To epidural or to not epidural?

[jumperoo2738]

Second pregnancy here. My first birth was a vaginal water birth. Back to back baby. 27 hours (not pain that whole time but I was exhausted from the length)

I had pethadine and they broke my waters to help dilate. I definitely asked for an epidural at times! 2nd degree tear.

Once baby was here, recovery was okay (minus spd not disappearing straightaway!)

I opted for hypnobirthing and the birth centre because it was covid and hospitals were giving everyone a c section (in my nct group everyone had one but me) but I lived on the top floor of flats so I was realllllly trying to avoid that. So I was never anti epidural but you are forced to pick between the birth centre and hospital.

Second time round I'm intrigued by an epidural aka less pain. It will be my last child.

Other mums make comments like I'm silly as most people want a water birth which I completely get but doesn't mean it wasn't still hard! I wish I was anti medicine more as it would be easier.

Any insights from other mums? Some say an epidural really messed up their backs etc. Not having an epidural would hopefully mean a quicker recovery so I can get home to my first.

TIA xx

I had no plans for an epidural, buy then i didn't really have any plans about how I wanted to give birth. But once 3 induction attempts had failed, followed by insanely painful attempts to break my waters with zero dilation (from what I can recall), they wanted to use the hormone drip to induce labour. I'd heard that the hormone drip was incredibly painful, and having had enough of induction already, I insisted on an epidural before the drip was started.

For about 11/12 hours while I dilated, there was no feeling from the waist down. As it was overnight, I was able to sleep. I couldn't move at all, the midwife and my husband had to move my legs for me to help me turn from side to side. That part was great!

Downside, in my experience, was that it could have been the cause of me vomiting and having severe shivering during/after the c-section I ended up having. But it didn't cause any long term problems that I'm aware of.

Had epidurals each time. Thank god. Had no lasting issues

I had an epidural with my first as I was induced and shattered. It really helped me relax but there was half of my stomach where it didn't work so I felt contractions there but totally manageable. I had one that I could top up myself with a button, ended up overdoing it and vomiting. Lesson learned there.
I also ended up with a ventouse delivery and episiotomy. I was told assisted births/episiotomies are more likely with epidurals but I don't regret having it at all. I healed quickly and had no lasting effects.
I had a c section with my second so never experienced a natural birth, my experiences were very much medical procedures.

Of my 5 I’ve had 3 with epidurals and 2 without.

The epidurals (for babies 1, 2 and 4) were amazing. 1 and 4 were drip inductions and I wouldn’t have consented to the drip without one in place. Baby 2 was my only spontaneous labour and in hindsight I might have been ok without one.

3 and 5 were too quick/no anaesthetists available. I coped because they were 2hrs from first contraction to delivery, the labours were intense and there was no break between contractions until it was time to push.

I went home the same day with babies 2-5. No side effects.

Oh I forgot about the violent shaking! That was quite scary actually, must have blocked it out.
Midwife said it was transition stage, didn't realise it was the epidural.

I've had three amazing, beautiful epidurals and would recommend it every time.

I don't fully remember, but there's a little bit of me that thinks someone said I wasn't shaking and shivering because it was wearing off? Unfortunately, I don't remember the whole c-section because I was also vomiting and passing in and out of consciousness - though that was because I was absolutely exhausted, not because of the epidural!

I had two.

The first time I was hoping not to have an epidural but I had to be induced and after half a day on the syntocinon drip and still only 5cm dilated I caved in and got the epidural. Baby was badly positioned and low birth weight and didn't tolerate the syntocinon contractions well so I ended up having a C-section. I don't think the epidural was to blame though.

The second time I was trying for a VBAC and they wanted me to have an epidural in place once I was in active labour in case they needed to do an emergency C-section. I spent early labour in the bath tub and then got the epidural at about 3 or 4cm dilated, just as the contractions started to get a lot more painful. Had a nice nap and then gave birth a couple of hours later. Definitely got the urge to push and no mobility issues at all. 10/10 would recommend.

There isn't a right or wrong answer here, you do what's right for you.

I got the shakes and vomited during my first labour/C-section but not the second one. So if it was the epidural, perhaps it depends on the dosage? Because I think I had a more strongly dosed epidural the first time round, which was obviously topped up to the max for the C-section, whereas second time round it was more lightly dosed to allow for greater mobility, and I had no side effects at all.

I had an epidural second time round and it was great. I gave birth in the early hours and was home later the same day. They told me not to top up about 1.5hrs before it was time to push so I’d feel enough to push. It was really great, I even had a bit of a sleep.

Had an epidural fairly late on in birth and would recommend it to anyone. The reason I wanted to avoid it was purely because it would be I'd have to be on the bed, on my back, and I wanted to be upright kneeling. Once I'd had it, the pain went so quickly and they gave me a button to top it up but I didn't as I could still feel when I was contracting with helped with pushing, but I wasn't in any pain. They also respected my choice to turn my sideways on the bed and birth that way which for me, made it a lot easier. I'd have it again in a heartbeat. No post birth effects.

OP, if you've not found it already, the Labourpains website (labourpains.org) is a really useful site - it's run by the Obstetric Anaesthetists Association and has a ton of objective info re epidurals/other analgesia/anaesthesia, risks/benefits, etc.

Epidurals are not thought to cause chronic back pain due to needle trauma/the effects of the drugs. Pregnancy and delivery are both common precipitants of back pain. For people who end up in theatre the profound muscle relaxation that comes with any of the modes of anaesthesia (GA/epidural/spinal) can cause stiffness/irritate a bad back.

(Re. shaking, as lots of people seem to have mentioned it... shaking can be caused by an epidural - mainly by the really dense top-ups we do for anaesthesia rather than analgesia, but if you have a top-up button and press it enough to get a dense block then shaking may happen in the normal room. Same thing happens fairly frequently with spinal anaesthetics too. Vomiting is common in labour with/without epidurals, but the specific mechanism by which an epidural/spinal can contribute to it is by dropping a patient's blood pressure (which isn't that common with an analgesic block, but is more common with an anaesthetic one. We try to prevent it happening in theatre, but sometimes brains register the change before a BP cuff does so there's sometimes a bit of catching up to be done).

This sounds ideal. Did you have to birth on your back? I birthed on all four last time - wasn't a preference just instinctive!

Thank you I didn't know about that website!

If you’ve done it once you can do it again and it should be easier this time. Statistically you’re so much more likely to start the cascade of intervention by having an epidural. You can do it OP

I had an epidural with my first and it was brilliant. I could still feel pressure with each contraction which helped with the pushing but there was no pain. The downside was that it took nearly an hour for two anesthetists to get it in the right position. I did also end up with an episiotomy and ventouse delivery but that was because my son wasn't descending after two hours of pushing because his head wasn't straight so I don't think it had any link to the epidural itself. Afterwards I ate too much too quickly and ended up vomiting it all back up and I was told that was quite common. Recovery was quick and I felt back to myself within 10 days.

Second time around I laboured at home until the last moment, arriving at the hospital when I was 10cm so it was too late for anything but gas and air.

This time around I'm ready to go with the flow and I'm open minded about having an epidural if I want one but I also know I'm capable of giving birth without one.

I agree in that this definitely has to be your gut and what you feel is right. No two births are ever the same and I think even with multiples, you're a different person each time you give birth. With my 1st I had contractions for a good 30 hours as he was back to back. I was coping with the pain. But as another has said, I ended up with yeh epidural purely because I was absolutely exhausted and needed a rest before pushing. I had an episiotomy and forceps in the end and I'm ever thankful I had that epidural in so I didn't feel any of that. We're TTC no2 and I know more now I'd say, been through it etc. I'm comfortable with not having a plan, going with how the baby is in labour and how I'm coping and just generally open to one or not having one. It definitely slowed my labour down massively and I think my son would have been born earlier if I hadn't had one. It also, I was just too tired. So it's swings and roundabouts. Good luck with your decision whichever way you go. You got this! xxxx

I had no pain relief even gas and air made me vomit, I found it horrifically painful a year later I still feel traumatised. I keep seeing people mention shakes but even with no pain relief I still got them. I think after reading everyone's comments I will be going for an epidural next time!

Thanks for all the useful comments.

I completely appreciate who knows what we happen. I could get something that makes me high risk and then planned c section it is. I appreciate the different perspectives though- personally helps me be more open and to decide.

FYI not helpful - I didn't ask for answers, I asked for insights

Don't reply to forum posts if you don't want to give people space to seek views

After an awful 20 hour labour with only pethadine that made me vom for DD I then had a spinal block for placenta removal and I remember thinking then I should have had an epidural!
When I got pg again I was very determined to have one and mentioned it very frequently during my anti natal care. When it was time the MW tried to put me off but I insisted and it was great. I was very relaxed, even had a nice nap and then pushed twice and DS arrived. I walked into the shower a few hours later and went home not long after that with no ill effects
Definitely the right decision for me.

Obs anaesthetist. There is zero evidence epidurals cause any form of back pain. Carrying a heavy baby for 9m and labouring can give you back pain. Real bug bear of mine

Theyre fantastic and incredibly safe, rarely get an anaesthetist give birth without one. They're the safest form of pain relief for baby (excluding gas) and the only option to be pain free in labour.

Pethidine isn't really a pain killer by an anaesthetists definition, they make people spacey and less with it so recall the pain less, but don't really pain relief else we'd use them

Nope, I had a "walking" epidural a few months ago and could move, feel everything below mid-thigh and birth in whatever position I liked.

Could still feel the pressure for pushing, but no pain. 2nd degree tear, but needed no additional birth interventions. I loved it

Yeah it's incredibly rare for people to manage the oxytocin drip without an epidural (occasionally get a few we are all amazed by)

Yes epidurals can make you v shivery for a section as it's much stronger stuff we use vs the epidural mix for labour. They can cause low BP which can cause nausea (far less so than a spinal which is the default for csections if no epidural) but equally we give many drugs that can cause vomiting so its multifactorial