Do epidurals usually lead to further interventions?

[goodnightdarthvader1]

Want the option of an epidural (although I'm hoping I can tough it out with a water birth), but it seems that most epidurals lead to interventions, from ventouse to EMCS. Is that true in your experiences?

It is unclear on the evidence whether it is causation or correlation (ie. Whether it is the already more difficult births where women ask for epidurals ) but there are more instrumental deliveries.

My own epidural did end in forceps. And the fucker didn't work properly either.But at the time asking for it was the right decision.

I had an induction and needed and epidural to cope with the pain of the drip. I went on to need forceps as well as being prepped for an emergency c section just in case

Once you have the epidural, you usually have to labour on your back as you can't feel your legs to move around/kneel. Being on your back is the worst position to labour in which often leads to needing help.

3 epidurals, two forceps, one ventouse here.

Looks like a resounding yes

Was it worth it to take the pain away?

Nope I had really quick easy births and no pain
Brilliant and a really quick recovery .

I didn't have an epidural and ended up needing an emcs at 10cm. If I had the chance again I would definitely have had it much sooner!

Three epidurals and only one (my first, induced delivery), required intervention. And I've been able to change my position side to side and kneel with all of them, never laboured on my back.

I loved my epidural. I din't have it until 24 hours into a 28 hours labour, up to which point I used hypnobirthing only. I could not possibly have gone on without it (no gas and air available at my hospital). So it wasn't really a choice as such. I had no other interventions, although I was at 8.5cm when the epidural was just put in. I believe that having an epidural early can delay things a lot but I don't think it has that effect if you have it later. Once I had the epidural, I had a few massive contractions which got me to 10cm and ready to push. I'm convinced it was being relaxed due to no pain at last which allowed me to get ready to give birth. No after-effects of any kind after the epidural btw.

I'm trying to search for the thread from a few months ago, because some posters had linked to very interesting studies.

The jury is out of whether an epidural leads to interventions, or whether asking for an epidural is an early sign that you are going to need help.
There have been a few studies which seem to indicate the latter - If you need an epidural, it is a sign that the baby is badly positioned and will possibly need help
There are countries where women get an epidural pretty much as standard (I think France is one of them) and their intervention rates arent higher...

I've had three epidurals, only my first birth resulted in intervention (forceps) but I think that was due to it being a first birth, long labour, badly positioned baby etc

Had an epidural with my induction, was great, no pain nor interventions. Was DC2.

I don't think it's true that epidurals "lead to" interventions, necessarily. But it's the women having long and difficult births who are more likely to get an epidural.

For example, several of my friends asked for epidurals but didn't get them, as there wasn't time. The baby was out before the epidural would have been in place.

By contrast, I asked for an epidural around 15 hours into labour and got one. By that point I'd spent a full day in and out of the water pool, on the birthing ball etc, I was in agony and things weren't progressing. DS ended up coming out with forceps - but he was stuck and wouldn't have come out without intervention, regardless of the pain relief I had. It was that or a section.

If I were to give you any advice it would be to go with the flow on the day and not try to put pressure on yourself one way or another.
Yes, interventions aren't great, but it's not like you'll be given a straight-up choice between ventouse, forceps or a "natural" birth - interventions are used in difficult circumstances which you will most likely have absolutely no control over.

Forceps were absolutely the right thing for me at the time, as was the epidural. And I say this as someone who prepped at length for a drug-free hypnobirth in the water.

I also had epidural followed by forceps. But the research I have read indicated that there is no real proof that it's the epidural that leads to intervention.

But let me tell you my experience, it might help you make up your mind. I had a very very long first labour with at least 8hrs of heavy and fast contractions before I got my wonderful epidural. So without question I was exhausted which may have led to the forceps as much as the epidural did. I had a standing epidural which was wonderful. I hit a button every time it started to wear off, approx every 40 mins. My midwife told me I was 10cm but it would be another hr before pushing so I hit the top up button. 5 mins later, consultant came in and told me I had 30 mins to push baby out and to get started. I could feel nothing and the pushing was a disaster so ventouse failed twice and finally the barbaric forceps worked.

I think that a standing epidural which is a light dose that wears off every 40 mins or so, gives you a good chance of no intervention because you can let the contractions roll again when the time is right and feel your body properly when you need to.

A non-standing epidural, well I wouldn't like my chances of trying to push with one of those. Could be fine, especially on 2nd + baby but I know how useless I felt full of epidural.

I recommend you find out if your hospital does a standing epidural or not.

That was the main reason I wanted to avoid epidurals at all costs. The old "cascade of intervention".

It stands to reason - if you can't stay upright and/or labour properly, the chances are more intervention will be needed.

I had an epidural, was being induced. But it made my labour day absolutely lovely. Pregnancy had been hard on my relationship and so without pain or interuptions my husband and I spent a nice afternoon together, me knitting him playing chess!!

Ended up ventouse but I think that would have happened whether or not I'd have had an epidural as my son had got in a tangle with his cord.
K

For a bit of balance, I had an epidural with my first baby and had no assistance to get him out My best friend also had one without further assistance. By contrast, my sister in law didn't have an epidural and had a ventouse delivery.

Was it worth it to take the pain away?

No. Because it didn't take the pain sway.

And forceps caused lasting (albeit minor) damage.

I think in my case it probably helped cause the forceps. I couldn't push her round the u bend from flat on my back and she became distressed. Also, once I was on my back she couldn't move from back to back. I needed the epidural because the labour was hard, but I think it made it even harder .

Totally worth it for me. I would choose one every time.

Just my experience but I had an epidural with my first labour and yes it lead to the need for a ventouse delivery. I didn't have an epidural with the next 2 labours as I found it took too long for me to recover.

Epidural due to induction so they had already started interfering because I was 12 days over. Rsulted in EMCS. Admittedly it gave me some much needed respite from a 20 hour labour before they decided he still wasn't coming out and wheeled me to theatre but I would still never want one again. The fear of having it put in, the awful shakes I had for weeks, the sleep paralysis that had me crying everytime I thought I was dropping off to sleep and the resulting constant lower back pain mean I had a pretty shit experience.

Good to hear it's not been the same for everyone though!

I had an epidural for my back to back labour, I'd been in labour for 16 hours with no progress so they had to give me induction drugs. I don't remember feeling like I had an option with it although I know I signed something, it didn't matter though as I wasn't against having one and the relief was like nothing I'd ever felt before. I didn't need any further assistance and it gave me chance to rest before pushing. The midwife did tell me that having an epidural would make it more likely that I'd need assistance at the pushing stage but she said sometimes that was because if other factors. I always blamed the the epidural for tearing as I couldn't control pushing, however, when I had my second baby I tore again and I still wasn't in control of pushing despite feeling everything.

A member of my family is an obstetric registrar. The general consensus is that epidurals are more likely to lead to intervention.

The reason being though, as a pp pointed out is it's often the long difficult labours that need intervention - usually because the woman is exhausted and struggling with the pain. Can't feel contractions and simply cannot push the baby out.

That said, if an epidural is done at the right time, it enables a woman to rest, sleep and not be suffering from fatigue when the time to push comes. By this point the epidural could also be starting to lessen so there is still "sensation" and she can actually push.

So not all epidurals lead to intervention - but often it's the circumstances requiring epidurals that often result in intervention if that makes sense?

I had an epidural both times and both were the best thing! I heard other Mums screaming in pain and I sailed through with a good rest before it was time to push. I had to be woken up to push for my first and did have forceps but this was after a long labour. The second epidural was better in that I actually wanted to push but was pain free. Unless you really like the idea of screaming with the pain, then an epidural might be for you. No-one ever considers the distress of mums when the pain is so bad and what that does to the baby. Epidurals can be a blissful way to give birth with little stress involved, for mum and baby.

Thanks everyone. Is a standing epidural a mobile epidural? And do you have a cannula in when you're given an epidural?

Goodnight, I believe so yes, and yes, you have a cannula in. Weirdly I wasn't allowed to stand with my standing epidural (they were progressive but not THAT progressive) but the important thing was the ability to let it wear off regularly.

Not sure if everyone knows this but depending on the hospital, there is often a policy of automatic catheter. Recent studies have shown that these dont need to be used until there is a problem with urinating post delivery but most hospitals just shove them in along with the epidural. I got an infection from mine. Along with MRSA and a third separate infection from someone along the way who was dealing with my stitches. Should have made a complaint. It was disgraceful. But my point is, if you are considering an epidural, your two questions to your hospital/midwife are:

1. Is a standing epidural available?
2. Do you automatically insert a catheter.

Because of the two above being no and yes in my backwards hospital this time, I'm not planning on an epidural. That and the fact that they no longer have even the possibility of a private room (shut them all down) and the main ward holds 24 women which is where i would likely end up if I have an epidural (as you must stay the night).