epidurals during child birth: an overview

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:

1. Opt out of the epidural at the start of labour, and only request it when/if you deeply need rest from the pain.
2. Ask your OBGYN about alternatives to an epidural, and what their risks and benefits are specific for your case.
3. Use a birth ball to open and relax the pelvis, which can help reduce pain by getting yourself and baby in a different position.
4. Try other birthing positions, allowing your body to move in a way that feels natural, which can reduce pain.
5. Have your birth partner apply counter pressure (pressure applied to your lower back during each contraction). 
6. Learn more about hypnobirthing during pregnancy so you can utilize it during labour. You can join a small group, online community, check out Youtube videos, or listen to hypnobirthing audiobooks/podcasts.

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