Epidural or no epidural

[BEO]

For context : first pregnancy and only 23 weeks but trying to prepare.

I am wanting to hear people’s opinions on epidurals. I am not ruling one out but don’t particularly want one if I can do it without. Just wanting some more info on the pros and cons on them.

The reasons I’m not so keen are that you can’t move about , you can’t feel when to push and you may be more likely for intervention (forceps etc).

Obviously the pros are obvious, no pain!

I know some people have the opinion ‘why put yourself through unnecessary pain when you can have an epidural’ but I would rather try with just the other pain killers and gas and air.

be interesting to hear from people who have had multiple births, and have experienced both with and without epidural and what they prefer x

In my opinion it's fairly pointless having a plan for Labour because you actually have very little control. My first labour was 2 days long and I ended up with diamorphine and then an epidural and forceps delivery because dc1 got stuck due to being huge and coming out sideways.

My second labour was too fast for my much wanted water birth but was I fine without the pain relief that time. I think just educate yourself on all the options and see how you feel at the time. Labour was quite different to how I expected it to be to be honest. I don't remember pain as such just feeling totally overwhelmed.

@WonderingWanda I was told to write a sheet of 'preferences' rather than a plan. So a list of things for the midwives to refer to in the case of any birth situation. What I'd prefer if to happen if I needed an induction or a c-section and what kind of pain relief I was open to receiving etc. In my situation (autistic) it was really useful because it meant I didn't have to explain anything during labour, it was all in the notes.

I'd seriously encourage you to examine your own feelings about this.

We don't encourage people to forego pain relief in other situations, only childbirth. The idea that childbirth is supposed to be painful is pretty cultural these days. In some countries, such as France, most women have an epidural and the kind of labours you see on One Born Every Minute, with women screaming in agony, are seen as what happens if you are unfortunate enough to be too late for an epidural, or giving birth in a less developed country. In Brazil, nearly all women give birth by elective C-section.

My labour involved a bit of sweat and blood, and the only tears were tears of joy when my baby was born.

Imagine that the woman is not Khloe Kardashian but someone you like and respect. Instead of doing her makeup and being filmed for reality TV when in labour, she has the epidural and then goes to sleep so she can get some much needed rest before the baby arrives. She wakes up shortly before it is time to push, and delivers her baby feeling calm, confident and excited. As soon as her baby is born she has skin to skin and puts her baby to the breast for the first time. A couple of hours after giving birth she has a decent meal and then walks to the bathroom to have a shower. Because she hasn't spent the last 24 hours before giving birth in sleepless agony, she has been able to conserve her energy for caring for her newborn baby.

It's hard to understand why that isn't a good outcome.

@MargotBamborough Epidurals aren't the only option for pain relief for child birth though. I genuinely didn't need one for my son's birth. It was perfectly manageable and the pushing stage didn't even hurt. There was no screaming or anything for me.

Epidurals definitely have their place in some births but I don't see why they should be the go to pain relief when there are less invasive pain options available to try first 🤷🏻‍♀️

Well the French would tell you it's because none of the other pain relief options actually work. Certainly I've had gas and air in a different context and was underwhelmed.

I always find it very telling when people say they didn't need an epidural because the pain was manageable. Maybe so but why should pain in childbirth be something you have to manage when it's pretty much optional these days?

I had epidural with both of mine, didn’t plan to but in the circumstances needed it. Was fine first time although hated the heaviness, had a CS. Second time didn’t work for the birth which was horrific, also didn’t work when topped up for my 3rd degree tear repair.

as a HCP who works in maternity, they do increase the risk of instrumental birth particularly in first time mums, but when they work well they can be great. Depends what you want though. I’m aiming to avoid epidural for my upcoming birth, hoping things will be different this time.

you will get a wide range of opinions but it’s only you who can make the decision, also just see how you feel. Have all you coping mechanisms and strategies in your tool box, try different things, if you need or want more then have an epidural… you don’t need to decide on advance

I had an epidural with dc1. I was induced and wasn't given a choice about it, it was just presented as 'what happens' and I went with it.

Bloody awful. Stuck to the bed, can't move, no change to walk around or let gravity help. I had no feeling, no idea what they meant by 'push' meaning there was 2 hours of unsuccessful pushing then episiotomy, ventouse and ending with me haemorrhaging and having transfusions.

I think most of what happened was due to the epidural. The ONLY thing on my birth plan with dc2 and 3 was NO EPIDURAL under any circumstances.

I had gas and air the second time, pethidine the third time. Both also inductions but far better births, minimal interventions and no complications.

I think there is an apparent correlation between epidurals and other interventions in the UK, where women having straightforward labours are strongly encouraged to manage without an epidural. This means that the group of women having epidurals is mostly made up of women who are being induced or who are having a complicated labour and have probably already been in pain for a long time by the time they have it.

There doesn't appear to be a link between epidurals and these interventions in countries where the majority of women including those having "easy" labours get one because there is no perceived benefit to managing without.

When I was preparing to give birth in France I was terrified of the epidural because of all the scare stories I'd heard from UK based sources and I said I wanted to try and manage without because it increases the risk of X, Y and Z. Every healthcare professional and French woman I said this to just looked at me in confusion and said, "No it doesn't."

I think in this situation, it's usually because your labour is progressing - in which case I'd try to focus on the end being in sight! Plus, for a lot of women (me included) the most painful contractions are just before you feel the urge to push. Once you are fully dilated I didn't find them painful at all as I felt like there was something I could do. The pushing contractions were a lot like when you have diarrhoea - you're pushing whether you want to or not!

I wasn’t prepared to take the risk of being in pain so had a very early epidural. It meant I got plenty of sleep and then watched tv. Trying other options wasn’t ok with me as I wasn’t prepared to see if they worked or not.

I would say make plans for what you would ideally like but not think that everything will go according to plan.

i had said i will take ALL the pain relief because i was terrified of the pain and giving birth but in reality for me, it was actually bearable with Gas and Air. 2 natural labours no tears etc. Im personally glad i didnt need further interventions but thats just me.

every woman handles labour and the pain differently so you just have to see how you feel when you’re in that moment.

@Lampzade "My dsis always said that she wouldn’t have an epidural. However, on the day she was screaming for it"

That's such a horrible way to put it! Couldn't you just say "she changed her mind"?

I wouldn’t rule it out completely.

My first was a booked Homebirth. He was back to back. I chose to be transferred into hospital because labour was so slow and I felt like pushing the whole time even though I was only 4/5cm. I pethidine, getting in the pool, and gas and air but nothing took away the intense urge to push. I opted for an epidural at 7cm. I was still aware of the contractions (I never used my top up button because I wanted to feel I had some control and awareness) but didn’t feel the same great urge to bear down or pain. Unfortunately, I got stuck at 9cm and he was delivered by caesarean. I can’t say whether the epidural contributed to that (because I was less mobile and couldn’t shift DS from his back to back position) or if he was already well and truly wedged by then. I wouldn’t change any decision I made at that time though. It was right for the situation that was unfolding.

DD was a straightforward vaginal delivery in the birthing unit. Labour was much quicker (9 hours from my waters breaking, 5 hours ‘active’ labour vs. days of contractions with DS) and I only needed the pool and a bit of entonox. Energy levels definitely have a huge impact on your tolerance for pain.

I definitely agree with the part about energy levels which is why it's good to be flexible.

I discovered in my second labour that walking increased the intensity and frequency of my contractions and got things moving again when it looked like my labour was stalling, whereas being in the bath tub (as lovely as it was) slowed everything down.

I probably won't have another baby but if I did I would bear that in mind. If I went into labour in the morning after a decent night's sleep I would probably walk as much as possible in early labour to get things moving as fast as possible, and then go in and probably have an epidural once things were already pretty intense. And if I had to be induced I would ask for the balloon catheter in the morning and then go for a long walk to try and kick things off, rather than having it done in the evening like in my first labour, where all it really achieved was a sleepless night with irregular painful contractions. But if it was night time or I was already feeling tired I would probably get the epidural early on and try to rest.

I had an epi with my first as he was back to back and it was painful. I had to be told when to push as I felt nothing, but could feel myself pushing. I had to stay in a bit after until I had done my first pee after getting my legs back working. We did have a ventouse birth but not sure if this was as of back to back, his arm in a funny position or the epi.

Second was a very quick birth from having been induced (even the midwives were surprised how fast) and that was as painful as no time to get accustomed to pain and I asked for an epi. The baby was out by the time the they turned up to give it to me though 😂 Only good thing was I was out of hospital faster as I didn't have the epi and was mobile straight away.

What if that’s what the woman wants? I wasn’t interested in gas and air or paracetamol, I wanted an epidural because it is more effective.

I didn’t want to ‘manage’, I wanted to be as pain free as possible.

@MargotBamborough I just don't want to take the risk of someone sticking a needle in my spine when it's not medically necessary. What's wrong with that?

I spent 3/4 of my labour watching tv and playing computer games at home with my husband. My contractions were 45 mins apart for over 24 hours. It was a slow build up and very, very easy to manage when I felt totally normal in between contractions. I was incredibly lucky and when I arrived at hospital finally I was 10cm. I was a bit cross I missed out on my water birth as we arrived too late to have the pool filled but ultimately being at home was really helpful. If i'd gone into hospital for an epidural I would have been far less comfortable (ironically).

I would never deny anyone the opportunity to have an epidural if they want one. I didn't want or need one and nor did lots of other women. Why is that not ok?

@SouthLondonMum22 Fine by me. That's your choice :) I have no issue with people making the choice to have one if they want it. Sorry if what I said made it seem that way.

I think I mean that I don't want it to turn into that the expectation in the UK is that women should have an epidural immediately upon arrival at the hospital (like it seems like it is in the US, which I believe is more money driven anyway). I feel like all choices of pain relief (or none) should be available.

I had two births with minimal pain relief. I was resistant to an epidural for a variety of reasons. First was an induction with gas and air, second I had nothing. Both were delivered by ventouse and the second had shoulder dystocia. So I mean, it's doable, but it's not a picnic, especially when intervention is needed. I clearly remember thinking death would be preferable at that point in time. Third, I had an induction and just gas and air again but at 10cms dilated I had an emergency c-section.

As soon as that spinal block went in, the pain disappeared and I thought WTF was I doing! There's no medals given out for enduring pain.

There won't be any more but if there had have been I'd have insisted on an epidural at the very start!

There should be an expectation that if women want an epidural (and not any other forms of pain relief) that it should be available as in the US.

@Parker231 Uh yes, that's what I said?

Augh why can't I convey what I mean? 😂 I don't want women showing up at hospital and immediately being given an epidural if they don't want it. If they DO want it then that's fine. I was saying I don't want it to turn into the expectation being that everyone will want it. I want all pain relief options to still be available. Does that make sense?

Edit: I think my fear is that at some point the choice might become epidural or nothing.

I didn't like it. I've had four kids and only had it on the last baby.
I didn't like the feeling of having it put in. And felt conscious it was there. And I then gave birth 6 minutes later so it didn't even take effect anyway!. Since having it done a year on I get some pain in the site where I had it and never did before. Can't say for certain it's that but wouldn't have it again. My mum swears by it though.

Though I feel right now, almost the opposite is true or at least my experience was showing up to the hospital, asking for an epidural right away and instead, I was met with 'Have you had paracetamol yet?', 'Lets try gas and air' and when I declined and again asked for an epidural, I was met with a baffled midwife asking me why I didn't want to see if I could 'manage' with gas & air.

No thanks, I don't want to manage. I want an epidural.

A woman shouldn't have to ask multiple times for an epidural when she's in labour.

@SouthLondonMum22 I agree. Asking for it once should be enough to be able to have it.

It's fine, I just don't believe the risks of an epidural are anything like what is commonly believed to be the case in the UK. I'm not sure whether it's due to a cultural belief that pain relief is bad and childbirth is supposed to be painful, or whether women are deliberately led to believe that epidurals are much risker than is actually the case because if they all asked for one the NHS simply wouldn't have the resources to provide them.

I live in a country where basically nobody believes epidurals are risky, almost every woman has one, and yet the increased rate of interventions and C-sections you would expect as a result just hasn't materialised.