Everything You Need to Know About Epidurals

Epidurals can be an incredible tool to use during childbirth. For some individuals, an epidural is the plan, and the plan is the epidural. For others, the epidural is a tool to use when labor is prolonged, exhaustion is real, and it is time to change things up. Both options can be highly empowering and lead to beautiful birth outcomes. 

It is crucial that as you make decisions for your birthing time, you know and recognize all of the risks and benefits of any choice that you make, and epidural is no exception. As we discuss the benefits and risks of epidurals, it is important to remember that every body and every birth is unique. How people experience using an epidural can vary widely. Trust your inner knowing as you make decisions about your birth. Chances are you will know what is best.

Some Benefits Associated with an Epidural:

  • One study found that epidurals can lessen pain by 3-4 points on a 10-point scale. This amount of pain relief can be enough to allow for rest and calm the fear and anxiety responses. The epidural is the most effective form of pain relief for childbirth.
  • Having an epidural in place during labor can help individuals avoid needing general anesthesia if an emergency cesarean section were to need to occur.
  • Some research shows that when birthing parents struggle to cope with labor, it decreases the blood flow to the fetus. An epidural can take away the parental stress response and provide more blood flow/oxygen to the baby.
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Some Risks Associated with an Epidural:

  • It is more common for epidural births to need forceps or vacuum assistance during pushing. This delivery type can cause more tissue trauma and require more extensive repair.
  • Epidurals can cause low blood pressure, which can lead to lightheadedness and nausea. In some cases, additional fluids and medications will be needed to reverse the effects of the epidural on your blood pressure.
  • There is an increased risk of needing a cesarean section if the baby is experiencing fetal distress during labor.
  • In some cases, the epidural might not provide relief or only provide patchy relief. At the same time, in other situations, it can numb your legs and lower body so well that you can't move. As I tell my clients, not all epidurals are created equally.
  • There is an increased risk of a fever during childbirth. When fevers occur, even if caused by the epidural, you and the baby will be treated for an infection. This commonly includes a few rounds of antibiotics and, in some cases, a NICU stay for the baby.
  • You are also more likely to need Pitocin (synthetic oxytocin) to speed up your labor. It is common to see Epidurals slow things down in labor, and in these scenarios, it is common for your OBGYN to encourage starting you on Pitocin to get them going again.
  • Other common side effects are itching, nausea, and inadequate relief.
  • More rare side effects of an epidural are spinal headaches, slow breathing, drowsiness, infection, and a sore back. In extreme cases, epidurals can cause nerve damage, seizures, severe breathing difficulty, and death. These are extremely rare but should be mentioned for a proper, informed decision to be made. Death is so rare that in one study, they found that in ten years, there were zero deaths from an epidural during labor.

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The last thing to consider with an epidural is what can come with it. In childbirth education, there is something that we often refer to as the “Cascade of Interventions,” and in many cases, this cascade starts with an epidural. Things that commonly come with an epidural are an IV, blood pressure cuff, pulse oximeter machine, Pitocin, IV fluids, catheter, continuous fetal monitoring, contraction monitor, and vacuum or forceps birth. Making sure that you are aware of what your care provider will require with an epidural is a great way to ensure that you are prepared to get one.

You are the one who knows what your body and baby need to make it through the intense and incredible experience of childbirth. Knowing the risks and benefits and having an informed decision-making conversation with your care provider can be one of the best ways to ensure you feel empowered about your end result.


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