To epi or not to epi?

[iamwhaticallpregnant]

i am nearing the end (36 wks) and need to prepare for the birth. My question is - should I have an epidural?

All I would really like is either "you should have an epidural because ........" or "you should not have an epidural because ........" in 2 sentences or less.

Please please please no stories of horror and pain - i am a first timer and completely terrified of what to expect and dont need anyone else telling me how extrutiatingly awful it is :-(

Lexy, I don't watch obem but that doesn't sound exactly like what I'd call fobbing off, though I can appreciate if you're the woman been told that it might feel like it. There's only one anaesthetist on the ward so if someone else is having an epidural then anyone else will have to wait for the dr to finish the first person.

thanks every1. just to clarify - its not my opinion that midwives fob u off when it comes to epidurals - just the very very strong opinion of one author.

what viva said, you can't just grab any old doctor from the hallway!

Yes, I just didn't want you to think that all midwives would fob you off, as if you did you might ask for an epidural before you felt you needed one as you'd be expecting it to take a few hours from asking to getting one!

Though I suppose some midwives might. If I were you I'd tell the midwife right at the start that if and when you ask for an epidural it means that you really want one. Not that you want encouragement for another few hours.

I get that. But what seemed to happen in that clip was that they didn't take her request at all seriously, and were saying 'ask later' - but she should have had the right to ask then, and get in the queue - how was she to know when 'later' was a convenient time to ask? I know they don't show everything on those programmes, so I guess it was written in her notes as 'first asked for epidural at xx:xx time' but they could have said any number of more positive, empowering things like "you're doing well, it may not feel like it but you are coping, try breathing through a few more" or something factual like how dilated she needed to be.

The point is it wasn't a straight answer

aha - spectacular cross post! every situation is different.

i wanted one for dc1 and dc2 as was not in the uk so could have a walking epidural where you can still feel when to push. didn't get one as everybody too busy on other deliveries and/or emcs.

with dc3 now in uk didn't want one as i knew i could do it without but mainly because i did not want to increase the risk to have to go thru an assisted delivery.

Have to say, I was induced for my DS birth and they pushed for an epidural before they even started the synotcin, advising me it's more painful than normal labour, that i'll probably ask for one later anyway so better to get it in now.

I really didn't want one, but declined, but just wanted to point out that it's going to differ from each person, and because they may encourage one woman to stick through it without an epidural doesn't mean they'll take that approach with everyone.

If you genuinely want one, ask, and you don't need to ask at the beginning, but just beware if you do progress too far, then sometimes it is too late to get one (but by then, you've generally done the hard work anyway :-)

Pros
Excellent pain relief
Don't slow down labour if fitted after 4cm
Don't increase risk of CS
If not coping and things not progressing quickly then can stop you from completely loosing it and getting into a real state
If you need stitches afterwards it's more comfy than local

Cons
Some evidence that slow labour at less than 4cm
Can't always feel where to push depending on the density of the block
Increase risk of instrumental delivery
Increase risk of other intervention due to need for continuous fetal monitoring
Can't be instantly mobile afterwards and just hop into the bath
Will often need intermittently catheterising during labour as the bladder needs to be emptied every 4hrs(ish) and with an epidural in you often can't feel when you need to pee (the risk of the bladder overfilling is damage to it in later life so worth having)

At the end of the day, if you're progressing quickly and everything else has been normal and you're coping well you won't need one as you'll be able to see the light at the end of the tunnel! If you've already needed other interventions, progress is slow or it's just bloody agony then go for it. Only you will know if it's the right thing and you can only really make that decision at the time with the information you have then but at least now you're fully informed! You do need to be aware though that if you decide you want one you do join a queue! Most places have 1 or 2 anaesthetists and emergency theatre cases obviously come first, followed by those needing epidurals for medical reasons followed by maternal request and these are generally first come first served!

Hope that helps