Water birth or straight to epidural?

[CharlieAndMoose]

At this week's antenatal class, birthing options were discussed, and in 2 weeks time I'll be starting to have the conversation with my midwife about birthing plans (I'm due early June). The class was insightful, but I've come away from it even more unsure what I want. Pretty much every mother I know has said "go straight for epidural", and before the class I was fairly certain that's what I wanted. But I don't feel as confident now.

I love to be in the water. I spend half my evenings in the bath, it's my go-to activity when I need to relax and have downtime. Swimming is my go-to exercise. I'm really intrigued by the concept of a water birth, but because you can't have any medicalised pain relief other than gas and air, that worries me slightly (my tolerance for pain is highly variable). But equally, the idea of an epidural and having less mobility/increased risk of needing an assisted birth, doesn't enamour me either.

FWIW I don't currently feel hugely anxious about giving birth overall, just enormously undecided. So I'm hoping for feedback from anyone able to answer the following questions:

Has anyone who's had multiple births ever experienced both water birth and epidural? If so, which did you prefer (if either) and why?

Has anyone ever started out planning on a water birth and switched to epidural part way through labour?

I would also value positive epidural and water birth stories, if anyone is willing to share! TIA.

I had an excellent water birth, but I was never really interested in an epidural due to the restricted mobility afterwards.

Only one baby here, epidural.

I went into it flexible but ideally no epidural as the idea of a needle in my spine wasn't great. Hoped to try a water birth.

Then labour started. Within 3 contractions I was having 3 in 10 minutes, I could barely breathe let alone talk through them. CTG at hospital showed I was hypercontracting, I wasn't coping well (essentially catatonic) and baby was not doing well with the hypercontractions and heart rate was really diving and taking some time to come back up. My waters also went and there was meconium and blood in the waters. A water birth wasn't safe, and I opted for epidural. I was 9cm about an hour later but got stuck there with baby getting more distressed.

Eventually had an EMCS. Turned out baby was in a really bad position. Twisted sideways, head slanted and caused the really bad contractions in my back in addition to the pain from the hypercontractions. My baby was never coming out alive vaginally.

My friend declared herself a huge wuss, declared opting for epidural ASAP. Ultimately found labour fine with gas and air, short uncomplicated vaginal birth.

Plan all you want but you never know what will happen, so be flexible and don't commit yourself 100% to I must give birth this way.

Water birth for sure; afterwards you can actually get out of the pool yourself and walk to the bed carrying baby.
Compared to being confined to a bed with an epidural for hours during and after birth. I've had both options and would always choose non-medicalised route now. The epidural drugs messed with my system for days afterwards and I wouldn't take it again. With the meds free births, my head felt so clear

I would have loved a water birth but was being monitored for both my births. How are you with period pains? If you can tolerate a fair bit then water birth probably is your go-to especially if you love being in the water.

I did eventually have epidural after a ridiculous amount of time it was probably many hours overdue tbh, it was a saviour and i remember the 20 minutes it took for them to set it up felt like a lifetime...and an epidural was never in my birth plan.

I didn't need assistance but they wanted a 'slow descent' and was 10cm for 2 hours before I was allowed to push to prevent the need for any intervention. I fell asleep during this time as had been in labour for 30 hours! Baby came out asleep too.

I honestly didn't care at that point, I had also been vomiting violently I think from all the gas and air and other induction drugs they gave me. I was vomiting well before the epidural so that wasn't the problem. I wish I'd been more open to an epidural. My only advice is to go in with an open mind and be vocal about what you feel you need.

Had an emergency spinal block with my first and a water birth with my second. Like you I take great comfort in the water and it was a lovely experience (well as lovely as labour can be!)

I thought I'd like a water birth, and tried it. I found that to get the benefit of the water, you need to be in a sort of squatting postition within the water, so that the water covers the bump, but I just wanted to stand up each time a contraction hit! Ended up getting out and choosing an epidural, as I found the pain hard to cope with. It's very individual. I honestly wouldn't make any hard and fast decisions now.

Doesn't usually have to be an either/or decision you make so far in advance (unless your LW doesn't have pools...but that'd be a bit unusual) - you could start in the pool and see how you go...epidural's still an option if you change your mind. The website labourpains.org is a good place to get objective info re the different modes of analgesia for labour and some of the risks/benefits (run by the obstetric anaesthetists association and lots of units use their information units as part of their consent process for epidurals so they're worth a read in advance if it's something you might consider). HTH.

I needed an epidural for one of my births and I absolutely hated it. The birth itself was fine though, but it was my third time.

My other two births were not water births but I only used gas and air. Really straightforward normal vaginal deliveries.

Anecdotally, out of all my friends and family, the ones who’ve opted for an epidural for their first baby, have all needed forceps or an emergency section. There is a strong link between epidural and intervention, especially for first babies.

that 'strong link' between epidurals and assisted deliveries is still thought to be association rather than necessarily causation (and will depend a bit on dosing protocols and timing of the epidural).

Could I ask what it was about the experience you liked?

What was it about the water that made the birth a better experience than the spinal block?

I’ve not had an epidural but I went into both labours open to progressing up the pain relief ladder as needed. With both I took a paracetamol at the start of contractions at home and used a Tens machine and never felt the need to progress to gas and air. For my first I wanted a water birth and laboured in the pool until I had a bleed. As soon as I stepped out of the pool I couldn’t believe how much more I felt the contractions! I got my husband to slap the tens machine pads back on super fast! My advice would be to not go in with a fixed expectation, but some ideas of what you would like and anything you really don’t want clearly noted. I couldn’t have a second water labour/birth due to previous PPH but I would have absolutely had this, in fact they were running it when they found out I had a PPH and turned the taps off.

I had a lovely water birth. Unfortunately I had to have a spinal block after delivery to get the placenta out surgically.
if you love water I’d recommend it and you can get out if/when you want.

I had a water birth that was amazing! No drugs needed. I previously had 1 long labour that ended with an epidural and 1 non water birth with no drugs that was very challenging due to being pushed about by the midwife. The water birth was far and away the best experience.

The key is you being free move around and into the most comfortable position.

I’m a total water baby- I have a long hot bath every day. I had all three of mine at home. With the first the midwives weren’t trained for Waterbirth so I cane out for third stage - only time I tore. 2nd and 3rd births no tearing at all. Personally I wouldn’t give birth in a hospital- particularly with the way things are now. If you are overdue you may find you’re not allowed plus sometimes it’s not available. I can hugely recommend water and homebirth. Planned home births are just as safe as hospital and less chance of unnecessary intervention and focused midwife attention.

Thanks for the tip @Greybeardy. The midwife leading our classes essentially said to prepare at least three intended birthing plans, so I am probably leaning towards water as option one and epidural as the initial back up. I understand that there's no guarantee either option will go as intended though; I have two friends who've recently had EMCS which they really didn't want. I'm the same, but I appreciate that getting baby out safely is the most important thing and if I end up in that position too, so be it!

To be honest, I wouldn't worry about deciding now. By the time you get to the hospital you'll be in a decent amount of pain, and can decide what you think then. You might find you're ok and want to try the pool, or you might want to scream "get me an epidural" at everyone - either is fine but you won't know beforehand.

I had one water birth and one non-water birth, both without any pain relief (gas and air made me queasy). But I couldn't have predicted that going in, and wasn't set on anything in particular.
FWIW I enjoyed the water birth, and would have had a second but had to be induced with DD2 due to PPROM so a pool wasn't an option. Actually, to contradict what I just said about not deciding in advance, I did decide that if I needed the drip for the induction I would flat out refuse to give consent unless an epidural had already been administered. But I didn't need the drip so that didn't happen.

Could you do a hypnobirthing course? Goes hand in hand with the water birth and will reduce the likelihood you'll need an epidural. Helps you control the pain you feel, so you won't hopefully feel like you need epidural.

Obviously every birth is different and an epidural is always a great option if you feel things are too much - there's no wrong way to birth. No two births are the same so it could have been many factors but for my water birth I liked being able to move comfortably (i found there was plenty of room to do so) the water helped with my contractions and I don't know, I just felt generally calmer - I always do in water though, the bath is my recharge space!

Happy birthing, however you go.

Yes I've done the hypnobirthing course, which may be a factor in influencing my interest in water birthing. In fact I currently use the breathing techniques to help me fall asleep!

If I'm interested in a water birth I have to advise in advance as the LW in my local hospital has limited capacity. That's what both my midwife and the antenatal midwife (who works in the same authority) have said anyway. Which equally means it may end up not being an option anyway if they're all in use on the day.

You’ve got the right idea by having a few plans and being open to whatever happens. It’s people who are most fixated on having a specific type of birth who often end up the most upset and traumatised. FWIW I’m also a water baby, love swimming and baths, and was keen to try the birthing pool. In the event, by the time I was at hospital with 3 in 10 I was crying, screaming and begging for an epidural. Next time I would go straight for an epidural again, that part of my labour was lovely and so relaxed, calm and pain free.

I thought I wanted a water birth, but the minute I got in the heat and the water and the dimmed light in the room made me feel so claustrophobic I had to get straight out again!

I then opted for an epidural and tbh it was lovely. We chatted with the midwife, had a bit of a rest, I pushed a few times and out popped a baby.

it’s all very well saying that anecdotally epidural can increase the risk of intervention, but you also need to bear in mind that on the flip side, not having an epidural increases the odds of needing a general anaesthetic if something is wrong. If for any reason they need to progress to an emergency caesarean, and you have the epidural already sited you are good to go, but in an emergency there isn’t time to site one so they will give you a GA instead.

I've had both, water birth was definitely my preferred experience, it was so calm and relaxed.....I actually quite enjoyed it.
I was lucky though, my baby was in the right position, everything went the way it's supposed to so it was easy.
It's definitely worth starting by going for a water birth if you can. But keep an open mind just incase - you can always switch plans if needed.
FWIW my epidural birth was also a very positive experience, but recovery wasn't as immediate. After the water birth I was home in my own bed within a few hours and felt like the queen of the world 😁

Re epidurals and anaesthesia for surgery...
If someone's had an epidural in for a while and it's worked well then it can often be used to for an emergency section. However, if someone has an emergency that requires a category 1 section (so something with immediate risk to either mother or baby's life) then it may still require a GA even if there's an epidural working - depends on the exact scenario.

If someone's had a naff epidural in labour (about 1:8 don't work perfectly) and then needs to come for a cat 2 section (urgent, but not immediately life threatening) then usually we'll take it out and do a spinal injection.

If someone hasn't had an epidural then a spinal would usually be first choice if there's time or GA if it's super urgent or there's a contraindication to a spinal. HTH.