epidural - subsequent implications

[Lisa B]

Hi there,

I'm trying to keep an open mind in terms of pain relief, but hoping I can manage as far as I can without drugs.

If I end up deciding to get an epidural what does this mean for my capacity to push? I want to avoid the episiotomy and definitely avoid forceps.

When I was teenager a family friend had a little boy with cerebral palsy and she put his condition down to a forcep delivery. That has always stuck with me. I'm not sure if there is a relationship with this or not.

What are your experiences with epidural and subsequent intervention?

Thanks

[YoYo]

I had epidural for both of my births

DS was induced, so epidural went on for majority of the labour, when it came time to push I could still do it...i wasn't NUMB...I could still move, I just couldn't feel the pain IYKWIM. I think they'd started to wear it off for the pushing stage...i could feel the burn I didn't need any further intervention.

DD's labour was much shorter. I actually think they gave me the epi too late, coz no sooner did it kick in, I felt the need to push. I could feel the sack bulging....I couldn't feel the contraction pain, as with DS. I pushed her out in 12 minutes No tears and no intervention.

If you have an idea of where to push and how, then you can still do it. My view is that an epi doesn't render you useless. Your body still knows how to do it, regardless.

Good luck

[Yeddi]

It depends upon the type of epidural, your own biology and the skill of your doctor. I had an epidural with DS which was self-admistering so I was able to stop dosing at 9cm so it had practically worn off when it came time to push. I only had it for the last two hours of a 36 hour labour because I needed the rest and food/fluids. I found I coped well with the epidural, it didn't give me low blood pressure or headaches but it can for some women; I have one friend who can no longer feel three of her toes four years later but is unsure if that was a biology issue or a crappy job by the doctor. There are a lot of things can come into play when it's time to push, and the epidural is only one of them, which is fine if it is one of the only things on the list, but if you have to add other things to it like adverse reactions, long labour times, dehydration, malpresentation etc. that's when things become stacked in favour of more and more intervention. Some things worth knowing is that some OB's will try and blackmail you into artificial rupture of the membranes if you have an epidural which just adds to the intervention, can increase the risk of rupture and cord prolapse if baby is too high and increases the risk of infection with every VE. My OB tried to do this to me. In the end I consented to having an IV before getting the epidural so that it didn't effect my blood pressure too much as I was dehydrated as I hadn't been having enough food and water because it made me feel sick. Also, if you have a posterior baby you'll want to weigh up the benefits/risks of an epidural. I only accepted the epidural because it was self dosing and I was able to stop administering it in time to move into a different position to push. My bub was posterior and often an epidural helps mum's with posterior babies to dilate because they are able to relax (as shown by my final 6cm in two hours after only getting to 4cm in the previous 34 hours). This was good for me, and my baby turned to come out facing butt (the right way). However, if baby doesn't happen to turn and comes out sunny side up this requires the pelvis to expand up to an extra 10cm but the lateral position (flat on your back) reduces your pelvis opening by a massive 30% so you can see how being stuck on your back in this instance is going to lead to more intervention. Then again not dilating leads to more intervention... The other thing is that it is BEST to be at the very least 4-5cm before having an epidural, otherwise it can actually stall labour, therefore again, adding to the intervention.

I had some discomfort at the site after birth, nothing drastic - I was just aware of it, so I went to the osteopath and he tweaked it for me. The osteo visit was most probably the best thing I could have done post birth as I initially had had difficulty telling the difference between when I needed to pass wind and when I needed to go to the toilet. I had thought this was just a side effect from tearing and the typical numbness after a VB but it was actually because of the epidural.

[toomanyshoes]

I had an epidural with DS and was still able to push, it really just took the edge off it but I was still able to feel lots.

I ended up with a 2nd degree tear but no intervention. And I was up and about with a 20mins of him being born.

[Lulliloo]

my sil had her second baby last friday and she had an epi for both her children.
now both had to have intervention. she had an emergency cs for bub 1 because bubs heart rate was dropping.
bub 2 same thing started to happen but they managed to do a vbac but she had 2nd degree tears and snips and forceps to birth her son.

i don't know if there is a correlation between the 2 but to me its enough for me to have a good think about an epi in the future.

[emc2]

On TV one day they were talking about new research to do with cerebal palsy, and they have found that in some cases they think the causes are earlier in the pregnancy and they are researching that.

[helle]

Totally off topic, but with inductions I didn't have an epi at all, not even one hooked up JIC, and no other pain relief.

just thought I'd put it out there, so you know if you do end up down that road and are induced you don't HAVE to have it.

[toomanyshoes]

Totally off topic, but with inductions I didn't have an epi at all, not even one hooked up JIC, and no other pain relief.

just thought I'd put it out there, so you know if you do end up down that road and are induced you don't HAVE to have it.

Yep, I've done an induction (induced with the drip) without any pain relief.

[helle]

Yep, I've done an induction (induced with the drip) without any pain relief.

My was ARM then drip. Maybe it was because I didn't know any better, or I was on the brink of popping anyway, or because I was induced with jayvan, but I didn't really find it to be as horrible as the horror stories.

[toomanyshoes]

My was ARM then drip. Maybe it was because I didn't know any better, or I was on the brink of popping anyway, or because I was induced with jayvan, but I didn't really find it to be as horrible as the horror stories.

I was induced with both DS and DD (the same way) had an epi with DS though but that was mainly because of other complications and I had a time limit on how long they would let me labour then I would need a c/s.

But I agree, I didn't find it as bad as some of the stories I've heard.

[Junglemum]

I had to have an epi with dd1 due to pe. It was either that or a c/s. I would rather and epi over a c/s anyday . But with dd2 I had an intervention and drug free labour.

I hated the epi. I hated that I couldn't feel anything. I could hardly move, I could but needed assistance. I felt the tightening of the contractions and I felt pressure when pushing, but I was not at all in control. Without the epi I felt so much better, sure there was more pain, but I felt like I could control the pushing and have a part in it, rather than being told when to push.
I didn't have an episiotomy but I did end up with a forceps delivery and a small tear when I had the epidural. I'm sure it was due to the epi and me not being active in labour. But I was just thankful to avoid a c/s.

After the babies were born, I felt a million times better when I didn't have the epi. But that could also bs due to the emergency, forceps drama at the end, my body went into shock and I was shaking uncontrollably and vomiting, I couldn't hold dd1 in my own.

Given the choice of epi or not, if I was coping well and things were all smooth sailing I'd definitely avoid one. If it was a choice between epi and c/s, I'd have an epidural for sure.

As for long term effects I had none.

[Sagres]

I had an epidural and I think it did impact my ability to push, but then I had it a bit too late when I was already 10cm dilated (not intentionally, I mean we didn't know I was 10cm). It didn't mean I couldn't push at all, but it did add a bit of a hurdle and then when DD and I were both looking a bit dicey and we realised it was time for her to be out NOW, that hurdle didn't help me get into the effective pushing when I needed to. She was moved along with the ventouse.
So possibly that is a worse case scenario, I mean having the epi literally a few minutes before starting to push.

[crumpet]

i was induced with DD, ARM and then the drip.....

i felt pressure at every contraction but no pain at all, and could still move my legs...

becasue i was on the CTG continuously i knew when i was contracting becasue it would show, plus id get the pressure.

i had no issues with pushing, infact i got told to push less!

i did need a episiotomy BUt that was because my heart rate was through the roof and things were going haywire, plus id already torn so was going to need stitches anyway.

[Early Kids]

I had an epi/spinal block combo with DS1, it was given as they prepped for an emergancy c/s thankfully for me things really sped up and he arrived via VB less than 30mins after the epi went in. With DS2 I had a self administering epi and it barely worked at all. It took away some of the pain for about an hour, I birthed him without topping up the epi.

I had no intervention as far as the actual birth went, no forceps or anything. I do have some ongoing lower back problems, but they were not due to having the epi, but was caused from being on bed rest for so long.

[~Trish~]

I had an epidural with DS2 (for psychological reasons after my first labour) and had no issues whatsoever pushing him out. I needed no intervention and he was out within 10 mins. The epidural was beginning to wear off so I could feel what I was doing. Like Junglemum, I shook heaps afterwards, I didn't know that would happen! But all in all, it went perfectly for me.

It's great to research all of your options JIC, good for you . Have you read this wonderful thread on natural pain relief methods: https://www.bellybelly.com.au/forums...methods-45345/? I highly recommend everyone read it!

Wishing you all the best in your upcoming birth

[Lisa B]

Thanks everyone for your responses. It was helpful to see what happened to different people and I can see that epidural doesn't automatically mean forceps which is good to hear.