A Nurses Perspective on Why You May Not Want or Need an Epidural

We think that our education has taught us all we need to deal with certain things and then life shows us reality is an entirely different thing. I learned this lesson quickly as an RN, a mother and in my daily life.

I found out I was pregnant with my first born quite by accident. A friend was trying to get pregnancy and was taking her daily basal temperature every morning. I had never even studied this one. I decided to see how my temperature fluctuated with ovulation until my friend looked at my first month's charts and announced " you are PREGNANT". I laughed it off. You have to understand I continue to have light periods my first month or two of pregnancy!!! The next weekend we purchased a home pregnancy test and to my delight i was pregnant.

What is really important to me as an RN is to get the information out that sometimes technology does not necessarily mean the best. I have noticed recently there has been a lot of criticism on women who choose to have natural childbirth. Many people think that it is ricidulous to endure the pain of childbirth but what they are not taking into account is the increase in the rate of cesarean sections over the years since epidural's have become the fad. I am not criticising any one who chooses to have an epidural. Many women have a great deal of pain and choose an epidural and this is fine but as a labor and delivery nurse I know that the choice of an epidural, especially too early in labor, can change the outcome of a delivery and sometimes the outcome does not change in favor of mom or baby.

One of the reasons it is so important to make sure a woman is dilated sufficiently prior to an epidural is because it can slow down labor considerably not just in contractions but also in her ability to push. When a woman can't feel the lower half of her body it becomes very difficult for her to know it is time to push and sometimes this actually decreases her ability to push her baby completely through delivery. This sometimes leads to increased labor which can cause fetal distress and/or cesarean section.

Once contractions have become shorter and farther apart the MD often orders a pitocin drip which is another assault of drugs on the women's body.

Epidurals are actually easier on the doctor as he or she can tell a patient to stop "trying" to push while she tends to another patient such as a woman laboring naturally. When a woman is pushing naturally her body tells her to push. She has no control over the timing and the only thing she can do to stop is to blow out through her mouth hard because iit is impossible to do the two things at once. Often the blowing is not effectively and then you have a precipitous delivery if a qualified person is not with her to assist. This is not the norm. Most women have time between contractions to rest and prepare for the next time to push.

Can you see how the epidural is already stopping the natural course of nature? I have witnessed on occasion an anesthesiologist deliver an epidural so skillfully that only the contractions are relieved and the mother is still able to push but this is not always the case. Many women totally lose feeling in their entire lower body. Doctors need to be more specific with women to the pros and cons of epidurals.

There are times when an epidural delivery is very much welcomed and necessary as in the cesarean sec†ion needed because of many various reasons i.e. breech presentation, twin delivery, or head or shoulder dystocia where the newborns head or shoulder are too large for the mother to deliver vaginally. Sometimes an epidural can offer a woman experiencing a very long particularly painful delivery a much needed break. Hopefully in these cases she can still push her infant out in a very controlled manner with the doctor or midwives assistance.

The success of an epidural actually depends on the skill of the person administering it. Women with epidurals may get a severe headache caused by leakage of spinal fluid although this is rare. She may experience low blood pressure and therefore her blood pressure will be taken often to ensure her baby is getting enough blood supply to his placenta. The mother will no longer be able to get up and walk or change her laboring and/or delivery position to one that is more comfortable to her.

Expect to be asked to change positions often, with the help of medical staff, to help the epidural from causing labor to slow or stop. Other complications sometimes caused with an epidural are, as I spoke about before, the slowing or stopping of labor needing pitocin to strengthen and increase contractions and the inability to push forcing a forceps or vacuum delivery both of which can cause trauma to the baby. All these are reasons why a women having an epidural may be at more risk of cesarean section.

Please remember these complications the next time you feel the urge to criticize a mother for choosing natural childbirth.

In the same way don't think ill of a mother choosing an epidural. We all know our bodies, pain thresholds, etc. We just need to know all the facts.