When Is The Best Time To Get An Epidural In Labor?

By: Jennifer Cole | Epidurals | October 11, 2021

If you are pregnant with your first baby, the number of unknowns looming ahead of you can feel endless. For example, there are so many things you won’t know about your baby until they are born, like what color their eyes will be, whose chin they will have or whether they will want to breastfeed as soon as they are placed on your chest.

In terms of the labor itself, there are also many unknowns:  how many hours will pass between your first contraction and your last? Will your waters break before labor starts or will that happen when you’re close to pushing? Will the breathing techniques you’ve learned really help you cope with your contractions?

But one of the unknowns you’ve likely thought about the most is whether or not you’ll make it through labor without an epidural. You probably have lots of questions about the epidural itself, including when the best time to get it would be if you do decide to get one. 

Leaving the Door Open for an Epidural

As we have established, unknowns are an intrinsic part of birth. Preparing for an unmedicated birth is a great way to get in touch with your body’s innate intelligence to go into labor on its own, dilate, and push out your baby. However, you cannot predict the plan your baby has for their arrival earthside. 

As much as you might have committed to the idea of avoiding medications during labor, you don’t have control over how long you will be in labor or how it will affect your body. If 24 hours into labor you haven’t slept and exhaustion is setting in, you could be in the position where an epidural is the best decision for you. 

Rather than rule out an epidural as an option no matter what happens, it may be wise for you to learn about them in advance so that you enter the birth room with all the facts. 

How Will You Know If Getting an Epidural Is the Right Decision?

If you’ve never experienced labor before, it’s impossible to know how it’s going to feel in your body. There are many great methods—such as Hypnobirthing, Hypnobabies, the Bradley Method, Birthing from Within, Lamaze, etc.—that you can implement in labor as comfort measures to help you avoid medication. Unfortunately, no method is bullet-proof if your baby has other plans. 

Sometimes the conditions conducive to unmedicated birth don’t line up. Perhaps you end up having to be induced, either because you go over your due date by a week or two, develop preeclampsia, or your waters break before you go into labor. While none of these circumstances mean you have to get an epidural, each one can potentially make labor last longer which in turn can increase the likelihood that you will eventually want one. 

In other cases, there may not be a “smoking gun”—such as an induction—that precipitates an epidural. You could simply reach a point where the sensations you’re experiencing become too intense for you to tolerate. If early labor is very uncomfortable for an extended period of time and there’s no end in sight (e.g., after many hours of strong labor you’ve only dilated to 4 cm), that’s when an epidural will probably sound appealing to you. 

So When IS the Best Time to Get an Epidural?

You’re the only person who really knows when the best time to get an epidural for yourself will be. However, something to be aware of is that the longer you’re on an epidural, the more likely it is that you will experience additional interventions which, in turn, can lead to complications.

For example, you will be given intravenous fluids for the duration of the epidural which over time can cause edema—swelling of the tissues—for you and the baby. The medications administered can also cause your skin to itch which may necessitate taking Benadryl. 

Of greater concern however is that the longer you are on an epidural the more likely it is that you will be given Pitocin—the synthetic version of oxytocin—which can lead to a host of other issues for you and your baby. 

Another thing to keep in mind is that once you have the epidural you are bed-bound until a few hours after your baby is born. This means that the upright movement that helps keep your baby moving down into your pelvis becomes limited. This can make dilation take longer and, in some cases, stall labor. A failure to progress in labor could lead to a c-section. 

Considering these factors, it’s best to limit the time you’re on an epidural as much as possible. You may hear otherwise from the anesthesiologist, who might tell you the sooner the better. However, when you understand all of the potential side effects an epidural can lead to the longer it’s in place, you might decide to wait.

About the author:
Jennifer Cole CD(DONA) DONA Certified Birth Doula and Hypnobabies Certified HypnoDoula supporting families throughout San Diego County.

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