The Trade-Off of Epidurals
I think the obvious pro is pain relief. When administered correctly, most women are able to stay awake and alert while experiencing no pain. Women are also able to sleep. In long or difficult labors, an epidural can prevent exhaustion, allow the mom to relax while her body continues to labor, and still allow her the ability to have a peaceful and positive birth experience epidurals pros and cons.
As I Mentioned before, Epidurals have Pros and Cons.
Epidurals are not without their cons, however. I am typing this up as these come to me and may be out of the order of events I tried to cut/paste some segments where they should be and for some reason I can’t.
- Epidurals may not always work. Women may experience windows of pain or pain on half of their body. Your experiences can differ from one birth to the next, so you can’t count on an epidural for complete pain relief.
- Epidurals slow labor, which increases the use of Pitocin to stimulate stronger contractions (because you will be unable to stimulate stronger contractions on your own laying in bed). Increased use of Pitocin leads to higher episiotomy rates, instrumental delivery (forceps or vacuum), and cesareans.
- Epidurals easily pass into the maternal blood vessels and cross the placenta into the baby’s circulation. Once there, it may slow the fetal heart.
- Other issues, such as a catheter or needle piercing a blood vessel, the needle going further than it should, or catheter migrating inward can cause convulsions, respiratory paralysis, and/or cardiac arrest. This can happen as commonly as 1 in 3000 cases! Interesting to note that drugs causing serious adverse reactions in this range have been taking off the market or forced into restricted use.
- Allergic shock is a possibility.
- You generally aren’t able to move around to keep your labor moving. In some instances, you can still walk with assistance, but your movement will be severely limited. You will also be hooked up to a fetal monitor, blood pressure cuff and IV which restricts your movement even more.
- Body temperature rises over time, so you are more likely to develop a fever (which can also signal a uterine infection and will cause your baby to undergo observation, blood tests, spinal taps and other testing/procedures to ensure the baby does not have an infection).
- Test doses and some of the tests done to be sure the epidural is properly placed can cause problems.
- Some women will experience a significant drop in blood pressure (even with the IV fluid given to try and avoid this, which in its self also carries risks such as fluid overload, pulmonary edema, possible excessive breast engorgement, excessive urine production, neonatal tachypnea and others.)
- Postpartum complications can involve urinary incontinence, nerve injury, hematoma, spinal headache (a debilitating headache which can last for days, interfere with bonding and breastfeeding and overall quality of life). In the newborn, adverse physical and behavioral effects may be noted, including trouble with breastfeeding, sleeping, self-soothing and adjustment.
- Other side effects of an epidural in the mother include the inability to push, itching and nausea (if narcotics are used), and psychological effects (with all that is involved in getting an epidural and monitoring, what was a normal process is now a high-tech event that the mother no longer has control over). Loss of internal pelvic muscle tone can lead to unfavorable positioning of the baby which can lead to longer labors or cesarean deliveries.
- in the fetus, other side effects in heart rate decelerations, hypoxia (from a drop in mom’s blood pressure), tachycardia and fever (from mothers fever).
- Complications arising from epidural use may lead to cesarean sections.
Most women are not told about epidural facts, especially in hospital-based childbirth classes. It is important for you to think outside of the box and take a childbirth class given by an independent childbirth educator, in addition to the hospital class if you wish, so you are fully informed.
Should you have an epidural?
Choosing an epidural is a highly personal choice, but one that should not be taken lightly. We have the right in this day and age to exercise our rights. We have options. Before we jump into them, let’s make a fully informed decision. Epidurals are not bad when they are used for the right reasons, but it is up to each woman to decide what those right reasons are.
As an educator, I do think it is important for women to be educated about epidurals even if they are choosing a completely natural birth. Complications or situations can arise that might make an epidural favorable or necessary, in which case it is very helpful to be informed. I also feel that students planning an epidural should be well informed about natural childbirth and pain relief techniques in case they go into labor and cannot get their epidural as quickly, or in case the epidural does not work, then they are still prepared and can make the birth a positive experience.
In the next segment, I will discuss how we can reduce the chances of complications, how the staff might also, and what intervention you will experience with epidural use.
About epidural during labor because there were some issues in the beginning of my pregnancy that made me high risk and I may have needed a c-section I keep hearing mixed things about getting the epidural and would like to hear more opinions on it.