To Epidural or Not To Epidural.. That is the Question


The question about whether or not to opt for an epidural during labor is on most women’s lips whilst planning their birth. Every woman has a number of options when it comes to pain relief during childbirth, while many opt for gas and air (Entonox), some choose a pethidine injection, a TENS machine or alternative relaxation techniques to ease the pain. The choice to have an Epidural is something that needs to be looked into before you go into labor as it has to be given at a particular time/stage of labor. Many women start thinking about it when they are writing up their birthing plan.

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An Epidural is a local anaesthetic that is fed through a catheter, inserted by needle directly into your back. It is used to help numb your lower body (either wholly or partly) so that childbirth is pain-free. Women who have had a difficult pregnancy, particularly when they have had hip issues and pain throughout, or women who are particularly worried about giving birth, tend to opt for an epidural to lessen the pain of delivery. It is considered the most effective and easily adjustable type of pain relief for childbirth, however, having an Epidural does not always mean you will feel no pain. 1 in 8 women who have an Epidural during labor will need to use another form of pain killer.

The decision whether or not to opt for an Epidural is a completely personal choice and depends on two factors: how concerned you are about being in pain during childbirth and how important a natural birth (without medicine) is to you.

There are two levels of Epidural, there is the ‘light’, ‘mobile’ or ‘walking’ Epidurals and the full Epidural. The light dose makes it possible for you to walk around and push during contractions. This usually is the preferred option to keep the birth more ‘natural’ without the associated pain, however, not all hospitals or birthing units offer it.

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There are some factors you also need to consider that may change your birthing plan if you have opted for an epidural, or have it as a backup plan. For example, the labor may be very fast and may not leave enough time to administer the Epidural or allow it time to work. Additionally, if you opted for a home birth, you will not be able to have an Epidural, as it has to be administered by an anesthesiologist and your contractions and the baby's heart rate need to be continuously monitored, which is not possible outside of a medical unit. Another reason you may not be allowed to have one may be due to a health problem such as low blood pressure, a low platelet count, or if you’re taking particular medications.

Epidurals are very common and labor pain is very unpredictable. Where you may have previously opted for a natural birth, you may decide once you are in the first stage of labor that the pain is too much and request this medicine to help you. It does not, however, come without its risks and side-effects that you should know before you make your decision.

Some side effects to consider include:

  • Legs feeling heavy
  • A drop in blood pressure (hypotension)
  • A prolonged second stage of labour
  • Finding it difficult to pee
  • Developing a Headache after
  • Prolonged back soreness
  • Pins and needles/tingling in legs
  • Feeling nauseous
  • Drop in the baby's heart rate
  • Baby is delivered drowsy

Some more serious, but very rare, side effects can include permanent nerve damage, convulsions, severe breathing difficulties and in extreme cases, death.

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Whether you’d prefer not to feel any pain, or try other options for coping like Entonox, it is completely your choice and you can talk to your midwife about your options and concerns during your birth planning appointments. They will be able to share their thoughts and recommendations, as well as explore all the options available to you in the best-case, and worst-case scenarios. Make sure you pack multiple copies of your birthing plan in your hospital bag to ensure all staff know your preferences when you do go into labor.

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