Epidural? what's the down sides? I like the thought of less pain!

[JoeMommuh]

I had first birth with just gas&air and a shot of pethadine. Normal delivery, about 18 hours from losing the mucas plug to delivery - and 7 hours of proper labour i guess.

2nd birth - C-sec for reasons outside my control,decided long before labour started etc, no reason i couldn't delivery naturally 3rd time round time if baby is happy.

3rd birth - .... so whats the downside of an epidural? I know it sounds flippant but i'm picturing reading a magazine whilst i get up to 10cm instead of shouting and screaming and it's a nice fantasy!! I also have the choice of another c-sec which is also tempting... i don't enjoy pain :) have a meeting with consultant soon to discuss birth options and they might try and put my off an epidural for cost reasons, but i'm wondering what the people of mumsnet have to say about it if they've experienced it?

I think to say it is correlation and not causation is simplistic tbh. Often it is a messy muddle of both.

A back to back baby may lead to a long an unproductive labour. So an epidural is requested. But then being flat on your back limits opportunity for the baby to turn and makes pushing it out a lot more difficult. So both correlation and causation in my case.

I had epidural with number 1 and not with number 2. The epidural made things much harder as I couldn't feel as well to understand the type of pushing I needed to do. I was also on my back, not mobile, and ended up with a ventouse and a subsequent 3rd degree year. I chose an epidural as it was day 3 of labour. Ds labour was much quicker- I toughed it out with water and gas and air and it was easier to push and no tearing

I managed both times without. For me early labour pains were entirely copable with. There was only an hour or two of intense pain after which I could get up off the bed, run my own bath and walk Dd to the GP's for her first day check. I wouldn't have traded that freedom for a couple of pain free hours,never,ind the medical complications. so for me downsides are catheter, immobility and longer hospital stay.

OP, in al honesty, if it's your third, I doubt you would have time for an epidural.

Down sides? Slows labour, can't feel contractions, doesn't block all pain, I still have back pain from site (although as had to have a spinal block too so can't really point finger directly at the epi although I've heard of 'tunnelling' from a lot of other epidural ladies...) the worst for me was that it's made the horrible midwife think it was ok to move me as she pleased.
My LO is three in December and I still see a physio every fortnight and take pain meds daily for my pelvic / lower back nerve damage. I've even had to have minor surgery. There is an attitude among some midwives that PGP goes when the baby comes but it doesn't always and having an epidural makes them think is ok to move you as you won't feel it (I did but they just said I was being dramatic?) and it would clear up straight away (it didn't). If you don't have one they will have to be more careful.

I fucking love epidurals. Right up there on the short list with fire and the wheel in terms of human advancement.

I've had experiences with the epidural turned off/ran out - I've sampled the agony so I know what I'm talking about.

With an epidural, instead of feeling the contractions (like being torn apart by wolves), I just watched them on a screen.

Fuck yeah, epidurals!

I had a great experience with having an epidural and have told friends who have asked that they should demand one if they feel the pain is unbearable.

While there are risks I think the biggest downside is that you prolong your labour. I think 5 or 6cm was the right point to get an epidural for me. As for epidurals not working, I can't help but think hospitals must be sending the students to perform the procedure. Here in the US, in my limited circle of female friends and those on our town FB group page, no one has mentioned any issues with their epidural being administered.

I think it's best to have it there as an option. If you want it have it otherwise use whatever other method for managing the pain.

I had one for DD1, 25 years ago. It was a godsend even though I could still feel the contractions. I wanted one for DS three years later, but the anesthesiologist wasn't available. I was induced and the pain was horrible.

After that I managed without one for the next three births, with all babies smaller than DS was thankfully.

DD1 was born just after midnight, and I was up next morning before 8 looking for my breakfast as the food service people hadn't expected me in the room I was put in. I was ravenous.

Oh and DS required ventouse, with no epidural. He was just really big.

sorry to serial post -- no gas and air either as I was in the States.

Interesting thread. What I am curious about is whether the "complications factor" from epidurals - be it assisted deliveries, ineffective pain relief, post delivery complications and so forth - is as high in countries where epidural are standard procedure for labouring women and they are given freely and early. Has anyone looked into this?

Practically anywhere in the (western) world uses epidural and nothing else for labouring women. Certainly we hear a lot about the dangers of epidural for the baby from the NHS, when Pethidine is "banned" in many countries and gas/air unheard of. DD was born in Spain so for me it was epidural or nothing. I went down a very expensive natural birthing route, but ended up on an epidural after 50 hours and 1-2cm dilated. Once I was "hooked up", she was out in two hours (I kid you not!) - a wonderful experience and I wonder why I ever listened to the natural birthing hype! No complications, and although I tore a bit, this healed up fine thanks to having no episiotomy. (Definitely better to tear than to be cut, for post-delivery healing, I did thorough research on this).

In response to your original post, OP, I would be far more concerned about the risks of VBAC - which are seems to be a UK /NHS "thing" - than I would about an epidural. I had understood that one of the main risk factors was rupturing the uterus where there was a weakness from the c-section. I would have thought this risk would increase with an epidural when you can feel uterine sensation(?).

As a final remark, prior to my daughter being born a few years back my husband came across a research paper that had consulted OBGYNs about their preferred delivery method for themselves or their partners. Overwhelmingly, 95% or so would elect for c-section!!! I would conclude from this that the risk of complications from natural birth (with or without epid.) far outweigh the drawbacks of a c-section. I will see if I can find the article, but if men had the babies I doubt we would still be so stone-aged about having them.

The epidural was the best bit of my birth.

As a final remark, prior to my daughter being born a few years back my husband came across a research paper that had consulted OBGYNs about their preferred delivery method for themselves or their partners. Overwhelmingly, 95% or so would elect for c-section!!! I would conclude from this that the risk of complications from natural birth (with or without epid.) far outweigh the drawbacks of a c-section. I will see if I can find the article, but if men had the babies I doubt we would still be so stone-aged about having them.

It isn't actually as simple as 'they'd opt for them so they are better'. There are all sorts of factors that go into that decision, not least the fact that surgeons see the worst deliveries, and that as medics they are likely to feel most comfortable with a controlled medical route. In similar surverys midwives normally say vaginal delivery without epidural if they can manage. I am not sure you can take a lot away from those types of surveys.

There is no downside. I had an epidural with my 2nd and had an incredible experience. NO intervention, baby wriggled out happily after I did lots of great pushing (wasn't exhausted after hours of agony).
First birth - no epidural, just gas & air, and baby was delivered by ventuouse because I ran out of oxytocin and was passing out with exhaustion having been in labour & agony for days. My dd screamed for 48 hours after birth and was miserable.
Whereas my son born after an epidural was very contented and trauma-free.

Hmmmum - Did you read the thread. The phrase you were looking for was "there was no downside for me".

VeryPunny - Recent evidence is NOT that epidurals cause complications - it's that births where mothers request epidurals are already more challenging and more likely to result in interventions with or without epidural.

I've always wondered this. Purely anecdotally, but lots of people I know in RL (and hear about on MN) decide to have an epidural more because they are exhausted and overwhelmed than just the pain.

If you've already been labouring for several days and are exhausted, you probably aren't going to labour effectively or be able to push very well anyway. How do they then work out what complications were caused by the epidural, and what were caused by being too exhausted to push well?

Thurlow - I agree. But I suspect in many cases it is a mixture. Especially where mobile epidurals are not available so the pushing is made more difficult by the mother's prone position. I certainly feel mine was a mixture of correlation and causation, but I suspect on a survey they'd say it was just a difficult birth anyway.

Practically anywhere in the (western) world uses epidural and nothing else for labouring women. Certainly we hear a lot about the dangers of epidural for the baby from the NHS, when Pethidine is "banned" in many countries and gas/air unheard of.

I know a lot of OBs/maternity nurses/pediatricians in the US and they uniformly are shocked that pethidine is considered acceptable in the UK, as it's an opiate that passes through the placenta to the baby. Apparently there are some American hospitals now starting to introduce gas and air though.

I've had epidurals twice (overseas) for uncomplicated deliveries and for me there was no downside. The labors were quick and totally painless (the most painful part was contractions when I left home for hospital, and that was just backache type, totally tolerable), no major tearing, and DC seem fine 5 and 7 years down the line. If men gave birth, it would always be like this. It would be an automatic procedure, you could opt out if you chose to and preferred some other approach but nobody would stigmatize you for choosing pain relief.

Oh, and I'm a medical professional. I consulted good people, a read a bunch of research papers and guidelines before making my decision. I could have had an elective C section too but chose an epidural because of the quicker recovery time, and my OBGYN and anesthesiologist were fabulous. I felt fine physically a few hours after delivering. Every procedure has its risks and downsides but it really worked for me.

Maursh - that's a really good question about other countries. I believe epidurals are offered as routine in France. I'd love to know their stats for assisted births etc.

For me, an epidural completely blocked all pain. It was wonderful. Clearly that isn't the case for everyone.

But it did make pushing hard - I couldn't feel anything. And of course I was flat on my back so working against gravity. I had an episiotomy and Ventouse and I think this is fairly typical with an epidural delivery. Recovery takes longer too - I've known women who didn't have epidurals looking as fresh as a daisy by the next day whereas I felt pretty zonked for the entire week afterwards.

Also, just in answer to Libraries - I've seen that study quoted too, and it's not 95%. A 1996 study showed the figure as 31%:

www.theguardian.com/society/2008/jul/11/nhs.health1

Of course, there are probably other studies too but I'm suspicious of the 95% figure.

Hacksmum- thanks. That's interesting. I shoild perhaps have questioned the 95% that poster quoted instead of responding at face value.I still think that when mw's say one thing and consultants the opposite there is probably a lot of personal prejudice in there that makes it not that useful for deciding ourselves.

I know a lot of OBs/maternity nurses/pediatricians in the US and they uniformly are shocked that pethidine is considered acceptable in the UK,

Pethidine is definitely used in labour in the US but is called by its trade name Demerol. There is loads of info online about opiates in American usage, although it may not be available everywhere of course.

my husband came across a research paper that had consulted OBGYNs about their preferred delivery method for themselves or their partners. Overwhelmingly, 95% or so would elect for c-section!!!

Definitely American. Several of my female obstetric colleagues have given birth in the past few years (I am a midwife) and only one has chosen elective section and that was for a medical indication. The last obstetrician to give birth was pregnant at the same time as me and was more determined to stay low risk and intervention free than I was! I can't say it surprises me as obstetricians are more familiar than most people with the benefits of a straightforward vaginal birth.

FWIW I agree Libraries that there is a mixture of correlation and causation with regards to epidural use and interventions. I had an epidural for my first birth 9 weeks ago. Labour was progressing normally but was getting extremely intense and it was really the fear of knowing what was to come that made me decide to have one, there weren't any complicating factors. It didn't slow down my contractions at all but it numbed my right leg, which only wore off partway through pushing and I ended up with a prolonged second stage and an episiotomy and ventouse. But they also found that the cord was extremely tight round my baby's neck and was holding her back a bit. So I might have needed the ventouse anyway, or I might have managed to push her out if I hadn't had the nuisance of the numbness. We'll never know! I'm still glad I had the epidural but next time I would definitely plan to tough it out, knowing that second labours are generally quicker and easier. (That being said, epidurals also cause fewer problems in second births IME and rarely result in instrumental births.)

bue America is a pretty big country and at my local hospitals Demerol isn't an option for management of pain during pregnancy. What is offered is an epidural and a top up if you need it. We also have many units where alternatives to manage pain are offered. I had massage and acupuncture provided when I was induced with my first.

VBACs are offered here By my obn group but they want a good gap between the kids. I've not got big enough gaps plus I've got a history of going over and considered high risk as I had preeclampsia with DD. The option for a natural birth is there. I'm only 14 weeks today but my obn is already talking to me about my options. If I go past 40 weeks a CS is what I will elect as can't be induced and going above 40 wks will mean a bigger baby when they already run big in my family. Dd was 8lb8oz and DS was 10lb 6oz.

My (large, teaching and research) hospital in Switzerland claimed that according to their data, epidurals lengthen the labours for about 10-15 min. They do mobile epidurals though, so you don't have to be flat on your back. I'm not sure I would have the latter kind.