An epidural, for many, is often seen as the best thing that you can do for birth and labour! The closer you get to your due date, you might even have friends and family start saying to you ‘Just book the epidural, make your life easy!” But actually it’s not as clear cut as that. As with anything to do with birth, there are benefits and risks or downsides. Learning what these benefits and risks are means that you can make an informed decision as to what’s best for you and your birth.
What is an epidural?
To understand the benefits and risks of an epidural, first of all you need to understand what an epidural is. An epidural is a form of pain relief which numbs or blocks pain from the lower half of the body. To start the procedure you will be seated and asked to lean forwards to give access to the lower back. If this is not possible you will be laying on your side, with your knees bent up towards your chest. First of all you’ll be given an injection of local anaesthetic at the lower back, so that you do not feel the procedure being carried out. A needle will then be inserted into the lower back, near the spine. It’s placed near the spine as this is were the nerves are that carry pain signals from your lower body to your brain. By numbing these nerves, the pain signals do not get to your brain, meaning you do not feel pain. This is why sometimes an epidural is sometimes called a spinal block.
The needle placed into your lower back will contain a thin plastic tube called an epidural catheter. Once the epidural catheter is in place, the needle is removed. Then medication can be fed through to you. It takes between 20-30 minutes before the pain relief starts working. Which is why you won’t be given an epidural if you are quite close to giving birth. Because by the time it’s fitted and working your baby will probably already be here.
What are the side effects?
I always say to my hypnobirthing clients that it is best to learn about potential side effects of any intervention of labour before you are in labour. This is because hearing or learning about potentially negative side effects can be quite worrying. It is much better to hear them when you are not in labour, so that you can mentally process everything in a safe space.
Some of the side effects include a drop in blood pressure, meaning you will be put on to a drip of fluids to help stabilise this. The side effects of this are that you are then on more medication, and your movement will be restricted as you’re attached to machinery. The epidural itself will also restrict your movements. When movements are restricted in labour it means that you can not move and sway to help ease your baby down. You might also find it hard to feel how you should position yourself to help get, or keep, baby in a good position for birth. When you are less mobile it can lead to a longer about, which in turn can lead to a higher chance of needing forceps, ventouse or a caesarean.
Other side effects include temporary loss of bladder control (meaning you will have a bladder catheter fitted), itchy skin, sickness and nausea, 1 in 100 people experience head aches. The next thing to consider is that epidurals don’t always work! 1 in 8 people need extra pain relief on top of an epidural because they are still feeling some sensations. Yet most people believe that if you have an epidural you will have a totally pain free birth.
What are the benefits?
The biggest benefit of an epidural is that it is a very effective form of pain relief. Many people have one and go on to have a really lovely, positive birth. The next big benefit is that they can be a great way to give your body a break if you are having a long labour or are tired. If labour is slowing down, because you have run out of energy or are tired, but can’t rest because you are having contractions, an epidural can be a good option. It can give you time to rest or sleep, then once it wears off or you feel more energised you can still go on to have a natural birth.
How to use an epidural with your hypnobirthing techniques
Yes you can have an epidural and still have a hypnobirth! In fact, I believe that hypnobirthing techniques are even more important during a medicalised birth. Generally a birth that involves an epidural is longer and more likely to need interventions like ventouse, forceps or a c-section. This is because if an epidural stops you from feeling contractions, your body doesn’t realise it’s in labour and then stops producing the hormones needed for labour to progress. This is why hypnobirthing is so important when having an epidural. Hypnobirthing techniques are designed to boost your labour hormones, and hopefully speed the process up.
So first of all you need to keep telling your body that you are in labour and it still has to do the work. Don’t sit around watching tv waiting for your baby to fall out! Get as active as possible to help ease your baby down the birth canal. This is a bit trickier when you are hooked up to machinery and have limited mobility, but it is not impossible. You could try sitting on a birthing ball, laying on your side or using a peanut ball whilst laying on a bed.
Next you need to boost the hormone oxytocin (this is the hormone that makes contractions happen). To boost oxytocin you need to feel loved, safe and unobserved. Some things that you can do in a hospital setting could include a massage or reassurance from your birth partner, dimming the lights, your hypnobirthing breathing techniques, listening to birth affirmations or using aromatherapy.
Finally, to really make sure your body knows that it’s still in labour you could opt for a lower dose epidural. This means that it is still working as pain relief but perhaps you can feel some of the sensations or you are able to be more mobile.
As with anything in birth – research your options, learn the facts but also keep an open mind. If you are thinking of having an epidural, maybe start off with some more basic types of pain relief and see how you go first. If you are planning a natural birth, also keep an open mind that maybe it’s what you need on the day. Either way, your hypnobirthing techniques can help!