Tuesday, August 3, 2010

Epidural: Worth the Numbness?


Epidurals. What do we know about them? Do the benefits of no pain outweigh the risks?
Over 50% of women in our country request and use epidural anesthesia for their births. Now, if that many women are using it, there has to be a clear cut reason why.
An epidural is a regional anesthetic that blocks pain in a particular regino of the body. This way, you get pain relief without a total lack of feeling.
To start with, when an epidural is placed, an IV is placed to give you fluids (1-2 liters during labor and delivery to stop a drop in blood pressure). When the epidural is given, you arch your back and must remain still while lying on your left side or sitting up. It doesn’t matter if your contractions are right on top of each other. It is VITAL you do not move.
Antiseptic is used to stop infection. A small part of your back is numbed, this can be felt as a tightness as it is injected. The needle is inserted into the numbed space, it feels like a pinprick, and a catheter is inserted into the epidural space. The needle is then removed, leaving the catheter so that medicine can be given periodically or a continuous flow used. The catheter is taped to prevent it from slipping out.
The benefits of an epidural include, but are not limited to:
- They allow rest
- They relieve discomfort and can cause a more positive birth
- They help you to remain alert and be an active participant (I don’t agree with this one, because you can be an active participant in a natural birth too)
- If you have a cesarean, you get to remain awake and your partner can be there with you during the procedure
- If coping with your contractions is not working, it can help you move past the exaustion, irritability, and fatigue of labor.
The disadvantages and risks of this are, but again not limited to:
- Your blood pressure can take a sudden drop, which is why they do the IV, but that doesn’t always help
- Severe headache caused by a leakage of spinal fluid. This happens in less than 1% of epidurals. If it happens to you, they perform a ‘blood patch’ by injecting your own blood in the epidural space.
- After it is placed, you will have to alternate from lying on one side to the other and have continuous monitoring for fetal heart rate. If you lie in one position too long, your labor can slow down or stop.
- Since you have to lie down once it is received, it is harder for the baby to get into position.
- The side effects are: shivering, ringing of the ears, backache, soreness, nausea, and difficulty urinating
- They make pushing more difficult. Since you are numb, you probably won’t feel the pushing urge and pitocin, forceps, vacuum extraction, or cesarean may be necessary.
- For the few hours after the birth, you may feel numb and need assistance walking.
- In rare instances, permament nerve damamge may result where catheter was inserted
- The baby will have a harder time latching on and nursing. The epidural does pass through the placenta, and makes the baby more lethargic. It should only last 24-48 hours after birth, if you received the epidural more than 1 hour before giving birth.
- If you decide to let it wear off to push, or finish out your labor, the pain will probably be more than when you got the epidural. Until you got the epidural, your body was helping you cope. Now that it doesn’t have to release hormones and endorphins for pain relief, and also because your labor will be more intense, you will feel everything you hadn’t felt before to a greater degree.
- You may not go numb. Most times they don’t numb you completely, so you can still feel your contractions. If you are looking for complete pain relief, it might not happen.
- You must be at least 4 cm and in active labor to receive. (They change this depending on the woman, how long she has been "in labor", especially an induction, and how lenient her doctor and anesthesiologist are with pain medication).
I had an epidural with my daughter, and had to get the dosage twice. The first one they gave went well. Before it started to wear off, my legs went into convultions and I had panic attacks. Finally, it wore off enough I could walk to the bathroom. Then they gave me the second dose. It would only numb half of my body at a time, so they kept injecting more and more medication into me. When they finally cut me open, they had barely gotten me numb with about 3 times the amount it had taken the first time. I was numb most of the day and finally had a little bit of feeling back about 8 hours later.
A lot of times I hear women getting epidurals at 8 or 9 or even 10 cms. You are so close! And I know that I have never experienced labor or transition, but while you are in transition, you will think that it will never end. You will beg for medication. Maybe if some of these women had a birth support to encourage them in the only way another woman could, they could make it those last few centimeters. But then again, maybe I am just crazy since I have never been there.
When you think about getting an epidural, weigh the facts yourself. Try to cope yourself if that is what you want to do. Don’t let nurses, doctors, or even your partner push you into something you don’t want.

5 comments:

Julian@connectedmom said... [Reply to comment]

I also got the epidural, against my own better instincts because the nurse told me it would be better for me to rest and would prevent a c-section. I SO regret that decision now.

The epidural brought what was otherwise a normal and perfectly healthy labour screeching to a halt. The nurses treated me as though once they had the IV lines in they had my consent to do what they wanted and I was dosed with pitocin to restart labour against my wishes.

The pitocin caused stronger than normal contractions which sent my son into distress and he ended up being torn from me with the vacuum by my doctor and whisked off to NICU. . . the doctors and nurses didn't see why I was so upset about the whole thing and basically told me that my labour and birth went just fine as far as they were concerned.

To this day I feel like my son was medically extracted from me (a bad vaginal birth can be just a traumatic as a c-section), not birthed by me as should and would have happened had that nurse not used my own fear of surgery to convince me that an otherwise smooth labour needed intervention.

Kayce Pearson said... [Reply to comment]

Oh I am so sorry that happened to you!! It seems that a lot of nurses and doctors think that as long as the birth is vaginal, it is natural and the mom or baby won't be harmed by it. I hate that they treat women this way, especially when one intervention leads to another and another, most without the woman even knowing!

Again, I am so very sorry for what happened to you! They had no right to do that, and the fear mongering makes what they did worse.

WiseWoman said... [Reply to comment]

It all comes down to "Do you want the pay now plan or the pay later plan?" Birth involves pain; facing the pain and going through it naturally reduces the chance of a lifetime of pain after.

CrunchyVTMommy said... [Reply to comment]

I did not expect to request an epidural but also did not expect the unusually fast labor I had either. I was slightly disappointed but did not suffer any consequences. I know I was lucky. I had an amazing experience and was not completely numb. However it is a risk and in 7 weeks I will try to do it naturally again.

Anonymous said... [Reply to comment]

I am very sorry that any of you had a bad experience with epidurals. I was fortunate to have had hypnobirthing training before my first child was born thanks to some pioneering friends who had used it to successfully birth their children. This method allows you to learn that birth does not necessarily mean pain. That pain in birth comes from fear and the expectation of pain. Woman to woman support is nice but a supportive husband can also help women make it all the way through transition and through birth as well. That was my experience. Although, he did sleep when I could have used his assistance, he was there when I really needed him to be.

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