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There are a few ways your OBGYN provides pain relief during child birth, but one of the most common ways is an epidural. An epidural is where a needle is inserted into the space around the spinal cord providing pain relief around the abdomen and back. It allows you to feel pressure during birth, and to still be able to push, with a reduction in pain level.
A Cochrane review of 40 RCT’s showed that epidurals reduced pain by 20-30% on average. This review also showed that epidurals do not increase your risk of having a c section, though several other studies have found that they do. In summary, it is inconclusive if Epidurals increase your risk of C Section or not. Benefits of having an Epidural -pain relief -allow your body to rest and sleep if you’ve had a long labour -tends to be safer than injectable opioids Risks of Having an Epidural: -1 in 8 people find it doesn’t provide adequate pain relief -increased risk your doctor recommending other medical interventions (pitocin augmentation, fetal monitoring, iv fluids, bladder catheter, mobility restrictions, forceps or vaccuum use) -longer pushing phase -difficulty moving your legs, often meaning you can’t utilize other birthing positions -side effects like itchy skin, nausea, urinary retention, severe headache, decreased respiration, drowsiness, numbness or tingling in the back -higher rate of the following: abnormal fetal heart tones, low APGAR score for baby, baby being born with with trouble breathing or poor muscle tone, and difficulty with breastfeeding/chest feeding. Overall, the higher the dose, the higher the risk of side effects. You can request your doctor start with a low dose epidural to reduce your risk. Alternatives to an Epidural:
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Close your eyes and think about how your body is positioned when giving birth. Were you laying on your back, with your legs in stirrups, and the doctor at the end of the bed delivering your baby? This is super common, and is what is depicted in movies, but that doesn’t mean it’s the best way to give birth! Research actually shows this is one of the more dangerous positions to be in during birth for several reasons. Laying on your back reduces the opening of the pelvis, and does not work with gravity. This means there is less momentum downwards, and less room width-wise for baby to come out. This makes it more likely for baby to stop progressing during labour, meaning there is increased risk of pitocin induction, the use of vacuum or forceps, and many other interventions. Evidence continues to show that upright birth positions are more beneficial in numerous ways, yet hospitals still recommend mums lie on their back. We think this is because it is more convenient for the doctor to deliver baby, and there usually isn’t any training provided for upright birthing positions during OBGYN residency. So doctors probably feel less confident in aiding a mom giving birth in any position other than laying on her back. What is so good about upright birthing positions?
*There are reasons you should not give birth in an upright positions, and this might include a high dose epidural, along with other reasons. Always discuss with your practitioner.  |
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