Birth Options Series – A Normal Vaginal Delivery With Epidural

Welcome and thank you for listening!

Epidural fact-file

There’s good and bad news, and there are points to ponder…

Epidurals are the most common form of pain relief in private South African hospitals. You’ll lie curled on your side or sitting on the edge of the bed, when an epidural is administered. The anesthetist will numb your skin, carefully guide a needle into your lower back, thread a catheter through the needle, gently pull the needle out, and tape the catheter in place. The medication flows through this catheter, and soon you should only feel the pressure of your contractions, but without the pain. An epidural leads to a temporary loss of movement in the lower body and you will need a catheter to keep your bladder empty, and an intravenous ‘drip’ in case you need medication.

A ‘walking’ epidural is intended to block the pain without limiting your ability to walk, but is unfortunately seldom very successful.

The good news and the bad news
The good news is that you should be alert throughout the birth, and, if there are no complications, epidurals are very effective at numbing the pain, and thus reducing your anxiety. But, before you jump with joy, there are a few things to consider. Studies have shown that epidurals lead to an increased risk of:
· Perineal tearing
· Caesarean section
· Fetal distress
· A longer labour
· Needing synthetic hormones to strengthen contractions (induction)
· Baby being unable to turn into the correct position for birth

There are three main reasons for this:
1. An intricate balance of hormones flows through your body during labour, one of which is oxytocin. An epidural lowers your oxytocin levels, which could slow down your labour and lead to induction.
2. After an epidural, your pelvic floor muscles, which are partly responsible for guiding Baby’s head into a good position for birth, will not function as they should. If Baby isn’t in the correct position for birth, you may need an instrument delivery or episiotomy, and tearing is possible.
3. You might not be able to push Baby out properly if you can’t feel those last few powerful contractions – instrument delivery and perineal damage are potential risks.

These outcomes are even more likely if you lie on your back during labour, which is mostly the case. However, if the epidural is timed well and starts to wear off just before you need to push Baby out into the world, outcomes are usually better.

The analgesics in your epidural will also enter your baby’s bloodstream, and it will take Baby longer to eliminate the drugs then for you. This could mean he’ll be less alert for his first few days, possibly affecting breastfeeding and bonding.

Take heart
All this may sound terrifying, but there’s no need to be scared of giving birth. You have many alternative options. Why not read our many helpful natural birthing blogs?