Epidural or not

[Irishfarmer]

Can anyone point me towards a good impartial place to read about having an epidural? I am 30 weeks pregnant now and no clue.

I have heard a lot 'it's a very personal choice' which I do get. But I suppose is there something inheriantly wrong with having one? I wouldn't decline the pain relief the dentist offers so I'm not sure why I would decline the best pain relief the maternity can offer me. I feel I must be missing something!

Labourpains.com is a site run by the obstetric anaesthetists association and has loads of info (we use their pt leaflets as part of the consent process). HTH.

I guess there's horror stories about the epidural going wrong- it can slow labour down- but tbh having had one baby without an epidural and one baby with- I have no idea why people wouldn't have one- a god send!

I didn't have one with my first as there wasn't time from 3cm to birth was 2 hours. I'm due in sept and I would love one this time!

Go in with a mind to get one if you need one, they can go wrong, 1 did for me and 1 didn't, but I also had births without them which I would choose over the working epidural.

Yes you heard right...It's a very personal choice. I said I wasn't gonna have one but ended up having one. There a pros and cons...It all comes down to you.

From my experience the only thing downside of it for me was that It did slow down my labour by a lot and My back still hurts till this day but I cant say the latter was def because of epidural. it could just be due to childbirth.

The upside? Pain free delivery lol. I felt like a new woman after that epidural.

I am in France where almost everyone has one and they don't understand why anyone would want to give birth without one.

I initially wanted to try without but I was induced and the syntocinon contractions were pretty intense so in the end I decided to have one. The induction ultimately failed but I think that was down to the fact that my body was nowhere near ready to go into labour spontaneously, rather than having anything to do with the epidural.

The epidural itself was excellent, took all the pain of the contractions away but I was still quite mobile. I'm glad I didn't labour for another 8 hours without one if I'd have ended up being anaesthetised for a C-section anyway.

I don't know anyone who has given birth here who has suffered any complications or after-effects as a result of having an epidural.

I'm hoping for a VBAC next time but I think I will have an epidural again, and probably earlier.

I’ve had one baby without an epidural and one with
Very different experiences and I would recommend the Epidural

Nothing inherently wrong with having one at all. But it really is personal choice. Pain is so incredibly subjective and no birth is ever the same. And no one attitude to either is going to be correct for everyone

Personal opinion time. I think of the dentist analogy this way. Usually, a tooth falling out naturally by itself in its own time doesn't hurt much, and requires little to no pain relief. If you try to hurry it on its way, it'll hurt a bit more, so I'll need some more, potentially stronger, pain relief. If the tooth isn't going to come out for a while, and the dentist doesn't think it needs extraction, but it's causing me pain, then I'm going to take very strong pain relief. Finally, if a medical professional is coming at me with scalpels and forceps because the damn tooth won't fall out on its own, it's in danger of decaying, or causing me massive issues, then you better believe I want all the pain relief.

From the NHS website:

Side effects of epidurals in labour
There are some side effects to be aware of.

An epidural may make your legs feel heavy, depending on the local anaesthetic used.

Your blood pressure can drop (hypotension), but this is rare because the fluid given through the drip in your arm helps to maintain good blood pressure.

Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby (instrumental delivery).

When you have an epidural, your midwife or doctor will wait longer for the baby's head to come down (before you start pushing), as long as the baby is showing no signs of distress. This reduces the chance you'll need an instrumental delivery. Sometimes less anaesthetic is given towards the end, so the effect wears off and you can feel to push the baby out naturally.

You may find it difficult to pee as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.

You may get a headache after an epidural. This happens in about 1 in 100 cases and can be treated.

Your back might be a bit sore for a day or two, but epidurals do not cause long-term backache.

You may feel tingles or pins and needles down one leg after having a baby. This happens in about 1 in 2,000 cases. This is more likely to be the result of childbirth itself rather than the epidural. You'll be advised by the doctor or midwife when you can get out of bed.

For me personally, being required to lie in bed even after the birth is a big con - I loved being able to get up and walk pretty much straight away with my first. I also don't like the idea of not being able to feel contractions - having to be told what my body's doing is just an unappealing thought to me. That said, my contractions weren't really painful first time round and I found the whole process overall pretty quick and easy with just gas and air.

With regards my second, I'm planning on having no pain relief at all as I feel the gas and air didn't really help and I didn't like that it made me lightheaded. That's on the assumption that my next labour will also be easy, though, and if it turns out to be dramatically worse I'm not ruling an epidural out entirely.

@Dyra I like your tooth anaolgy!! If it is like a tooth falling out naturally I may like childbirth, I remember liking loose teeth as a child (I think many do) 😂But no I get it.

I have GD, and already had high BP before pregnancy, have done for donkeys years don't know why. Anyway they have said induciton will most likely happen.

I suppose it's just some ppl, inc close family, have said 'I managed on just gas and air or nothing or whatever' like it is a bigger honour/ they did better/ better mother not to take the epidural. One recently said 'I have a strong pain threshold and so do you so you should be able to manage with out the epidural' Then follow it up with, but what ever you choose yourself. I am from a family of mosly women and I know I do not have to discuss my labour/ birth with anyone but they will ask.

I am going to read the link above now for my lunch break.

From the start of my first pregnancy I was adamant I didn’t want an epidural. I had 10 hours of very painful labour but the thought of an epidural didn’t actually cross my mind when I was there! I managed on gas and air and diamorphine.

I like being in control and being able to get up and down if I need to. I also preferred being in control of when I was pushing because I knew when a contraction was coming! I’m 20 weeks now and again I won’t have an epidural!

Labour is very subjective! Go into it thinking if you need it, you’ll take it, if you can manage without it then manage without it. You are no better a person or a martyr for going with or without, whatever helps you cope the best and gives you the least amount of stress!

Does anybody know if you have to birth on your back with an epidural?

No you don't have to. I was advised to try diff positions although I ended up just doing it on my back.

You don't get any awards for having a birth without pain relief.

I had an epidural with my dd and was a gift of medical science after unbearable back to back contractions, due to her position. I'm pregnant again and I'll be getting one again.

I was planning on refusing an epidural. I used a TENS machine etc which was fantastic. In the end, after a 30 hour labour I had one and it was THE BEST THING EVER. You can always see how you feel when you’re there - for me it allowed me to think straight when I was getting more and more tired and weary from a long labour.

I don't think it makes any sense to decide in advance. You don't know how painful the contractions are going to be.

Some people don't feel they need one, others do, and that's fine.

If you are feeling really tired then an epidural will allow you to lie down and have a nap during labour, which can help enormously.

It's not like you've missed the boat for having an epidural if you don't sign up for one immediately. By the time you're in active labour you'll have some idea of how difficult you find the contractions, and you can decide then.

But there are no prizes for soldiering on without pain relief and I wouldn't put yourself through labour without an epidural because of some idea that having a "natural" birth is somehow better.

Your goal is to birth a healthy baby with as little damage to yourself as possible. If an epidural helps you do that, have one.

For what it's worth, there is a male gynaecologist at the private clinic where I gave birth, where something like 95% of mothers have an epidural and all the doctors strongly recommend it, who spent a few years working for one of the big NHS hospitals in London. He tells anyone who will listen that the way women give birth in the UK is "barbaric" and he can't understand the NHS's approach to pain relief. He believes there is a cult of natural childbirth in the UK which leads women to believe that drugs are inherently bad and that natural birth is best, and that this is done to discourage women from accessing effective pain relief which is expensive. There also aren't enough anaesthetists for every woman to have an epiduram.

Although I find him somewhat irritating, if his overall impression is that women in France are having calmer and more enjoyable births under epidural whilst women in the UK are in a lot of pain and making do with gas and air, he might have a point.

They don't use gas and air in French maternity units, so the first time I tried it was quite recently, when I found myself in A&E having stitches. My impression was that it was an absolute waste of time and didn't really do anything other than momentarily distract me from the pain. Not sure how much use it would have been during labour.

It's important to look at all the pros and cons of having an epidural. Ideally you would want to labour without it, but perhaps when you are in the moment you may decide it something you want. The point is to educate yourself before you birth so that you can try to have the best experience possible. A lot of women do seem to have a negative first experience, but I think this is because they don't always know their choices, they just do whatever is recommended by the midwife or consultant at the time. I didn't know what I was walking in to when I decided to have a baby.

I recommend reading (or listening) to the positive birth book by Millie Hill and I would also recommend following some birthing accounts on Instagram. My favourites are;

@birth_ed (Megan, the lady who runs birth Ed also has a fantastic podcast and she does also have a course)

@kemibirthjoyjohnson love this woman, she's a firecracker, she is a strong believer in psychological birth

@lucyflow_official Lucy is doula, yoga instructor and just had her third baby. She is also on Facebook.

I kinda see that doctors POV and I agree with what you said regarding the gas and air. Its a waste of time. It just made me dizzy and lightheaded.

Also I could remember during labour, I did tell the MW, I wanted to try natural birth and she was like that great, when the pain started being unbearable, back to back contractions I immediately changed my mind and asked for an epidural and she was trying to persuade me not to. She was like, why don't you try the pool and some some more gas and like an idiot I agreed. Then at one point I just couldn't take it anymore and fell to the floor and screamed I need an epidural NOW and then it was administered a few minutes after.

If I we're to have a 2nd I'm going straight for the epidural!

I didn't have time. But in my birth plan, I just put that I'd ask for anything I wanted. You don't have to have everything straight away - see how things go - but you can always ask for whatever you want.

You really don't know how much pain you will experience, nor its duration. It was described in my antenatal class as productive pain, which is what I found. I used a Tens Machine both times, with additional gas and air first time, but didn't like it. I preferred being in control and aware of what was going on. I didn't feel the need for more than that. I'm not brave or stoical, just saying that our experiences are very individual. Maybe have it on hand in case you need it?

There is a risk of lasting spinal damage which is a big reason I didn't have one. It's a small risk though so no judgement here!

Seconding the recommendation for Milli Hill.

I think the most important thing is to be as informed as possible about all the different potential outcomes before you go into labour.

I think women should be empowered to make their own choices in childbirth as far as possible, whether that means a drug-free labour, an epidural or an elective C-section.

If you want to try giving birth with just gas and air, or just a TENS machine, or have a water birth because you've read up on epidurals and decided it's not for you, you should be supported in that as much as possible. If, on the other hand, you decide that you want an epidural, nobody should be allowed to deny you one. It is appalling to make women beg for effective, available pain relief. It should be given to any woman who wants it.

One thing I regret is not doing enough research about C-sections, which is what I ended up having. I think I would have had a better experience if I'd known what to expect. I also think I would have felt better if we had gone for a C-section earlier, rather than waiting until nearly midnight, when I'd been in labour all day and was knackered. But I wasn't ready to give up on my plan for a vaginal birth at that stage. The point is, the timing of when you go into labour and how quickly you progress is also likely to influence what pain relief and/or interventions you decide to agree to.

Finally, I think it's important to get the balance right between remembering that you have choices and that you are allowed to assert yourself and ask for what you want, but also recognising the fact that childbirth is to a large extent out of our control. Please don't beat yourself up if your birthing experience isn't how you imagined it. The most important things are that your baby arrives safe and healthy, and that you are treated with respect and dignity.

It’s worth doing your research. The most serious side effect is a dural tap - when there is a leakage of spinal fluid. My SIL had this and hospital were awful- it gives you killer headaches - and they didn’t diagnose it and told her she was making a fuss. My MIL, who is a nurse, had to make a fuss to get it sorted. Other downsides, they don’t always work, they’re not always available, they generally lead to more interventions in the third stage statistically.