When it comes time to give birth, some expecting mothers choose to have their babies naturally, while others are all about getting a little something to help them get through the pain and anguish of bringing a tiny human into the world. The most common form of labor management during the delivery of a baby is an epidural.
According to AmericanPregnancy.org, "Epidural anesthesia is a regional anesthesia that blocks pain in a particular region of the body. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body."
Epidurals come with risks, but also present many benefits. Along with allowing laboring women to rest during prolonged labor, epidurals can help minimize discomfort and allow a woman to enjoy her delivery. They can also help laboring mothers cope with the irritability and fatigue that often comes along with delivering a baby. The down side? Epidurals may cause a drop in blood pressure, severe headaches, shivering, ringing in the ears, nausea and even permanent nerve damage.
Every mom-to-be must weigh the pros and cons of getting an epidural and decide for herself whether or not she wants one. However, there are some expecting moms who don't have a choice in the matter. The women that follow had to kiss the epidural goodbye. Read on for 20 reasons why.
According to Dr. Sarah J. Buckley, "Epidurals slow labor, possibly through the laboring woman’s oxytocin release, although there is also evidence from animal research that the local anesthetics used in epidurals may inhibit contractions by directly affecting the muscle of the uterus."
She continues, "On average, the first stage of labor is 26 minutes longer in women who use an epidural, and the second, pushing stage is 15 minutes longer. Loss of the final oxytocin peak probably also contributes to the doubled risk of an instrumental delivery—vacuum or forceps—for women who use an epidural."
If a woman's labor progresses too quickly for an epidural to be safely administered before she gives birth, she will most likely need to forgo pain management as she delivers her baby.
Kelly1377 wrote on a labor and delivery forum, "With [my son], I went from 4cm to 9 cm in 30 minutes and they wouldn't give me [an epidural], it was too late. I was lucky they had enough time to get the doctor back in the room...He thought it would be a few hours laboring and was probably walking out the front door when [he was] called back in."
MayoClinic.org states, "Research on tattoos and epidurals is limited. Theoretical concerns such as the development of skin cancer in the affected area years later remain controversial. Actual reports of problems associated with lower back tattoos are extremely rare...a lower back tattoo won't necessarily prevent you from having an epidural during labor. The exception would be if the tattoo is raised and scaly, red, swollen or oozing fluid."
New mom Meghan shared on a CircleofMoms.com forum, "So I got a tattoo on my lower back when I was 16. When I had my son years later I was told that I couldn't get an epidural because of the tattoo. (I guess the worry is the ink can be spread to the blood from the needle?)"
According to VeryWellFamily.com, "Your hospital may only have an anesthetist available during certain hours of the day or days of the week. You may also have an anesthesia department that covers an entire hospital and not just the labor and delivery unit."
One of the most frustrating reasons moms-to-be must kiss the epidural goodbye is the lack of an available anesthesiologist. Hospitals do their best to ensure that all of the women in their labor and delivery units get the interventions they desire, but, as mentioned above, there are instances in which a qualified professional is not available to administer an epidural. This, in turn, may cause an expecting mom to be forced to go without.
As unfair as it seems, in many states, expecting moms who are underage are denied epidurals simply because they are not old enough to give consent for anesthesia.
According to an article published on NPR.org, "In Ohio, people under 18 who are in labor cannot consent to their own health care. They can receive emergency services, but nothing considered to be elective. For the many Ohio minors who become pregnant, it's a painful gap in coverage."
The article continues, "Dr. Michael Cackovic, an obstetrician at The Ohio State University Wexner Medical Center, says every couple of months he sees a teenage mom who, under Ohio law, is unable to receive elective treatment, like an epidural. He says it's frustrating to see patients in unnecessary pain."
Certain medications pose risks when combined with epidurals. Doctors will not go forward with an epidural if there is a possibility that it may do more harm than good. For this reason, pain management through an epidural may not be an option for women on certain medications. VeryWellFamily.com states, "Medications that you take can affect how likely you are to be able to get an epidural. The biggest culprit is blood thinners."
An anonymous poster shared on the DC Urban Moms forum, "I was refused an epidural, but given a spinal...[the doctor's] justification was that I take medication to control epilepsy and she had not 'cleared' the epidural with my neurologist."
According to VeryWellFamily.com, "Sometimes, due to the normal growth of your back or weight or back problems...it may be impossible for the anesthesiologist to find the epidural space."
New mom marissawhale shared on a WhattoExpect.com forum, "With my first I was unable to get an epidural [because my doctor] couldn't get it in the right place...[he] said I had a good spine and it should have [gone] fine, and didn't have an answer as to why he couldn't find the right place. I...was told...that about 5% of epidurals fail or can't be placed for various reasons. What happened to me is one of the more rare situations."
As many moms can attest to, labor can be extremely painful. Believe it or not, one ironic reason why some expecting women are not able to get epidurals while in labor is that they are experiencing too much discomfort. In some cases, moms can't stay still long enough for an anesthesiologist to administer an epidural.
New mom abbottcarla shared on a WhattoExpect.com forum, "I...was shocked to find out that it was possible for the epidural not to work. The doctor had a lot of trouble getting it into the correct spot, mostly [because] I couldn't sit still."
A mother-of-three who's epidural failed to take effect shared on Mommyish.com, "While inserting my catheter, the nurse told me that the pain I claimed I was experiencing was probably just pressure, as the epidural was in place. She did offer to see if they would up my dosage. At this point things started moving pretty quickly."
She continued, "Thankfully I was pushing for less than five minutes, but let me tell you that during those five minutes I felt certain that this was it [...] While I didn’t die, and ended up with a gorgeous baby girl that I got to take home, I do have nerve issues...and a referral to see a chiropractor."
Sometimes, a doctor or anesthesiologist will advise a mom-to-be against getting an epidural because it is their professional opinion that getting one is too great of a risk. More than one woman has wanted an epidural but was not able to get one due to the apprehensions of the medical professionals caring for her.
Speaking about why she couldn't get an epidural, an anonymous mother wrote on a DCUrbanMom.com forum, "There are some conditions (I have a mild case of spina bifida) that make anesthesiologists nervous. There is an increased risk for the patient and an increased risk for the anesthesiologist. The risk tolerance level of every doctor is different."
Some expecting women are not allowed epidurals due to the simple fact that the medicine they contain is not safe for their bodies. If it has been discovered that they are allergic to the anesthesia used in epidurals or even other similar anesthetics, the healthcare professionals caring for them may advise against getting and epidural.
One mom shared on a HelloBee.com forum, "I [had] damage in my lip and chin from wisdom tooth removal with general anesthesia, and only had a 1 percent risk of it happening. Knowing this, they have told me I'm not a good candidate for an epidural."
Women who have had adverse reactions to epidurals in the past may be advised to avoid using them for pain management with future deliveries. One mom-to-be's body may react differently to anesthesia than another. If it is known that a woman has had trouble with previous epidurals, medical professionals may advise that it is in her best interest to avoid them in the future.
A mom who suffered severe headaches after her first epidural shared on an online forum, "The fear of this happening again made me hold off from trying for [an epidural with] baby number two. It was that bad."
According to VeryWell.com, "Some hospitals will place restrictions on when you can have an epidural. It may be that you must be at a certain point in labor before an epidural can be given. Other hospitals may decide that [an] epidural should not be given after a certain point of labor, for example, when you've reached full dilation."
Many women have been shocked to find out that they cannot get an epidural because of the guidelines that have been set in place by the hospitals where they are delivering their babies. Certain rules and guidelines may prevent them from getting epidurals. It's a good idea to find out in advance what restrictions may be in place at a hospital before choosing to give birth at that location.
According to AmericanPregnancy.org, when an epidural is administered, "a small area on your back will be injected with a local anesthetic to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back. After that, a small tube or catheter is threaded through the needle into the epidural space." Because of where epidural medication is injected, women who have had previous spinal surgeries may not be able to receive epidurals.
Frogleggs444 shared on a BabyCenter.com forum, "I've had 7 spinal surgeries and the anesthesiologist at my hospital said that they will not be able to perform an epidural."
Another reason an epidural may not be possible is if an expecting mom has an elevated white blood cell count. An anonymous new mom shared on an online forum, "I had originally planned to have a natural delivery at home, but, after five hours of pushing with no progress, our midwives took me to the hospital where they gave me two choices: an emergency c-section, or they could give me an epidural and I could continue pushing."
She continued, "They came in a few minutes later and said that they couldn't give me an epidural because my white blood cell count was high so I would have to have a c-section. I am a pretty healthy person who RARELY gets sick. I didn't have any symptoms before labor and didn't have any symptoms of illness afterwards, either."
The website HudsonValleyScoliosis.com states, "Epidurals and scoliosis can be a concern for some people, especially if their scoliosis is severe...If the scoliosis is in the lower back, it can be difficult to get enough space in between the vertebrae to safely insert the needle."
The site continues, "Epidurals can be a concern for those who have undergone scoliosis surgery as well. With someone who has had scoliosis spinal fusion surgery it can be difficult to place the epidural, and, if it is placed, it has to be lower than a usual epidural which can result in headaches."
Knittylady wrote on HelloBee.com forum, "I can't have epidurals because I had a spinal fusion to correct scoliosis. My rod is in just the place they need it not to be."
According to VeryWellFamily.com, "If you have a low platelet count or other problems with your blood work, [it] may make the placement of an epidural riskier."
JenniePark wrote on a BabyCenter.com forum, "I'm getting induced on Friday and at my appointment today [my doctor] told me my platelets were low a month ago and it may mean I can't get an epidural and my baby is big."
Another Baby Center forum user, newmomtobe shared, "My doctor told me that if [my platelets] were too low I wouldn't be able to get an epidural. I was induced....[and] he told me that he couldn't administer the epidural."
According to MedicineNet.com, HELLP syndrome is defined as "a combination of the breakdown of red blood cells (hemolysis; the H in the acronym), elevated liver enzymes (E), and low platelet count (LP) occurring in pregnancy. HELLP syndrome has been considered to be a complication of preeclampsia and eclampsia (toxemia) of pregnancy, but the syndrome can also occur on its own."
Ann89 shared on a BabyandBump.Momtastic.com forum, "I had HELLP syndrome my last pregnancy [...]. My platelets dropped to 17,000. My doctor was trying to stay away from a c-section if [at] all possible, and I couldn't get an epidural."
VeryWellFamily.com states, "If you are [leaking] heavily or are suffering from shock, you will not be given an epidural for safety reasons. Since many women tend to have lower blood pressure with an epidural, [and] this may be made even more dangerous with the lowered blood pressure of some of these problems."
MrsStar shared on a Hellobee.com forum, "I'm not allowed [an epidural] because of a [...] disorder...the risk is too high [...]. If I have a c-section then I'm only allowed to have a general anesthetic."
Leaking red during labor may occur due to a variety of reasons including placenta previa, placenta accreta, clotting disorders or other complications.
VeryWellFamily.com states, "It is not in your best interest to have your anesthesiologist place an epidural through an area that is infected. This can cause the infection to spread to the spine and other areas of your body and can potentially cause a great deal of damage."
For good reason, when the time comes to give birth, moms-to-be who are suffering from infections on or around the places on the body where epidurals are most commonly administered are often advised by their doctors and anesthesiologists to forgo this management option in order to ensure the safety of themselves and their babies.
References: Mommyish.com, VeryWellFamily.com, ThisWestCoastMommy.com, DCUrbanMom.com, MumsNet.com, AmericanPregnancy.org, Boards.Hellobee.com, BabyandBump.Momtastic.com, CircleofMoms.com, WhattoExpect.com, MayoClinic.org, NPR.org, SarahBuckley.com, MedicineNet.com, HudsonValleyScoliosis.com