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

Paralysis rates are 1 in 100-250k patients

Nerve injury that is temporary (patchy numbness pins and needles or weakness in the legs) is 1in 1000.

1 in 10k chance the nerve injury is permanent. They're really safe

I had an epidural with one of my labours.

The doctor botched it and I was left with the worst pain in my head and neck for days, I couldn't lift my head without excruciating pain. Eventually they gave me a blood patch but only after days of pain. I'd never have another epidural.

I was induced for both of my births (no.1 took 5 days to get going) and both needed the drip. I didn’t have an epidural either time, just a lot of gas! I don’t have a ‘natural’ birth to compare the pain to but it is possible to give birth with the drip without an epidural.

Unfortunately not, it kept getting ramped up throughout labour.
@jumperoo2738 I think just go in with an open mind and see you feel 😊 you might surprise yourself!

There's no particular benefit to giving birth without one though. And I think that if you are going to have an epidural it's better to have one at a relatively early stage so that you get the benefit throughout your labour, rather than wait until you're exhausted and delirious with pain and too tired to push effectively.

I had an early epidural - was the best way to give birth. No pain or discomfort. I had a long sleep and watched the Wimbledon final! No side effects- recommend it to everyone.

I didn't have one first time around and swore I'd have one second time. However, I can affect where you're able to give birth. MLUs typically won't have anaesthetists in the venue so if you want an epidural, you may then not be able to use an MLU (with the exception of MLUs within hospitals). I want to go to my local MLU, which is a standalone venue unconnected to a hospital so won't be able to have an epidural while I'm there.

There's risks with having an epidural and you can't move around should you want to do that. It can also potentially cause further interventions if you can't feel anything. It definitely has it's cons so I guess everyone can just share their own experiences for the op.

Honestly, all you can do is be aware of the pros and cons (as with any intervention) and make the choice based on your situation at the time.
It is more likely that you would need an assisted delivery simply because you wouldn't feel the sensations to know when and how to push. I am not saying that is necessarily bad in itself, but you have to be aware.
In terms of long term affects I do know someone who had epidural migraines for months afterwards. I dont know how common that is.
I do agree that it is strange to not want a natrual birth as it obviously went well for you last time.
My second was an induction. It was painful yes, more so than my first because of the broken waters but I was home 5 hours after the birth and my son met his sister at home rather than the hospital.

Having had a non-medicated homebirth with my first after a full weekend of back to back labour, I wouldn’t want an epidural at all with my current baby. The most important things for me were being able to listen to my body and move around, and I found my TENS machine and birth pool gave me plenty of pain relief. I can’t imagine not being able to feel anything when I needed to to push the baby out.

That said, I will wait for baby to come in its own time and won’t accept induction. If the docs are telling me there’s something high risk and baby needs to come out, I’d have a c-section because I don’t believe that forcing my unready body and baby to birth is best for either of us. Most women I know who had epidurals were induced and it was due to the intensity of the drip.

Only you will know what your own birth ethos is like OP, but being able to move around and have more agency in your own birth was super important to me.

I had an epidural when I had the oxytocin drip and it worked for a few hours and then wore off. They topped up a few times but it just stopped working so for the last 12 hours or so of labour I had the full force of pain.

You’ll mostly get replies saying how wonderful it was but do be aware that sometimes they don’t work or have side effects. I had no feeling in my bladder for around 6 weeks afterwards so I had no urge to go to the toilet. If I sat on the toilet I would have a wee but there was nothing but numbness (not incontinent though). I also had a numb patch down the outside of one thigh for a few months and for both of these side effects the midwives and GP were ‘meh,’ so I took it that it was fairly common.

I still have a weird, throbbing sensation in my back where I had an epidural but that was 23 years ago so I expect anaesthesia is even better now.

But tbh it's something I'd try to avoid because having an epidural can create other problems like stopping your contractions.

I was absolutely convinced I wouldn't need an epidural with my first, but I had all the confidence and ignorance of being a first time mother and underestimated the pain I would be in 😂 so after about 12 hours of labour I went ahead and had it because I couldn't bear it any longer!

Good points:
From that second I felt absolutely no pain, I didn't even realise when I was having contractions! In active labour I felt not a thing so the remaining 11 hours hours of labour were completely painless

Bad points:
I ended up with third degree stitching because my body didn't bother producing the strength I needed to push, and I also ended up needing forceps delivery
The first night in hospital was horrendous, the lower half of my body was still numb so I could barely move to pick up baby and I was hooked onto a catheter. Because I couldn't feel any sensation I didn't realise I was bleeding and losing lots of blood whilst in the hospital bed. I didn't even realise until one of the midwives turned the light on and it looked like a blood bath!
The recovery was horrendous, I was in pain for 6 weeks, on round the clock paracetamol and ibuprofen, couldn't wee properly, couldn't walk properly. Even now it still aches sometimes when I wee (15 months later!)
My back has never been quiiiiite the same

This might just be my experience so I know it won't be like this for everyone, but with my second I'm having a home birth and eliminating the option to have the epidural!

I had an epidural and it was marvellous. I had to be induced via the drip and the pains were awful, I was vomiting and struggling to get through them.
I still needed the gas and air along with the epidural because the pressure of the contractions was a lot, but once the epidural was in full flow it was lovely. Managed to have a little nap and remained able to move my legs.
I ended up having an episiotomy and ventouse delivery, which on paper doesn’t sound ideal but it wasn’t as bad as I thought. Everything healed nicely and no lasting issues.

This isn't true. People in the UK think it is true because most of the time women only have an epidural if they are being induced or otherwise having a long/complicated labour. NHS midwives seem to be quite ideological about "natural childbirth", which probably helps to explain why this myth persists. But I think it's wrong to discourage women from having effective pain relief in labour based on misconceptions about pain relief causing other complications.

In France the vast majority of women have an epidural, the rates of other interventions aren't higher (they actually appear to be lower), and you can move around just fine.

And how exactly do you move around if you are numbed from the waist down?
What you are saying seems unlikely

And no, NHS midwives (with some exceptions eg homebirth) tried to push interventions on me from the moment I got into the labour ward

You're not numbed from the waist down. The epidural, if administered correctly, takes away pain, not mobility.

I've had two epidural and was able to move around just fine both times.

I have one DD I had with pethadine which was useless, I had a fast labour and delivery thankfully but next time I plan to have the epidural, I did ask, multiple times, begged even for the epidural but they kept telling me I wasn't ready, by the time they reluctantly agreed to check me to see if I can have one, I was 9cm

couple of people have mentioned headaches....there's about a 1:100 chance of getting a particular type of headache (a post-dural-puncture headache) after an epidural but it doesn't necessarily mean 'the doctor botched it'. The technique for citing an epidural is probably not what most people imagine it to be and anatomy can be (surprisingly/disappointingly) variable so you can do absolutely everything right and still have a patient end up with a PDPH. Doing an epidural blood patch (another epidural, but injecting some blood to 'patch up' the hole that's causing the headache) can fix things but isn't normally done immediately because a) occasionally the headache does resolve with conservative treatment, b) a blood patch is less likely to work as well in the first 24-48 hours than if it's done a bit later c) as the patch is also another epidural injection so there is of course also a chance of causing another dural puncture during the procedure so there does have to be a bit of thought that goes into it. Having a PDPH is flipping horrible for patients and it's one of the things that we're most careful about really trying to avoid because it can spoil the whole experience, but really it can happen with the very best of anaesthetists.

Re. the degree of numbness people have - the aim is that you should be able to move around with modern low-dose epidurals but there is quite a bit of variability in how much effect people get from the same doses of epidural drugs though so there is variation in how much people can feel/move. Historically people had much stronger epidurals and it was more common to not feel much and have very heavy legs. These sorts of threads would probably be much more useful if people said how long ago they had their epidurals and knew what drug protocols they had because quite often it's obvious that people aren't comparing like for like!

There is a fair bit of witchcraft involved in obstetric anaesthesia and no two patients or labours are the same. All of the analgesia options come with pros and cons, but untreated severe pain also has significant cons. From a professional PoV, epidurals that work beautifully are a joy to put in, but the naff ones or the ones that cause complications are really, really disappointing. Best advice to try and work out where the balance of risks vs benefits lie for individual women is that if you're thinking about an epidural but aren't sure if there are any particular pros or cons for you then ask to speak to an anaesthetist if there's one free before things get too 'sharp' - most of us are pretty approachable, most of us can spot if there are particular advantages or risk factors, or if there's anything that might make it tricky to get an epidural in/things that might slow down being able to proceed (it's also much easier for most women to have that conversation before things really get going in labour!).

I haven't read the replies but have the epidural. I had 3 - one for each kid. By the 3rd time I'd accepted it wasn't a failure but a positive and knew to ask early on and let them know that was in my plan.

Each time I told the anaesthetist that I loved them - and I truly meant it till this day.

I'm having the same debate with myself at the moment. I was induced with my first and ended up with an epidural, which was great and such a relief. I was up and about less than an hour after birth and the last part was so peaceful. I was going to try water birth in the birth centre this time, but I'm scared of having to go through the pain I was in before the epidural and not being able to cope. I've been stressing so much about it that I've decided to go on the labour ward and see how I cope without. Like you, I wish I was more anti pain relief so it would be an easier decision!

I had it in my plan for an epidural as soon as possible - I wanted every bit of pain relief there was available and wasn’t prepared to wait to see if I could cope. I couldn’t see the point of being in any pain or discomfort.
According to DH, I told the anaesthetic I loved him very much!

I didn't plan for an epidural with either of mine, but I definitely wanted them when I was 2/3 of the way through 24 hour labours.

1st epidural was great

2nd stalled labour so it was in longer and took longer to get on my feet or empty my bladder.

But all in all I thoroughly enjoyed them both. Or at least the gas and air made me think I did

That's somewhat unfair. A post dural puncture headache is a recognised complication, that we consent for. The incidence is 1in100.

The layer between the epidural and csf is equivalent of cling film, even the slightest movement of the patient when v near can cause it, but it can be one of those things. It makes me really nervous when people move a lot, I've occasionally had to just stop and say its not safe to continue