Epidurals

epidural

It’s a pretty well known fact that labor pain is probably the worst pain you will experience… EVER. As a labor and delivery nurse, I see women in labor all the time. Some women handle the pain of labor extremely well (I believe these women are aliens). The majority of women display that they are in a substantial amount of pain… excruciating pain (I know I was). The thing is, pain is subjective. There is really no real way to measure it. Women describe labor pains anywhere from “contractions are like really bad cramps” to “labor pain is equivalent to breaking 10 bones simultaneously.” Whatever the measure, labor is PAINFUL. And thank God for drugs, we don’t have to suffer through all of those labor pains if we choose not to!

This week I had a reader message me and ask me my thoughts on using epidurals. I think that epidurals are a reliable and safe option to manage pain during labor. I know that natural childbirth is all the rave these days and if that’s you (it was me) then go for it! If not, you don’t have to suffer through 12 plus hours of the most intense pain known to WO-man. It is your choice and you should have control over your birthing experience. And remember, you don’t get any medal for giving birth with out meds.

Common myths:

Epidurals take away ALL the pain 

The goal of an epidural is to numb you from waist down and decrease the pain you feel. However, you still need to be able to bear down and push effectively so you need to have some feeling and be able to move. You will still feel contractions and pressure but not nearly as much as you could feel them before the epidural. In my experience, patients will go from pain score of 10/10 to maybe 2/10.

 

If you get your epidural too early it will wear off

 This is not true. An epidural administers a continuous infusion of pain medication into your body. Therefore, you will not run out of medication and it will continue to infuse until your nurse turns your pump off after delivery or before delivery if indicated. It is true, however, that you will not be able to get an epidural until you are in active labor. So most OBs will want you to be at least 4cm dilated before allowing you to have one. Also, you will likely not be able to get one after you are 8cm dilated. The point is, don’t wait until you wish you were dead to ask for an epidural. Go ahead and get it when you are dilated enough, there is no need to continue feeling the pain if you plan to have one. Remember, you have nothing to prove to anybody!

 

I may get paralyzed

 It is true that having a needle inserted into your spine can be a scary thought. Epidurals are placed by highly trained CRNA’s and Anesthesiologists. These guys and gals know what they are doing. Plus, your L&D nurse will be right there to help you get into position and coach you through the procedure.

 

The epidural can have a negative effect on my baby

Unlike IV pain medications, an epidural will not negatively affect your baby by causing respiratory depression. For this reason, it is safe to have an epidural going until the delivery of the baby.

 

As with any medical procedure, epidurals do have possible risks and complications. Common complications include: having a significant drop in your blood pressure which would decrease the oxygen flow to the baby, urinary retention, and spinal headaches. All these can be resolved. It is very rare to have any permanent neurological deficit as a result from an epidural. Seizures and cardiovascular collapse are rare but life-threatening complications that can occur after unintentional direct IV injection of anesthetic.

Even if you plan to have an epidural, The Association of Women’s Health, Obstetrics, and Neonatal Nurses (AWHONN) highly recommends that you go to birthing classes to prepare you for labor and the stresses that may arise during labor. Women who attend these classes have shown to cope with the pain of labor more effectively than women who do not attend birthing classes.

So, if you want an epidural go for it. If you don’t think an epidural is for you and desire an epidural free delivery, go for that! It is your choice. Either way, you are still pushing a human out of your vagina, therefore you are a freakin’ rock star.

 

From your friendly neighborhood nurse

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