Epidural - love or pass?
Let's get one thing out of the way: I've used an epidural for both of my deliveries, so I'm not fundamentally opposed to it. Or if I ever say I am, I'm being a tad hypocritical. Did I go into my deliveries thinking, "Give me all the meds and painkillers NOW"? No, I didn't. My initial plan was to give birth as naturally as possible, but that didn't happen. In both cases, I made a conscious decision to use an epidural based on the information I gathered during pregnancy. For me, the epidural relaxed me and maybe even made me a little woozy. It completely blocked my contraction pain, allowing me to rest. With my second delivery, I hoped the epidural would help relax my pelvic floor muscles and cervix enough for full dilation.
So, what is an epidural?
An epidural, which effectively alleviates contraction pain, is used by over 70% of first-time birthing mothers in Finland and a little over 40% of second-time mothers. The epidural uses fentanyl, which is injected through a catheter placed in the spine. The anesthesiologist inserts the catheter between contractions, and during this time, the birthing person has to remain completely still. It takes about 10-20 minutes for the anesthesia to kick in.
Like all medications, epidurals come with side effects. I believe it's wise to research the side effects of any drugs used during childbirth well in advance during pregnancy to have some kind of understanding of them. The midwives and medical staff will inform you at the hospital, but in the heat of labor, you're not in the best position to take in (nor should you be expected to take in!) new information. That's why you should lay the groundwork beforehand.
After gathering the facts, think about whether this medication is right for you. And if, for some reason, your birth experience means you "have" to use this medication anyway, how will you feel about it?
What are the potential side effects of an epidural?
- Lower blood pressure for the birthing person (sometimes a desired effect in specific situations)
- Requirement to lie still for 30 minutes after the epidural is administered
- Difficulty urinating or urinary retention
- Fever
- Nausea
- Headache
- Itching
- Dizziness
- Pain at the injection site and risk of infection
- Long-term nerve pain and spinal headaches
- Allergic reaction
- Not being able to go in the tub or shower
- Being hooked up to wires after the epidural is administered
- Relaxation, which can lead to "malposition"
- Loss of the urge to push or difficulty finding the "right direction" to push in, which may result in a prolonged pushing stage
- Contractions may weaken or stop entirely, requiring synthetic oxytocin to increase contractions
- The use of synthetic oxytocin increases the risk of tearing
- The epidural suppresses natural hormone production, such as endorphins, lowering pain tolerance and leading many birthing people to request additional doses
- As doses increase, so do the side effects
- The epidural doesn't always work as intended: your legs may go numb, or the anesthetic may not work thoroughly
Does the epidural affect the baby?
Yes, fentanyl, which is injected into the spine and is 75-100 times more potent than morphine, does affect the baby, at least according to midwives' observations.
- A numbed parent, a numbed baby.
- Epidural use has been associated in some studies with lower APGAR scores and an increased need for newborn intensive care.
- The baby may be sleepy, perhaps nauseated, and may lack the strength to latch and breastfeed.
- If the baby can't latch, the likelihood of supplementing with formula is higher, which can delay milk production and, in the worst case, jeopardize breastfeeding (OK, this is a worst-case scenario).
But if you choose to get an epidural, all is not lost. It's fantastic that we have access to epidural anesthesia and that nearly everyone giving birth in a hospital in Finland can use it if they want. I'm still breastfeeding both of my children (3 years and 10 months), even though I used epidurals. My milk came in around 4-5 days after birth, and we went home with formula supplementation for both.
So, why do I mention all these possible side effects? So you can inform yourself now and make an informed decision about using an epidural. Epidurals, like any other medication, aren't absolutely good or bad. I can't say whether it's a hit or a miss in my own opinion, but for many, it's an absolute hit.
What do you think?
<3: Henna