No matter where or how you plan to birth one of the biggest assumptions is; of course you’ll get an epidural- birth hurts. Culturally according to data from the CDC more than half of all women use an epidural during labor and birth. Some would argue that number is way higher and some hospitals see a >90% use of them for their deliveries.
So everyone does it, what’s the big deal? As a doula my job is support women, no matter where or how they choose to birth. However, my mission in life is to assure that all families who are making an medical decision have all the facts they need to make an informed decision. So, do you know how to make an informed decision regarding the use of an epidural during labor and birth. Let’s use one of my favorite acronyms to talk about it!
B- “Benefits”; pain relief is the obvious and biggest benefit to epidural use. While some clients have an epidural due to exhaustion and length of labor, most get epidurals due to the pain and the ability to be comfortable. Epidurals typically provide pain relief, but do not take away the pressure or all of the intensity.
R- “Risks”; as with any medical procedure there are risks. Risk of nerve damage, spinal headaches, back pain, inflammation at the site of injection, pain from the injection, hypotension (lower blood pressure due to the medication, can cause lightheartedness, dizziness, blacking out), fetal heart deceleration (sometimes epidurals make babies sleepy and therefore they do not tolerate labor the same way), risk of epidural only taking on one side, or having patches or spots that are numb and others with feeling, increased pushing time, increased used of forceps or vacuum for delivery (due to ineffective pushing), increased episotomy rates, and can lead to increased cesarean sections.
Also with every epidural there will be multiple “wires.” You will be hooked up to a pulse ox, unable to get out of bed, with a catheter, a blood pressure cuff, an iv with fluids, continuous monitoring for the contraction and the baby, and oxygen if you or your baby have issues with the epidural.
Still think it’s just one needle?
A- “Alternatives”; What are some great alternatives to an epidural. Some of the local hospitals in Longmont, Boulder and Denver are now offering nitrous oxide. In essence it’s laughing gas. Some moms love it, others hate it. There are also narcotics and other medications that can be given to take away the pain. How about water- water is the “midwives epidural.” While it doesn’t remove the pain many mothers end up falling asleep during contractions because the water relaxes them so much they are able to sleep and restore themselves through the pain. What about a doula who can offer comfort and labor techniques to help cope with the pain?
I- “Intuition”; What does your momma gut say about what is going on? Would an epidural be helpful? Would it allow you to sleep since you’ve been awake for 36 hours, or do you think it will stall out your labor?
N- “Nothing”; What happens if we do nothing? Is there risk to mom or baby?
This acronym is a great way to make all of your decisions regarding labor and birth. Ask for time and space to be with your doula and significant other to make these decisions. Know that every time an intervention is offered, there is often another intervention awaiting behind that one. Hence, why we call it the cascade of interventions. Be informed, know your options and your choices. No matter how you birth or where you birth, be informed.
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