“I was scared to give birth”, shares first time mommy Jinal Parekh.
“I saw the two pink lines on the pregnancy test and my first thought was labour pain! I was terrified! I called my mom and told her I was pregnant but I cant even think about giving birth! No matter how hard I tried, I was feeling a mixture of emotions. Yes I was happy to be a mother but I couldnt forget that to get the baby, I will have to endure mind numbing pain.”, Jinal shares.
From time immemorial women have been expected to endure the pain of childbirth. Yes, though its natural, the threshold of pain tolerance differs greatly among women and safe childbirth is what we need to focus on. A study published in the Journal of Perinatal education states that upto 44.3% of women who have given birth vaginally choose to have epidural.
An increasing number of women are using epidural analgesia as a pain-management strategy during labor. As consumers of health care, women historically have requested relief from childbirth pain. Since ether anesthesia became available, consumer demand has influenced pain-relief options during labor. From the National Twilight Sleep Association in the early 1900s through the Lamaze-prepared childbirth movement that originated later in that century, women have pressured the health care community to offer options for pain relief during labor.
Did you know that Queen Victoria was a huge advocate of pain relief in the mid 19th century?
Yes she birthed nine children but was “repulsed” by childbirth. She has been known to use chloroform for pain relief when she birthed her eight child Leopold.
More recently, consumer requests appear to have prompted a growing trend for labor epidural analgesia.
So what exactly is epidural?
An epidural is a medical procedure in which a local anesthetic, often combined with a narcotic, is administered into the lower back, near the spinal cord. The purpose of an epidural is to block the nerve signals from the lower body, thereby reducing pain during labor. It numbs the lower half of the body while allowing the woman to remain awake and actively participate in the birthing process.
How is it administered?
Before receiving an epidural, the woman will typically need to have an IV line inserted for fluid administration and continuous monitoring of blood pressure and fetal heart rate. A healthcare provider will then insert a thin needle into the lower back, guided by ultrasound or by feeling the bony landmarks. Through this needle, a small catheter is placed in the epidural space, and the needle is removed. Medications are then delivered through the catheter, providing pain relief within approximately 10 to 20 minutes.
There are pros and cons to taking an epidural in your labor!
1. Individual sensitivity to epidural varies from woman to woman!
Epidurals do offer pain relief but the magnitude will vary from person to person. Some experience complete pain relief and some feel discomfort or some other sensations. The amount of pain relief is also dependent on factors like your body mass index, your hydration levels and the specific technique used by the anesthesiologist.
2. Is there a "Best time" to take an epidural?
Well the answer is YES!!
The best time to take an epidural is when you are in active labor and still not fully dilated. Experts suggests that you can typically take the epidural even at 4-5 cms dilated.
Its important to remember that the procedure to put the epidural in place takes around 10-15 mins and for the epidural effect to kick in it takes another 15-20 mins so if you are too far along in your labor, it might not be enough time for the epidural to work!
3. Is the "walking epidural" myth or fact?
Epidurals traditionally numb the body from the waist down to the toes and its considered that you will be immobile in that time. However in recent years, “walking epidural” or “combined spinal-epidural” is gaining popularity!
This technique involves giving a small dose of the medication, which allows women to stay mobile while actively participating in the labor process. The amount of medication given varies according to hospital policies.
4. Epidurals can affect the pushing stage of labor!
A lesser known fact is that epidurals can increase the pushing stage of labor. Since many women find it challenging to feel the natural urge to push, it can make it harder to apply the needed pressure and push the baby out,
Jinal Parekh, who did take an epidural in her normal delivery shares, “I did not feel anything when i was asked to push. The epidural had numbed me waist down so i didn't know if I am applying any pressure or if I am even pushing! Eventually the nurses had to manually apply pressure to my abdomen and help to push the baby out. It was extremely challenging. There was a time the doctors were going to use forceps or vacuum to deliver as I was not able to understand how to push due to the numbness.”
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5. Epidural can have an impact on mental health!
Recent studies have shown to have a link between use of epidurals and reduced incidence of post partum depression. While the exact reason for this is not yet understood, it is assumed that the pain relief and reduced stress during labor may contribute to the better emotional health of mothers in the postpartum period. This can cause a positive birthing experience for the mothers and ensure better bonding with the baby.
How do I decide if I want an epidural?
Epidurals are the most common form of pain relief available in child birth. However there are some well known side effects of this well. The well established risks are:
- Drop in blood pressure
- Prolonged labor and need for additional interventions.
- Severe shivering.
- Difficulty emptying the bladder.
- Rare but serious complications like infection and nerve damage can occur but its extremely rare.
Taking an epidural should be a personal decision. Here is a diagram to help you figure out what to do!
Please Note: This is a decision you need to take keeping your gynecologist advice as priority always.
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Shreya
such a informative article. i am thinking of taking an epidural and this helped so much. can you do article on back pain after delivery as i heard many get back pain after epidural and csection.