Epidurals. They can be a touchy subject.
Let’s discuss what may, or may not, occur if you choose to get one. And, yes, Buddha Belly Doulas support your choice for an epidural.
“We were made to give birth”. We have all heard that before, right? It is true, we were made to do this. We can do this! But some women can’t. Better yet, some women don’t want to and what business is it of mine to tell any mother how to birth her baby? None. It is my job to support her whatever her choice may be.
I have had three births of my own and here is my experience with and without an epidural.
With my first child I had an epidural that worked beautifully. You could have chopped off my legs and I would not have felt a thing. I opted to have an epidural again with my second child. It did not work the way I remembered. Needless to say, I was not a happy camper and the atmosphere was less than calm. For my third child, I decided to have an unmedicated water birth at a birth center. I vividly remember the moment I said “this is when I would ask for the meds,” followed by “I would never do that again” once my baby was finally born. The funny thing is, I probably would do that again. Aren’t our minds wild when it comes to pain?
When we talk to potential new clients, lots of them say that they would like to attempt an unmedicated birth but are open to the idea of getting an epidural if it comes to that. In my experience, most of those moms do end up getting an epidural and that is okay. We will be here to help you navigate that.
Ideally you would get an epidural when you are considered to be in active labor, 5-6 cm dilated or later.
In our experience, there is a greater chance of your labor slowing down when the epidural is placed earlier than that. This may lead to other interventions to get labor progressing at a regular pace again. If this is your first baby, it can sometimes be difficult to hold off for that amount of time but we do our best to assist you with comfort measures during this time period.
You will need to receive an entire liter of IV fluids prior to getting your epidural.
The medicine can cause a decrease in your blood pressure and the fluids help to regulate that. Your doula will discuss with you the length of time it may take to complete the fluids and wait for your anesthesiologist to arrive. This is helpful when you are expecting a very quick fix. I typically see it take about 30 minutes to one hour until the anesthesiologist enters the room from the initial request to get the epidural.
You will sit at the edge of the bed, legs dangling, holding a pillow or your partner. Doulas are usually asked to leave but every once in a while they let us stay. The anesthesiologists will explain exactly what they are doing and what you can expect. They are really great at working fast in between contractions. It is a fairly easy and uneventful procedure.
Once the epidural is placed, you will be asked to lay on your back for about 30 minutes. The medicine works with gravity and we want it to start off evenly.
You should slowly feel your contractions shorten and decrease in intensity. The nurse will give you some time for your lower body to feel numb before placing a foley catheter to collect urine. You can no longer get up to use the bathroom. Now, I know you don’t want a foley catheter but I can guarantee that you also don’t want a full bladder during labor and childbirth. A full bladder is not helpful when trying to push a baby out.
At this time you will also notice that there are a lot more wires attached to you. Due to having these medications in your body, the hospital staff will need to keep a close watch over you and your baby’s vital signs. The wires can be a nuisance but we will work around them.
Now you have your epidural! What could happen?
Well, lots of things or nothing. Your labor could stall, causing your provider to want to use pitocin, the synthetic form of the hormone oxytocin, to stimulate contractions. This may or may not lead to other interventions including internal monitoring and in some cases cesarean. It could also lead to a glorious nap and a very relaxed body that causes you to dilate at a fairly fast rate and have your baby swiftly. You may have to really work for hours to push your baby out, or your little one may come out much faster than expected. We have seen both sides of this and everything in between.
Your doula will help you to navigate when to get the epidural, keep you informed about potential interventions, keep you comfortable and help you change positions. With your approval, we will assist you to move from side to side in bed, use a peanut ball to open your pelvis, get you onto your hands and knees and other helpful labor positions. You will not be stuck on your back!
Doulas are here to serve you, to make your experience better whether you are birthing at home, at a hospital, medicated or unmedicated.
My advice is to keep an open mind and go with your gut. If it tells you that you should get the epidural, then get the epidural. And find yourself a doula that supports you and your choices.
By: Cara Call, Certified Birth Doula, Postpartum Doula & Childbirth Educator