Doulas are most often associated with the desire to have as natural a birth as possible - and we’re pretty good at that! It is a popular misconception that this is all we do though. Doulas provide professional birth support for all types of birth, whether they are natural and unmedicated, inductions, with all the pain relief or even caesarean births. And while not everyone knows about the amazing benefits of having a Doula yet, we’re getting there fast!!
When they approach the end of their pregnancy, many mothers to be start wondering about how they will cope with contractions during labour. While it is becoming more popular to aim for a natural, unmedicated birth, some women feel relieved to know that they have the option of an epidural for pain management during labour and birth.
Epidurals divide the birthing nation - is it the best thing you can do? Or is it the absolute worst thing and lead to nothing but interventions? There are many pros and cons here, it’s not as easy as right or wrong. Like anything, it’s an individual decision that serves some birthing persons’ needs but not others. An epidural can sometimes save the day in the labour ward but it is merely one of many tools that are available to birthing persons.
So here is some information on epidurals:
What is an epidural?
An epidural is a common type of pain relief used for childbirth. After a drip is placed in your arm so you can received IV fluids, you will be asked to sit down and lean forwards, with your chin on your chest. An anaesthetist will then give you a local anaesthetic to numb the area where the epidural will be inserted. A needle is then used to insert the catheter, which is a thin tube through which the medication is administered, between the vertebrae in your lower back. When this is done, the needle is fully removed and the catheter fixed to your skin. If the epidural is successful, it will take about 20 - 30 minutes for the full effect to be felt. You will find that you have a loss of sensation in the lower areas of your body but it will not impact on how alert you are or your ability to birth your baby vaginally.
There are several reasons for a mother to request an epidural. You might find it difficult to cope with the sensations of labour, you might be exhausted and in need of sleep, you might have a medical indication like high blood pressure - or you might just want an epidural!
Of course, like any other medical procedure, there are risks. For example, in some cases an epidural can increase the likelihood of interventions and, subsequently, a caesarean birth. Other risks include low blood pressure, an element of loss of bladder control, itchy skin, nausea, headache, breathing issues and nerve damage.
If an epidural is something you think you might consider in labour, make sure you speak to your health care provider and that you have all the info BEFORE the day so you can make an informed decision.
And here are the tips to having a successful birth WITH epidural:
Wait until you are in active labour
An epidural can slow your contractions and even temporarily stop them. Waiting until you are in active labour reduces the likelihood of needing medical interventions.
An epidural does NOT mean you have to remain on your back for the duration of your birth.
True, you won’t be able to walk around but there are plenty of ways to keep that pelvis open and active! Bring a peanut ball with you (they come in different sizes, make sure it’s the right size for you) and put it between your legs after the epidural is in place. This increases the pelvic outlet and helps baby to rotate and descend.
Get your birth partner involved.
Ask your birth partner to help you turn from one side to the other every 15 minutes. In the absence of walking, this is a great way of keeping your pelvis active and helps baby to navigate their way down.
Wait until baby is low down in the birth canal before you start pushing.
With an epidural, you will not be able to feel the signals your body is giving you to push, instead your midwife will read the contractions from a monitor and ask you to push. To avoid you getting exhausted, wait until baby is nice and low!
You do not need to remain on your back.
If you are supported by 2 people, you can push in a semi-squat and make full use of gravity. Birthing upright has numerous benefits, including but not limited to quicker birth and less risk of tearing!
Know what to do if the epidural fails
Approximately 12% of all epidurals fail. It might fail completely, only work on one side or only minimally decreases the sensations of labour. If you choose to have an epidural, it is so important to also inform yourself about other ways of coping with the intensity of labour! After an epidural is placed, whether it works or not, the body’s own production of endorphins is decreased and with that your natural pain relief. So if the epidural is less than effective, you could be dealing with contractions that seem more painful and are harder to handle.