6 Steps to an Epidural
Get me the juice!!!!!
AND BY JUICE…. WE MEAN EPIDURAL RIGHT!?!?!
YEP! FOR MANY WOMEN ON THIS PLANET, THE THOUGHT OF GIVING BIRTH WITHOUT MEDICAL PAIN RELIEF IS AS CRAZY AS SKYDIVING WITHOUT A PARACHUTE. WHILE GIVING BIRTH NATURALLY DEFINITELY ISN’T CRAZY, BIRTHING WITH AN EPIDURAL ISN’T NUTS EITHER! SO, LET’S JUST GET DOWN TO BUSINESS AND SHELL OUT THE INFO YOU NEED TO KNOW IN ORDER TO HAVE A POSITIVE EXPERIENCE WITH AN EPIDURAL….THE JUICE!
KNOW THE BENEFITS & RISKS INVOLVED!
We in the birth world call it informed consent. An epidural can have many benefits such as PAIN RELIEF! HELLO!! It can lower an elevated BP, relax your body so that all that tension is gone and you can actually loosen up and let the baby come lower in the pelvis. On the flip side, It can numb you so much it can severely impair your ability to push. It can lower a normal BP and cause the necessity for an emergency cesarean do to fetal distress. It’s use can slow contractions therefore necessitating the need for further intervention such as pitocin. The list goes on as far as benefits and severe risks of epidural use in birth go. So, talk with your provider, pick up the consent form for it from the hospital you are birthing in. That way you can read over it ahead of time to get a better handle on what your desires regarding epidural use will be. Because after all, you cannot consent to treatment you don’t understand.
KNOW WHEN TO REQUEST IT!
Most labor & delivery units will not even admit you until you are 6 cm dilated. Yes you read that right…6. They want to ensure you are actually in active labor before admitting you. So, a good portion of your labor will need to happen out of hospital for those who go into labor naturally. This is actually a GOOD thing! I know. You’re thinking ‘yeah right’! It is actually. The ACOG (American college of obstetrics & gynecology) states that having free range of motion and movement is PROVEN to help ease labor pains and aid the PROGRESS of labor!! Once you have an epidural placed you are limited to the bed as well as positions in the bed in order to get proper placement of the medication within you. You will want to relax at home during early labor and go in to the labor & delivery unit when things get more intense and close together. Once you get there inform the staff of your wishes for an epidural and when you would like it depending on how far along you are in the process. They will need to notify the anesthesiologist as well as give you a bag of fluids prior to getting the epidural placed. As a birth doula, I see the most benefit to choosing an epidural be had when you are around 7-8 cm dilated. This is because the medication will be at its peak right around transition. And it will not be too heavy when it comes time to push! I’ve also witnessed it’s benefit slightly earlier on in labor in past extreme trauma victims. It can help you relax in order to aid the progress of birth.
KNOW WHETHER IT IS WORKING PROPERLY!
If an epidural is doing its job correctly, then you should feel some tightening and pressure during the contraction waves, but no pain. You should feel equally numb on both sides of your body. Sometimes epidurals are placed incorrectly or your position in the bed alters where the medication goes. Therefore, at times it can cause only numbness on one side of the body. Or numbness in your upper body instead of lower. There are times when an epidural will need to be adjusted or removed and replaced in order to get it properly distributed. I always say, what’s the point in getting it if it’s not going to work properly!?! So, know what is normal so that you can communicate your needs to the staff.
KNOW BABY’S POSITION.
This is probably one of the most important points to remember. A baby’s position of their head and body CAN sometimes be a factor in whether you need a cesarean brith. There is more to it than just having baby be head down. Baby should basically be facing your back side. You should ask the staff which direction baby is facing prior to getting the epidural if possible. That way you can get into some positions prior to getting the epidural that can help baby turn. These positions are much harder to do with an epidural. Although not impossible. Especially if you have a skilled doula to help! This point is key because if baby isn’t in a good position… having an epidural in place can make pushing your baby out much harder. And at times, necessitate the need for a cesarean if baby can’t turn. Epidurals are great. It’s not all doom and gloom! This is just a point to go alongside the use of it so that you can be prepared to do some homework first!
KNOW HOW LONG TO WAIT TO PUSH!
As a cardinal rule you want baby to be low in the pelvis and you want to have a strong sense of intense pressure. Like you need to poop bad! Thats when you know you are ready to start to push your baby out! Sometimes a provider or nurse will do a cervical check and note that you are fully dilated and can push. But if you do not feel what I mentioned above, you will want to wait to keep your pushing time shorter! Just say you don’t feel much of anything and would like to labor down a bit if baby is ok. You can sit up in the bed with your feet down like you are sitting in a chair really. We call it laboring down. Basically giving the baby and your body time to catch up and realize that its time to give birth and let baby come lower in the pelvis!
KNOW THE RIGHT SUPPORT TEAM FOR YOU!
Ensure you have a provider who will be supportive of your intended birth choices. Get a doula who is well versed in attending clients who choose an epidural. And by that, I mean one who has much experience and SUCCESS in vaginal birthing with an epidural. Because a lot of providers and doulas will agree to that but in the end their experience ends in more in severe tearing or cesareans than positive vaginal births. Ask questions of the hospital staff when you take the tour as well. Ensure they are comfortable caring for patients with your intended birth.
At the end of the day no one can control all aspects of birth. No one can guarantee a specific outcome. Some may not have time for the glorious epidural they desired. Others may have things go off course and need a cesarean for medical reasons! But what you CAN do is educate yourself, prepare, have a flexible plan & higher the best birth team for YOU! By doing these things you will set yourself up for the most positive birth you can have given whichever way your birth goes! You will be as ready as you can be. And that my friend, is it until next time!
