The Truth About Epidurals
There are two kinds of mommies: the ones who take epidural during childbirth and the ones who don't. Epidurals are often hailed as the golden standard of childbirth pain relief. Today, they are by far the most popular method of pain relief during labor. Getting an epidural means that a local anaesthetic is injected into the epidural space (the space around the tough coverings that protect the spinal cord). Epidurals block nerve signals from both the sensory and motor nerves, which provides effective pain relief, but immobilizes the lower part of the body.
So, let’s clear some myths about epidurals, shall we.
1. Myth: Epidurals slow down labor
Reality: Epidurals do not slow down labor. This is one of those myths that have a life of its own. Three of the last four studies of this issue published during the last six years show that epidurals and spinals given early on in the course of labor (before the cervix is four centimetres dilated) actually speed up labor. The fourth study showed that there is no effect between giving the epidural early or late.
Bottom line: There probably isn’t much of an effect of epidurals on the duration of labor and certainly no reason to believe that it slows things down.
2. Myth: It’s difficult to push if you have an epidural
Reality: With today’s “walking epidurals”, the mother-to-be is able to feel the pressure of the contraction, but not the pain, so she can push in relative comfort. By using patient-controlled epidural analgesia (PCEA), the laboring woman can push a button to give herself her own doses of epidural medication. This way, she is in control, and is able to “fine-tune” the degree of pain relief she wants.
3. Myth: Epidurals lead to C - Sections
Reality: Although epidurals are associated with caesareans, they do not cause them. What does this mean? It means that women who are more likely in need of a caesarean, for example, if they have a large baby and a small pelvis, will more likely get an epidural because they will be in a lot of pain. However, the epidural itself is not the reason for the caesarean.
4. Myth: Epidurals make it more difficult to breastfeed the newborn
Reality: They do not. In fact, the opposite is true. When a new mom is rested and pain-free after the delivery, they are more likely be able to fully concentrate on their new-born than if they were to be experiencing pain. If someone has a delivery that is associated with a lot of pain afterwards (e.g., a caesarean, or a difficult vaginal delivery that causes tearing of tissues of the vagina and perineum), post-partum epidural analgesia can relieve all their pain without causing drowsiness and enable the new mom to walk around effortlessly. On the other hand, a new mom experiencing moderate-to-severe pain after delivery may need to use a narcotic to relieve the pain. This will make her sleepy, make the baby sleepy (the medication will be passed through the breast milk) and won’t even relieve the pain.
5. Myth: There is a window of time when an epidural can be given – not too early, not too late.
Reality: Epidurals can be given at any time from zero centimetres cervical dilation all the way to ten centimetres. Unfortunately, this myth, which is still believed by many women and obstetric care providers, has resulted in considerable suffering for many women. Many women (and obstetric practitioners, for that matter) still believe that there is a window of time during which an epidural or spinal may be administered. The myth is that if epidurals or spinals are given before 4 centimetres cervical dilation, they will slow down labor. In fact, recent studies have shown that if given early, epidurals and spinals can actually speed up labor. The bottom line is if a woman wants pain relief, she should get it, regardless of her cervical dilation.
6. Myth: The pain of labor isn’t all that bad, and anyway, it’s only temporary
Reality: There can be long term psychological consequences of unrelieved pain. Many people have the attitude that pain is just a “natural” part of childbirth –something that should simply be accepted. The story goes something like this: Labor pain, although it may be quite severe, is at worst only a temporary nuisance. Tolerate it and it will pass. After all, medications like morphine and procedures like epidurals have come around only quite recently, and it isn’t as if women women didn’t always experience painful childbirth? However, it turns out that pain may have many harmful effects on the mother and even on the baby that can last long after delivery. Serious psychological illness such as postpartum depression and even post-traumatic stress disorder (PTSD) may be more likely to occur in women who experience painful labor and deliveries. And you may be less likely to come back for seconds or thirds.