Wednesday, July 22, 2009

Don't count on your epidural

I used to work with a great midwife who gave a presentation of research on women's satisfaction with pain relief in labor. She said "If women are expecting pain relief and don't get it, they are not satisfied. If they are expecting unmedicated labor and end up with medications, they are not satisfied."

I thought of that when I read Reality Rounds' great post on expecting an epidural...and not getting one.

This is something I wish more women understood. Just because you expect to get pain relief in labor, you may not get it. You may never get it: you may have a fast labor, or show up too late, or have to wait too long for the anesthesiologist and by the time he shows up the baby is crowning. (If he ever shows up.) You also might have to wait for hours. When you get one, your epidural may not work, or only work partially. (My least favorite kinds of epidurals.) And most women do seem to feel a baby emerging from the vagina, regardless of the epidural.

I agree with RR: every woman should take a class that teaches them non-medical forms of pain relief. If your expectations for pain relief are met and you never needed those techniques - great. But if you need them, they could come in pretty handy. Above all, of course, keep your expectations flexible - then it's harder to be disappointed.


Reality Rounds said...

Thanks for the hat tip! I agree with the point about when the epidural only works partially. That has to be torture.

Dou-la-la said...

And I, in turn, continued this variation upon your theme like so:

Great post!

Sheridan said...

I had a friend who I offered her my Hypnobabies Classes. She wasn't interested. I could just sense she was going to have a fast birth. She DID and didn't have time for an epidural. She freaked out for about 15 minutes, refusing to push because she couldn't get the epidural. She finally pushed, the baby came out and she felt that awesome NCB high! She said had she not freaked out the baby would have been born 15 minutes earlier.

I said, Maybe you can take Hypnobabies next time. Her response? I am just going to get to the hospital faster.

Hmmmm, where is the logic in that?

publichealthdoula said...

Doula-la-la - like the post! Nice that this is provoking a chain of them :-)

Sheridan - that mindset is strange to me too. I have seen women told that they are 9 centimeters and they still ask to get an epidural. To me, why get an epidural at the moment where it might hinder the most (pushing)? On the other hand, going through transition can be a very scary time and I can see emotion beating logic at that moment ("just make it stop!"). I'd be curious to hear from women who did get a very late epidural on why they did and how they felt about it in retrospect.