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.

Epidurals

How an epidural is administered
How an epidural is administered | Source
Source

Why New Technology is Not Necessarily always the Best

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.

Shoulder Dystocia

Great books for Labor and Delivery Preparation

Times when an Epidural is need and Complications

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.





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Comments 9 comments

whowas 4 years ago

Hi, thanks for this hub.

I live between the UK and Italy. In the UK the rising trend since the seventies has been for a return to natural homebirths and it is now a legal right for a mother to request this from her obstetric/midwifery team.

In Italy, it is unheard of and all births take place in hospital, although not necessarily with an epidural intervention.

I was born naturally at home, as were both my parents and all my grandparents. My own children were safely delivered at home without medical intervention of any kind, my wife being attended by me and one professional midwife.

I'm not one of the 'back to nature' crowd who decry all technology as something bad. On the contrary, I think that medical technology has brought huge benefits the world over. However, I do believe in assessing things rationally based on the evidence and the vast majority of peer reviewed research shows that modern natural childbirth is far safer and healthier for both mother and child and medical interventions should be initiated only in emergencies or or in the case of complications.

Thanks for an interesting hub. Voted up.


nancynurse profile image

nancynurse 4 years ago from Southeast USA Author

Thank you for your insightful comment. you are so right about the benefits of medical technology but as you said sometimes it is best to let things happen naturally especially in childbirth. All this makes me also think about how much the medical community has also overused antibiotics and now we have flesh eating bacteria and mrsa


whowas 4 years ago

Yes, I agree with you also about antibiotics. However, to be fair, this error was made in ignorance and as soon as the evidence was in, many medical practitioners changed their prescription practices. Scientific medicine is not a religion with absolutes, it is a journey of discovery and constantly under review. The difficulty is that there are so many financial interests at stake in terms of pharmaceutical companies, anxiety about litigation and so on. But that is the fault of politicians, not science per se.

However, to stay on the topic of this hub, I think the clear way forward is natural home birth as the norm, given extensive and appropriate medical back-up where needed.

Kindest regards.


Giselle Maine 4 years ago

Thank you for your valuable perspective as a nurse. One problem that many obstetric patients face (in trying to avoid an epidural) is the fact that hospitals nowadays keep trying to 'move labor along'. This often means a pitocin drip and other stuff that is not really fun, and makes the contractions much more intense. And if labor is not progressing quickly enough then they do even more stuff to move it all along (even in the early stages of labor I mean) and then things get even more uncomfortable for the woman, so an epidural becomes even more attractive at that point. As you can tell this is speaking from my personal experience!!

I later discovered from my friend's experience that for those wanting a more natural birth in a US hospital, a doula can be a good way to go. Because a doula will advocate for the patient's rights, which is helpful if the patient wants to avoid the pitocin drip, for example, which she would otherwise get pretty much told she has to have.

My issue is more that there are a lot of series of INTERVENTIONS to labor which CAUSE extra discomfort. Obviously, there are often medical reasons why this should be the case. But sometimes I suspect that the hospital just wants to 'get to the end result quicker'. I'd be keen to hear your thoughts on this.


nancynurse profile image

nancynurse 4 years ago from Southeast USA Author

I do believe there are times when pitocin is overused. A women needs to seek out an obstetrician she truly trusts and know is working in the best interest for her and her baby.


kimh039 profile image

kimh039 4 years ago

It's funny how much my thinking on this topic has changed over the years. I did natural x2 and would not have considered an epidural. If I were making that decision today, I would go for the epidural! Most people I talk to today have epidurals and don't seem very aware of the risks. Their primary concern is to minimize pain. Thanks for sharing your professional perspective, and the reminder to consider the benefits and the risks of any procedure. Thanks nancynurse.


nancynurse profile image

nancynurse 4 years ago from Southeast USA Author

Thanks for sharing, I so don't want to scare anyone against an epidural. I had one with the C section of my twins, but people need to know there can be complications. You gave me a very thoughtful comment. Thank you so much!!!


aDayInMyLife1 profile image

aDayInMyLife1 4 years ago from CA

As a Labor and Delivery nurse I too face and deal with this issue. I agree that if an epidural is taken too early on it can slow things down and sometimes result in the need for C/S. It is quite difficult to advocate and educate patients on waiting it out and doing the work until they are in active labor, when the OB is telling them it is okay for them to have their epidural as soon as they are admitted and their bloodwork is back. nice Hub.


nancynurse profile image

nancynurse 4 years ago from Southeast USA Author

Thank you so much for writing. I agree with you. It is also so sad to see a young mom come in nearly fully dilated also and receive an epidural when she has already gone through most of her pain and needs to have the ability to push. Thanks for your comments.

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