People's reasoning behind wanting an Epidural?

[Spice17]

Following on from my earlier thread about being gutted about my birth options, it's got me thinking about reasons why I might be considering an Epidural e.g. really trying to think about and understand why I might want it, my reasoning etc.

I just wondered if anyone else is mainly considering it/had it previously for the same reason as me - for the possible tearing and stitching afterwards?

I think it's what I'm most scared of, much more than any pain during labour, feel I can cope with that but am pretty scared of feeling the tear and stitching after.

Can anyone offer any pearls of wisdom re this? Do you 'feel' the tearing or does the pain all merge into one? Will I even be that bothered at the end?

I'm thinking a natural water birth feels 'do-able' but that bit is stopping me somehow........

On a positive note only one in four need an epidural so I wouldn't be put off going to a birthing centre or mlu. Chances are you won't need one.

I would also not recommend pethidine. I had it for first and it made me totally out of it and I struggled to focus on pushing. Water birth and gas and air second time was so much better and I felt completely fine after.

People's reasons for wanting an epidural?

Seriously?

Because they are in AGONY.

What else would possess you to want an injection in your spine?

The only thing I ever say about birth is keep an open mind re: pain relief. The truth is you just don't know how you're going to feel until you're in the situation. Even with subsequent births.

I had epidurals with both of my DC's because in all honesty I just didn't want to be in pain. Yes there is a higher rate of intervention but that doesn't mean it will definitely happen. With DS I had a minor tear which the mw ummed and ahhed over stitching (she did in the end, I think it was 1 stitch), with DD I didn't tear at all. Was still pretty sore afterwards though.

I had a waterbirth with DD2, second degree tear. Didn't feel a thing. For the stitches, gas and air and a local. Again, no pain.

I had an epidural with DD1 and it was hellish for me personally.

I know I said this on your other thread, but your best bet if you really wanted to try it all woudl be to start with a home birth and make a decision to transfer if you feel you need to. Home birth might not be for you, but worth considering. Also, whilst they might not be super keen on 'try it all' as a plan, if you go for the natural birth approach and it isn't working for you the MW's are likely to be pretty keen to transfer you. Where that gets difficult is, as applies near where I grew up, transfer from the MLU to CLU is 30 mins by ambulance.

I got one because I couldn't cope with the pain and G&A made me feel ill. I was adamant I didn't want pethidine so was left with no alternative. I had an episiotomy, which I didn't feel but did feel the stitches.

With my second, I was booked for the epi but things went too quickly for anything other than G&A. The lovely midwife spent precious time counting me through breathing and made sure I was ok. It was great! I needed another episiotomy but thanks to the G&A and the very good doctor who stitched me, I felt nothing. They had to prise the mouthpiece from my hands!

I used Hypnobirthing breathing & relaxation techniques during labour and found contractions very manageable. You couldn't have paid me enough to have an injection in my spine during labour, and that applies right up to 10cm dilated. When I arrived at hospital, they found DD was severely distressed and I had the most urgent form of emcs involving general anaesthetic. I was overwhelmed with relief that it would be a general as I was terrified of the idea of a spinal or epidural, the contractions were much nicer than the thought of the massive needle!

Having said that, I have two good friends who were both induced and who had epidurals when the drip was started - they both speak very positively about their birth experiences and neither of them tore or ended up with any interventions. I actually had it in my birth plan that I wanted an epidural if I had to be induced as I had heard the contractions were stronger and faster than with natural labour. Once labour was in full swing for me, I wanted to be constantly mobile and I couldn't have sat still long enough to have one even if I'd desperately wanted one.

My biggest mistake was assuming I'd actually get one when I wanted it!

Ds - long, awful labour. Finally got an epidural after I think 4 hours of screaming for one, after which I felt absolutely fine but ds firmly wedged & delivered by ventouse.

Dd1 - induced due to threatened pre-eclampsia, & consultant refusing me an elective CS (was in a state of advanced gibbering terror at prospect of re-run of ds's labour, begged for CS). Promised epidural as soon as the induction kicked in. Then some other selfish caaaaaaaaaaah turned up in an ambulance & nicked my anaesthetist just as he was on his way to do me. Found impassioned swearing to be surprisingly effective pain relief. Epidural finally administered too late to be of any use.

Dd2 - induced again, epidural, dd2 decided she was quite happy where she was, nearly an ECS.

So the one thing I'd say is if you do think you might want one, start hollering asap. You can always say no if you don't need it, but trying to be all warrior princess, then finding that you are absolutely desperate for effective pain relief & can't have it because there's only one anaesthetist on duty & you're in a queue is NO FUN AT ALL.

I don't know if anyone has mentioned it before but one of the main reasons I ended up with an epidural (which was a great decision for me by the way!) was because I was induced. I was determined beforehand that I didn't want a needle in my spine (in the end I couldn't have given a damn - I wasn't even thinking about anything other than getting a bit of relief). Now I haven't done it without being induced yet (hopefully this time I will) but from what I understand, it gets more intense quicker when you're induced and your body doesn't always have time to keep up with the endorphins (or something like that!)

I didn't have a problem with knowing where to push and i had a very tiny tear (according to the doc because I kept on pushing when she told me to stop!) - for me, the epidural was great and just what I needed at that point. I also don't think it's actually a decision you can really make until it actually happens (in your first labour at least) - you just don't have a clue what your pain threshold is or whether the baby is going to be the right way around etc etc - personally I'd want to be somewhere i could have an epidural if I wanted it but I'd try and do without if I could - but every single person has a different comfort level (before and during labour) and you have to decide what is right for you in the circumstances.

I had a mobile epidural in each of my labours (caveat: not in Uk and gave birth privately- outcomes may not be typical). First one I left a bit late. Succumbed when it felt like someone was tearing my right leg out of its socket (I think i now know what it was like to be racked c. 1550). If someone had said "put up with this for another 2 hours or I can shoot you in the head" I'd have said "don't miss".

The second one I had at 5cm when the pain was still fairly manageable after 3 hrs of labour. I gave birth 2 hrs later after 10 mins of pushing and had no stitches. Throughout the remaining period of labour I could always feel the pressure of the head/ waters, but not the pain of the contractions.

My logic the first time round was "i must do this pain free or other people will be judgy and think I am a failure. Oh crap. I think I'm dying. Get the anaethetist"

Second time my reasoning was "This is my labour. Why do I care what anyone else thinks? This doesn't have to hurt that much. Get the anaethetist"

Btw- your logic is flawed because mine had worn off so I could feel the crowning in technocolour so I'd have been able to feel the stitches, but as someone said, they usually give you a local for that anyway.

I was induced and only had gas and air BUT labour itself was only 2.5 hours - couldn't tell you what would have happened if I had been going longer.

I didn't want an epidural for various reasons, all to do with me. I did ask for one, and I'm not the only one who has done it - I was in transition, and I was having about 3 contractions at the same time too. I didn't tear at all but that's probably more to do with perenium massage and a small baby so I can't help with stitches and tears.

Me and DH had done NCT classes, but I'm pretty sure any class or research that helps you understand what your body is doing helps. Transition is wierd, people ask to go home, they ask for their mum, they ask for epidural, they even announce they arn't doing this (giving birth). I feel it's really important to be confident your body can handle what it's going to be put through, although my baby was small I think one of the reasons I had very minor grazing is becasue a) DH massaged my perenium and b) I relaxed and let my body get on with what it was telling me it needed to do and I just concentrated on not fighting it. I know it sounds a bit woo, but it's easy to over think loads of stuff and make yourself tense up - so if you were going to graze, you tear, if you were going to tear you tear worse. If you feel like you need an epidural to be confident you can cope with what is going to happen to you then it's important you get one as being stressed and worried will not help you give birth. It's your birth and every woman is different, I'm off for induction on monday so I may totally change my mind by the end of the week, but that's just based on my one experience.

I wish I had been given better information before the birth about induction and pain relief.

As I had no experience or idea, I just thought I'd see how I went and then work my way up the menu of options.

Anyway, when I got to the point of wanting an epidural, they told me I was not able to sit still enough to get one!!! Bastards. Of course I couldn't sit still, I was in agony. This left me no option but to have even more pethidine but that made me completely out of it. I had a very long labour and it came close to EMCS- this would have had to be GA because I had no epi in - fortunately it did not come to that.

If I have another I would still try and do without and work my way up the options UNLESS I have to be induced again - the main problem was the fact I was forced to be immobile on a bed for 10 hours. If that happens again I will clearly write in my birth plan that I am not going on a syntocinon drip until an epidural is in place.

I have had 3 children and am pregnant with my fourth.

No way would I have had an epidural (unless it was an emergency section i suppose) because the thought of someone putting a needle into my spine horrifies me to the extent that it makes me feel sick.

I was induced with my first two and had gas and air, no tears and short labours. My third came naturally and again I had gas and air and no tears. I was lucky though as my labours are short and not very painful (compared to what I've read about how much agony some people go through ) I found the thing that helped me was to keep the gas in my mouth constantly. I never took it out and counted to 10 over and over in my head - I was fucked! I don't remember a thing really about my labours I was so far removed from reality! But it worked for me so hopefully will be doing the same again in a few months with this one. Oh a vague memory coming back of being on my knees on a visitors chair ignoring the perfectly fine bed and ball available!

I wanted a water birth but there was no time to fill up the pool unfortunately. Our hospital seems to be the same as yours, delivery rooms downstairs and a midwife unit upstairs, luckily I got an upstairs room.

Make sure you talk to the place where you will give birth.

When carefully choosing what I might need - my community MW swayed me in the end to an epidural.

HOwever when i got into hosptial those MW put me off one.
I got through it with pethadine, but the pain was too much, that was with tens/aromatherapy and my DH constantly massaging my lower back for the whole six hours and a birthing ball.

I tried to get into the pool but seeing as I couldnt even move my foot from its side to flat - there was no way I could get into that pool!

This time round I am going to talk to MW at the place where I will have second DC about having an early epidural and then make up my mind about ELC.

I also put in my birth plan for the MW to encourage me without major relief for as long as possible, but the pain was just beyond all imagination. It was too much. I was very very lukcy that it was only 6 hours, I honestly do not know how women manage for longer.

i havn't read your other thread but i did tear during birth and didnt even know until they were doing the stitches, i did feel the stitches and yes they were painful but the pain was a bearable. i have only ever had an epidural with my first but it never got chance to work as i was rushed for an emergency c sec so dont have much of a clue what pain it blocks out, but i did have diamorphine that was brilliant also pethadine and that was also good, also as aufaniae said the pain is different for everyone. i think some people look at pain relief during is looked at the wrong way by some people. i say why suffer when you dont have to.

I had gas and air and TBH, I could feel the tearing but it didn't hurt. The labour itself was so painful that the tearing didn't register as painful.
As for reasons behind choosing epidural, I am going to have epidural next time, due to the pain. As simple as that.

I think you are more likely to tear though if you have an epidural.

Use almond oil before the birth to lessen the chances of tearing.

Another one coming into say I am worried about tearing. But nowhere near enough to consider an epidural. I say this with the caveat of being 34 weeks pregnant with my first - I firmly believe and trust all these women who say they don't notice the tearing, that it's all mixed up in the pain of birth. My own mother and MIL all say the same thing - all these women can't be wrong! And I do tend to think - with no empirical data - that epidurals lead to a greater chance of intervention, which leads to a greater chance of tearing/being cut/generally suffering a bit more than if you go through the intensity of the sensations of giving birth. I say that with the understanding that there is nothing wrong with choosing an epidural - just that there's a flip side to everything. I am one of those that tends to err on the side of not wanting one at all because I think you need the sensations, you need gravity on your side etc - but let's see how I get on in six weeks!

I think it's mostly mental. The thing that keeps going through my head is - when I'm crowning - thinking, OMG am I tearing?? I do trust every single woman that says they didn't feel it but is just knowing it could be happening just as bad anyway? That's the thing that bothers me. But I keep telling myself, it is but a tiny aspect of the entire process so be brave, grit your teeth, and get through it. I think more than anything it's the apprehension of it happening - the reality is probably no where near what it is in my head but still - I find it a bit of a head fuck to be honest

When I was crowning I didn't give two shiny shits about if I was tearing or not, the only thing I thought of was that that baby was coming OUT! Although I didn't tear, so perhaps that is why I didn't think about it. Who knows.

I had the birthing pool in hospital but after hours of nothing happening the pain got too much and i had epidural at 9cm. I wasn't even considering possible tearing just wanted rid of the pain. Did have episiotemy but of course couldn't feel it and was stitched up rather neatly.

The evidence suggests that despite the slight increased risk of intervention you are less likely to have a serious tear if you have an epidural. They think because your pelvic floor is more relaxed and you are less likely to push when you shouldn't. I think the relevant research is mentioned in the NICE guidelines if any wants to look.

It also has the evidence that demonstrates an epidural is the most effective form of pain relief in labour. Other methods may of course be enough for some women but this is why some women opt for an epidural.

To reduce the risk of tears you could try perineal massage and using an EPINO also. I had an epidural and used an EPINO. There is not much good quality evidence for the EPINO but some small trials including a few independent of the company that makes it. For my part I'm convinced it was helpful - I only had a couple of scratches and it really did feel like good practice for the second stage.

I'd planned the whole home/waterbirth thing, but ended up being induced. To be honest, I was coping fine with the initial contractions (the gel) - they were intense, but not painful ifswim, but once I was on Syntocin, and it'd been ramped up to full whack, the contractions were just relentless. I needed the edge taken off (I asked for paracetamol, so they can't have been completely horrific to me - was given morphine - did nothing).

TBH I think that had I made any kind of progression I'd have gritted my teeth and been OK, but nothing was moving (I'd been at it for 3 days by this point and my waters hadn't broken and I was barely dilated - despite contractions every 3-5 minutes when I was awake and moving) I could see EMCS looming, was knackered and despondent, and so I took the epidural when offered.

In the future, I would try to avoid one unless I was in a similar situation (no reason to hate it, but I do prefer knowing what's going on rather than being numb), and I wouldn't bother with the morphine at all - but we all have different reactions and birth experiences.

The thing I didn't understand prior to birth, is that to a large part, it's luck of the draw whether you end up with an easy birth or in so much pain you feel you need an epidural. And that the range is huge and to a large part beyond your control.

With all this talk of positions, hypnobirthing, etc etc, it gave me the impression that labour pains were something that could be managed with the right technique / environment / frame of mind / positioning.

But that's not how I see it now I've experienced it.

When you give birth, you will experience some pain. But no one can tell you before hand how much pain. This may be manageable, and within the range that positioning, hypnobirthing, environment, frame of mind etc can make a lot of difference. Or it may be so extremely, unimaginably painful that tearing or needles in the back are the last of your worries.

Asking how painful labour is is like asking how painful an accident will be! For some, minor cuts and bruises, for others pretty bloody painful indeed.

And people saying "I didn't need an epidural" only relates to their own labour. It doesn't mean that labour in general is bearable without an epidural. It means that for some people it is.

The OP asks "what's the reasoning behind choosing an epidural".

For many of us, there is no "reasoning". It becomes clear that the pain of labour is going to be unbearable (and I'm not using that word lightly) and then screaming for pain relief is an instinct, not a reasoned "choice".

I would urge against cutting yourself off from that possibility. I'm not saying choose to have an epidural now. But making sure one is possible is giving yourself a back-up. Friends of mine have been traumatised by the amount of pain they had to endure without really understanding that it might have been a possibility.

I hope I'm not scaring people here, it's very possible that your labour will be totally manageable! But it's rash to cut yourself off from help that you might need in the event IMO.

Also remember there is no shame in pain relief, and no gold medal for going without it. The only thing that matters is that you both come through safe and sound. You have nothing to "prove" by giving birth without an epidural, and you don't need an excuse if you want one. It is entirely up to you, so go with what you think is best for you on the day.