What Are the Pros and Cons of Getting an Epidural?

By: Jennifer Cole | Induction | December 18, 2020

If you’re newly pregnant and trying to decide the type of birth experience you want for yourself and your baby, one of the biggest choices you’ll be faced with has to do with pain management. When polling your friends and family, you may discover that most of them opted for an epidural at some point during labor, since statistically speaking the overwhelming majority of birthing people receive them. A Stanford study conducted in 2018 found that of the 17 million births that took place between 2009-2014 in the U.S., epidurals were administered 71 percent of the time.

So why then are there so many books written about natural, gentle, unmedicated birth? Since epidurals have become a standard practice within modern childbirth, is it really that big of a deal for you and baby to get an epidural instead of using other less invasive comfort measures to cope with labor?

An Epidural Can Help You Rest When You Need It Most

The biggest benefit to an epidural is that it can provide effective pain relief in a relatively short amount of time. Depending upon how long a birth giver has been in labor prior to the time the epidural is placed, they may be exhausted, depleted, and in real need of rest in order to push their baby out. An effective epidural allows that rest to take place by giving the person in labor a much-needed break from the sensation of contractions.

The ability to rest, restore and garner strength for the second phase of labor, i.e., pushing, can be a godsend for those who’ve experienced a prolonged first stage. For some birthing people, the discomfort of labor leads to the body tensing and tightening up, which can impede labor progress. In these instances, the epidural may help the body release tension and help with the progress of cervical dilation.

Getting An Epidural Also Has Some Drawbacks

The pain relief and ability to rest an epidural can offer are not without their drawbacks, however. First and foremost, once an epidural is administered, the birthing person is confined to their hospital bed from that point on and restricted to a clear liquid diet only.

They will experience a numbness/tingling from the mid-chest down and be unable to stand or walk once the epidural is placed. This lack of ambulation requires catheterization; they will also continuously receive an IV drip with fluids, fetal monitoring, and frequent checks on their vitals (think blood pressure cuff, pulse oximeter adhered to the forefinger, and routine temperature checks).

Being bedridden and relatively immobile may hinder cervical dilation and baby’s ability to find the optimal position for entering the pelvis, which can lead to what has been referred to as the “cascade of interventions,” beginning with the use of Pitocin (synthetic oxytocin) in an IV drip and/or the artificial rupture of waters (amniotomy). These interventions can increase the likelihood of fetal distress, which in turn can increase the chances of a c-section.

If full cervical dilation occurs, the pushing phase of labor can be additionally challenging for the birthing person due to the lack of sensation, lack of mobility, and the absence of an urge to push. Epidurals have been found to prolong the pushing phase of labor and increase the likelihood of the use of forceps.

On a physiological level, an epidural disrupts the exchange of natural hormones between birth giver and baby. According to Dr. Sarah Buckley, author of Gentle Birth, Gentle Mothering, there is a feedback loop during labor in which the physical sensations the birthing person feels send signals to the brain and uterus to step up the contractions.

By eliminating the sensations of labor with an epidural, this natural feedback loop is blocked, which in turn can slow or stop contractions and lead to the use of Pitocin. The combination of an epidural and Pitocin inhibits the brain from releasing its own natural oxytocin, which is necessary for calming, pain control, and activation of maternal instincts.

As Dr. Buckley has stated, “An epidural can turn birth into a medical procedure because it alters the hormones that support the birth experience, as well as those hormones released after birth and in the early days of motherhood – maybe even longer. We are interfering with a very ancient system that is designed for maximum reproductive fitness.”

Education is Key to Making Your Decision

Choosing an epidural has its time and place in birth, but making the decision to get one shouldn’t be entered into lightly. It’s true that an epidural is touted in the medical community as a routine procedure that provides safe and effective pain management in labor and birth, however, it’s important to understand what its significant disadvantages are. Because many birthing people are averse to the idea of medicalizing birth, they’ve decided to make different choices when it comes to pain management. For more about this, please read, Why Go Unmedicated?

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Resources:

  1. https://scopeblog.stanford.edu/2018/06/26/epidurals-increase-in-popularity-stanford-study-finds/
  2. https://sarahbuckley.com/

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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