Explanations Why Women Don’t Always Want Epidurals

 

Epidural for Labor and Birth

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She Doesn’t Want to Be Numb. For some mothers, they aren’t worried about the actual procedure, but they don’t want to feel numb. This may lead them to other medications like IV narcotics or they may choose to do without medications at all. Epidurals can cause a sudden drop in your blood pressure.

Your blood pressure is monitored throughout your labor and delivery to ensure adequate blood flow to your baby and throughout your body. If. Epidurals are extremely common and extremely helpful for a lot of different reasons.

If you don’t want one, that’s totally fine, but if you do, don’t feel like it somehow makes you weak. It doesn’t. Labor Hurts and I Don’t Want to Feel It.

Easing pain from contractions usually tops the list when it comes to reasons for choosing an epidural. Women understand that labor is going to hurt, but many choose to minimize the pain of labor and an epidural is good option for that. Reasons for epidurals not working can include catheter placement, patient expectations and low pain thresholds. Perhaps the last one could apply to me.

But it was not the case that the epidural worked a little bit. It didn’t work, full stop. Around 61% of women get an epidural or spinal anesthesia for pain management during labor—and research shows epidurals don’t work 12 percent of the time. That’s usually due to the placement of the. For these reasons, doctors usually recommend the use of an epidural nerve block when a woman chooses to get anesthesia during childbirth.

Side effects include a. Finally, one of the biggest reasons why some women skip the epidural is that it feels “unnatural”. After all, throughout history, women haven’t been giving birth without the discomfort of labor. This is a rather new trend of the 21st century.

However, all of this is in the eye of the beholder. Epidurals have been around for almost a century, but they exploded in popularity in the ’70s. Today, they’re the most common choice for. Failure of epidural to provide adequate pain relief is low.

Published data most likely overestimates it. In the vast majority of laboring women epidurals result in excellent pain relief. Epidural that is not functioning properly is one of the most frustrating situations for obstetric anesthetists.

List of related literature:

the woman’s perineum and may not be an option for women with epidural analgesia.

“Foundations of Maternal-Newborn and Women's Health Nursing E-Book” by Sharon Smith Murray, Emily Slone McKinney
from Foundations of Maternal-Newborn and Women’s Health Nursing E-Book
by Sharon Smith Murray, Emily Slone McKinney
Elsevier Health Sciences, 2017

N Epidurals almost always cause a dramatic drop in blood pressure (hypotension), so women who will be given an epidural are first loaded with IV fluids to lessen the fetal distress involved with hypotension.

“Birth Matters: How What We Don't Know About Nature, Bodies, and Surgery Can Hurt Us” by Ina May Gaskin, Ani DiFranco
from Birth Matters: How What We Don’t Know About Nature, Bodies, and Surgery Can Hurt Us
by Ina May Gaskin, Ani DiFranco
Seven Stories Press, 2011

Many women who assume in advance that they will want an epidural find in the moment that this kind of emotional and physical support helps them flow with the rhythms of labor and realize they do not want this flow interrupted by the administration of drugs.

“Birth as an American Rite of Passage: Second Edition, With a New Preface” by Robbie E. Davis-Floyd
from Birth as an American Rite of Passage: Second Edition, With a New Preface
by Robbie E. Davis-Floyd
University of California Press, 2004

Because they require a larger dose of the anesthetic than an epidural, and therefore carry greater risks, caudals have largely been supplanted by epidurals.

“The New Harvard Guide to Women's Health” by Karen J. Carlson, Stephanie A. Eisenstat, Stephanie A. Eisenstat, M.D., Terra Diane Ziporyn, Alvin & Nancy Baird Library Fund, Harvard University. Press
from The New Harvard Guide to Women’s Health
by Karen J. Carlson, Stephanie A. Eisenstat, et. al.
Harvard University Press, 2004

These fetuses may also benefit from the improved uterine blood flow and controlled delivery that epidural analgesia allows.

“Hacker & Moore's Essentials of Obstetrics and Gynecology E-Book” by Neville F. Hacker, Joseph C. Gambone, Calvin J. Hobel
from Hacker & Moore’s Essentials of Obstetrics and Gynecology E-Book
by Neville F. Hacker, Joseph C. Gambone, Calvin J. Hobel
Elsevier Health Sciences, 2009

Women are very often given no indication of the rate of risk associated with having an epidural for pain relief in labour.

“Midwifery: Preparation for Practice” by Sally Pairman, Sally K. Tracy, Carol Thorogood, Jan Pincombe
from Midwifery: Preparation for Practice
by Sally Pairman, Sally K. Tracy, et. al.
Elsevier Health Sciences, 2011

The woman may feel safer there or wants the reassurance of knowing that an anaesthetist is on hand if she chooses to have an epidural.

“Becoming a Midwife in the 21st Century” by Ian Peate, Cathy Hamilton
from Becoming a Midwife in the 21st Century
by Ian Peate, Cathy Hamilton
Wiley, 2013

Factors that predispose a woman for a spontaneous epidural hematoma include an abnormally low platelet count, hypertension, a clotting disorder, vasculitis, anticoagulant use, and the Valsalva maneuver.

“Labor and Delivery Nursing: Guide to Evidence-Based Practice” by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
from Labor and Delivery Nursing: Guide to Evidence-Based Practice
by Michelle Murray, PhD, RNC, Gayle Huelsmann, BSN, RNC
Springer Publishing Company, 2008

If the woman chooses either epidural or spinal anaesthesia for labour and birth, the woman and midwife need to be aware of the possibility of the symptoms of pelvic girdle pain being masked and excessive mobilization of the joint, causing increased pain during the postpartum period.

“Mayes' Midwifery E-Book: A Textbook for Midwives” by Sue Macdonald
from Mayes’ Midwifery E-Book: A Textbook for Midwives
by Sue Macdonald
Elsevier Health Sciences, 2011

It is for this reason, supported by logic rather than evidence, that we discourage the use of epidural anaesthesia because, at least in cephalic babies, this increases the need for traction in the form of instrumental birth.

“Munro Kerr's Operative Obstetrics E-Book” by Sabaratnam Arulkumaran, Michael Robson
from Munro Kerr’s Operative Obstetrics E-Book
by Sabaratnam Arulkumaran, Michael Robson
Elsevier Health Sciences, 2019

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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19 comments

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  • Quick question. My husband would prefer I have a natural childbirth, where I know I’m a suck when it comes to pain.  As much as I don’t like needles, I feel that a epidural would be the best option.  What should I do? Does he have a say in that, or no since I am the one going through labor! thanks =)

  • I’m hoping to go natural, I have a very high pain tolerance and can manage it quite well with breathing and such… I’m about 21 weeks now but still terrified lol

  • I had a natural birth as a first time mom, even after 21 hrs of hard labor. However, I completely understand why people get the epidural. No shame in it!

  • Can you please reply back or anyone?
    What if your doctor does an episiotomy without your consent and also didnt even make sure you were numb and also the baby wasnt even in distress or stuck. (I have the doctor notes). I lost so much blood from the cut that I went to ER 4 days after having my baby and I was 1 point away from a blood transfusion. The doctor didnt even ask for permission or let me know that he was going to put his whole arm inside me and then proceeded to stitch me up without even making sure I was numb & I overheard him telling a nurse that I had an episiotomy and when i got discharged they had no instructions on how to care for it and when I saw another obgyn she told me how yo take care of it and to do sitz bath and it honestly has affected me so much it made my post partum depression worse and i also started seeing a counselor. What should I do?

  • Please can you make a video on breathing technics, that would be very helpful..my due date is 10th feb…and i would like to learn from you.I love to watch all your videos.

  • This is my first pregnancy. Still have a ways to go only 14 weeks but I am not quite sure if I want an epidural or not. I will probably decide the day of but I like to be informed. Thank you for your videos!

  • So I completely passed out when I was given my epidural. My question is is it safe to get another one in the future or should I just do natural. I didn’t want an epidural to begin with but I had to be induced at 33 weeks because of PROM and I had a placental abruption. The Dr told me I had to get an epidural bc at any point I could need a C-section.

  • honestly, i hope i have a nurse like you. my OB is a little rough around the edges so having someone with your gentle, educational, energy would be so helpful!

  • when my mom gave labor to 3 boys, and had difficulty with the 3rd, she didn’t opt for any epidural. What are the long term effects? My cousin, who is my age, has opted for epidurals and is now suffering from severe back pain. What studies have been conducted on the long term effects, & safety of what you are doing?

  • Then how can I tell my hospital i don’t want to deliver on my back I did that 4 times already and I always dred it they always tell me to lay back when it’s time to push

  • Hi guys did any body feel like water was running down your leg while getting the epidural i don’t remember feeling this with my first 2 pregnancies???

  • Ok am not yet but what if you had fun with your husband and after all the fun it doesn’t start to hurt but or itch when I open the bottom of my garden it hurts even when wiping just the little touch on it and it feels like little needles in on it could I have rip it when having fun with my husband?

  • You made me feel so much better. I’m due in two weeks and this has been my biggest fear. My friend had her baby last week and she had a 4th degree tear and that horrified me. Although I’m opting for epidural, I don’t prefer to give birth on my back. Thank you so much.

  • epidural cost more and is the preferable option which the doctors prefer to give you (2000$)
    I had totally natural hospital birth (1st baby) with no drugs and I survived. don’t be scared of birth it’s natural proces.

  • This video alone has basically confirmed without a doubt that if I’m low-risk I’m delivering out-of-hospital with a midwife. Its true, you all are well-trained in normal birth.

  • Whether FDA approved or not, Medicaid paid for these injections. The first one I had @ L5 S1 worked but only for a couple weeks. You have to wait 3 months before getting any more. I just had my second injection 2 weeks ago this time @ L4 L5 so far so good, pain level was 4-5, now is 1 2, (I have 4 bulging lumbar disks), I continue with PT as well

  • I’m all for natural stuff but I had to do things differently as my baby had the cord tight around his neck…you make it sound rare but I know many ppl who had situations like this. It’s great to be natural and encourage moms to trust their bodies to do what it needs to,but this advice seems a little dangerous on how it was shared.

  • In order for a woman to give informed consent to epidural risk vs benefit she should research it herself on site such as PubMed, Cochrane/Wiley Library, Evidence Based Birth…not wait until she is in labor, fearful, contractions very strong…or induction process is going on…educate yourself, know the facts, be informed…completely.

  • Since I had an episiotomy, if I were to have another baby vaginally, would I have a more likely chance of tearing on that scar tissue? Like a second or third degree tear?