How much do YOU know about Epidurals?

[DoulaFelicity]

In the interests of challenging ourselves to remain well-informed in our birthing choices, I thought it would be poignant to pause for a moment, and reflect on what we actually know about Epidurals.

What do you know about how it is administered? What the risks are? What the benefits could be? The reasons an Epidural is intended to be administered for? The effect of the Epidural on the unborn babe? Etc...

And, if you have had an Epidural, were you fully informed by your care provider? (ie: obviously, you'd be able to answer the above questions in detail if you were.) Had you done research beforehand? Were you fully aware of the impact of your choices at the time - and are you now? If not - why not?

There is a wealth of evidence based data out there. Let's share it and ensure we're all making fully informed choices and truly giving "informed consent" if we're ever faced with a situation where an Epidural becomes a possibility.

Some links to start us off:-
http://www.compleatmother.com/epidural.htm
http://www.healing-arts.org/mehl-madrona/mmepidural.htm
http://www.lalecheleague.org/ba/Nov99.html

[poshBecks]

Wow, what a thread!!

I don't know a huge amount about it, only what they tell you in antenatal classes!!
you, know how they put it in & the risks...

I had one with ds however i am reluctant to do it foer next bub as....

My girlfriend had a hysterectomy (sp?), & she'll allergic to most pain killers so they gave her an epi just to get through the worst of the pain. When they removed it she started leaking spinal fluid which left her with a constant migrane for nearlly 6 weeks ( the blood patches they did to try and fix it didn't take!). She couldn't sit up or stand very much at all!! She said it was more painful that the original op!

I know they say that this is a risk, but boy after seeing my friend like that i don't think i'd want to risk it again!! :eek: OUCH!!

[JanetF]

I'd prefer to have an epidural over a short period of time than a dose of pethidine so that's in my birth plan if I transfer to hospital. It scares me how little info we get in hospy prenatal classes so thanks to Felicity for starting this one off! Invaluable!
:D
It was info like this that helped make my decision. I'd rather risk me than my baby in an emergency scenario since an emergency is the only time I'd have drugs in labour anyway :)

The link between drugs for pain in labour and later drug addiction in the child.
http://www.acegraphics.com.au/parents/drugs/addiction.html
There is no doubt that the increasing problem of drug dependence in teenagers parallels the increasing reliance on opiate and other drugs during labour and birth. The potential link between the two is an issue that is rarely raised and it is a difficult area in which to research (especially using randomised control trials), given that they are expensive and require long-term commitment. There may also be an unwillingness to face the possible unpalatable truth that obstetric practices may be harming our children and that women are being misled into thinking that drugs given during labour have no long term effects for their baby.


Narcotic (Opiate) Drugs
Pethidine (demerol), Morphine, Heroin (diamorphine)
http://www.acegraphics.com.au/parents/drugs/drugs.html
Pethidine.
Effects on the baby
Advantages: None.

Disadvantages:
1. Pethidine crosses the placental barrier and depresses the baby's respiratory centre. This will cause breathing difficulties for the baby if it is born when the drug is at a maximum dosage in its system (between 1 and 3 hours after the injection).
2. An antidote to counteract the depressive effects on the baby can be given but this gives only temporary relief and the baby may still suffer breathing difficulties when the antidote wears off after a few hours.
3. Increased likelihood of jaundice as the baby's immature system works to eliminate the drug (and its antidote, if given). It may take 4-5 days for the baby to eliminate most of this drug from its system.
4. Separation of mother and baby if these problems are severe.
5. Difficulties establishing breastfeeding due to a depressed suckling reflex.
6. Research has demonstrated a potential link between exposure of some babies to pethidine during labour and their later development of an addiction to opiate drugs as teenagers.

[rynosmum]

I'd prefer to have an epidural over a short period of time than a dose of pethidine so that's in my birth plan if I transfer to hospital

I wasn't intending on having any drugs at all although had a fairly fast labour and was fully dilated before my OB found that bubs still wasn't engaged and still was in posterior (even after all of my gymnastics trying to turn him for the previous few weeks :D )

I started pushing involuntarily but I asked for the Epi as the OB explained that there was going to be some intervention to get bubs out. I actually adore my OB and midwife as they were incredibly supportive and wonderfully informative and patient. I also chose against Pethidine due to the risks directly to bubby.

I'm glad I had the Epi (even though the risks were all explained) due to the intervention required. The delivery had to be sped up as bubs had the cord around his neck twice and his pulse dropped dramatically over a couple of contractions. I only had the epi in for 45 mins or so and was able to get up and walk around after bus was delivered.

And, even referencing another thread you have started Felicity, even with an epi, I still felt that wonderful feeling of intense excitement and blissful peace after the birth of my little boy. Even an hour later, I was telling hubby that I'd be more than happy to do it again in an instant. DS took my breath away at his birth and he continues to do it - every single day. :D

[tickle]

I researched epidurals on the net as I found the information given at ante natal classes insufficient.
My DS was induced and posterior and in the end I had the epidural, it was in for about 1.5hours. I absolutely agree 100% with JanetF about the pethidine. At least the epidurals effects on the baby are not so significant. I'd rather something happen to me than my baby any day!
I am going to do everything I possibly can to avoid an epidural with this baby, but if it came down to the pain I had with my DS, I would have another one.

[3timesaMum]

When I was pregnant with my first I decided after much research that I would NOT have an epidural under any circumstances. I maintained this view with bub#2 and managed to survive a very painful delivery yet again. But with bub #3 things changed and my resolve soon went out the window. My body had the urge to push which I proceeded to do after the midwife had examined me and told me I was ready. It wasn't until the obstetrcian examined me and found that I was only 8cm and that I had to now stop pushing! Easier said than done!! But bub#3 was stuck pretty fast and her head was starting to "cone". I tried using just the gas and breathing through the contractions and hoping that I would finally fully dilate but that didn't happen. I was given pethidine which had absolutely no effect on me whatsoever. My obst could see that I was in extreme pain and recommended an epidural. My husband was concerned as he knew what my feelings were on this. At the time (and after hearing that theatre was on standby for an emergency caesar) I agreed to the epidural in the hope that it would settle my body and finally allow me to fully dilate. After the epidural had been inserted I was actually able to manage a smile for the first time in nearly 15 hours. The epidural was in for about an hour with syntocin to help things along and after only 2 relatively easy pushes our daughter arrived. I admit that I was extremely scared to have the epidural and for what some of the after effects are but I was up and walking around 2 hours later feeling fine. I had an excellent team with me and would recommend listening to your obst (he/she knows best). I do not regret having the epidural - I am grateful that it saved me from an emergency caesear - and am happy to report that bubby is doing fine!

[Mummabear]

YAY, YAY, YAY.

I'm SO glad to see that you have started your own thread in the hope of getting your message out there. That was only ever the point I was trying to make in other threads. Good on you. Isn't it so much nicer to be able to have nice discussions about what you want to share :).

I was planning on a totally natural birth - no gas, no epi, NO PETHIDINE (very fixed on that one!!!) and as little medical intervention as possible. When I was 8 days overdue they gave me the option of rupturing my membranes and getting things started. I really was very naive about this and not very well informed - all I knew was that I wanted that baby out of me. Long story short, nothing happened for over 24 hours and I ended up being induced with the drip. This brought on the most intense pain I have ever experienced in my life. I attempted to go with my drug free plan for as long as I could, but my contractions came on so hard and so fast that they were just one constant peak within less than 15 minutes. I was totally out of it - my body hadn't had enough time to build up and release endorphines to get me through because it was thrust into the pain so quickly. I honestly thought I was going to die (I knew I wasn't, but YKWIM :p ). DH convinced me to have the epi - he was beside himself seeing me in that much pain. I kept holding out until I couldn't take it anymore and then burst into tears at the thought of having an epi. But I relented when bubs showed signs of stress. Once that epi kicked in I had the most wonderful birthing experience I could have ever hoped for. I was calmer, I could feel past the pain and focus on DS moving through my birth canal (I actually felt him slide the entire way down), and my midwives were so in tune with me and so good at their job that they timed my top up so that I was able to feel everything invovled with pushing him out.

Even though I had no intention of having an epi, I had read up on them extensively as I realised that things often don't go to plan. I am so happy with the decision that I made as it allowed me to have a wonderful birthing experience instead of what was gearing up to be a traumatic one. Knowing what I do now, I will avoid induction next time unless bubs tells us otherwise, and I will once again aim for the drug free birth - but I will not be afraid to ask for that epi should I feel that I need it.


DS took my breath away at his birth and he continues to do it - every single day. :D

Rynosmum - this is the most beautiful thing I have ever read. I hope you don't mind if I quote you in future. It brought a tear to my eye. Oh, it's so true.