mum's who've had epidurals - would you have another one?????

[liznay]

I'm having my first baby in 12 weeks or so and having watched around 100 births now on Discovery H&H i'm convinced that I'm going to have an epidural.

Why is every (wo)man and his dog trying to talk me out of it though? I don't understand why someone would want to be in that much pain when you can choose not to?
I know there are risks attached to having an epidural but some people have said I won't be able to push the baby out.
I was under the illusion that women have given birth whilst in a coma, so why wouldn't the contractions ease the baby down the birth canal?

If you've had an epidural or if you had both a natural birth and an epidural to compare the two - would you have another one?

LOL mogwai - at the mooing ladies ( I was one of those!) and then at the magazine and banana (I never managed that, even with the epidural in but good for you!)

It's amazing how many doctors and wives of obstetric type people have epidurals isn't it??????!

Feeling 'high' and 'empowered' were honestly not my feelings after my first birth (no epidural). I was more just traumatised and shocked by the intensity of pain of the delivery, annoyed at the midwives who had taken away my gas and air and said it was too late for more diamorphine, and relieved it was over. I also remember thinking 'never, ever, do this again'.
That was with the first baby. Am now expecting number 3!

megbusset I had my first at the Ridgeway, and I couldn't fault the mws for 'niceness', however I would advise you to not just take for granted that everything will be natural/optimal because they share mws with the labour ward who aren't always up to speed. You may find you need to be a little assertive about them following your birth plan.

I am further East to you, but still felt the extra distance to the Edgeware to be worth it. The place is the childbirth version of heaven. All rooms have pools with underwater lighting!

My birth story if you're interested.

I'll email you!

I just want to say nobody gives you a big medal for giving birth naturally so do what you want not what people want you to do. I had a epidural with my first I think out of fright more than anything I was so scared however I did have a long labour and he was back to back which made it more difficult. I ended up with a ventouse delivery and had to be told when to push. The after bit isnt nice like being helped to the loo ect. Second time round I had a natural birth and I did that because I felt more in control. The natural birth was better but I knew what to expect and I had alot shorter labour. Good luck

Labour started 4am, went into hospital 1pm, put on drip at 7pm as only 1cm . At midnight was 2cm and decided that I would be in no fit state to push at 9am (anticipated time by that stage) - opted for epidural. Unfortunately 1st one didn't work, 2nd one placed - anesthetist said back in 5mins to check - came back 3hrs later to find that it hadn't worked. She then had to give me a spinal to get the epidural in - was great in terms of suddenly being able to think etc (had been 23hrs by then..) However, found that ds's heartbeat dropped unless I was on my back. Short version was pushed - no baby - theatre for forceps trial - consultant got one on, gave up (said later he could tell that I'd pushed OK but ds had just got stuck) so emergency section - but epidural had been topped up sufficiently anyway.

Wlked to the shower about 4hrs after ds arrived (with help) - could lift ds by this stage and was 100% in charge of him, bf etc despite section.

So, I would prefer to have a water birth, as planned, but if things went not-to-plan again I would not avoid an epidural...

GOod luck whatever you choose!

Thanks Moonlight. I meant to have DS in the Ridgeway but got transferred to the labour ward for my epidural -- where the MWs weren't all as nice! Hoping to make it into the birthing pool this time.

Your story is lovely

had one with Ds.
it was a nightmare labour and resulted in an episiotomy and distressed baby which meant 12 hours in special care and a 3 day spell on the wards for us both.

i didn't have so much as an aspirin with DD. all went well and we were home in about 12 hours.

I'd never have an epi again.

I had one with DS nad it was great! After labouring for about 27 hours, I'd got to 6 cms dilated but was completely exhausted - it was about 2 am by this time.

I'd had pethadine but i didn't like it, as it made me sleepy between contractions but didn't really take the edge off the contractions themselves IYSWIM.

The epidural was bliss. Yes, I was stuck to the bed, but I could still wiggle my toes and move my feet a bit, so my legs weren't completely dead.

I managed to get a couple of hours kip at that stage as the pain had melted away, and contractions are involuntary at this stage. The midwife woke me a couple of hours later to push. They also eased off the epidural so I could feel the contractions, so I knew when to push but it didn't hurt.

After 1 1/2 hrs of pushing I had an episiotomy and DS was delivered by forceps. We'll never know if this would have been the case with or without the epidural, but i had lovely bonding moments with DS while the placenta was being delivered and I was being stitched up - I couldn't feel a thing.

I had the epi at 3 am, ds was born at 6.45 am and I was back on my feet by lunchtime IIRC.

I'm 38 wks with DC2 now and wouldn't hesitate to have another one. Saying that if the labour was quicker and I wasn't so exhausted I might have a bash without one - we'll see

COI: I peddle epidurals for a living but haven't actually had one myself (yet).

Epidurals have risks (for full info please see the information that the Obstetric Anaesthetists Association publish in their information for mothers section) www.oaa-anaes.ac.uk/
No one, least of all us anaesthetists would try to tell you otherwise. Only you can weigh up the risks and make a decision for YOU...however the following may help.

Modern labour epidurals use much lower concentrations of local anaesthetic than have been used in the past. In the unit I work in most woman who have a 'standard' epidural will be able to move around and change their position in bed.

We also offer 'mobile' epidurals which give smaller doses of the same mixture. In general, these are less efficacious in terms of pain relief but you can mobilise. We have 'telemetry' CTG monitors to allow woman to mobilise freely with a portable monitor pack. I generally advise people that if they are motivated to get up and move, stand, bounce on a birthing ball then a 'mobile' is a good choice. If they dont' get adequate pain relief extra drugs can be given to make it into a normal epidural.

I 'm not sure why people in our unit are so reluctant to mobilise with 'mobile' epidurals. They do all have the physical capability to do so - maybe they need to sleep once they get adequate pain relief, maybe the midwives aren't supportive. Some woman definitely do mobilise though.

With regards to pushing - research shows that women who have epidurals have an increased risk of instrumental deliveries - the mechanism of this is unknown. Your epidural should not be allowed to wear off completely for pushing as suddenly hitting you with lots of pain when your body hasn't been allowed to acclimitise would be very very sore. However the midwives often try to time it so that you don't end up pushing when your epidural is at it's most effective.

My experience suggests that a lot of the time people end up with epidurals because their babies are malpositioned and consequently labour is more arduous than you would otherwise suspect.

My own birth plan: I'd have an epidural if I needed one but would prefer to 'see' if it is necessary by exploring other options first.

If you are having one you do need to accept the biggest risk which is that it may not work perfectly (see gigglewitch's post above regarding a unilateral/ one sided block).

For certain women, who are at high-risk of complications, it may be beneficial to think about having an epidural early as once one is in and working it can generally be 'topped' up to provide a rapid block for operative proceedures. Having one in can avoid the need for a general anaesthetic in an emergency situation (normally we would just put in a spinal anaesthetic) which is thought to be more risky for you, your baby and from reading previous mumsnet threads appears to be considered to be a generally bad thing!

Sorry this is a bit of an essay

Liznay, I would base your decision on the progress of the labour. A lot of first labours are very very slow. Mine was 36 hours. I wasn't progressing, so was given epidural and synotocin to speed up contractions. blessed relief and birth happened normally. Had low dose epi, could walk fine immediately after birth. (1 hour after).

If the dilation of cervix etc had been progressing normally, I could have stood it (maybe).

So my advice would be:

1. get a tens machine, they are BRILL
2. gauge the progress of the labour, ask if you are progressing normally.
3. if they suggest the drip to increase contractions, insist on epi as otherwise it's 's bloody painful
4. first birth is much harder and longer and I think epidurals have more of a place in it. Remember they are an extremely safe form of anaesthetic. No prizes for suffering pain.

1. ask about low dose epi, brill as takes away a lot of the pain but you can still push effectively, and insist that you are able to sit up, go on hands and knees and give birth not lying on back (e.g. on side is better, even), this decreases the risk of instrumental delivery

gasman, interesting what you say.. I really wanted to be mobile with the low dose epi, but it hasn't been fully thought through, for example the catheter tube into your back is not more than 2 metres so you can't really get very far! Also in the hosp where I gave birth (in Belgium) they were very into their CTG and kept asking me to lie still for the monitor, in fact the monitor got more attention than me. Would have really welcomed mobile monitor...

gasman I found your post really interesting particularly about mobile epidurals.

I had a epidural with DS but wasn't offered any kind of mobile alternative - the one I had pretty much knocked me flat, I couldn't move my legs at all and was on the bed for the rest of the labour. (DS' head was malpositioned and the whole thing ended up in an emergency CS)

Aer mobile epis standard in all NHS hospitals? I would have loved to stay mobile - I have always questioned whether if I had been able to move around DS's head might have righted itself and I might have been able to give birth normally.

Is it something you have to request? Am a bit that I wasn't offered this if it was available, to be honest.

ps I had a mobile monitor for the first part of labour (was induced) and it was a nightmare! It kept losing the signal and the belt had all these trailing wires on it so I looked like some kind of weird BT fitter....

I wouldnt have another epidural, yes the pain releif was fantastic, but ended up having to have a ventouse because i couldnt push ds out

What Dracula said for my second as I had planned and had an amazingly effective epidural for my first (could feel contractions but no pain). Was long but then I think my second labour was long too - just didn't realise I was actually in labour. Did the second with zero pain relief (oh, a bit of codeine because they thought I had a kidney infection...) and LOTs of baths - that's what got me through.

Would prob plan to have an epidural next time - although giving birth completely without intervention was an amazing experience. Would maybe try and ease it off for the actual pushing part (first time I had to have it topped up, as possibility of ceasarean, not so great as couldn't feel anything at all).

Both births fab

Well, my experience was similar to mogwai (but without the banana).

Seriously though, I had always planned to have an epidural, as I am a wimp with pain. I also worked (before having ds) as a staff nurse in the recovery room, so had had lots of experience of seeing people with epidurals, and was convinced it was the only way to remove all the pain.

When I arrived at hospital and was 5cm dilated, I asked for the epidural straight away. I then spent most of the day relaxing, reading the newspaper etc. Although I couldn't feel anything, I was still able to push. Just before ds was born, he became a little stressed, so I did have a very brief ventouse (basically one suck and out he popped). When he was born I was laughing and joking with the MW and doctor. The epidural wore off a few hours later, so I wasn't too inconvenienced by immobility.

I'm not planning any more dcs (ds is now 7, and I'm 46!) but if I was, I wouldn't hesitate to have another epidural.

second somuchtobats - was very relaxed post epidrual (even chatted with mw re holidays , ate sweets whilst waiting an hour before pushing when fully dilated).

Its the only thing I would put on my next birth plan if I do have another

Not read all the thread but NO, not if I could avoid it.
I had it for a section, so not much choice. But I've had niggling back trouble since in that area. Thankfully it's been ok lately, but had it for a good three years afterwards, on and off.

I've had vaginal births too, with gas and air, and pethidine. I'd rather do that than have an epidural again.

If I was going to have a first baby again, which obviously is impossible, I would have an epidural like a shot. My first labour was a lot longer than the second (16 hours as opposed to 4.5 second time) and I am not sure I could have coped without one. Fear of the unknown and not even knowing if I could give birth worried me.

I didn't want any of the other drugs as I had read/been told that they make you feel out of it and I didn't want that.(control freak). Epidurals leave the baby alert too in comparison to say, something like pethidine which, if given too late can affect the baby as well.

The down side is the increased risk of intervention - I had a failed ventuouse and then forceps and a pushing stage of 4 hours. Right towards the end, they did as gasman said they shouldn't, and let the epidural wear off at the same time as giving me more drugs to make the contractions more powerful (epidurals can make them less strong) and I ended up with no gap between contractions which was awful. Pain went from 0 on the scale to about 9 on the scale in five minutes.

I was desperate for an epidural when pregnant with DS2 and was really worried by the fact that the hospital I was booked into (different one to DS1) had an epidural rate way below average and a cs rate way above average so I didn't think I would get one. As it turned out I didn't even make it to the hospital, thank goodness I really didn't like it, and DS2 was born at home with nothing but a dubiously useful TENS machine. No pushing - he kind of dropped out as I was on my knees - the contractions changed and they eased DS down and out all by themselves.

I think if I did have an epidural again, I would make a conscious decision to let it wear off slowly for the pushing stage. But of course that is all with the benefit of hindsight.

If I had another birth I would go for a natural homebirth because I know I can do it and it is likely to be quicker. If it wasn't proving to be quicker then I would happily go for an epidural. However, as I said at the beginning, for a first birth, the epidural option would still be my first choice.

Heaven in a tube!

I gave birth in France where an epidural is practically compulsory - I wasn't offered any other forms of pain relief. I was actually quite worried about this having read only English pregnancy books and heard testimonies form English friends. The reality was I had an epidural right at the start, had a very relaxed labour (even managed a snooze) let it wear off slightly for the delivery and fresh as a daisy managed to push dd out with about 8 pushes (as you say, the contractions painlessly eased the baby down the birth canal so I didn't start pushing til she was really ready to be born). I absolutely loved it and wouldn't have contemplated giving birth to ds two years later without one. I had a similar experience with him. I certainly had no problems pushing - I just didn't have any pain. As other posters have said, noone gives you a medal for suffering and fortunately we don't have to these days.

Yes I did, on the advice of my consultant. Next time around I would prefer to look at other options.

At the end of the day you are the one in labour, you are the one giving birth, do what you want, not what other people are telling you.

I was glad for mine in the end, I had a loooooong labour and was exhausted I slept for a coupe of hours after I had mine it was bliss.

I did however end up having an assisted delivery with forceps and an episiotomy and I would like to avoid it next time if possible.

I had an epi with my first and swore I'd never have another one. Stuck to that too - even through three days of ACTIVE labour with my third child.

The epidural that I had with my first resulted in me having to have my baby removed with forceps, followed by weeks of breastfeeding misery with a baby who didn't feed well.

With my second and third I opted for homebirths with back up support from friends who acted as doulas, plus an independent midwife. It was a belt and braces approach to reduce the risk that I'd get to the point where I felt I needed an epidural. Second labour was only 7 hours (first was 24 hours), third was the longest of all, and v. painful, but didn't 'need' an epi as had great support.

"I just want to say nobody gives you a big medal for giving birth naturally"

Well I got a medal for having a natural birth: a natural high to beat all highs, a body primed with physiologically normal mothering hormones at the moment I first held my new baby in my arms, and a baby who spent the first crucial few hours of life outside the womb without synthetic opiates like fentanyl and pethidine clouding his perception and responses.

Not being judgemental but I've done it all ways - with pain relief and without (including a very, very long labour without pain relief). There are rewards for going without drugs - for you and your baby. Labour is tough, tough, tough, and I'm not saying everyone should go without pain relief, but it's important that there's an acknowledgement of the drawbacks as well the benefits.

I had gas and air with my first 3 births....nothing else was needed.

4th birth was horrendously more painful and i had an epidural.. it was fine.

1st c-section i had one which was a bummer to get in and very painful..but no problems once it was in.

3rd one was as easy as anything to get in..and again fine.#

I do have painful parts on my back now though where the needles went in.....the last anathtetic person (ya know who i mean) said i have scar tissue from where they all went in at differnt spots...so painful when it si pushed upon.

However the moral to my stories is.......start with the gas and air...and work upwards from there....every birth is different.

Good luck!

fabsmum, I agree there are positive sides to not having pain relief, but I know several people who were really traumatised by the birth and have flashbacks etc, what about the positive sides for the mother's mental health?

Also, lots of processes are natural, like dying, but it doesn't mean you shouldn't have pain relief if you want it.

I firmly believe in total choice for each person, with no moral judgements..

a final point is that you can easily have forceps or something else go wrong whether or not you've had an epidural. A lot is down to your body, position of the baby and chance.