There is nothing on earth I am more afraid of than needles.
My fear is slightly on the irrational side, and it is deep-rooted: the four-year-old version of me kicked a doctor and had to be held down by several nurses to receive a routine vaccination.
I realize there are few people who like needles, but I would honestly rather break a bone than get a flu shot.
So when confronted with the choice of whether to get an epidural during my daughter’s delivery, all I could imagine was a horse tranquilizer needle being jammed into my spine (along with an array of horrific side effects that you could only see in an episode of “House”.)
I had avoided doing much research on having an epidural for one reason, and one reason only: I’m a giant wuss. Just watching a video on how they perform an epidural still makes me want to crawl out of my skin.
Maybe your fear is not so much the about the needles: you may be worried that with medication, you won’t get the full birth experience. You may not like the idea of anesthesia or the potential of side effects.
Don’t make the same mistake I did, and go into the delivery room completely unprepared. If you are going to have an epidural, you should know as much as you can about the risks – and what you shouldn’t worry so much about.
The word “epidural” refers to three types of procedures used for pain relief during labor: the epidural block, spinal block, and combined spinal-epidural anesthesia (or CSE). “Epidural” also describes the space around your spine where the medication is injected.
Epidurals are the most well known and widely used forms of pain relief: according to the CDC, around 61% of American women choose to have an epidural during childbirth. It is usually given when a woman is approximately 4-5 centimeters dilated.
The CSE, or “walking epidural”, is becoming increasingly popular. Since it uses the least amount of medication, it is safer and more efficient than an epidural or spinal alone. There are typically three types of local anesthetics used: bupivacaine, chloroprocaine, and lidocaine. These are usually combined with an opioid or narcotic, so less of a dosage of anesthesia is needed.
Though epidurals are regularly used in C-sections as well as in repairing episiotomies, the epidural is a very common method of pain relief used during and after many other types of surgeries as well.
- If you have blood issues: if you are on blood thinners, have low platelet counts, a blood infection, or issues with excessive bleeding.
- If you are hemorrhaging or in shock, these medications cannot be given.
- If you have an infection in or on your back.
- If the last stage of labor is moving too fast, there is a slight chance that there won’t be enough time.
What Could Go Wrong?
As with any form of anesthesia, there are potential side effects and risks. Since procedures vary between different hospitals, make sure to check with your doctor beforehand to find out what type of epidural and medication you’ll be given.
The most common side effect of an epidural is a sudden drop in your blood pressure. To make sure there is enough blood flow for your baby, your blood pressure will be monitored throughout and after having the epidural. If a blood pressure drop does happen, it is treatable; a combination of IV fluids, medication, and oxygen may be used.
Other possible (but temporary) side effects include:
- Soreness at the injection site
In rare cases, you could get what is known as a “spinal headache”: a severe headache resulting from medicine leaking into your spinal fluid. Even more rare possibilities include nerve damage, infection at the injection site, slowed breathing, seizures, or even death.
Don’t let any of these possibilities send you running away from relief, however: according to a U.K. study, you have about a 1 in 80,000 chance of suffering permanent damage from having an epidural. Since you have more of a chance of winning big on a scratch-off ticket than something going wrong, don’t worry too much that a serious complication will occur.
Why I Changed My Mind:
I told myself I was going to “tough it out” and deliver my baby without any help from drugs – but that’s easy to say before you’re actually in labor.
What wasn’t easy was seeing how scared my husband was after seeing me in the worst pain I’ve ever felt for 9 hours.
While I still wasn’t really into the whole “shot in the back” thing, I decided it was going to make things better for everybody if I quit being so stubborn. I can never thank my nurse enough for these words: “You don’t get a ribbon from the hospital if you deliver without an epidural.” After 9 hours of trying to avoid it, I made what was literally a painful decision – and found out it wasn’t anywhere near as bad as I thought it’d be.
A few things I learned from my experience:
- It’s a lot less invasive than I had believed. I had pictured a metal version of a chopstick jutting dangerously out of my back for hours on end. In reality, the pain medication came through a catheter: a tiny, flexible tube about the same size as a pencil lead.
- The needle itself is only about 4 inches long and even thinner than the catheter. Parents.com compares the width to “a thick piece of hair.”
- I thought the process was going to take at least an hour. In reality, the whole procedure only took about 5 minutes – and maybe ten more to start feeling some relief.
- I thought I would be “all doped up”. It turns out, you are completely awake and alert with an epidural – and it doesn’t leave you so numb you can’t push. There is evidence that suggests having an epidural will prolong the pushing part of labor, but since I had no point of reference, I didn’t feel that it made anything more difficult.
- I was worried the medicine would affect Maxine. While some of the drug does reach the baby, it is only a very tiny amount. Research is always ongoing, but to date, there have been no reported cases of babies being affected by the medication in an epidural.
Here’s how the whole thing will go down: An IV should be administered 1-2 hours before active labor begins, and is always used during an epidural to deliver medication as needed.
- You will be asked to either sit up, or lie on your left side (I was sitting up, and remember being held tight by a lovely nurse that didn’t seem to mind me soaking her scrubs with my Fear Tears). If you’re sitting, try to do your best “Hunchback of Notre Dame” impression: pull your stomach inwards and hunch your spine out. If you’re lying down, you’ll be asked to pull your knees up to your abdomen and arch your back out. This may feel pretty awkward and vulnerable – and that is totally normal. Don’t worry – you won’t have to stay like that for very long.
- An anesthesiologist will find the best spot on your back to put the catheter, mark it, and clean the area.
- You will be given a small injection to numb the area (this was the worst part for me – but the tiny needle prick turned out to be a nice distraction from the unimaginable pain of labor).
- The catheter will be injected where the doctor has marked, and the needle used to inject it is carefully but quickly removed.
- The catheter is taped in place. The doctor may give you a small “test dose” to ensure there will be no complications. The medication can be adjusted as your labor progresses, and turned down or even off once it’s really time to push.
Things Don’t Always Go As Planned.
Sometimes, you won’t be able to go with your original birth plan – and that’s okay! I thought I would be way more disappointed in myself that I had “help” with delivering Maxine, but I don’t regret my choice at all.
My husband said my whole demeanor was like “night and day” before and after having the epidural; it made everything so much easier. I was able to focus less on the pain and more on pushing.
I don’t feel at all like I “missed out” on any part of the birthing experience: since I avoided the worst parts of it (by not experiencing the worst of the pain), I got to experience the best parts of it. My husband and I were even joking around by the time they were sewing me up.
Don’t worry about “not being tough enough,” either. I found out through my experience that having an epidural is no reflection on your character (or your ability to withstand pain). Nobody will judge you for choosing not to suffer.