The Big Bad Epidural

by Mrs. BWF on January 26, 2012

The Natural Birth Community is quick to say, “Don’t do it! You can do it without it! An Epidural is dangerous! It is evil and causes problems!” Mostly, this is true. You CAN do it naturally and Epidurals do come with risks to mom and baby.

There are studies, personal experiences and more that show Epidurals are a drug, has risks, and effect the mother’s body and the newborn as such. They also can slow down labor and be the beginning of a cascade of interventions. If you didn’t want  pitocin, constant monitoring, not being able to move around, etc., those options are no longer yours. Epidurals often lead to purple pushing, tearing, episiotimies and cesarean births.

That is all true.

As you can see though, I linked to information about Epidurals and their risks. I will not go over that here. This is not another blog post to tell you how horrible you are if you birthed your little one with an Epidural.

Is the Epidural always evil? Is there never a good use for one? Just like with any allopathic remedy or intervention, it is there for a reason. Unfortunately, it (the epidural and other interventions) are used far too often, when NOT necessary. This is why many are quick to say, “It’s pure evil!” What is missed though, is those times when it is needed. When it serves its purpose. When it does good. Yes, I said good.

Here are a few examples when an Epidural is a blessing to a mother.

Mom has become too exhausted. She has had a long labor and has become too tired and can not rest. In this case, an epidural may help her to get the rest she needs. Her uterus can still contract and baby can move down the birth canal. It is a better outcome than an unnecessary surgery. It would be best to help ensure mom gets adequate rest when she can during labor to prevent exhaustion from occurring.

Malposition of baby. When a baby is not in an ideal position it can cause a very painful, long labor. It may become difficult for mom to relax as baby tries to turn with the contractions. I’ve been there…twice. It’s so painful. I got an epi with one and did not with the other. Optimally, mom will do what she can during pregnancy to help baby find a great position. There are also things you can do with your midwife or OB in labor to help baby shift (hands and knees rocking, etc).

Fear. Yes, that is a valid reason for an Epidural. If a mother can not work through her fears in pregnancy and they are carried over into her labor, her uterus will not have the blood supply it needs and may not be able to work at its best. This also causes a great deal of pain. There is more information about this in the book, Hypnobirthing, the Mongan Method. Having an epidural will allow the woman’s body to do its job without her fear (mind) getting in the way. Of course it would be wonderful if all women could Birth Without Fear, but that is not the real world.

Lack of support. I truly hope all women will have the support she needs to birth so that this is not an issue. However, if she doesn’t she may find that she needs an epidural to be calm and birth.

Any situation where it helps avoid an unnecessary cesarean section.

A Cesarean Birth (instead of a spinal).

Remember, each woman, pregnancy, labor and birth are unique. I know this is not a popular view on Epidurals in the Natural Birth World, but it is reality.

Please, if you are researching Epidurals, use the links I’ve given in this post. Try to do what you can to avoid your chances of needing an Epidural.

Sometimes though, it can’t be avoided and that is OK. That is what it is there for. It is my hope that women can work through fears, have the right support and be able to avoid an unnecessary Epidural. However, the Big Bad Epidural is not always evil.

*Picture of Dale by Studio Viohl

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{ 72 comments… read them below or add one }

Monica September 9, 2013 at 1:02 am

I too am very grateful for this post. It is a post I needed at the right time. I am pregnant for the second time. I am having a singleton baby this time. My first was twins(one stillborn). I had a birth center birth with an awful midwife whom basically neglected me. I felt abandoned by her and she was overly rough. I SUFFERED with my birth and postpartum recovery. I suffered for months as well with NO pain relief options available to me. I suffered PTSD from my first birth. I was extremely traumatized to the point of mental break down even to think of becoming pregnant again. But, I knew I wanted more than one baby. I knew I had always wanted to be a mommy of more than one child. I especially wanted my twinless twin to have at least one living sibling. I wanted to try for her more than for myself to have another baby. Well, I had planned a water-birth home birth this time around. But, as my pregnancy progressed my mental state was so low that I thought I would break down. I became afraid of everything. The moment I admitted to myself that I wanted to get the epidural I felt a wave of relief wash over me. I wish I had known better options for myself during my first birth. I wish I had access to pain relief and would have been able to find respect in my birth plan. I am so thankful this time to have a doula , my mom, my husband and a highly recommended OB. He has okay-ed my birth plan and has talked with me about what feels the best options are for me. Made me feel so far that I am in control and will have a better experience this time. I won’t suffer this time. I plan to get the epidural as close to 5 cm as possible. to establish labor first. I toured my local hospitals and found one that my OB has privileges and I feel the most comfortable with. My fear isn’t completely gone but I can at least sleep at night and am finally feeling excited about my baby being here in my arms. To me natural means vaginal with or without pain meds. Thank you for this post!

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Karen March 17, 2014 at 11:27 am

Fear prompted my epidural with my first. My water broke at 35 weeks and did not repair and labor was not progressing as needed. So started pitocin – fear of all the horror stories of pitocin pushed me to get the epi – I would have ended up a section without it.

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R April 1, 2014 at 4:01 pm

I was planning on a completely natural birth with midwives, but the birth didn’t go as planned. I got to 8 cm but could not progress after that, at about 25 hours in labor, the pain was too much and baby was in distress, so I conceded to an epidural. Eventually, baby was too much in distress and I had to get an emergency c-section. Thank God for the epidural, which took away some of the pain as the midwife tried “alternative” methods to bring down my baby to avoid c-section.

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Sandy April 1, 2014 at 4:32 pm

I’m a labor and delivery nurse. I have often seen epidurals speed up labor. A woman will be stuck at 4 cm, crying out in pain, and then get an epidural. Then, because the woman can relax, she progresses to 10 cm within the hour. I’ve seen that often, although I’ve also seen them slow labor and then need pitocin. One study showed that on average, a labor with an epidural is only a half hour longer than without one. My job is to support a woman in natural or medicated labor, whichever she chooses.

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Elizabeth April 1, 2014 at 8:19 pm

Love this post! I 100% believe that a natural birth is optimal and obtainable for most women. But, there are circumstances where an epidural is truely helpful. With my second, I got an unplanned epidural at the suggestion of my midwife due to many unexpected factors. I was a VBAC, and the longer my labor went on, the more worried we became about a uterine rupture and/or a repeat cesarean. After 2 weeks of prodromal labor preventing me from sleeping more than a few hours at a time, I went into labor at 8:00 pm. After being awake for more than 30 hours and in labor for 18, my contractions were slowing and faltering, and I truely believe the epidural is what allowed me to avoid a repeat c section. I was able to sleep for about 2.5 hours, and was still able to move around a bit and get on my hands and knees, finally getting little man in the right position. On top of letting me sleep, I think it also helped me emotionally, because as the labor grew longer I became more and more fearful of another section. Knowing that things were not progressing as we had hoped and that I would have to be knocked out if I didn’t have an epidural in place if something went wrong was pretty scary. I think knowong the epidural would allow me to be awake to be in control of my son’s birth and to meet him right away helped me relax, and in turn, dilate. I wish I hadn’t had it, and if I have another I will prepare for an unmedicated delivery again, but I am confident that in the situation I was in, I made an informed decision and the risks were worth the benefits.

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Brenda April 13, 2014 at 4:59 pm

I am so glad to hear someone in the natural birth community call an epidural what it is-a medical intervention that, when used competently, and for the right reasons, can offer significant benefit to mom and baby and provide one more chance to avoid a c-section. Having 2-generation family history of first-baby complicated births, both of these precious children are autistic, I was determined not to be the 3rd generation! I accepted from the beginning of my first pregnancy that an epidural would most likely be necessary, both to provide dilation support and as a safeguard in case a high-speed emergency c-section became necessary. My pregnancy progressed beautifully until 8 weeks before my due date I began leaking fluid, which was unfortunately amniotic. I was admitted to hospital from my OB’s office and steroid injections given to speed baby’s lung development. My OB Dr on call was at my bedside within an hour and explained the plan: slow leak, let’s do everything possible to let baby cook 2 more weeks. Thanks to their excellent, attentive care I made it longer than 2 weeks before full water break at 3am, having been in hospital the entire time. Labor progressed well with help of my husband and doula, but 13 hours in I was only at 4 cm dilation, in spite of walking between contractions. My baby had descended all the way down during this time but contractions not strong enough for dilation. Epidural was given an hour later, this alone produced 2 more cm dilation in less than an hour, then a low-dose pitocin drip was started and only increased in small increments as long as vital signs for myself and baby were kept in safe range. After only a few hours I was at 10 cm and only pushed for 30 mins before I got to meet my beautiful boy! At 6 weeks premature he was small but never required oxygen, only antibiotics for an infection in the intestine. Neither of us suffered any trauma related to birth, I received 30 mins of perineal massage prior to pushing and delivered with no tearing or episiotomy needed. I firmly believe it was the APPROPRIATE use of medical intervention, including the epidural, that allowed for an excellent delivery, healthy baby and mom, and ultimately the avoidance of a c-section as there was no medical reason to utilize this option. I have had no complications whatsoever from the epidural and my son, nearly 4 now, shows no signs of autism or even negative effects from being born 6 weeks early. Thank you for having the courage to say epidural are not always bad!

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Holly August 15, 2014 at 7:05 am

With no intention to be “snarky” I would just like to encourage women to look again at current studies on epidurals during labor. There is no data that currently suggests that there is a higher cesarean rate with it’s use, and a negligible increase in length of labor ( 20-30 minutes longer) it’s important when making birth decisions without fear to have accurate up to date information from reliable, evidence based sources. It’s unhealthy to create irrational fears toward “medicalized” birth. Natural is not synonymous with better, good, or healthy. Every birth is different, presents it’s own challenges etc. I’ve read so many birth stories with unnecessary amounts of guilt or shame over their natural birth failure that they miss the beauty in their own journey to motherhood. I’ve had 2 natural births and 2 with an epidural, once I got over my natural is better indoctrination I was able to get over birth guilt and feel totally happy and empowered in my pain free births. Every woman is so different in what makes her birth experience joyful, and you can not know until you are in the midst of birthing that baby. Information is powerful and understanding that natural birth has it’s own set of risks can free your mind to assess risks and benefits in a better light.

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Mrs. BWF August 26, 2014 at 4:23 pm

Did you read the post? We too feel like every woman’s birth without fear is going to be different for many reasons! Thank you for sharing. :)

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Taryn September 12, 2014 at 1:11 am

I’m late to the game on this one, but it’s nice to read the reminder that I did what was right for me at the time. It’s hard to be in the “crunchy” world and admit that I broke down and got the epidural. I’d been in labor for so long, screaming through insanely painful contractions with a sunnyside up baby who eventually was born face down but chin up. I am grateful that although the epidural didn’t work as well for me as for most, it worked well enough when she came out forehead first that I only felt some of the tearing. It’s been difficult coming to terms with the fact that I only got it because I didn’t realize I was in transition and it was nearly over, that it probably caused my suddenly slowed labor, which led to instructed pushing (and “the hemorrhoid from hell” that hasn’t disappeared 19 months later), and the purple pushing with my legs held by nurses that drove me nuts and wouldn’t let go of them expire the fact I had full muscle control. But this reminds me – I was exhausted, the pain was insane, the tearing feeling would have been horrifying, and I needed it anyway for 2 hours of stitches. It’s nice to have outside validation.

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