Epidural or not?

[leighdinglady]

Hi all

Just wondering if anyone can advise on what pain relief they went with and why?

I'm 29 weeks now and starting to think (panic) about the birth. There's been some really REALLY traumatic births in my family recently and I'm so worried about something going wrong that I'd like to not worry about pain relief too.

In the ideal world I would have gas as I'd still like to feel in control and be able to feel something and not be numb. I want some of the experience but without it being too horrific.

However, I don't know much about epidural. Does it mean you really can't feel anything at all?

Look at hypnobirthing. Even if things deviate from original plan apparantly it can help keep you calm and grounded.

I asked about this a few months ago. You might find that thread interesting

www.mumsnet.com/Talk/pregnancy/2993591-Tell-me-about-your-epidurals

To be honest you can't really decide what pain relief you'll want/need as you've no idea in reality how much pain you personally feel or how well you cope with it.
First thing, don't listen to anyone's birth stories and if someone starts just say I'm really sorry but I'd rather not talk about it. Last thing you need is to be terrified before you're even there.
Second thing, everyone's labours are different even your own. I've had hard and I've had easy, you don't get to predict it.
Third thing is helping yourself keep calm and not caring what you need if anything when you get there. Look up hypnotherapy, in all honesty I found it a load of mumbo jumbo when I was watching the YouTube videos but when it came to it I actually did my own less voodoo-ish version and it helped me stay calm in my own way.

At the end of the day the female body was actually designed for this job, just think of it as having a really big poo, except with a lovely outcome.

With regards to your actual question I have found water to be the absolute best pain relief. Pethedine/diamorphine completely knocked me out and the gas did nothing but make me feel nauseous (although the mouth piece was great to bite down on)

On my first I had it all. Pethidine after 3 days of irregular pains just so I could get an hour r two of sleep as was exhausted. The following day when I was finally 3cm dilated with regular pains I started gas which was great but quickly went to epidural...I knew at that point I could go no further with out it. Second labour was similar..long! No pethidine as was 3cm when I went in so used the gas until they were able to give me epidural..about half an hour.
Definitely if my labours were quicker I might have been ok with the gas alone. Also if I had access to a birthing pool (I don't) I might have managed.
I found the epidurals fantastic. Pain completely gone just felt lots of pressure towards the end.
To be honest unless my next labour is super quick (very unlikely given my history) I'll be getting an epidural again.
Basically I think the best way is to see how you go. Find out what's available to you in your unit and read up on it but really there is no way of knowing what you will use or might want until you're in the situation.

I think people make all these plans then often feel disappointed with their birth experience because they 'gave in' and had an epidural. Even though I had an epidural and a vacuum delivery with my first (baby was in distress so wasn't given time to push myself), normal delivery with my second I felt like Wonder Woman. I would have felt equally proud of myself had I had to have a Caesarian. Giving birth whatever way and with whatever pain relief is the most amazing thing. Make sure you have a supportive partner with you. Best of luck x

I used gas and it didn't really help at all. I ended up with a spinal block (prep for emcs which i thankfully avoided!) which, yes, made everything completely numb. I had to be told when i was having a contraction and when to push. I don't know if an epidural is as 'strong' but i think i was told they top it up or not as you want so you have much more control.

I would take it as you find it, but don't be shy to say you need more pain relief - i was scared of an epidural and wish i had asked for one, the relief from the spinal was immense and i felt more in control as i could concentrate on what was going on rather than the pain.

My only really strong advice would be to avoid Pethadine. It made me really woozy, i constantly fell asleep between contractions (about a minute apart) and I really couldn't follow what was going on. I still can't remember lots of the labour, just that i was scared. It made me feel very out of control and disorientated.

The thing that put me off having an epidural is the fact that your chance of having to have an assisted delivery rises from 7% to 20%.

There's no evidence that epidural a actually cause greater assisted delivery rates though. Poorly positioned babies result in longer and / or more painful labour, and poorly positioned babies are more likely to need assisted delivery. So if my baby is not in a great position, I'm in extra pain for a longer time and so more likely to request an epidural. Even if I didn't receive the epidural, my poorly positioned baby is more likely to need assisted delivery anyway.

Op, I had two epidural and adored them. I never once felt numb, I just felt an absence of pain. A bit like the way I feel right now, sitting on the sofa surfing the net - I'm not using my legs right now but I don't need to use my legs so that's fine. It was the same for me during my epidurals. I didn't feel tingly or numb or weird or paralysed - in my first, I simply went to sleep after it kicked in; for me second I sat reading for a while until I could feel the baby move down and asked to be examined and was ready to push. I could feel the baby move down, I could feel the crowning, I could feel my pushes but all with zero pain. Have you ever had local anaesthetic for a skin biopsy or anything like that? It was the same - I could feel sensation and pressure but no pain. I also felt a lot more in control of everything once I wasn't being slammed by contraction pains every three minutes.

I loved not being in pain - there are no benefits whatsoever to pain for either you or the baby. However I also loved the reassurance of having effective anaesthesia already on board in case of an emergency - be it assisted delivery or EMCS or retained placenta or shoulder dystocia. That reassurance was very valuable for me.

There are of course the risks of side effects but epidural a are generally a very safe procedure. For me, I was trading the absolute certainty of severe pain right now, for the small risk of future complications. It was definitely worth the trade in my book - all the more so as I was lucky enough to have zero side effects from either epidural. Also, epidural is the only effective pain relief offered in child birth - all the others are only managing or coping with pain, not removing it.

Search for a blog called The Adequate Mother by a Canadian anaesthetist; she writes very clearly and well on epidurals.

Best wishes.

Oh and based on tales of the current state of the NHS, if you even think you might like an epidural, get it on your notes now and mention it as soon as you arrive in hospital in labour. Staff can be so stretched that it takes a long time for anaesthetists to be available - you can always ask to hold off at that point if you are coping ok but I've seen far too many birth stories on here and elsewhere where the woman waits until she is in unbearable pain to ask for an epidural and then suffers an agonising delay or doesn't get any pain relief at all.

I had a very long birth with DS and tried pretty much everything going: paracetemol, TENS, pethidine, water pool, gas and air, epidural. I also did a hypnobirthing course and used essential oils.

The TENS really helped me with what was a very long early labour. I'd definitely recommend hiring one / buying one 2nd hand off ebay, there aren't really any downsides other than it may not work, and there isn't much else for early labour. I only took one paracetamol in my 1st labour as I didn't think it would do anything, in my 2nd labour I took it religiously through early labour and actually it did help - again not really any downsides to trying it.

Loads of people swear by hypnobirthing but it just didn't work for me in labour, although it helped with sleeping after the birth. I found active movement and distraction very effective in my 2nd labour though (read Active Birthing by Juju Sanjin). The water pool was also very effective for me but you can't guarantee getting one in hospital. Gas and air worked a bit but nothing like as well as it did when I needed stitches after my 2nd labour - think I just couldn't breath in deeply enough while contracting to get the full effect.

Pethidine did let me get 2 hours sleep in a very extended early labour but made me vomit despite the antI nausea stuff they give you so was on my list to try and avoid the 2nd time.

My epidural didn't work 100% so I had a lot of trouble with break through pain. They did eventually agree to resite it but I had a pretty bad 12 hours until then - but it was magic when it did work right. I had an instrumental delivery because I was taking too long pushing which led to complications. I'd have had an epidural if I hadn't been able to cope without for DC2, but only if I really couldn't cope because of what happened with DC1. For me, it was more how long it took that meant I needed one the first time not how painful it was, I was just too tired to do anything more active anymore.

I wouldn't rule anything out, and depending on the type of labour you have you may need it all!

Take it as it comes but don't make yourself believe that some pain relief is cheating or wrong or whatever some people believe.

Whatever you need at the time is what you need and they are all low risk otherwise women wouldn't be routinely offered them.

As PP have said, just try to be open minded, don't set yourself fixed plans and go with whatever you need and is available come the time. No harm in knowing what your options will be and how they work but so much depends on how your labour actually goes. I had 1 with epidural and 2 with absolutely nothing. Both sides of that are circumstantial. Good luck OP.

Thank you so much everyone. I will stay open minded and tell them that I'm not writing it off. I guess there is part of time that thinks it's cheating, which I know is ridiculous! It doesn't sound as numbing as I thought it would be, so that's good.

I had an epidural and still felt my contractions enough to push dd out naturally. Did 20 hours before any pain relief though and I honestly think I would have been too exhausted without it as it allowed me to rest for an hour before the pushing stage.

There's no evidence that epidural a actually cause greater assisted delivery rates though

There is actually a lot of evidence proving this. It was even in the information in my maternity notes, which is where I got the % from.

Look up the Cochrane review on epidurals, it's explained in more detail there.

Hey OP. My cousin is an obgyn who has recently had 3 kids and she said what is the worst for mum's and babies is when they have 20-30+ labours and are exhausted when thy come to push. He advice was if it's going on a bit have epidural and have a sleep! Get yourself on an even keel. It's much less dangerous.

Hypnobirthing sounds awesome and am starting it this week. Pregnancy yoga is also meant to cut labour time by 2.5 hours so I say WIN on those!

I'd say definitely examine hypnobirthing stuff on YouTube - breathing techniques are great and easy to nail - but as a PP said it's easier to request an epidural and then decline rather than go for the intervention free water birth, struggle and have a scramble to find an anaesthetist. Woe betide that happens at a weekend too.

As long as it's in your notes it's there. Good luck and I hope your labour goes smoothly!

I had similar exp to previous posters, very long early labour so by the time I was In active labour I just didn't want to be in pain anymore. i didn't feel numb or like I had no sensation, just free of pain. I could also still move my legs. The downside for me was it did take away the ability to push, I think if I had carried on gas and air only I would of been able to push him out but I could only get him so far and I needed forceps. I think the contractions when you can feel them do give you something to push against. But that's just me. Also I was up & walking around one hour after birth, didn't need catheter and was home the same day. Maybe if my early labour had been shorter I would of bypassed the epidural but it's impossible to predict how your labour will go so just stay open minded xx

I also felt the same way as you re cheating- but you get no medal or reward on your labour, no extra badges for being in more pain than you need too, just a lovely baby who doesn't care how they arrived! Xx

I'll definitely be having one if Labour is dragging on a bit!

I was planning on having an epidural for my first baby and made that very clear in my birth plan. My labour was too fast though and I wasn't able to get one in time. It was quite traumatic as I was induced and it all happened so quickly that nobody believed I was in labour so refused to examine me until I begged and the head was coming out (whilst still in the induction suite) Even though it happened very fast, I had no gap between contractions and I had practiced no techniques to help with the pain (my fault I suppose but I was certain I'd have an epidural throughout the worst of it!) I personally would not like to give birth again without an epidural, but if I were you I'd just keep your options open and prepare for all eventualities. Good luck

Don't let other people put you off with their birth stories - everyone is different. I was in a birthing pool and had only gas and air, and it was totally fine. This was after people told me all about their horrible births, and one even said I'd never be able to give birth naturally as my baby's head was sure to be too big. You'll be totally fine - a lot of it is just breathing, staying calm, and going with it. It's what your body is designed to do.

I loved my epidural, could have kissed the anaesthetist when he arrived! Everybody is different, every birth is different. I say just keep an open mind in everything, make it clear that you are very open to an epidural (so they don't start trying to persuade you not to have one later on) and play it by ear. Best of luck!