To epidural or not to epidural? That is the burning question for many mothers-to-be these days.
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Some experienced moms got an epidural and loved it. Other moms got it, hated it, and are still suffering the ill effects.
Some moms said NO to the epidural and would make the same decision again while other moms refused the epidural and still wonder if their labor might have been easier if they chose otherwise.
It’s a complex decision surrounded by lots of love-or-hate stories. If you’re an expectant mom asking yourself the epidural question, here’s what we think you need to know.
What You Need to Know About Epidurals
1. First and foremost, epidurals are medical interventions
As such, it carries both benefits and risks – contrary to what others, even doctors, may tell you. As a reminder, medical interventions are meant to treat or cure a condition.
An epidural is where painkilling drugs are passed into the small of your back via a fine tube. It is called a regional anesthetic, which means the drug is injected around the nerves that carry signals from the part of your body that feels pain when you're in labor.
Pregnancy, labor, and birth are normal parts of a childbearing woman’s life, not a “condition” to treat or cure.
2. Epidurals were developed for a good reason!
For women who have c-sections, epidurals allow them to remain awake and alert during the procedure. This means they get to meet Baby immediately after birth, which is wonderful!
For women who have extremely long, unusually painful labors (think 3 days of excruciating back labor), epidurals help ease the pain and strain for Mom so she can relax and Baby can get out. This eases any chances for distress in Baby.
Under these circumstances, epidurals can be not only life-changing but life-saving. Epidurals are neither good nor evil. It all depends on how they’re used (or, in the case of Western maternity practices, overused).
3. Epidurals can start a “cascade of interventions.”
Tracy Cassels, Ph.D., of EvolutionaryParenting.com writes:
“There is ample evidence that women who receive an epidural are much more likely to require the use of oxytocin/Pitocin…and because of that intervention, these women are also at a higher risk of requiring an emergency c-section.”
Why? Here’s an example:
Epidurals typically mean you are bed-bound, on your back, which is NOT the ideal (nor the most helpful) laboring position. Being bed-bound means labor slows down and gets harder. You don’t have gravity or movement to help you move the baby down.
Epidurals numb the sensation of the contractions, which weakens them, which slows labor even more.
At this point, Pitocin is often administered to make the contractions stronger, to speed up labor again, “which can be too much for baby, meaning you end up with baby in distress and the need for an emergency c-section for failure to progress.” (source)
“Failure to progress” is a common reason for “emergency” c-sections, but how often do women realize that the “failure to progress” was not due to their body’s failure, but the epidural?
4. Epidurals block your body’s natural pain relief, especially oxytocin!
What too few people in the medical birthing community recognize is the importance of oxytocin – the cuddle hormone, the love hormone, and the hormone responsible for birth, bonding, and breastfeeding.
During labor, there’s a beautiful feedback cycle called the “Ferguson reflex.”
First, oxytocin causes contractions.
The contractions send signals to Momma’s brain to trigger more oxytocin for “calming and pain relieving effects.”
This additional oxytocin causes more contractions, which triggers the release of more oxytocin for more pain relief.
See the cycle?
Dr. Sarah Buckley explains it like this:
With an epidural, your labor sensations will usually be completely abolished. This means that there is no sensation to drive this oxytocin feedback cycle, and your oxytocin levels will decline. (source)
It doesn’t stop there. Low oxytocin levels impact more than just labor.
5. Declines in oxytocin due to epidural affect bonding and breastfeeding.
Just when Baby is birthed, oxytocin levels surge. According to Dr. Buckley’s ebook Ecstatic Birth, this surge is triggered by “stimulation of ‘stretch receptors’ in a woman’s lower vagina as the baby descends.”
This surge results in a powerful feeling of “calm and connection” in the minutes after birth, which is probably the feeling women have when they report that the instant Baby is born any and all pain they felt just moments earlier disappears.
Unfortunately, birthing with an epidural means the surge of oxytocin that usually happens right at birth is inhibited. Without this important cuddle hormone, some mothers have difficulty connecting with Baby right away.
In one study, mothers given epidurals spent less time with their babies in hospital, in inverse proportion to the dose of drugs they received and the length of the second stage of labor. In another study, mothers who had epidurals described their babies as more difficult to care for one month later.
Additionally, Dr. Buckley cites in her book a study implicating epidural opiates in breastfeeding difficulties, another study which found that…
[in] over 500 epidural mothers…the chances of their babies not suckling within the first four hours were almost four times higher…compared with mothers and babies not exposed to epidurals.
6. Epidurals DO affect Baby!
While many doctors will casually suggest that epidurals pose no risks to your baby, ALL medical interventions carry some degree of risk!
The American Pregnancy Association writes the following about risks associated with epidurals:
…most studies suggest that some babies will have trouble ‘latching on’ causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries, and episiotomies.
Coping without an Epidural
Opting for an epidural is not a small decision and should not be undertaken lightly. There are many, many ways to manage the pains of labor, from breathing and movement to birthing pools and showers, without medical intervention.
The American Congress of Obstetricians and Gynecologists even released guidelines in February 2017 recommending “techniques such as
- education and support,
- oral hydration,
- positions of comfort, and
- nonpharmacologic pain management techniques such as massage or water immersion.”
… for pain.
If you find yourself experiencing back-breaking, endless labor knows that the support of the epidural is there for you.
Until then, have faith that everything you experience during labor has one sole purpose – to get that beautiful, healthy baby into your arms as fast and as easily as possible.
Your body was made to do this! It will give you all the pain relief you need. Naturally…if you let it.
Good luck, Momma!