During labor and delivery many women find that using an epidural as an anesthetic is very beneficial. I didn’t much care for the idea of epidurals when I began considering raising a family a few years ago, but I wanted to be super thorough about this post and not just give you my opinions. So I did my research.
And that’s where I derp’d. I used wikipedia as my primary source. I know. I know. So lo and behold when I was editing and looking to add my hyperlinks the next day the entire page had changed. Layout, information, statistics. Kiss that epidural post goodbye. But yay, I did prevail f’ur yee my faithful readers!!!
Okay, explanation over, let’s get to it.
An epidural is a very specific kind of anesthetic often refered to as a nerve or neural block. This is because an epidural is administered directly to the epidural space between vertebras in the spine. Once the epidural has been administered you can no longer feel anything below the site of the epidural. That’s right, needle to the spine, insertion of catheter, and hellooooo jelly-legs. You can’t get up and walk around without help, and motor function ability varies.
Here’s a video of an epidural being administered. I didn’t much enjoy it and I don’t recommend it unless you’re really interested or plan on getting one yourself. Even if you’re squeamish I’d really recommend knowing what you’re getting into.
I initially didn’t want an epidural for two reasons. First, not being able to feel anything below the site of the catheter really makes me nervous. I mean, you’re pushing something the size of a large melon out of what’s usually a very small opening. And that something is a living creature. So if something were to go wrong internally you wouldn’t feel it. And since you wouldn’t feel it there’d be no alerting a medical professional until this wrong thing had come to pass entirely. I really, really, didn’t like that idea.
Then I remembered that with that came very limited mobility. And that’s rather unnerving too. I don’t think I’d ever want to temporarily paralyse myself from the waist down if given the choice. And that is the real result. Absolute numbness.
I was lucky enough to be able to discuss what it’s like to have an epidural with a high school friend who had major surgery to his legs. He described it as being really strange, not being able to feel his legs at all. There wasn’t a tingly feeling or the ghost of a sensation, there was just nothing. Trying to discuss epidurals with women who have given birth, I find, is very difficult. Not because they’re unwilling to answer questions, but because the sensation of epidural isn’t where their focus lies. Their attention is stolen the moment baby arrives and other memories rarely stick.
These were my two initial reasons to avoid epidurals. I could deal with the idea of getting a large needle stuck in my spine, having a catheter inserted, and even the possibility that a urinary catheter would need to be inserted simultaneously. But I can’t deal with the idea that if something were to go wrong, internally or externally, I would be just that much more helpless.
Then I did my research and I found a few more reasons that make me uncomfortable. I’m probably writing this a little bias due to my existing opinions, so if you really want to use an epidural bear in mind that I really don’t and learn what you can from the post. I would also encourage you, regardless of which way you’re leaning, to do thorough research on this matter and go in with a plan, rather than being the leaf on the wind. (Although that seemed to work for Wash).
Let’s get to facts. There are two types of Epidurals which can be administered. You got your regular epidurals and your C-section epidurals (which is actually called a Combined Spinal-Epidural, a CSE, or a “walking epidural”). Both begin with a large needle being inserted into the epidural space between the vertebras of your spine. This needle then threads a catheter directly into said space. All drugs will be administered via the catheter. The catheter should be placed by a doctor called an anesthesiologist. If anyone other than an anesthesiologist suggests they will be placing your epidural catheter, use some of those kind labor words you’ve been bottling-up to get an anesthesiologist to do it instead.
In your common run of the mill epidural you get a narcotic/anesthetic cocktail pumped into your epidural space. This cocktail can be made up of a few different drugs, narcotics including fentanyl or morphine and anesthetics including bupivacaine, chloroprocaine, and lidocaine. You should familiarize yourself with the drugs which are likely to be used in your hospital.
There’s a long list of side effects attached to these drugs which very rarely come to fruition, but are quite serious. These risks include seizures, temporary or permanent paralysis, temporary or permanent neural injuries, and in extremely rare cases cardiac arrest and death. Now please, please bear in mind, these side effects only occur when the drugs have been administered incorrectly, so if you’re getting an epidural the important thing is to ensure you use a capable anesthesiologist whom you can trust.
A CSE is essentially a special epidural which is most often given prior to a C-section. I can’t really find many specifics on how they differ, which leads me to believe it’s really technical medical stuff I probably couldn’t explain properly anyways. So I’ll chalk this one up to “ask your caregiver about the differences” and move on.
So “why on earth would a woman get an epidural?” you may be asking. An Epidural will dramatically reduce the amount of pain experienced during labor. This is especially great if you have a long labor, and even if you have a short labor, not many people really enjoy being in pain.
Moving on. Due to the decreased pain women find this creates a “more positive birth experience.” I kinda roll my eyes at that, but hey, whatever floats your boat.
Other perks include being awake while a C-section is performed. I cringe at this idea. I’m the “KNOCK ME OUT OR I’LL KNOCK MYSELF OUT” type when it comes to even minor surgeries, so the idea of wanting to be awake during a C-section kind of baffles me. Seriously, if I could have been knocked out for the six stitches in my hand there would be no question.
Similar to the “positive birth experience,” many women find that an epidural gives them some time to rest and regain their strength, determination, and center in order to focus and get baby out. I’d imagine this would be especially helpful during long labors.
Okay, so why do women not want to get epidurals? Well let’s remember: an epidural is a procedure where a needle is being inserted into your spine, the core of your nervous system. There’s a great deal of risk associated with this including infections, nerve damage, and other more rare and serious side effects. But let’s focus on common side effects and disadvantages.
Following the start of the epidural your blood pressure may drop at any time while the epidural is in place. Because of this your blood pressure will be checked routinely and if it begins to drop you may be rushed onto IV fluids, oxygen, or other medications. You’ll also need to move more frequently (so that labor doesn’t slow or stop) and your baby’s heart rate will be monitored. So, you’re guaranteed more machine and nurse interaction.
A fairly common risk (but still under 1% of women) is that when the catheter is placed a small amount of spinal fluid will leak, causing a severe headache. In very serious cases some of your blood is inserted into the epidural site in order to clot at the leaking puncture. I think that’s just super groovy medicine, but I’m sorry if I caught you squeamish folks off guard.
You can also have plenty of side effects including pain at the injection/insertion site, trouble urinating, and nausea. There’s a longer list, but I won’t bore you.
There’s also an increased likelihood that you’ll need help getting baby out via drug stimulation, forceps, vacuum, or in rare cases C-section.
And finally, there’s even shaky evidence that you’ll have trouble breastfeeding or that the arrival of your milk will be delayed. “Shaky” because to the best of my knowledge there’s just one study that’s proved it, yet none which have disproved it.
There are also some cases in which you really should not get an epidural, which include having a thinned blood supply, infection, or a fast labor.
So there you have it. No epidural for me, and hopefully some thought inspired in all of you. I’d highly recommend these sources for additional reading.
You should also discuss any concerns with your caregiver. An epidural, though a common procedure, holds risks to you and possibly to your baby. You should weigh your pros, cons, and opinions regarding an epidural just as you would when choosing a home birth, birthing center, or hospital birth.