Epidurals: What You Should Know

Ok, so going into labor is kinda scary. Its something we as women are both excited for and dread. Its a lot of unknown factors that can have a million and one different outcomes, not to mention that more than half of those outcomes include bringing home a new little person...and how the heck are you supposed to take care of it?! And they have to stick a needle in my what?!

Some of you may be wondering how I delivered and I admit, mine was actually a rather easy labor and delivery, so I hope no one holds that against me, but I did have an epidural and was induced. My labor lasted 6 hours and Elsa was born after just 30 minutes of pushing, if even that. But let me tell you how things went...

Around 5 or 6pm I laid down on the couch, thought to myself that I really didnt want to go to work the next day and all of a sudden I felt a gush. My water had broken. I told John and we sat around the house for a little while trying to get a hold of the hospital to let them know we were on our way but after about 30 minutes of no answer we decided to just head over. I had tested positive for Group B Strep, a virus that is present in the body at all times but goes through periods of inactivity and activity. If the virus is in its active phase during labor the baby has a chance to develop spinal meningitis or viral pneumonia, so its important to get to the hospital as soon a possible if your water breaks so they can put you on an antibiotic drip to keep the baby from getting sick. Anyway, I wasn't contracting yet but was leaking a lot of amniotic fluid so we decided we needed to head to the hospital.

After getting into a bed the doctor said they needed to do a ferning test to confirm that it was indeed amniotic fluid. The test failed three times but the nurse forcefully reminded the doctor that I was practically swimming in fluid, there was no way it was anything other than amniotic fluid. So after a couple hours I finally was moved to a labor and delivery room. They gave me a pitocin drip (a drug that induces labor) because I had not yet started contracting, and with the Group B Strep and a ruptured amniotic sac they wanted to reduce Elsa's exposure time to the virus. The contractions hit me like a freight train. There was no time to adjust to the pain, they didn't come on gradually, and they started within about 5 minuted of starting the drip, rather than in 15- 30 like the nurse said. I was about ready to climb the walls it hurt so bad. By the time the nurse came in to talk to me about an epidural I didn't care WHERE they put the needle, they could put it in my eye for all I cared, I just wanted the drugs. I had hoped to do a natural birth, or at least close to it but the pitocin highjacked that possibility. I was in too much pain too quickly to be able to manage it on my own. Anyway, the tiny pinch you feel from the needle going into your back is nothing compared to full blown contractions. 

Within moments the pain started to fade. Within just a few minutes I was pretty much numb from my sternum down. This was great for a while but when I went into active labor and was ready to start pushing I was very frustrated. Granted, my active labor was very short, but I felt that if I could just get up on my knees that Elsa would be out so much faster. But as I couldn't feel my legs, I couldn't move them, much less get up on my knees. So I was stuck, on my back, using a pushing method I knew was inferior to letting gravity help me. 

Pro's:
I couldn't feel any pain. I could feel pressure, and could feel when Elsa dropped into the birth canal, I could feel the progress of the labor, but it didn't hurt. I didn't feel a thing when they put in the catheter, which it a good thing, but then again I wouldn't have needed a catheter if I hadn't had an epidural. I don't know if it was just the timing of it all, but by the time I had delivered both baby an placenta and needed to move to a different room I could feel my feet and was able to get out of bed and walk to the wheelchair on my own. I think the lack of pain during the delivery was neat but I think would still like to try to go natural, or as close to it as I can stand, with the next baby. 

Con's:
During labor I could not move without assistance. My legs were useless. If I wanted to roll from side to side or even just scoot up just a little bit I couldn't do it on my own. That was really annoying to me. I think this is probably why my lower back was so sore afterward, was because I laid in pretty much the same position for 6 hours, I know this because when I am particularly sedentary at home my back does much the same thing. I know back labor can cause lower back tenderness but I really didn't have much back labor. Anyway, I now have occasional sciatic nerve pain. I believe this to be because I contracted while they were putting the needle in the first time and had to remove it and try again. If I do not do yoga semi regularly the nerve tightens and causes pain radiating from my lower back down into my thighs. Not fun. But I love yoga, so I guess its not a big deal. Also, my perineum was REALLY sore afterward and, this may be to graphic for you, I have not been able to pass a bowel movement quite the same since. It seems like the muscles got stretched and lost tone, so sometimes I have to really strain, or manually assist the passing of a bowel movement. What that means, exactly, I will leave to the imagination. This I believe to be the result of not being able to feel what Elsa's head was pushing against during labor. If I could have felt a little more I think I would have realized sooner that I needed to not just push, but push UP. I know that wont make much sense if you haven't been in labor before, but when you get there you'll know what I mean.

Would I get an epidural again? Probably, but I would like to experience a natural birth, or as close to it as I can get. I would love to be able to move around and get into whatever positions I feel I need to in order to get the baby out swiftly and as painlessly as possible. Its been proven through research that laboring on your back is the least effective method, and that a squatting position is actually the most common, and most effective, natural birth position which results in faster deliveries and less stress on the mother and baby. Most animals deliver either standing, squatting, or laying down on their side with legs braced against something so they can push. So why do humans labor on their back? No other animal does, so why do we think this is a normal or natural position for us to deliver in? Because its what's most convenient for the doctor. What about the birthing mother? She's the one trying to push a baby out. Forget the doctor, lets make sure mom is comfortable!

Are Epidurals Safe?
The article you can find at this link http://www.slate.com/articles/health_and_science/medical_examiner/2012/01/the_truth_about_epidurals.html discusses the common arguments for and against epidurals and pretty much states that with modern advancements epidurals are really quite safe and have few, if any, real side effects to be concerned about. For example, the concern that an epidural makes the newborn sluggish and prevents them from establishing a good latch right away for breastfeeding, but the studies this article looked at showed that most babies learn to breast feed within 6 days of birth regardless of what pain management was used, if any, during their delivery. My daughter was born with an epidural and latched just fine and was feeding normally within just an hour of birth, so I think difficulty breastfeeding is probably more commonly linked to issues with technique than to what pain meds were used in delivery. 

Should I get an Epidural?
Sure, if you think you'll need one, or have decided you want one. I think they are perfectly safe. The only thing I will advise you on is to make sure they don't give you one too soon. Ask the doctor how long you can hold off on getting one, and request that they give you one when you enter the window just before the 'point of no return'. Just keep in mind that this could possibly result in you not being able to get one depending on how busy Labor and Delivery is that night. If the anesthesiologist had come in just a half hour later my contractions would have been too close together to safely have on administered. As it was they were already cutting it a little close. But talking to the doctor about the epidural when you get to the labor and delivery room, when you would like to get one, when you CAN get one will help ensure that the epidural does not slow or reverse your labor. I have heard of women laboring for several hours longer than what is normal for them because they were given the drugs too soon, or whose labor actually stopped after getting it. I would ask the doctor how common this is though before deciding whether or not this will effect your decision to get one. 

What I recommend to any expecting mother is to be flexible. Do not get set on delivering a certain way. If you get too attached to a certain delivery style and things happen in such a way that you cannot go that route you may end up being so disappointed in the delivery that you don't actually get to enjoy the moment that your baby takes their first breath. Thankfully I had already done some research into what my delivery would likely be like because I had tested positive for Group B Strep, so I knew that if my water broke first that I would more than likely end up getting induced and would then probably need an epidural. So be sure to research all the options so you know what to expect should a complication occur. This will allow you to relax a little bit more and get to enjoy, as much as you can, the experience of giving birth.