To Epidural or Not to Epidural

Early labor, before the pitocin increase

I answered a question on Quora, “What is it like to have an epidural” and thought I’d share it here:

I am glad that it was available to me, but if I have another child I will try not to have an epidural. It was necessary in my situation so I don’t regret choosing it, but I do believe that it contributed to the fact that my labor ended in an emergency C-section.After doing a lot of reading about the natural process of labor, I decided I wanted to try for an unmedicated birth (something I never thought I would do!). Unfortunately, fate had me stuck with a dr. and nurse who did not respect my body or my wishes (I know now I should have asked for a different nurse, regret #1). Despite repeatedly and clearly stating that we would like to keep the Pitocin as low as possible, the nurse cranked it up when we weren’t looking. None of us realized it until my contractions were out of control, one on top of the other and I was only dilated to 2 cm. I was too out of it and didn’t understand what had happened until later, so I didn’t demand that she turn it down (regret #2). Instead, I begged for an epidural, thinking that was my only choice.

The only thing that I found scary about it was that I was unable to hold still while the anesthesiologist was inserting the needle. He had to ask the nurse to turn down the Pitocin and I had to squeeze my husband as tight as I could to stop shaking. I don’t want to freak anyone out so I should mention that I do not think that is normal. As far as I could tell, it was due to the irresponsibility of the nurse who didn’t take note of the way the drugs were affecting my body.

I have heard that the needle looks scary, but I didn’t look at it and I’m pretty sure my husband didn’t see it (I’ve heard stories of fathers nearly passing out). I’m also not afraid of needles, though, so I just didn’t think about what he was doing. I just knew it was important for me to hold still. Also, my labor was so strong at that point that I’m pretty sure it would have overshadowed any other sensations. I felt nothing as he inserted it and if he numbed the area beforehand, I don’t think I felt that either.

The epidural was effective very quickly. It was pretty amazing. The only problem was that I could still feel every contraction in my left butt cheek. It wasn’t extreme pain, but it was hard to ignore it because I wasn’t able to move around or get in a good position to deal with it. Lying on a bed in pain is so much worse than being able to move around, sit on an exercise ball, etc. I kept pushing the button to turn up the epidural, but it wasn’t helping so I asked about adjusting it (regret #3).

Let’s go back a little. When I first got the epidural, my son’s heart rate dropped. Suddenly, the room was full of people telling me to get on my knees (really hard to do when you’ve had an epidural!), squirting something in my mouth that gave me a temporary headache, inserting a monitor into my son’s head, and who knows what else. They got his heart rate back up and things calmed down.

BUT, when the anesthesiologist adjusted the epidural to ease the pain in my left butt cheek, my son’s heart rate dropped again. They tried to raise it again and it worked, but then it dropped again and my dr. felt uncomfortable letting me continue to labor and suggested a C-section. At that point, I was scared and probably would have agreed to anything.

During the C-section the anesthesiologist told me that usually they are not able to fix the epidural when something like the pain in my butt happens. Overall, he was great and a super nice guy (which was a refreshing change from the nurse and dr.), but I really wish I had known that because I would have just dealt with the pain in the butt. I also wish someone had told me that an epidural could lower the fetal heart rate. I felt like it was sold as something with rare side-effects that they just have to tell you about for liability. I don’t know how often it affects the baby in that way, but since talking to others about my experience I have gotten the sense that it is not uncommon.

Here’s some info I just found regarding an epidural lowering fetal heart rate.

I’m not sure if this was related, but the next day I vomited a few times. The nurses kept offering me drugs to stop the nausea, but I was sick of being pumped full of drugs and refused until I missed my son’s first visit with a pediatrician because I was hovering over a puke bucket and I realized that the nausea was not going away soon. Once they gave me even more drugs, I was fine. I suspect this may have had to do with the morphine they gave me before the C-section because they weren’t sure the epidural was working well enough, but I’m not sure.

Like I said, I’m glad that the epidural was available to me because I’m not sure I could have made it from 2 to 10 cm with the labor I was experiencing, but I also feel confident that I could have done with out it if the medical personnel attending my labor had respected my wishes and paid attention to what was happening with my body. Despite having a disappointing birth experience, I did feel empowered once I realized that the labor I was experiencing was the same most women go through during transition and usually only lasts a couple of hours. I experienced it for about an hour before the epidural so I do feel that I could have gotten through it without drugs if it had been a normal labor and I was further dilated.

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8 thoughts on “To Epidural or Not to Epidural

  1. I did it naturally for all of Tuesday and Wednesday and was still only 1.5 cm dilated. I gave in, had the epidural and slept for 3 hours. In those 3 hours I went to 10 cm. I’m now torn. I feel that with my last birth the epidural allowed me a better birth. Without the epidural I think I would still be in labor now! But I know that generally epidurals do increase the risk of a c-section. I think realistically whatever ends up with a healthy baby and healthy mommy is a good birth. So if I need an epidural or a c-section it will be ok as long as we are all healthy!

  2. I was fortunate enough to have a hospital full of nurses who respected my needs and my intelligence, so I’m VERY grateful I didn’t have to have your experience. I’ll say this: that pitocin was a BITCH (sorry, but there’s just no other word for it). The nurses respected my request to turn it up VERY SLOWLY, but I also felt overwhelmed by contractions the first day. Yep, the first day. I slept terribly the night before and was just too exhausted to handle labor. My son’s heart rate dipped, and thankfully, the nurse decided that was the cue to cut off the pitocin (not rush me to a C-section!). They made a deal with me: no pitocin that night, and I could sleep all night, but I’d have to agree to take a mild sedative (antihistamin, actually–Vistaril). I got a full eight hours, went from 2 centimeters to 5 centimeters in my sleep, and then did ANOTHER 13 hours of pitocin-induced labor before giving birth naturally to my son.

    I truly believe the only reason my birth experience didn’t end up like yours is because the nurses were on my side. Having said all that, I’m more aware now of 1) what even gentle interventions can do to make labor overwhelming; and 2) why it is that some women need an epidural or drugs to deal with labor (there were times in that two-day odyssey that I would have said yes to drugs if anyone had been asking me). TOTAL respect for parents, who have to make tough decisions under duress, from this mom.

  3. I had an epidural with my first. Labor was progressing very slowly and painfully and I was starting to get scared that I wouldn’t last. The epidural had its pros and cons. I was exhausted and was able to nap which was good and gave me the energy to edure. It slowed labor down even more though and then I couldn’t even feel the contractions. They were telling me when to push and it just wasn’t working. The doctor was a jerk and was telling me I had to hurry up or we’d have to go the c-section route. Eventually some of it started to wear off and I was able to start feeling the contractions and push more effectively. The forceps were needed though and Jack was born with a big red cone head. I was still pretty numb and the nurses need to drain my bladder for me. To this day I wonder if some of my bladder issues are from that!

    I was not nearly as educated with Jack and I was with Keira. I learned a lot from the book Birthing From Within and was determined to have a drug free delivery with Keira. I was obviously more experienced and calmer the 2nd the time around. I labored at home as long as possible. When we finally went it my contractions were about 3 minutes apart and I was dilated to like 5cm I think. Labor continued to progress quickly and they were ready for me to start pushing at 5am. I pushed for 15 minutes and then at 5:15am she was here! It was excruciating and so much more painful than I remember it being with Jack but I did it drug free and so proud of myself!

    Naturally, I’m planning to do the same with the 3rd but we’ll just have to see how it goes. At my ultrasound yesterday they were concerned that the umbilical cord was down too close to my cervix but after draining my bladder and checking again it seemed to be moved far enough away. They’ll check again at my next ultrasound as the umbilical cord needs to be a good 2 inches away from the cervix or I’ll need to go the c-section route. Hopefully as the baby grows and my uterus grows it’ll end up far enough away.

  4. My wife was planning on having the epidural, but never got it. After seeing the birthing videos and how completely out of it the mothers were without any pain meds opened her up to having an epidural. She wanted to be aware of what was going on instead of focusing on pain, especially once the baby was finally born.

    Our baby was three days late and she had low fluid, so the baby had to come out soon. Labor hadn’t started, so they did pitocin and something to soften the cervix and after 12 hours of labor, she wasn’t dialated at all, and each contraction stressed the baby. We were given the choice of continuing labor and in all likelyhood having an emergency c-section, or having the c-section now on our terms. We chose to have it as soon as possible, which was good because the baby had the cord wrapped around her body and wasn’t coming out any other way.

    We we spoke with our OBGYN about epidurals and effects on the baby, he said it’s going to be stressful on the baby no matter how it comes out, and epidurals go to the spine so they don’t cross the placenta. Long, exhausting labor isn’t good for the kid or for Mom afterwards. If mom is relaxed, baby is more likely to be relaxed. He said epidurals don’t have any statistical effect on whether or not it ends in a c-section. It was just an old wives tale like it takes three months after stopping birth control before you can get pregnant (two weeks for us), or that the first baby always comes past the due date when really, you just hear those who go late complain louder. My three favorite thing our OBGYN said is “Nobody chooses natural denistry,” “we used to give you a shot of whiskey before sawing your arm off,” and “Modern medicine stopped childbirth from being the #1 killer of women in this country, so take advantage of it.” We found that very reassuring and helpful in making the decision.

    My wife works for a women’s organization and works with a lot of women who kept giving her a bunch of crap for planning on having the epidural and going to a hospital, instead of a water birth at home. Some of them even said that women who have c-sections can’t bond with their children, and that real women don’t use pain meds, like it’s some sort of macha thing or you got a medal if you made it through. My wife kept telling them we believe in science and enjoy having people around who went to school for 10 years, and how her aunt had a distended uterus from insisting on natural birth and both her and the baby would have died if she had the baby at home.

    My advice is have a birth plan and be very clear with the doctors and nurses before things get going too far. Dad’s #2 job (after making sure Mom and Baby are okay) is to make sure Mom’s desires and needs are met through the process, and to make those hard decisions when Mom isn’t thinking too clearly. Like they told us in the yoga for birthing class we took and never got to use, things won’t go as planned, and you just need to accept changes and focus on the fact that at the end, you’re going to have a baby. Having the epidural or not is each mother’s choice, and doing it one way or an another isn’t better than the other. It’s just different.

  5. i need to vent and cry! I want someone to listen and say its o.k…1st baby..watxhed business bei g born ..decided in my head i would go UNMEDICATEDNATURAL..at the hospital..ugh..i already still do.not trust doctors ..went in at 5cm…cotractions every 3 min but barey lasting 40 sec…LOTSA PAIN I RECTUM….yhey said Babu O. was sunny side up….ughh..Mu doula suvgested dofferemt positions…then 12 hrs later..dr wants to do another cervocal check….o just about told her to jump!..them dr tells me…i
    only dilated 1 cm in 12 hrs..and she says i was not progressibg…..with the butt pain….they said i would be good candidate for epidurall and give littlest amt of pitoxin they could give…

    I SHOULD BE GRATEFUL AND OPTIMISTIC AND HAPPY…..because no c-sect no hemmorage….. no brain damage / ADHD (yet?? babe is only
    4mo) AND no circum
    BUT…….

    i am FRUSTRATED!!! mad at myself for”giving in” to the darn medical staff……could i have endured the contractions that my rectum felt??? Could i have SAID.NO NO NO!!!!! ??

    WHEN I ASKED THE NUTSE IF the drugs affect Baby O….she said No….WHY THE HEC K DID I BEIEVE HER???

    SO……here i am……i am mid thirties..never taken birth contro l pills ..its been a decade since i took advil or aspirin…..i eat Orgamic applrs and veggies….i eat gluten free i eat steamed broccoli with my breakfast..i eat swiss chard by the pound…i exercised swimming/hikong up to 39 weeks…and i am about as LOW RISK AS U COULD BE….5’5″ 122#…no smoke..very little alcohol…

    NOW…..ALL THE SUDDEN…..I GAVE IN?!??!!
    yeah …i totally threw in the towel…we were exactly 41wks….
    I JUST KICK MYSELF AND NEED A HEAVY DOSE OF WOMAN POWRR TELLING ME …ITS ALLRIGHT….

    Well he latches great….still great at the breast….Weighed 6# 9oz…NO JAUNDICE….9 on Apgar…dr yanked placenta out ….(saw her wrap umbilical cord around hemastats..ugh!!!! i told her just wait fir it to expel naturally..) and she said she indeed DID WAIT for cord to stop pulsing.but she cut at about 1min aftr he born…i think she was lying….but then againi dont trust doctors…(my husband says i have a problem with trust…but he also says doctors know Birth well..they are trained….BLEECH!)

    MY last rant is the drugs.pitocin/epidural made me sooooo Hot!!!! they opened windowd and said it was 55degrees in the room

    I never got that supposed RUSH OF ENDORPHINS…when baby was born…took 10 min….5 pushes..and i was like.hmmm …..is he smiling? i was not GUSHING with love or crying or smiling exuberantly….HONESTLY…I REMEBER telling myself..”smile steph ..everyone is looking…smile and pretend to be overjoyed”…yes i was happy….but i felt FLAT..AND only NOW…4 MONTHS after he was born….am i able to begin processing the birth.My Husband Shakes his head and DEFINITELY TELLS ME ….everything is fine..ad tells me not to Dwell on it……

    but i feel weirdly strange…..I THINK RAISING A CHILD IS A GOOD CHALLENGE….dealing with the in-laws and the stupid things they say and DO is ACTUALLY THE HARDEST PART!!

    Thank you for reading and i looj for u response!

    1. Hi- It is so interesting to read this, because you and I had a VERY similar labor. I, too was very set on have a completly unmedicated birth. I had a midwife and doula who supported my wishes (I had hospital birth with midwife). My labor was long and hard, and baby was not in right postion, back labor, etc. My cervix was swelling and I was DEgressing at 6cm. I finally got an epidural after 30 hours of hard labor (first 20 hours was at home), and it relaxed me enough to give birth 6 hours later. My son is now 3 and every since he was a newborn, he has been so tempermental, very strong willed, violent, doesn’t sleep well, etc. Every day I wonder if it was the long stress of labor that did this to him. Did I wait TOO long to get the epidural? Was he is so much stress that he may have neurological problems? It makes me sick to think I could have done this. So, do not feel guilty about the epi. The feeling of being flat was probably because you were exhausted! I can relate to that feeling too! Yes, it does suck we didn’t get to experience that “rush”, but think that if your body was in stress, that could have stressed the baby and if he has problems down the road, you would never know what caused it. Oh, PS_ my cord stopped pusling after 3 minutes, so if she waited 1 minute the baby got most of the good stem cells. Just thought I would share my thoughts. You did great!

  6. Another thought on this: last year I used a babysitter a few times so I could get things done and found myself being jealous that I was paying her to play with kids and I was changing sheets and mopping floor. So, we hired a housekeeper once a week so I can make a list, and i can take kids to aquarium or park while someone else does my chores. For me, my frustrations with being a stay home mom is not taking care of my kids full time, but rather all the housework and errands that goes along with it. So, that solved our problems some. I know that it isn’t cheap to hire a cleaning person, but child care isn’t cheap either (or, the cost of our sanity)! It’s still hard to find a balance but luckily my husband gives me the choice to explore what works best for me.

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