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15 Ways An Epidural Isn't What It's Cracked Up To Be

As a general life truth, no body enjoys suffering so there have always been attempts at pain relief.

Since the history of … well… people, childbirth has always been a major pain. Honestly, how could it not be painful when you think about it? As a general life truth, no body enjoys suffering so there have always been attempts at pain relief. Prior to the 1900’s many pain relief options focused on choosing certain positions that help relieve pain as well as certain herbs. For example, the ancient Egyptians frequently used a squatting stool to help relieve pressure; some even bit onto a rope or leather strap to help manage pain.

Hospital births became more common during the 1900’s although hospital births were generally reserved only for the wealthy; most moms labored at home with no medications. With the rise of hospital births, there were many attempts to use drugs as a pain management tools. During the first two decades, there were some scary attempts at pain management like a little drug called Twilight Sleep, a mixture of morphine and scope that usually left mothers in a very forgetful state. Sounds scary if you ask me!

Luckily, during the 1970’s the epidural arrived, which gave women a less scary approach to pain management. No more trippy amnesia drugs! Although an epidural isn’t nearly as scary as Twilight Sleep, an epidural still isn’t perfect. In fact, you may get more than you bargained for. Here are 15 ways an epidural isn’t what it’s cracked up to be.

15Under Pressure

Is pressure good or bad? “I work best under pressure” is a lie we sometimes tell ourselves when we want to feel good about procrastinating, right? In a sense, that “pressure” forces us to excel and focus on the work at hand, which is a good thing. Pressure from a boss can inspire us to work harder to meet expectations; on the other hand, too much pressure from a boss can cause to stress out over unattainable goals. And let’s not forget peer pressure. So pressure can be good, but it can also be bad.

In the delivery room, the same is true of pressure. The good news: pressure means that labor is progressing and baby is descending further and further down. The bad news: pressure is super uncomfortable and even painful. From experience, epidurals do not remove pressure. Sure, they remove pain… but not pressure – a fact I found to be thoroughly disappointing during labor.

14It’s Just A Little Pain

It might be confusing, but the term epidural doesn’t refer to the name of the medication. The medication is actually injected (via a catheter) to the epidural space. Epidural space is just outside of the spinal cord. When the anesthesiologist administers the medication, he, in a sense, does it without visuals. There is no imaging scan to show him where to go. Because everyone’s bones and bodies are different, no two injections end up being the same.

What does this mean for you? It means that some people may not have any feeling or any ability to move their legs at all. Unfortunately, that also means that sometimes epidurals don’t really do much in the way of pain relief.

Epidurals can also cause a laboring mom to still feel pain for another reason – the medication wears off. In this case, though, the fix is easy. The anesthesiologist can top off your meds.

13The Headache Of All Headaches

I’m going to speak on behalf of all women who get epidurals and say that the only reason (although it’s a big reason) to get an epidural is for that much desired pain relief. So when you hear that a potential side effect of an epidural is more pain you might scratch your head.

Many moms refer to this side effect as an “epidural headache” but the proper term is “post-dural puncture headache” – sounds pretty medical. Not everyone gets this headache at least. For those that do, the cause is because the dura membrane was punctured during the administration of the epidural itself. If you have a headache, speak up! Your doctor may have you drink extra water and/or get IV fluids to help replenish the lost fluid from the puncture.

12You Need A What?

When a laboring mother requests an epidural, getting pain relief is more important than keeping function of her legs… at least temporarily. It’s no big deal to give up walking for a few hours when you are promised some relief from waves of contractions. But… if you cannot walk at all, that also means you cannot walk to the bathroom. See where I am going with this?

If you can even feel the need the pee or walk to the bathroom, you’ll need to have a catheter inserted once your epidural is all set. It may seem like a major invasion of your privacy, but there is good news in all of this catheter stuff: you will already be numbed so you won’t even feel it. Although just a warning, it sure makes going pee after the catheter is removed that much more difficult.

11Push 1, 2, 3

Pushing is a bittersweet event. On one hand, pushing sort of feels good in the sense that it helps manage all that intense pressure, but on the other hand, pushing is physically akin to climbing Mount Everest after running a marathon. Pushing is hard, hard work. It’s called “labor” for a reason.

Unfortunately, pushing with an epidural is extremely difficult. Imagine trying to tell your body to walk or hop across a river without the feeling of your legs. It seems impossible – or at least very difficult – to even manage that task. Pushing is no exception; it is much harder without feeling in your legs. Because of that, the pushing stage, on average, lasts much longer for mamas with an epidural in place. How long does it increase pushing? Some studies show that an epidural can double the length of pushing from 2 to 5 hours! That’s exhausting just thinking about it!

10Doing Laps

Since the history of midwifery, midwives have always worked with nature to bring to babies into the world. What does that mean? For starters, it means that midwives try to work with the body’s natural process, and one way to help labor is to allow gravity to lend a helping hand. Laboring mamas who walk (or at least stand up) during labor help the baby descend into the birth canal.

Birthing while reclining on a hospital bed isn’t always ideal – at least in terms of working with gravity. Unfortunately, an epidural prohibits a laboring mom from working with gravity. There won’t be any laps around the hospital corridors once the epi is in place. Of course, the pain relief is great, but being stuck in bed may just slow down baby’s descent into the birth canal. If you can manage, try to get in a few laps before the epidural is administered. If you can’t, no judgment here.

9Shaken, Not Stirred

I have had the opportunity to experience one epidural birth and one non-medicated birth. During my medicated birth, I was surprised to learn firsthand the many odd things about having an epidural. One of those things was that what I like to call The Shakes. Shortly, after I was settled into my short reprieve from contraction pain, I began to shake uncontrollably and to be blunt it freaked me out. Majorly.

When the nurse came in, she gave me a warm blanket and told me that she wasn’t concerned. A quick look into any labor forums and you’ll find that many moms experience the same thing. Some nurses say it’s a side effect of the epi itself while others say it’s adrenaline after the break from the intensity of the contractions. Either way, don’t be surprised if you started shaking like a Polaroid.

8You Get A Cool Yellow Bracelet

 

 

 

 

 

After delivery and a little clean up and repair, your nurses will want you to use the restroom. This is especially important if you’ve had a catheter placed during your labor. In a sense, your bladder needs to relearn how to “go” on it’s own rather than just rely on the catheter to empty itself. However, between the jelly sea legs (from the epidural wearing off) to the dizziness (loss of blood), actually walking to the bathroom is actually kind of dangerous. That’s why the beautiful souls (aka the postpartum nurses) always accompany you to the bathroom the first few times.

After your first visit to the loo, you’ll get a cool yellow bracelet highlighting your condition for all to see: FALL RISK. That means that you get escorted to the bathroom until you (and your nurses) are sure you can manage on your own.

7The Actual Process

For many women, the thought of actually getting an epidural is terrifying, and that is enough to make many moms opt out of receiving one… in theory… before labor begins. Trust me, I was one of those women. But then the labor actually gets going and you’ll sign off on anything to get even the smallest relief from contractions. Even if it means “the big scary needle.”

The process of getting an epidural isn’t all fun and games. First, you have to wait for the anesthesiologist to come, and let’s hope he isn’t backed up getting other moms meds when you need him. Second, there’s the first shot. Thankfully, you do get a numbing shot first. Then, a catheter (which is just a tube) is placed into the epidural space near your spine, and that’s where the meds will flow. The catheter stays in your back the entire time you labor; it’s not just a one and done shot – it’s a continuous flow. The worst part is that you have to remain perfectly still which is difficult give the state the of the contractions.

6If You Give A Mouse A Cookie

One of my favorite books to read to my son is “If You Give a Mouse a Cookie” – basically it’s the story of how one things leads to another and another and another. Getting an epidural reminds me of that book because an epidural can lead to intervention after intervention.

It starts like this: you finally enter the pushing stage, but you’re numb so pushing is difficult and you don’t even know if you are pushing correctly. The pushing stage just drags on because the pushes aren’t that effective and you are beat – utterly exhausted. Your doctor decides to help move things along with an episiotomy (intervention #1) followed by the forceps or vacuum (intervention #2). If that doesn’t work, it’s off to the OR for a surgery.

It doesn’t always look like that but the stats don’t lie: epidurals are more likely to lead to C-sections.

5An Eye On You

One of the more serious side effects of epidural analgesia is that it can cause low blood pressure. (Just another reason you might feel light headed for a bit after birth.) However, nurses always monitor this by taking your blood pressure every 5 minutes for the first 15 minutes after you receive an epidural. After that, your blood pressure will be monitored every 15 minutes. You will also receive an IV of fluids to help keep your blood pressure where it needs to be.

Of course, all of that monitoring is necessary and in the best interest for you, but you may find it hard to rest with all that constant commotion. In addition, those fluids may make you feel really cold (remember all that shivering?) so you might need an extra blanket or two for a bit.

Remember, it may seem like an inconvenience but these steps are very important.

4It Might Actually Take A While

 

 

 

 

 

 

Any mom is throes of labor wants instant the relief from the moment she finally decides enough is enough and she yells, “I WANT AN EPIDURAL.” But it’s not as easy as pushing the nurses’ call button and asking for a Tylenol. The nurse just can’t bring in a pill and call it done. Unfortunately, the process may take longer than you expect or want it to.

First, before any epi can be given, labs must first be drawn. You will also need fluids before the epidural (to help keep that blood pressure where it needs to be). Neither of those two things are instant. Third, you have to wait for the anesthesiologist to come to you. Most hospitals have one on staff 24/7 but if it’s a busy night, you might not be first in line. The short answer is that it may take anywhere from 30 minutes to an hour to get an epidural after you request one.

3Movin’ In The Slow Lane

Another not-so-fun side effect of an epidural analgesia is that an epidural can actually slow down your labor. What? That almost doesn’t make any sense. How can pain relief cause labor itself to slow down? In addition to blocking pain signals, the epidural also blocks a few hormones. Oxytocin, which is a hormone that helps your uterus contract, can be blocked by the epidural. Because you need contractions for labor to progress, this is an obvious stall in the whole process of birth.

So what is a doctor to do? It’s a vicious cycle: contractions hurt, get meds, meds slow down labor. The answer is Pitocin, which is a synthetic version of oxytocin. In fact, many moms who have epidurals have a tripled risk of also needing Pitocin, and Pitocin is ruthless.

2Tear What?

Moms preparing for childbirth have many tricks to try and avoid the dreaded vaginal tearing. I mean, that just sounds like a nightmare. Some moms swear by perineal massages to keep tearing at bay while other moms rub oils on their bits to try and loosen the area up. Listening to your doctor or midwife’s instructions to push or just pant can also help reduce the risk of tearing.

However, having an epidural doesn’t do much for reducing mom’s risk of tearing. In fact, it can double her chance of tearing! Ouchie! It makes sense though. If you can’t feel what is happening down there, you might push when you just be panting, letting your body have a second to stretch for a second before pushing. Try to do your best to follow those instructions. Panting when you want to push may be hard, but if it helps avoid a tear, it might be worth it.

1It’s Exhausting

Childbirth is like snowflakes and finger prints; no two births are alike. Even the same mother will have very different birth experiences with her different children. However, there are certain elements of childbirth that are always true, no matter who you are or what kind of birth you are having. One of those truths is that childbirth is exhausting.

But epidural can make labor even more tiring. You would think that with a break from contractions you could rest and feel less tired, but that’s not necessarily the case. Remember how the epidural can block hormones like oxytocin? Well, it can also block adrenaline. During a non-medicated birth, adrenaline increases through the labor so that mom will have energy to actually push. Adrenaline = energy. But when adrenaline is blocked, that leaves mom with a serious energy deficit. Just another reason why pushing is so hard for a medicated mom.

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