of needles. Can't say I like them but not too fussed.

But... I'd prefer to be mobile. I have really bad spd and I'd prefer not to birth on my back. I'd prefer not to be catheterised. I'd prefer to be in control. I'd prefer to be able to direct pushing. I'd prefer not to run the risk of slowdown of second stage. I'd prefer not to have the increased risk of instrumental intervention.

However. All these are preferences. Birth is unpredictable and if I'm in absolute agony, I'll take one. If I need to have a synto drip I'll take an epidural too. If I need intervention I'll take one (although no one is putting forceps within a mile of me if c section is still an option!)

Basically, I have my preferences but I'll go with what happens.

[Skiptonlass]

Also not frightened of having it done, and fully aware of how they work.

I'd just prefer to have a crack at it without, if I can and if things are straightforward.

If things go tits up, I'm in a hospital with one of the best maternal outcomes in the world, and I'll take everything technology can do ;)

[eaiand2]

I didn't say most women are afraid of epidural, I was saying most women WHO ARE afraid of epidurals.. Totally different and in response to a lot of the responses here. Not wanting an epidural because you don't want intervention or don't want to drugs is completely separate to being afraid of having the epidural.

[Skiptonlass]

i think the two are connected, to be honest. Fear for me, and I suspect most people, comes from the mixture of the unknown and lack of knowledge. What frightens me is not being aware of/informed of what's happening or being unable to participate/having things done without consent. Pain per se is less frightening for me.

I'm unfortunate in that I have a fair amount of the knowledge bit - I know how hard it is to put a needle/line in the right place (granted animals not humans but a mammal's a mammal in my book.) I've done it wrong some days, I'll admit. Not that I wasn't paying full attention but we are all different on the inside - anatomy isn't identical for everyone on that level. The last human spinal I watched got totally cocked up and we had to insist on a specific person coming in to fix things.

One of my good friends at work is an anaesthiologist with, let's say, a dark sense of humour. I'm well aware of how odd and different reactions to analgesia/anaesthia are. That's why anaesthiologists are so incredibly skilled.

Anyway, I get both points of view. Birth is unpredictable - some people want total pain relief and that should be offered without so much as a raised eyebrow. I mean you wouldn't be criticised for wanting pain relief at the dentist, would you? Some want to go it without and that's great too.

The important outcome is BOTH mother and baby delivered safely both physically and mentally Not just 'baby ok.' The mother has to be ok as well. Intact physically and not traumatised by pain/intervention/lack of control.

[LibrariesGaveUsPower]

I don't know how epidurals are now. But I do know that six years ago mine was hell. Dead down my legs and flat on my back but still in pain in my spine. Forceps delivery probably linked to being flat on my back.

I gave birth to my last child last year and I wasn't risking everything on them having got better. They may have done, but I am not a gambler.

[PerspicaciaTick]

My epidural didn't work properly so I could still feel pain down one leg...but not when to push during contractions. And it left me with numb toes in one leg for 6 months. Just glad I didn't get the debilitating headache afterwards too.
The "too fast for pain relief" birth I had the next time was much easier to recover from.

[LibrariesGaveUsPower]

Oh and going back to getting them in, a fountain of blood that sprayed up the walls and made DH look green. wasn't up for a re run of that either

[MustBeLoopy390]

Refused epidural during first two births,even when labour with dd needed speeding up with drip, and didn't have time with number three as the out of the 5 people I know who have had them 4 had assisted deliveries, 1 c section and all have problems with migranes/headaches/back pain now. I don't regret my decision and managed to deal with just gas and air after 8cms all three times. Most drugs in general make me feel ill in one way or another (can't even take paracetamol without feeling sick) so didn't see the point in taking anything.

[girliefriend]

I had a spinal with dd and can honestly say it was the only positive part of the entire birth experience but then I had already been in labour for four days and dd was in distress. Ended up emcs anyway but by God by the time they put the spinal in I was so ready to not feel anything from the waist down.

If I ever have any more dc I would be more than happy for an epidural/spinal again.

[AmberLav]

I choose to give birth in a midwife led centre attached to a full obstetric labour ward, as I want a less medical delivery, with the option of a quick transfer to a more medical centre if required. In my case I have ended up upstairs both times, once due to a third degree tear requiring surgery, and once due to an infection in my baby... I think that DC1 would have been forceps if I had started upstairs, so I am glad I have made the choices I have.
Epidurals were not required for me...

[HazleNutt]

"But... I'd prefer to be mobile. I have really bad spd and I'd prefer not to birth on my back. I'd prefer not to be catheterised. I'd prefer to be in control. I'd prefer to be able to direct pushing." - this all possible with an epidural nowadays. Not in every hospital, as I've heard, but unless you don't have a choice, I would certainly go to a hospital that offers mobile epidurals. I still think mine was absolutely amazing.

[LibrariesGaveUsPower]

Hazlenutt - though worth bearing in mind that many many women live in areas with no genuine choice of hospital in the UK.

[LibrariesGaveUsPower]

Sorry, that wasn't very clear. What I meant was it is often more a case of "if you are lucky enough to have a choice" not "unless you don't"

[IfYouWereARiverIdLearnToFloat]

I want to birth actively, on my feet & in the pool etc for as long as possible. I want medical intervention kept to an absolute minimum - that includes IV access, catheterisation, episiotomy and of course epidural. Ideally I would like to birth my baby then go straight home.

I'm well informed and not afraid of these medical procedures - in reality I'm possibly heading for early delivery & medicalisation of the event anyway but if that is the case it will be because of circumstances beyond my control & I would happily accept any or all intervention necessary to ensure the wellbeing of my little one.