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've had two water births, delivered both in the pool. I had gas and air whilst in there. It was nice but I feel I could have done it out of the pool, with dd2 also I felt I preferred to stand up so was stood up for ages in the pool 😂 not sure why I didn't just get out. Really you won't know until your in labour, birth plans should only ever be a loose idea of your preference as until your in the moment you won't really know how you feel. But put it down if you think you'd like to try. Some hospitals often only have one pool though or often the pools are in a midwife led centre (for me the pools are in a specialist midwife led ward within normal delivery ward) and when there you can't have an epidural as it's midwife led so you'd need to be moved to get one to the normal consultant led delivery ward so best check how your hospital works regarding where are the pools etc

I think it’s worth trying to see if it works for you OP. My first was back to back and I was in agony in the early stages, unable to sit or lie down and vomiting between contractions, the midwife wanted me to try pethidine but I got into the water (a bath as I was in the wrong room) and the way I remember it I almost immediately began feeling the urge to push (from my notes, I went from 3cm to birth in less than 2 hours but the 0-3cm part was 10 hours). Baby was born in the birthing pool (though moving from the bath to the pool was horrible!) with only gas and air. DC2 was much less painful, but again my pain control was tens machine then gas and air then finally water, this really worked for me.

I was convinced I need an epidural. I'm a total wuss with pain, cry when I stub my toe level wuss. Also baby was big, back to back and didn't drop until I was in labour.

I used water to labour at home, mainly shower as like others I felt contractions easier when I was standing. I only went into hospital when I was 6/7cm and fully effaced so they were able to get me straight in the pool.

Between the gas and air, the dim light and the warm water, it honestly felt like a spa. I was able to very freely move in the water, rocking, a frogs leg type position, squat, even on my back for a bit. This was great as baby was not helpful with positioning so I could really move to help work him out. At one point i grabbed the handles, braced my feet against the side, I could do what I needed. I felt really in control and I know people bollocks the hypnobirthing 'breath the baby out' thing, I did too, but truth is it really worked for me.

Got baby out with no tearing just a minor graze.

I would say there are three pillars to a good birth.

1.is a good support network. I felt so safe, heard and advocated for between my midwife and husband so could focus on birthing and trusted them to do what was best.

2. Prep, Id read the books done the classes, felt informed and had a plan a- z so when transition hit I didnt panic and could call on my breathing.

3.Pure dumb luck. You can be as prepared as you like, the baby might get stuck, your body may handle birth in an unexpected way, there may be a medical emergency so thank god for modern health that saves lives. Sometimes nothing you can do, baby will come how it needs.

Hello!
May I recommend you search Ina May Gaskin on YouTube and even consider reading her book. It’s on Spotify if you have it, just search her name. It changed my whole perspective on childbirth. I had two natural deliveries with gas and air, the second one was at home in a pool. I’d highly recommend this it was the most positive experience. If you want more information I’m happy to share just DM me.

First birth - induction, epidural because the pain was so bad I wanted to die, forceps (narrowly avoided a c section).

Second birth - did a hypnobirthing course, had a doula and had a fantastic waterbirth at home with no pain relief. I wouldn't do being pregnant again if you paid me but the birth was amazing (a bit like running a marathon - hard work but doable and such a great feeling at the end!)

Link doesn't mean causation. Pain in labour isn't linear. For example, back to back labour is known to be more painful and take longer. So more people with back to back labour will opt for epidurals. Back to back labours often require instrumental assistance. Not because of the epidural, but because the position of the baby isn't optimal.

My case I needed the epidural. During my forceps attempt and EMCS it was found my baby was never coming out alive vaginally because of the position he had got himself stuck in. Which was a position that made my labour more painful. I can tell you I was bloody glad I opted for the epidural early on than suffering through the pain for no reason!

I had 3 babies. all no birth plans- best decision IMO is to go with the flow and not make them to avoid disappointment etc but also IMO I don’t think you can really plan it too much.

first birth was back to back- I had terrible nerve pain down my back very early on so had an epidural. He came out in 1 push so no instruments. He was a lock down baby so I didn’t do any NCt classes. Looking back I hadn’t really grasped Hypnobirthing.

second- was gas and air, on my knees. I used the Freya app religiously to keep me Hypnobirthing . It was amazing- a very controlled birth. No pain relief.

third- again has and air, no pain relief on all fours. The midwife was filling up the birth pool but he came too quickly in the end. Again with hynibirthing it was controlled and an amazing birth.

I have a science brain and thought Hypnobirthing sounded a bit hippy. But in fact it makes total sense, a lot of oxytocin is all you need.

I needed more pain relief after birth than during!! The afterbirth pains when you have more babies is something they don’t warn you about!

obviously this was just my experience and it all depends how your baby is positioned.

I've birthed 4. One epidural, 2 water births and one no drugs but out of the water. Water births were the fastest and least painful with the least damage to me. I absolutely loved them and would always choose water as my pain relief!

I’ve had 3 babies and all were back to back. First I had an epidural but still needed gas and air for contractions as I still felt the pain! Second I had just gas and air. Third was in the pool with gas and air and was the perfect birth, I honestly wish I’d have been given the chance to do it the other 2 times. I felt completely in control, didn’t suck the life out of the gas and air til I was dizzy (like I did during my second birth). It was also super quick, but not sure if that’s a third baby thing instead? I went from 6cm to delivering in 25 mins after getting in the pool, only 2 pushes and no stitches needed unlike first 2 births. Baby was also born still in their sack so waters never broke! Good luck it’s amazing x

Thank you all so much for sharing your experiences. It's nice to hear positive birthing stories, as often people only want to share if it's been a bad one. I know friends mean well and that they're trying to "prepare" me when they tell me the bad bits, but it's really not helpful. I have to do this regardless, and I think it's much healthier to go into it with a mindset of "I can do this" rather than a fearful or anxious one from the get go.

You've definitely given me food for thought to discuss with my midwife anyway ♥️

I had a fabulous water birth with DD1. I used a TENS machine up until then. I would highly recommend both!

I tried water birth with my first but found that the gas and air-only pain relief just wasn’t cutting it. I ended up being too late for an epidural, and had a fairly traumatic first birth. I asked for an epidural the next time around and me for an epidural birth was 10 times better - I felt very in control, minimal pain, less tearing because I was calm.

i think it’s good that you are open to either option because it’s hard to know how you will respond to labour.

I had a water birth but DS was born too quickly and I had a very bad tear that needed surgery and a spinal anaesthetic afterwards. I think with a water birth there is less a midwife can do to intervene during the birth to reduce the risk of a tear. But not sure how often they actually intervene.

In my case it wasn't to scare you, it was to let you know that while many absolutely can 'do this', some cannot. It is not a failure, there is zero shame. The goal is healthy mum and healthy baby and you get there however you can. There is no medal or prize for how or where you gave birth or what pain relief you had.

What happens happens, and you'll be in the hands of people who can help you through it.

I’ve had three home water births. I had to lift my belly out of the water and at that point, when I wasn’t under water, I could really appreciate how much the after helped. I found gas and air really helpful. And, an underestimated, and rarely discussed point, but I also felt fairly fresh and clean afterwards which was a bonus. I was up and about making tea about 8 hours after my first - not because I wasn’t be looked after but because I was euphoric. Those are my only births though, so I can’t compare.

I wanted a water birth both times but missed out as first labour was too long / not progressing and I got too exhausted so opted for epidural...which was needed as baby had gotten a bit stuck. Second labour was too fast and baby arrived before I could get near a pool. I think you won't really know what you want until the time...and that could change. Maybe just talk through your options for different scenarios.

I've had 3 waterbirths, 2 also with gas and air.
Water also makes me relaxed, a soak in the bath is my way to unwind.
I think the most important thing about labour is being comfortable in your environment, this will make you a lot less stressed which in turn makes labour easier to cope with.
Water birth gives you freedom of movement, allowing you to change positions and made me feel calmer.
However as a pain relief it is very limited so I recommend adding gas and air.
I know you need to have an epidural fairly early on as they often says it's too late and it takes time to get the anaesthetist.
However in my experience by the time you are thinking I need an epidural now you are nearly there!
I've no experience with an epidural so can't compare the two. I was a bit worried about not being able to feel my legs/walk/lack of control. However I think epidurals have moved on now.
Labour is painful but it's not continuous pain you have breaks between contractions, if you are well supported by partner /family and midwives and understand what is happening is makes a big difference psychologically, it's productive pain with a positive outcome.
Whatever you choose it will be fine

I see women grunting and out of it when they’re having water births on ‘one born every minute’ but my epidurals (administered early in the labour) were amazing. Relaxed, laughing, no pain. I hopped straight off the bed and into a bubble bath afterwards so I don’t know what this ‘limited mobility’ fear is!

The horror stories you hear about epidurals is when women edge their bets and leave it to the last minute. Administered early into the labour, it’s great.

I had one birth that was too quick for an epidural - it was super quick but I’d rather have had several hours of pain free.

Keep your options open, would be my advice.

I started in the water, but it slowed down contractions and the baby was back to back so gas and air didn’t really do much in terms of pain relief. It was a long labour, I had an epidural after 15 hours and it went on another 18. I found the epidural wore off quickly and I was mobile within an hour of giving birth.

Overall I think of the experience as a positive one, because I was listened to by the professionals at each stage. Obviously it being rather shorter would have made it even better!

I've had both with and without epidural. DC1 because I was in labour for 70+ hours and needed the sleep in order to get to the pushing phase. No regrets at all. DC2 couldn't go for water birth due to meconium so opted for epi, unfortunately no time as I delivered in 3 hours. Definitely unbelievably painful but I noticed that my recovery was very very quick compared to DC1. Was able for 5 km walks with the buggy within 2 weeks. Had a knock on effect for weight loss, I never got back to pre baby weight after DC1 but got back to pre DC1 weight within 4 months of having DC2 which I've kept off. My mood was better as a result of being able to exercise.

I went in really open minded - I know I feel really happy in the water (I find baths very relaxing and kind of a safe space if you know what I mean) so I thought the idea of a waterbirth sounded really nice. I also liked the fact that birth without an epidural has a quicker recovery time and is less likely to end in medican inteventions. But also I have a low pain threshold and honestly was a bit apprehensive about birth. The thing is you can always change your mind when you are in labour. I decided to go for the waterbirth, but also accept that if I decided the pain was too much that I was ok to get out and have an epidural instead - no one can stop you changing your mind!

As it happens, I never felt the need for the epidural - I laboured in the pool, but personally felt a bit 'out of control' when it came to pushing (it was my first, and honestly I was a bit scared!) so I got out do the pushing which the midwives were happy to assist with. Overall it was perfect :)

My birth plan was start with gas and air, open to suggestions.
I thought I wouldn't be able to access the midwife led unit as I was high risk which would have made it less likely that'd have a water birth (fewer pool in the maternity unit compared to the midwife led unit) and just had it in my head I would have a medicalised birth.

My waters went before I went into labour so I was booked in for an induction 22h later, added to the thoughts that I'd need intervention. A fewer hours later contractions started 3 in 10 from the start. At half 7 they were all at least a minute so I phoned and went into be assessed. I was 2cm. It was half 9- 10 when we got home and an hour later I was struggling to cope. Really thought I'd need an epidural at this point. The first midwife I spoke to on the phone was dismissive of letting me back in so soon but the midwife I'd seen earlier was running the midwife led unit and there was a room available even if i was still less than 4cm and she run the pool whilst i headed in. To everyone's surprise I was fully dilated got straight into the pool and baby was born 30 minutes later with a little bit of gas and air!

The way the dice rolled on the day I had a very straightforward birth but there were several points over the course of the 12h between my waters going and baby being born where intervention may have ended up being necessary. If I'd needed a quick induction to minimise risk of infection due to my waters going that would have been a different birth experience. If I'd still only been 2-3 cm I would have been asking for all the drugs epidural etc. if I'd listened to the first midwife the second time I called I would have had my baby at home!

Giving birth isn't one decision, one risk profile. Of the course of the hours and days there will be rolls of the dice and you just have to hope for the best at each point and try to make the most appropriate and informed decision each time. The only thing I asked my partner to do was to help me make informed decision and to stay calm.

I don't have any fears about epidurals. The information about limited mobility came directly from the midwife who led my antenatal class. Though I do know a friend of mine lost all feeling in her legs during her epidural birth and had to have them moved for her by her birthing partner. She also had an episiotomy. Another friend ended up with a forceps delivery. I wouldn't necessarily describe these as horror stories, they're just some of the limited examples I have from people I know. However, both have also said they're glad they'd had the epidural and both have recommended I do the same, despite their need for assistance.

If you’re a bath person, you will probably love the birth pool. I am a huge bath person, I have one almost every night. For my first birth I couldn’t be in the pool because of complications and I remember having a particularly painful contraction on the toilet in the hospital, and looking at the bath just longing to get in it! I ended up with an epidural, which took all the pain away but I had a too-heavy block which caused issues with pushing.

With my second, I had a home water birth and it was one the best things I’ve ever done. It went too fast to fill up the pool, so I hopped in the bath instead. The water made everything so much more manageable.

Just try it and see. Just because you start off in the pool doesn’t mean you have to stay there. You can move to an epidural if you need to, it happens all the time with first births (I’m a midwife so I see this a lot).

I had a water birth at home with my first and it was amazing.
Second was an unmedicated induction. Also great.
The water aspect to me was less important than the general principles of how I wanted the birth to go. The circumstances of my births were very different but both were calm experiences and I did things my own way. Hypnobirthing, own Playlist, aromatherapy and being left alone to get on with it.
If you dipped your toes into the unmedicated world and the principles resonated with you then I'd be inclined to persue that.