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?

i did mean 'are' there not is

I had one with dd2, did'nt with dd1 as stupid me wrote 'no pain relief' on birthing plan

Would deffently have one again.

best piece of advice i got re childbirth was that the mosthospital labour beds can be adapted to positions more suited to giving birth in than just lying flat. the MW who did my first sweep told me this and i had a chuckle to myself and told her i would be having an active birth so not really relevant

... two weeks, one induction and an epidural later, that knowledge made all the difference and i was really quite active in a sitting-on-bed- kind of way. no intervention and managed to push baby out. my bed basically could be adapted into a kind of seated crouch for me - withouth interfereing with all the drips and things i was connected to.

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?"

I'd be the last person to argue that drugs have no place in childbirth. I was just taking issue with the statement about there being no medals handed out for going without. I feel this truism gets trotted out too often and without thought. I sometimes think it unintentionally belittles those people who want drug free births by making them seem as though they're somehow being too idealistic, pointlessly masochistic, or a trying to be a bit of a hero, when in fact they're making a perfectly rational choice which can have major benefits for them and their baby.

I think it needs to be acknowledged that trauma in childbirth really, really isn't just about levels of pain, otherwise you'd have far more women traumatised after homebirths (where far fewer drugs are used) than after hospital births (if we're comparing two similar groups that is - low risk women giving birth at home who have uncomplicated labours, with low risk women giving birth in hospital who have uncomplicated labours). In fact women are much, much more likely to be happy and satisfied with a homebirth, even after long and difficult labours. Nope - a great deal of trauma in childbirth is connected with fear - for yourself and your baby, control issues, and with the quality and type of care you're getting, and not just with the degree of pain you experience.

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

Two differences here though: first off there are no 'after effects' when it comes to using drugs at the end of your life, because there is no 'after'. Secondly there is only one person in receipt of the drugs, and they're usually consenting. Not so with childbirth.

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

Yup - but as I said, there are two people affected by the decision to use drugs in childbirth. No judgement - just thinking about advocacy for the baby.

betty - you are so right to point out that just because you're having a medicalised labour you don't need to forgo the benefits of gravity or forget about using your knowledge of basic female physiology to help your baby out!

Sorry - wanted to add, in addition to the epi with my first, which did leave me with long term problems connected with having a forceps birth, I have also had two spinals during pregnancy for operative procedures. Both times I had no ongoing problems at all and the process was quick and easy (or it felt that way from where I was sitting!). Mind you - it's a very different experience having a spinal when you're not in labour. Much more nervous making!

Gemzooks

'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?'

This was me after no. 1. I spent 6 hours scared out of my wits begging for an epdirual in an understaffed, under-resourced hospital. My solution for no.2 was to arm myself with knowledge and support and increase my chances of not NEEDING an epidural, rather than on insisting I had one. I had a fantastic 2nd birth with just a little gas and air when pushing to control it.

'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.'

Yes it is, and an epidural increases your chances of a less than optimal body state, and position of baby, and imo reduces your chances of 'good luck' as you will be in a more highly medicalised environment on a timer and more at the mercy of 'policy' rather than individual assessment.

fabsmum

'Nope - a great deal of trauma in childbirth is connected with fear - for yourself and your baby, control issues, and with the quality and type of care you're getting, and not just with the degree of pain'

I had two text birth vbs. The first was the worst experience of my life leading to symptoms of ptsd. The second was the best. The difference was mainly, that with the second I had improved my chances of 'luck'. I was EXTREMELY knowledgable and VERY well supported (I also had a 7 page birth plan for every single eventuality - that's how much research I had done).

I had an epidural after 14 hours of labour because my SPD had spread to lots of joints and I couldn't sit or lie down without screaming - the contractions were being handled just fine with gas+air.

Given that I wasn't dilated until 30 hours after labour had begun and waters broke (and 18 hours of that was with syntocin speeding things up), I was very glad of it.

We then did pushing for a few hours, and I could feel the monitor waggling in and out, so I don't think the epidural was affecting the failure to shift him. In the end one pull of a ventouse popped his head out.

Only downside of the epidural was that later that night I was still attached to a drip and catheter tied to the bed, and got diarrhoea... not fun!

Hardly any vaginal pain afterwards even from my stitches, no problems with urinating or pooing even a day later - again don't know if the epidural was related. I'd be up for an epidural again but hopefully my joints will stay intact next time.

MoonlightMakenzie - that's why I have such difficulty with people being dismissive about the birth 'experience' as though wanting to have a 'good birth' (note, not the same as an 'easy birth') is some sort of weird, self-indulgence for lentil huggers. If I get to 90 and look back on my life I know I'll still see the night my second baby was born as one of the key moments of my life - it changed me as a person in the most positive way. I've followed your story on this board over the past few months and was so pleased that you were able to have a happy experience of birth. I'm sure you'll agree with me that it's not just about more pain = bad birth, less pain = good birth. It's much more complex than that.

Someone else here who's done both - the loooong first labour culminating in an epidural and completely drug-free easy peasy second one.

Would I have another epidural - yes, if I needed one, but I wouldn't go into a birth planning to.

Do your homework about all types of birth and remain flexible on the day. Look into other non-drug pain relief strategies like TENS, water, etc, but be prepared for the possibility that they may not help as much as you'd hoped. But hospitals won't guarantee you an epidural in this country, generally, so it wouldn't be a good idea to make that your plan A and not have a plan B, or you'll risk feeling helpless and out of control if they say they can't find an anaesthetist. And keep active in labour if you possibly can (though it's not always easy after 30 hours, I know).

a fascinating set of replies, thanks everyone for your input

Don't do it.....if you don't have to. Be open minded and see what happens on the day. For a starter when you have an epidural you cease to have a low risk labour. The drugs do go through to the baby and can affect bf (especially the drugs in a 'mobile' epidural), the baby needs to be monitored continuously which can increase your risk of having an unnecessary cs, you are unlikely to be able to do a wee yourself, which means having a catheter introduced to your bladder, not nice especially if you end up getting a urine infection. You might well find it difficult to push, yes the contractions help to push the baby down to some extent, but it is so common to need an instrumental birth if you have your first baby with an epidural. Pushing hard is the only way to get a baby out with an epidural which is not usually good for you or the baby. (to be fair some people without one have to do this as well, but without one many people just have to go with their body's natural urges and it happens) With an epi you will feel like a beached whale, unable to move much for several hours at a time. There was a third time mum where I work recently who had a cs under general anaesthetic which would have almost certainly not happened if she had had a normal labour without an epi,it was down to an inexperienced dr as well but I'm as certain as I can be that without it she would have had a normal birth. Of course the positive side of them are that you don't normally feel the intense pain that you would otherwise, assuming it works. I know it all sounds really negative but I just think that it is so important to be aware exactly what is involved if you do go down that route. I am not anti epidurals for women who really need them, but I think it is a real shame to have one and risk such a horrible birth experience with such side effects if you don't have to. The vast majority of midiwves who have babies try and do it without, which I think says a lot really. I really hope that you make the right decision for you and that you have a positive satisfying birth experience whether you have one or not.

Thanks fabsmum. I'm really not anti-epidural. In fact, my story looks very simple written on this thread, but the long version includes:
a) a battle for an elective c/section,
b) depression,
c) miscarriage,
d) battle for guaranteed epidural on admission and before 2cm,
e) meeting Head of PCT Midwifery
f) interviewing for a doula,
g) battle for homebirth,
h) battle for pool at homebirth,
i) battle for access to pethidine at homebirth,
j) battle for more than 20mins gas and air at homebirth.
k) resignation that homebirth support unpredictable and booking birthing unit
l) 7 page birth plan based on LOADS of research and support and info from MN
m) fantastic birth

I do agree fabsmum that fear is probably the trauma factor, not just the pain per se. It's the feeling of being in an inhuman environment with lots of grim things happening to you, plus lots of pain.
I am now 17 weeks pg with DS, and am in the Netherlands where homebirth is the norm; I'm even considering it. I definitely don't want the epidural if I can cope without it, but with DS it was SUCH a long labour, I just couldn't go on, and was having synotocin. hopefully 2nd time will be quicker and more manageable. I also do think the very medical atmosphere can panic women and wish there were more home-like birth suites attached to hospitals; it definitely made me seize up being in the hospital...

I've had 2 mobiles after 2 inductions both at 42+ and I would definitely have one again.
What you need to remember is that you have no idea how you are going to respond in childbirth. In my case I had no idea that I was going to vomit my way through the pain as that was my body's way of dealing with it. So all my NCT and active birth preparation, all my yoga classes and my long birth plans, were completely useless as I retched and vomited through every contraction, never having a chance to concentrate on my breathing.
That said, I had 2 vaginal deliveries with no other intervention and no tearing at all.
My advice would be to read up on everything, prepare yourself for a natural drug free birth then go in with an open mind.
Good Luck

I was so sure that I would give birth without an epidural but things didn't work out that way. My contractions didn't progress so pitocin was started. Evil, evil drug...the pain got so bad I was hallucinating - seriously. So they decided I wasn't progressing b/c of the pain and I went for an epidural which was not bad at all and I finally got some rest and relief. Of course as it turns out ds1 was breech the whole time so it was a good thing I had the epidural in as it decreased the time getting me ready for the emergency section once they figured out they had been touching a butt the whole time instead of a head

one caveat, don't let some twisted nurse put in your catheter before the epidural like they did with me the first time There's no need to have that extra pain and discomfort thrown in on top of everything else.

Christ yes, the anaesthesiologist was my best friend!! Baby presented asynclitic (head tilted and firmly stuck), back labour completely agonizing. They ended up dragging him out with forceps and God bless Dr. Carruthers for topping me up so well that I didn't feel the ensuing train wreck (episiotomy, horrific tear and haemorrhage)... I'm thinking of adding the anaes. to my Christmas list, and if I have a second baby I'm ordering my epidural as soon as the test turns positive!!

I asked the anaesthetist to marry me. Bloody marvellous things, those epidurals. I went from violent contractions to ......aaahhh.... relief. Warmth. Sunshine. Conversation. DH and I played scrabble during labour, although I confess I did let him win.

Oh, and I bonded with both DCs immediately as we spent the first few special hours gazing at each other in well, not mutual adoration, but certainly on my part. They were chilled out, calm and contented. No adverse effects at all.

I've had both (although I was induced both times and there's no way I'd call that natural!)

Epidural was very painful going in and it took a few goes. Mine only numbed me from the top of my bump to a few inches above my crotch and then from the top of my thighs and all of my legs. It was weird as my contractions didn't build up I felt nothing and then suddenly full power! It's fair to say I felt the birth! I hated not being able to get up or to pick up baby after etc. though.

The second time I used TENS for most of it (the new digital ones are brilliant!)then I had gas and air. I had pethadine about 15 mins before the birth (we didn't know I was nearly there, 2nd stage was 2 mins) so I didn't get the benefit but baby was very sleepy for about 3 days. It was great being able to get up and change positions while in labour unlike last time. I loved being able to take a shower after and pick up baby whenever I wanted to, it made a big difference to me.

If I was doing it again, I'd consider an epidural for an augmented or induced birth but if I went into labour properly on my own, I'd use TENS and gas and air again and avoid epidural unless desperate.

If it's your first baby odds are labour will be longish. If you're not sure, you could give it an hour or two and see how you cope with it and decide then. If you think you want an epidural, have one. There are no prizes for how you do it, it's about getting the baby out safely.

You don't have to tell people either way, it's none of their business!

I have to say I think fabsmum has written some fab posts!! I can really see where she's coming from.

It's so true - people do tend to trot out 'There are no medals for giving birth without pain relief' - well I agree with her, the rewards can be huge - I have never felt so empowered as I did after giving birth as a first timer naturally. It was an incredible feeling, and I believe it did a lot for my confidence and self belief.
Fabsmum is also spot on in her other comments. Pain relief in labour affect two people - the mother and the child, unlike other medical situations.

Also, the last point she makes sums it up really. If the issue was really about degree of pain, then how come most mothers who have home births aren't terribly distressed about pain levels? - after all, they are giving birth without epidurals? How come it's often women who are in large hospitals, having lots of interventions who end up feeling cheated or upset by the birth?

My first birth was very painful.My second, a csection with epidural was practically pain free. Yet I felt totally empowered by the first birth, whereas the second was a medical procedure which I had done to me. It was necessary medically, but it wasn't satisfying in the way my first birth was (though of course I was delighted to have another lovely baby at the end of it!)

Of course it is totally up to each woman how she wants to approach labour and whether she wants drugs or not. But I think people who don't understand why some women want to achieve birth naturally are completely missing the point.

I totally understand why women want to give birth naturally, and I want to do the same myself. But I also understand women who don't want to suffer, and don't want to be made to feel they are harming their baby or risking their ability to breastfeed etc. there's so much moral pressure both ways..

If I was going to have a third vb, I'd definitely have another epidural.

As a first timer, though, Liznay, you may well be "counselled away" from having one . They were the words of a mw who guaranteed my epidural for my 2nd delivery, and when I asked what would happen if someone else wanted an epidural at the same time, that's what I was told. I can personally attest to that with my first delivery.

It would be well-worth clarifying what your hospital's approach is to epidurals and who gets them.

If I needed one again, then yes I would. But I would only have one if I needed it, just like last time.

I have done both ...and one in-between

With my first dd i had an epidural. It was horrific. It only worked down one side despite them trying to 'tip' me. It did however work well enough that i couldn't feel when to push and ended up with the ventouse delivery of a beautiful 9lb plus baby girl.

With my second dd, i refused the epidural and tried gas and air instead. It made me sick so in the end i plumped for pethedine ...which also made me sick
Twas a very good, quick and easy birth of lovely 8lb plus baby girl.

With my third dd i refused everything on the grounds that i hated the epidural and every other bloody method of pain relief made me feel sick!! I'm no martyr having no pain relief, but the pain of the labour was preferable to keep throwing up!! It was the shortest, easiest and most painful (obviously!) labour which resulted in the quick and easy delivery of a gorgeous 9lb plus baby girl.

Good luck

"But I also understand women who don't want to suffer, and don't want to be made to feel they are harming their baby or risking their ability to breastfeed etc. there's so much moral pressure both ways..."

I don't think anyone should be guilt tripped about using pain relief. I start from a position of trust in mothers to always do their best for their baby, based on what they know and what they feel able to cope with at any time - that goes for everything, not just pain relief.

But we do need to be honest when we talk about it and acknowledge that there are drawbacks as well as benefits of using drugs for childbirth - and be clear about it. I think if we stopped trivialising and dismissing the effects of labour interventions on babies and on breastfeeding then we might all feel a bit more militant when it comes to demanding better maternity services, be less tolerant of the poor care that results in so many of us needing to be anaesthetised from chest to knee even during a normal, healthy labour...