What To Know About Epidurals

Oh the controversial topic of Epidurals... Often, our views on such topics are predetermined due to stories we've heard from family or friends. It's so important that YOU decide what is best for YOUR experience. No matter what you decide, please know that you are strong and capable!

Let’s dive into some epidural basics.

What is an epidural?
An epidural works to significantly reduce pain during labor and delivery, though a sense of intense pressure is often still present. An epidural is a nerve block delivered through a small, flexible tube (catheter) that is inserted into the spine at the small of the back. They are used for both vaginal and c-section deliveries. When given an epidural, a pump is also placed at the bedside so the mother can choose to push the button to receive a controlled boost. Some epidurals are lighter doses and you may still be able to lift your legs while in the bed. With a higher dose epidural you may not be able to move your legs. Your upper body is not affected.  You are awake and alert. It takes about 10-15 minutes to take effect and sometimes things have to be adjusted.

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Pros

• Provides pain relief
• Safer for baby than medication given through IV
• Can allow for rest during labor
• Can assist in relaxing the pelvic floor (though this isn’t typically a goal)
  
  

Cons

• Lengthens labor by an hour on average
• Loss of sensation to push  
• More likely to need forceps or vacuum delivery which increases risk of more severe vaginal tears
• More likely to need pitocin to help labor progress
• The medication transfers to the baby, so babies tend to be a bit more sleepy which can lead to a short delay in baby latching for breastfeeding. The medication is also present in breastmilk.
• Cords - requires urinary catheter, constant fetal heart monitoring, IV, oxygen sensor on finger, blood pressure cuff on arm
• Limited Movement - confined to bed, so positioning is more limited up to a few hours after birth (though I have some tricks 😉)
  
  
• Needle Insertion - pain and having to stay still in sitting position
• More people in your room
  
  

Side Effects

• Drop in mother’s blood pressure is not uncommon and dizziness and nausea can result.  This can lead to a drop in baby’s heart rate and oxygen levels.  An additional medicine usually quickly remedies this.  
  
  
• Itchiness or nausea from opioids 
• Infection
• Headaches lasting a few days - can sometimes be remedied through a procedure, this is a more rare side effect, affecting about 1 in 100
• Nerve damage pain
  
  

The Unintended
IV’s are given with epidurals. IV fluids can cause retained water weight in the mother and baby. If the breast is swollen from fluids, this can impact the baby’s ability to latch for breastfeeding.  IV fluids also can slightly increase a baby's weight, so when they naturally lose that water weight, it may inflate how much weight a baby has truly lost and cause some anxiety in mothers and pediatricians.

The 615 Doula Co Approach
Doula support is correlated with fewer requests for pain medication, however, I proudly support women that are planning for either option! As your doula, I will be right by your side as you and your family make this tough choice.

Sources // Evidence Based Birth, DONA, National Library of Medicine, Stanford Study