Why is an epidural a big deal

[Muddytoes1]

Currently 30 weeks with my second and spoke to midwife today about the possibility of having an epidural this time round and she was all “well lots of options to consider before that” and started talking about the nice lighting etc in birthing room and aromatherapy etc. Didn’t want to be rude and point out that nice lighting isn’t the most effective pain relief option out there - she is really lovely and only trying to help. I didn't have any pain relief other than gas and air last time because NCT and midwives had made out that was the best option and yes I got through it but it wasn’t some amazing experience where I had a huge sense of achievement it was horrid. It hurt like hell and I don’t see why if there are better pain relief options out there I can’t use them? The main downside I can see to an epidural is not being able to feel pushing so increased likelihood of intervention but I never felt a pushing sensation anyway just lots and lots of pain which I think if anything was hindering the process not helping as I was fighting against it at every contraction rather than pushing. Anyway not really looking for any advice, just wanted someone to vent to and maybe reassure me that it’s ok to ask for pain relief in labour if I want it. Thank you x

It might have already been said but I don't think you can be in the birthing pool with an epidural.
Some hospitals don't offer epidurals at all.
Ask for clarification on your next appointment and make it clear if you ask for one you expect it in labour.
Would you take diamorphine instead?
Pure hypothetical here as I had a CS but have been reading about options for next baby.

First baby - no epidural, needed intervention and the baby was delivered by Ventuose.
Second baby - had an epidural, could feel the contractions, baby delivered without intervention.

My epidural experience was really positive. I wasn’t planning to get one, I was hoping the birth would be faster. But it dragged on, and then slowed right down (this was before I was given an epidural) and I felt like I was in this never ending agony. I’d have really struggled to push had I not had the epidural as I was getting so worn down by the pain

I had an epidural with DC1 after a long labour and delivered without intervention....but...I literally couldn't walk or even stand up for about 24 hours after, and I had numbness on one side for several weeks after the birth, which meant I couldn't drive or even walk easily. I actively avoided having one with subsequent labours.

It was amazing during labour, but the after effects put me off having another one.

P.s. diamorphine did nothing to help the pain in my case. Just made me very confused and drugged up - I was in agony but saying things that made no sense.

Also - sorry I keep adding bits - I wouldn’t say an epidural means an extended hospital stay, as one poster said. I had one and I went home the next day!

But everyone’s experiences are so different, that’s why it’s hard to decide.

I can’t believe he amount of people who have been denied/had to push for epidural. I had one both times and they got it for me no problem when I asked. I did have to wait a bit for the anaesthetist to be free but I never got dissuaded from one.
They were bloody AMAZING and although I felt nothing at the pushing stage the midwife told me when to push and they both came out with no interventions. Best bit was not feeling the being stitched up but afterwards either !

I had an epidural - 3 attempts to get it in, and all I had was a very numb left leg with damage to my back. Epidurals are risky - but it's up to you whether it is worth that risk. I'd probably have one again - despite the fact that getting one was hell.

www.rcoa.ac.uk/system/files/12-NerveDamageSpinalEpidural2017.pdf

Asked for one twice. First time I was 2cm and they said I needed to be 4cm. I was only kept in because baby was in distress and had passed meconium.

Second time I asked for it immediately after an examination (8cm). Bless the midwife, she said ok straight away, put the fluids in my hand first time and went out to call the anaesthetist. By the time she got to the end of the hall way I was pushing and 45 mins later DD arrived.

I recall the conversation whilst pushing going like this:

Me: I'm not getting that epidural am I?
Midwife: No dear.

I didn't want an epidural because I'd had i.v. opiates before and the itching associated with it was so awful I scratched my skin raw. There's no way I wanted to be dealing with that after just giving birth. But obviously not everyone experiences that side effect, certainly not to that extent.

I had pethidine (given i.m. so no itching) and it was great.

I did what a pp did and told my mum to note the midwife's name and time that she refused me an epidural.

The needle was in within 20 minutes.

@Redken24 no I get you can’t have an epidural if you are in the pool. That does makes sense. Not sure about pethadine but I don’t like the sound of being drugged up on anything that strong. Even the gas and air I found a bit unnerving.

I am about to have my 4th bub. All previous births have been drug-free naturals. 1 waterbirth, and 2 bed births.

I can't have epidural due to a spine defect. I'm unsure about why she would try to dodge the question, but all I can say is, if you want it, get it! If you can get it (unlike me) then go for it.

It seems that with any birth choice you have to fight for it. I’ve 4 births, all with very clear requests to not have an epidural. I was offered an epidural during two of my births (and one birth I didn’t make it to hospital so couldn’t be offered one). So maybe if you want one the thing to do is explicitly refuse one.

There is a tiny risk of paralysis. That put me off. Along with the increased intervention statistics. Plus the possibility of it not working and me having relied on it in my birth plan. And I hate the idea of lying in bed, immobile and pissing myself. But the biggie for me was that if anything went wrong I didn’t want to be able to blame myself in any way.

Still I know people who went in, got tapped, read a book, had a nap and gave birth. I think of myself screaming in a pool of blood and shit and do wonder if I’m an idiot.

I had an epidural for my 1st and would absolutely choose it again. I second everyone who's said you need to be persistent.. REALLY persistent. I was brushed off 4 or 5 times- oh just wait for a bit (I've waited 20 hours), oh the anaesthetist is busy (understood. Kept asking, very politely, if he was free yet), oh it might be too late (no the doctor said it was fine and I'm only 6cm).
Eventually the anaesthetist appeared- the line was put in my back quickly/painlessly- and from then on labour was great. I felt enough to push certainly. Had an episiotomy but may well have done anyway, and it healed quickly.

I had it with my first and I wouldn't choose to have it again. The reason I had it with my first was they gave me the induction drip to hurry along my labour which lead to excruciating pain. It relieved that pain so I don't regret having it but I didn't realise that I would then need a catheter which I hated. Plus it ran out towards the end which wouldn't have been such a big deal if they hadn't of delivered the baby through forceps with an episiotomy (serious pain!). Due my second in 8 weeks and I will be avoiding one if possible. But everyone is different and every birth different so what works for some won't work for others.

I had an epidural a week ago while giving birth to my daughter. I'd gone in really prepared with hypnobirthing strategies, etc, but the pain was unreal as my contractions were 50 secs long every 2 mins from the very beginning when my waters broke, no gradual ramp up for me!

The anaesthesiologist explained the risks but what I found interesting is that she told me the hospital statistics too (such as' 'In this hospital in the last five years, this has happened once) etc. I found that reassuring at the numbers were absolutely tiny.

Unfortunately I had to have an emergency section shortly after, unrelated to the epidural. In fact the monitoring for the epidural picked up that my baby was having major decelerations and very slow recovery during my contractions, so it was discovered she was in distress sooner than it might have been.

But anyway, I would 100% have one again. I didn't even notice the catheter. I had been so staunchly against one, but all the up breathing and visualisations in the world wouldn't have worked for my labour. It was bloody awful. I could have kissed the anaesthesiologist when it kicked in. I don't plan to give birth again, but if I do I am going straight for it.

I would love to see some proper high quality research on the extent to which epidurals really do increase interventions. As others have said it seems very likely that most of it is correlation not causation... My most difficult birth was epidural and forceps, but I think it is fair to say that the problems started well before the epidural!!

My suggestion is to make it clear from as soon as you get to hospital that you want an epidural.

Also. As a way to stop them denying you one at the last minute. Do not allow midwife to see how dilated you are when anaesthetist gets there. Mine said "it looks like you need to push [I did], shall I check how far along you are before he does it?" I Shouted NO!! I had had to wait for the on-call anaesthetist as it was the middle of the night and the other one was doing EMCS.

After the epidural was in, I let the midwife examine me and I was at 9cm. She said I wouldn't have needed the epidural as I was nearly there ....!!! Errr no piss off. I then had a lovely rest for an hour and then pushed DC2 out easily with no pain.

Don't let them swizz you out of an epidural if you want one!!!

There's a great book called Epidural without Fear written by an anaesthetist which gives a clear no-nonsense description of all involved.

Its not just about money - epidurals are not without some pretty heavy risks. Not just in terms of extending labour but things that can go wrong. Its fairly uncommon but they can cause nerve damage, infection and mega headaches.

That said, I'd take that risk over mood lighting anyway.

My advice if you want it would be to write it clearly in your birth preferences 'I want an epidural' and say it as soon as you get into the delivery room. Xx

I’m 33 weeks pregnant and had an apt with a consultant anaesthetist and obstetrician recently. They said the evidence that epidurals increase chance of interventions is flawed as it’s impossible to control for the fact that women with back to back babies, babies with heads that are misaligned to the pelvis/not properly engaged when membranes rupture, less favourably shaped pelvises etc are more likely to be in greater pain and request an epidural. It’s likely these women would need an assisted birth anyway and also more likely they’d request an epidural.
Causation and correlation are two different kettles of fish.

We discussed the ethical issues around creating a trial to test this- never going to be fair to insist that a control group of pregnant labouring women are offered no/insufficient pain relief whilst it’s a free for all for the other group.

Purely anecdotally I had an epidural with my first DC and managed the pushing stage fine. The midwife and DH kept an eye on the CTG trace and told me when a contraction was approaching and I went for it with the pushing, even though I couldn’t feel anything. It was quite successful and the pushing stage was short- only needed a couple of stitches for minor tears.

When the time comes demand it. I had one with my first and they didn’t even blink just did it. I wanted pain relief with my second and they were evasive and kept telling me how good water births were for pain relief - little did I know I was too far gone and DS was born within 10mins of me getting to hospital so I understood lol your body, your birth, your choice!

I wanted a water birth but after three days plus of contractions ramping up and dropping off I went in and begged for help. I was told I could have pethedine but that would mean no pool birth. So worth keeping in mind. My birth plan said pain relief as needed, nothing ruled out, but I still had to be very clear I wanted the pethedine, I think because the midwives wanted to give me the opportunity to have the birth in my birth plan, which I respect.

I took the pethedine, and slept for the first time in 72 hours, then got transferred to the consultant unit so they could break my waters. They offered me the epidural straight away, and I discussed it with my husband for a sec, and went for it. Best decision ever. I slept through the next six hours or so, and then dozed on and off for another couple of hours, I was exhausted when I got to the hospital but the epidural really saved me from running on empty when it came to the pushing stage.

Worth bearing in mind, you will have to have a catheter, however for me this was a huge relief as it turned out a blocked bladder was delaying my labour, once the catheter went in and they broke my waters I went into full labour very quickly. I also had a completely numb right leg for several hours after they took out the epidural, and in fact it was about 4 weeks till my leg was completely back to normal. That meant I had to stay in hospital an extra night, they didn't want to release me until I could get around safely. I would still have an epidural again, I had a very calm, peaceful labour, which is what I wanted with the birthing pool. This time it will be in my birth plan from the start.

I had an epidural because they don't offer gas and air in Spain, where I had DS. It is epidural or bite a pillow

The epidural itself was unproblematic, I didn't feel the needle going in. DS had shoulder dystocia and was back to back, therefore needed turning and hoiking out with the salad tongs.

The only weird thing is you don't know when to push.