Epidural use in birth nowadays is quite common. In Canada, the rate of epidural use is 58% nationally but for more populated provinces such as Ontario (60.3%) and Quebec (72.1%), the numbers are higher than average. And for some high population cities such as Toronto, the epidural rate is between 80%-90%. However, most common labor and birth tips are based on the assumption that you are giving birth unmedicated. Below we will discuss tips to labor with an epidural.
When To Get An Epidural
People joke that you should get the epidural with the first sign of labor. And while you may want to not experience any discomfort there is a better time. Many labors will include some laboring at home, and those labor tips you find for unmedicated labor will work great here. Hospitals now will advise you to come in for your birth when your contractions are between 3 minutes to 5 minutes apart, and lasting about a minute in a consistent pattern for approximately 30 minutes to an hour. This means you will be getting to the hospital at the end of early labour or the beginning of active labour. Active labor now is considered to start when you are 5-6cms dilated. This is a good time to get an epidural if you are choosing to have one. As your contractions are progressively opening your cervix the chances of an epidural slowing or shutting things down is less likely. Ultimately, however, you should get the epidural when you feel you need it. Don't be pressured into getting one before you are ready.
Stay Off Your Back
Most of us think to have an epidural means you will be laid out on your back. And for a little bit of time after the epidural goes in you will be positioned on your back until you have full coverage and relief from your contractions. But staying in a laid back position for the entire labor has the potential to move the baby into an awkward position of them facing your belly instead of your back. When baby faces your back, it puts them in a great position for labor and pushing. So once the epidural is making you comfortable choose a side lying position. Every hour, change sides to keep the baby moving and in a good position. The only time you wouldn't change sides each hour is if you are sleeping. Tell your support people to leave you be if you are asleep. You are going to need that energy to push the baby out (and for the next 18 years of no sleep!).
Create Space In Your Pelvis
If we look at ancient pictographs of birth we always see the birthing parent squatting. Squatting in labor can be comfortable, allow labor to progress and move the baby down and put them in an optimal position for birth. But how can you do that when stuck in bed with an epidural. Easily! When you are on your side simply fold up the hospital's pillow and place it between your knees to create space and open up your legs. Being elevated slightly too so you aren't flat on your side will also give a little gravity help.
If you want to be even more professional with creating space, see if your hospital or labor unit has a therapy ball called a Peanut Ball. Shaped like a large peanut, placing it between your legs to again create space for baby to move down and get them ready for pushing. I personally have seen a peanut ball take a stalled labor with a baby high in the pelvis and discussions of a cesarean birth change to pushing and baby in arms in no time at all.
Choosing to have an epidural is a personal choice, this is your labor and you get to experience it how you wish. So if you are choosing to have pain medication make sure you are still being active and keeping labor in the room and on your mind.