Many childbirth stories from women in our culture reflect an "inconceivably painful" labor and delivery experience. If you have ever discussed childbirth with your mom, aunts or friends, it is likely that you have heard these stories first hand. You may have even been encouraged to get an epidural as soon as labor contractions start to “control” the pain. Even when a laboring couple has attended birthing classes to learn more about laboring comfortably, they find it difficult to recall what was taught without the help of labor support; support that cannot always be provided by medical staff due to their obligations to multiple patients.
In our country, women are often unaware of the side effects that epidurals impose on the mom and the baby. In addition, their perception of pain in labor has unknowingly been shaped through avoidable circumstances occurring in a majority of our childbirth experiences, e.g., the common use of pitocin for starting and progressing labor (increases pain significantly). Ways to avoid these many times unnecessary circumstances are infrequently taught. Without this counsel, a woman and her birth partner are left unaware of the applicable techniques that can turn contractions into tolerable rushes that help progress labor in a sustainable fashion, consequently allowing the laboring mom to delay pain medication for as long as possible to minimize the side effects and to give their baby protection from a harder, lengthier labor.
Here are some reasons to consider delaying epidural use for as long as possible (or avoiding it if desired):
- An epidural restricts you to your bed limiting mobility, which can lead to the baby being in a posterior position (or other malposition) in up to 20% of babies. A lack of mobility also can cause a failure to progress at any stage of labor, a need for more pitocin and a possible cesarean outcome. (Click here to learn more about pitocin vs. oxytocin.)
- Up to 50% of moms who received an epidural have a drop in blood pressure. When a mother’s blood pressure drops, the baby can easily go into fetal distress due to receiving less oxygen and the resulting drop in their heart rate. Possible interventions to treat these symptoms are an increase in fluids to try to control the blood pressure or c-section to deliver the baby.
- Up to 24% of moms develop a fever, which can then elevate the baby's heart rate and cause fetal distress. The longer an epidural is used, the higher the risk.
- A bladder catheter must be put in place with the long term use of epidurals. A full bladder can prevent cervical dilation in labor as well as the decent of the baby into the pelvis. It can also cause infection and postpartum bladder problems.
- There is an increase chance of bladder incontinence by almost 15%. It also can increase the time it takes to regain normal bladder function by up to 3 months.
- Shivering (30%), nausea (33%) and itching (8-100%) are all side effects that detract from the mom's comfort and her experience during the first moments with her newborn baby.
- You are 10% more likely to experience back pain post delivery.
- It is possible that you may experience incomplete pain relief where a segment of the body does not numb to the pain.
- Studies have shown the first stages of labor to be lengthened by up to 4 or 4 1/2 hours. Moms are three times more likely to need pitocin to continue laboring. If these first stages continue to stall, the mom may require a c-section delivery for failure to progress. (Pitocin poses even more possible side effects for the mom and the baby. Click here to read more.)
- 22 out of 24 studies showed an increase risk of instrumental deliveries with forceps or vacuum extraction
- There is an increase risk of episiotomy.
- Studies show an increased length of up to 55 minutes in the pushing stages of labor.
- Studies show 2-3 times increase in cesarean rate with moms who received epidurals. C-section side effects on baby may include respiratory distress syndrome and other impacts of surgical birth. C-section side effects for mom include infection, increased bleeding, longer postpartum stay, longer healing time needed, possible anesthesia effects, more postoperative pain and possible impact on future pregnancies.Resources for statistics: Leighton, B.L., and S.H. Halpern. 2002. The effects of epidural anesthesia on labor, maternal, and neonatal outcomes: A systematic review. American Journal of Obstetrics and Gynecology 186: S69-77. Lieberman, E., and C. O’Donoghue. 2002. Unintended effects of epidural anesthesia during labor: A systematic review. American Journal of Obstetrics and Gynecology 186: S31-68. † Mayberry, L.J., D. Clemmens, and A De. 2002. Epidural analgesia side effects, co-interventions, and care of women during childbirth: A systematic review. American Journal of Obstetrics and Gynecology 186: S81-93.“Epidural Anesthesia in Labor: An Evaluation of the Risks and Benefits” by Thorp and Breedlove, Birth, June 1996. This was a literature review article, which summarized the results of numerous studies involving thousands of births. Other information from: Pregnancy, Childbirth, and the Newborn by Simkin, Whalley, and Keppler (2001 edition). Maternity & Women’s Health Care by Lowdermilk, Perry, and Bobak (6th Edition, 1997). Family-Centered Maternity and Newborn Care by Celeste R. Phillips (Fourth edition, 1996). “Epidural Epidemic” by Dozer and Baruth, Mothering, July-August 1999. “What no one tells you about Epidurals” by Penny Simkin; “The Cascade of Interventions” by Pam England; and Epidural’s Effects on Babies” by Beverley Lawrence Beech, in Mothering, March-April 2000. “Epidural Express” by Nancy Griffin, Mothering, Spring 1997; “So you Want an Epidural” website by Kim James;.this material was excerpted from an article by Janelle Durham