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

Given I've never even heard of epidural migraines and Google agrees, it's not a thing. Being sleep deprived from a crying baby is likely to cause headaches

You aren't completely numb. People move from bed to operating table for surgical interventions. People can stand. Most just don't choose to. I've seen epidural lady's on birthing balls, but it's rare most just lay there

Personally the epidural felt like a dream for me - in lots of pain beforehand, to forgetting I was even in labour, laughing and chatting on the family WhatsApp 😆

I had epidural with my first 2 children. Millions of people will have had them and be perfectly fine . But I do know one person who is now disabled. Obviously that's extremely rare though.

Hm well a previous poster recognised it and at least 3 NHS trust sites had info pages about them (just checked) sooo...
And no lol not the same as being tired.
Fact check properly if you must.
I never said common but absolutely a thing.

Can you not go to a MLU attached to hospitals? Most places I work many come to mlu for their water birth but if they change their mind and want an epidural they just come round the corner to us on labour ward

Hard to decide isn't it. Labour ward was my plan too for options. But a private room to yourself in the birth centre is also appealing!

Our birth centre is just on the next floor but the reality is once you are admitted there if you asked they discourage from having one (nicely)

Labour ward does make sense for options x

D'you have any links you can share? (Am also an obs anaesthetist that's never heard of epidural induced migraines...be nice to know if I've missed some new research development/research).

If you read other people's posts about their experience of epidurals then you'll see that there is truth to it.

I had an epidural for another reason – operation on my ankle – and it didn’t cause any issues at all. I personally would go for it and make it clear in advance it’s what you want. Congrats btw!

Posts aren’t the same as statistics across a population – there will always be a number of people who experience issues with any route, but the point made is there isn’t data to suggest that having an epidural -increases the likelihood- of complications or other intervention. That doesn’t mean that the two can’t happen together though.

Women having straightforward labours don't usually have epidurals in the UK. Correlation does not equal causation.

Post dural puncture headaches are not migraines. They're horrific headaches in the days post epidural. If they don't self resolve at 48h then we treat them with a blood patch, as explained earlier. They don't go on for months and they aren't migraines. They need testing longer terms as risks to traction on the cranial nerves untreated. So yeah

I've spent 40min googling to try and work out what they're on about. I can only assume it's some misinterpretation of pdph. But no clue what they're on about in terms of duration and their phrasing suggests they clearly know better than obs anaesthetists so I've not pushed it lol

Labour ward is all private rooms too!

OP I was the same as you. DD was back to back, 25 hours of labour with 4 hours of pushing alone. In an MLU so no access to an epidural unless I got moved to the labour ward. After 2 hours of pushing they tried to move for an instrumental delivery however labour ward was full and as there were no concerns with me or baby they kept me on the MLU.
When I was having DS I made up in my mind that if he was back to back I was going straight to the main labour ward and was demanding an epidural. I'd have chopped my head off with DD if it meant the pain had stopped!
He wasn't so I was on the MLU again and I had the best birth, it was the most exhilarating experience of my life and I would relive his birth in a heartbeat. From when I realised I was in labour to when he was born was 2.5 hours. Got to the hospital an hour before, straight in the pool and apart from the contractions there was no pain, I was actually able to have a conversation with DH between them whereas with DD I just zoned out. He was out in 2 pushes (embarrassingly I thought I was pushing for a poo on the first push), no tears or anything. We were home 6 hours later just in time for DD to get home from school to meet her little brother.
If you can play it by ear I'd definitely hold off, imo a labour with a normal facing baby was a doddle compared to back to back.

And?
The point remains. Epidurals have risks and this is one of them. I dont care frankly if I got the name of it wrong. Seemed a useful experience for the poster to look into when making a decision.
It might be rare but that experience was a big deal to the person I know.
Frequenting mumsnet to talk down to people is exactly why people don't trust health care professionals.

I'm not talking down to anyone. I'm telling you there is no such thing as what you are referring to, as I don't want you to cause people to worry unnecessarily.

A post dural puncture headache is curable (within a week) and doesn't last many months.

Neither me nor the other obs anaesthetist on here said epidurals are risk free. I've quoted the incidence rates of all serious complications and explained them in great detail. We aren't trying to mislead or bribe people into them!

I had an epidural with my first and not with the subsequent 2 (including a 10.5lb-er) and I wouldn't do it again. It absolutely made birth easier then and there but the recovery was horrendous compared to the other two. I ended up needing forceps and so episiotomy and had no understanding of how hard that would be. I was so much more mobile after the other two; I was still sore but it was like I'd run a marathon (I imagine!), rather than been hit by a train. I also hated being tethered to the catheter, drip etc and not being able to move. I have found that left to my own devices, I can't sit still in labour and hate being on my back! I also get a nasty dose of the shakes every time.
All that said, it's pretty common (though obviously not a rule) that your first labour is longer and harder than second or third so it may be you don't feel the need for it at all.

You have described epidurals as 'fantastic' and quoted statistics but then described the headaches that 1 in 100 get as 'horrific' and curable within a week. Something that gives me a 1% chance of a horrific headache that stops me getting home to be with my family is frankly not fantastic.The impact of that to the 1 percent is huge. Sometimes it's needed obviously but routinely absolutely not.
It makes sense given your job that you want to portray these things as harmless but I've had my fair share of hospital based gaslighting thanks.

Most self resolve with no treatment after 24h. I can't say I've ever seen anyone admitted more than 2d for it.

1% is a 1 person in a village.

I can count on one hand how many blood patches I've done in 9y (the treatment if it doesn't resolve)

Vs doing about 9-15 epidurals every week in the same time frame

It doesn't remotely bother me if someone has one or not, not like I'm paid per epidural (I wish haha), but I do want to try to allay the scare mongering that nct does to petrify women about them when they're incredibly safe and routine

Why NCT?
That's certainly not where my opinion on interventions and specifically epidurals comes from.
I don't appreciate you downplaying the risks and impacts of a major intervention. Obviously this is common place to you but 1 person impacted by a side effect is still a person and that person may have been robbed of their birth experience and recovery if they didn't need the epidural in the first place. Epidurals might be routine but they shouldn't be. That's exactly my point.

My experience of NCT is that there's a big focus on relaxation, breathing and using non invasive pain relief methods. I found the classes incredibly helpful and empowering. There was no scare mongering about epidurals. All the main methods of pain relief were covered: epidurals were discussed in a factual way, no bias at all.

I can quite see that if you're keen to have an epidural, you might feel the classes aren't so relevant to you, because 45 minutes of every class I did was actual practice of deep breathing, how to breathe through contractions, how to relax, in other words, non medicalised strategies. If I'd been determined to have an epidural then I wouldn't have signed up for NCT because I probably would have felt I wouldn't get my money's worth. But it's very unfair to make out the NCT Scaremongers. They're upfront about what they offer; I didn't want an epidural, I wanted as natural a birth as possible and I found the techniques I learnt from NCT incredibly helpful

I agree with @lolly792 - I found NCT gave a detailed explanation of all the different pain relief options and pros and cons of each, plus a factual and good explanation of how birth works. Having all that knowledge empowered me to make decisions that gave me and my baby the best experience possible.

In contrast, I found the consultant I saw at 40 weeks to be coercive and to scaremonger. He said things to me like ‘well being induced doesn’t inevitably lead to epidural or other interventions’ which is true in that it’s not a certainty, but it is disingenuous to pretend that one intervention doesn’t lead to a cascade when that is well documented.

Epidurals by their nature prevent you from listening to your body and trusting your instinct - that was a red line for me. Women’s bodies are designed to birth babies, so being able to listen to my instincts and move around as I needed, go with contractions and instinct of when to push etc was essential for me.

For some women feeling no pain (during the birth, but query if you actually experience worse later due to recovery from interventions as some PPs have said) is more important and that’s fine. As long as women are making informed decisions, that’s the most important thing.

What do you mean 'why nct?'

I have no idea where you get your opinions from. I'm just saying nct often causes women to be petrified of epidurals and see themselves as a total failure for requesting one which is equally inappropriate. Noone should be made to feel like a failure for requesting pain relief which is safe and reliable

I'm not down playing any risks. The risks are there. I give everyone the same statistics that I've said here. They are rare. It's individual choice what people want to do in their labour.