top of page
  • Writer's picture Suzanne Fowler Evans

Five Questions Challenge about Epidurals 🙂

Five Questions Challenge about Epidurals 🙂

Having an epidural is the answer to many a woman's prayers when they are in labour and for many of us thank goodness for modern medicine 👏🏻 Some women have put an epidural on their birth preferences and others think they will have one only if they feel it is necessary when they are experiencing labour, others are adamant they will not have an epidural. The funny thing is you just never know, if you go into labour spontaneously and don't have time for an epidural although you were planning on having one or if you said absolutely not before labour started and 24 hours later you are having second thoughts you will be in good company - my anecdotal evidence is that about 60% of women have an epidural at some point during their labour.

For that reason I have pot together 5 questions to ask when you are planning an epidural.

If you are contemplating an epidural these are the 5 questions I think are worth asking 🤔

Q1 Will I still be able to use some gravity positions once my epidural has taken effect❓

The old fashioned epidurals, ones that your mother might have been offered, worked more like a spinal block i.e. would numb you from your nipples to your knees and therefore you had very limited movement or feeling. The more modern version of an epidural is normally better managed, once you have had the epidural sited you can then manage it yourself, either via a pump or your midwife will work with you to help you get just the right amount of pain relief. These are called low dose epidurals, if you discuss with your midwife and anesthetist what you are hoping to get from your epidural, for instance you might want to still be able to at least maintain some gravity positions such as leaning over the end of your bed, make sure they understand this and will then they can work with you and manage your expectations.

Q2 Will I need to have a catheter

Normally yes, a catheter comes hand in hand with an epidural as a rule. Once your epidural has taken effect the catheter is inserted, this should be a pain free experience and does allow you to have one less concern as you don't have to think about emptying your bladder every hour or so. On the other hand a catheter can feel like another restriction to your movement and it may be something that you were hoping to avoid. If you would prefer not to have a catheter, talk this through before you have your epidural and discuss the possibility of seeing how you do without one. If you have enough feeling to know you need a wee and can be supported to do so then you could get by catheter free.

Q3 How will my baby be monitored during labour❓

Generally once you have an epidural in place you and your baby will be monitored using the CTG straps. These are an effective way to keep an eye on your contractions and how your baby is doing, especially when you can't really tell how strong and how close together your contractions are getting. The main problem with this style of monitoring is that as your baby rotates, the heart beat can keep disappearing out of range which can be unnecessary alarming and distressing for everyone. They are also really restricting and most women being monitored in this way will be in a semi recumbent position which is not ideal if you are trying to promote a vaginal birth. So before you have your epidural discuss how you will be monitored and as you have already established that you want to be able to use at least a bit of gravity, can you have the mobile or telemetry monitoring. You could also consider a fetal scalp monitor if you have a very active baby who is proving difficult to keep tabs on.

Q4 Will I be able to feel to give birth to my baby❓

This question comes up a lot when women are thinking about having an epidural, the reason being that if you cant feel to push when your baby is being born you are more likely to need some help, be it an episiotomy or ventouse (forceps can be used but I would like to think only if your baby also requires a bit of repositioning). That is why you want to ensure that your midwife works with you and allows the epidural to start to wear off about an hour before you are going to move from active labor to the birth of your baby. Contractions might start to feel quite intense so some entonox (gas and air) could help you through this stage but if you can feel to push your baby out you are much less likely to have assistance or suffer undue perineal trauma. The actual birth of your baby is also a feeling you will never forget and many women find it incredibly empowering, which you might not want to miss.

Q5 What are the side effects

I am fairly confident that the days of permanent damage or paralysis are a thing of the past in our modern maternity units and epidurals have progressed in leaps and bounds. However they are not risk free, some women will say they had aches and pains after their epidural had worn off in places that they had not experienced discomfort before. Others find that they had patches of numbness that took a while to get the feeling back. The most common side effect that I hear about is a really banging headache, which is more uncomfortable when you sit up and less so when you lie down. This has been caused by a nick in the sheath that runs up and down your spinal cord and is allowing a small leak of fluid and pressure from your brain (sounds more serious that it actually is). The headache will ease over a few days or can be stopped by using a blood patch at the site of the leak. The other concern is about how an epidural might impact on how your baby is born, statistically there is a link between epidurals and assisted birth, there are many reasons for this but if you can avoid being on your back or semi reclined for the majority of the time you have your epidural in place it shouldn't mean that you will not have an unassisted vaginal birth, you might just need to be a bit creative and get the best of both worlds - less discomfort and a more manageable labour with an empowering birth at the end!

As always, get in touch if you have any questions about your birth preferences and choices xxx

15 views0 comments


bottom of page