on epidurals

03Apr10

I was talking about my new doula career path with a friend of mine the other day.  She said, “it’s sounds like you want to go all natural.  I want pain medication as soon as I walk in the door.”  She’s obviously not alone.  About 70% of laboring women choose to get an epidural.

The biggest benefit of the epidural is that it takes the pain away.  However, epidurals don’t work in 5% of women.  Another 15% only experience partial pain relief.

The biggest downside is that getting an epidural starts the cascade of interventions in labor.

You may not be able to pass urine so you will have to have a catheter inserted.  Also, you will need an IV inserted if you didn’t have one before.  You are much less likely to be mobile after an epidural.  In most cases, you will have to spend the rest of your labor in bed!  Getting an epidural slows labor down, so you will be given pitocin.  If you have an epidural, you may not be able to push effectively, so you may need the aid of a vacuum extractor during the pushing stage.  I’m sure there are many more that I’m forgetting!

I believe that epidurals are better used as a last resort, i.e. when mom has truly had a long and exhausting labor.  Take  Leila Ali’s childbirth experience as an example.  I’ve heard many birth stories where the epidural truly helped mom to get rest so that she would be able to enjoy the moment of birth and first few hours, when she may have been too tired otherwise.  It is also an option available to a mom when labor stalls.  If a mom “going natural” stalls, an epidural is one of the options available to her.  If a mom who got the “epidural upon arrival” stalls in labor, she’s running out of options.

At doula training, we learned that we do not make decisions for our clients and we do not judge our clients.  And we need to support our clients in whatever decisions they make.  There are many ways to support a laboring mother who has had an epidural, including:

  • comforting touch
  • emotional support
  • validation that mom made the right choice
  • encouraging mom to speak up if needed
  • discussing and alleviating any fears

How can you get through labor without an epidural?!  Take a childbirth education class.  Labor at home as long as you are allowed.  Move around.  Change positions.  Learn breathing and relaxation techniques.  Get a birth doula! 🙂

Most importantly, remember that the epidural decision is up to you.

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