3 Common Questions About the Epidural

1. Why would someone want to give birth without an epidural?

There are a lot of different answers to this question! When people have epidural questions and want to know what to expect, they may already know they’re sensitive to medication and feel some trepidation over side effects. (See common question #2.) Some people instinctually feel childbirth is something they want to experience fully. And so as we learn more about the birth process, we understand that gravity is an important force in childbirth! Gravity brings babies down and out through the birth canal. Having full freedom of movement also helps babies to navigate the pelvis and birth canal. With an epidural, there will be numbness and restriction of movement that can sometimes lead to the need for a Cesarean birth. There’s really no such thing as a “walking epidural;” people with epidurals remain in bed through the duration of their labor. Sometimes people can still bear some weight on their feet and legs especially with the help of a support person or two. Roughly 70% of the time, babies can still navigate the pelvis and birth canal even when there is restriction of movement or numbness from the medication. So epidurals are by and large a safe option! They do make damage to the perineum more likely due to forceful pushing or instrumental delivery (forceps or vacuum extractor). So if your preference is to avoid epidural use, then you will definitely want to hire a doula and take a birth class to arm yourself with lots of tools and support!

2. What’s the most common epidural side effect?

Serious side effects from the epidural are rare. Most side effects are either mild, temporary, or both. A drop in blood pressure is the most common side effect and it can cause heartrate irregularities for the baby. Once irregularities are detected, providers may recommend Cesarean birth. Usually the drop in blood pressure can be managed by the labor & delivery nurses and won’t cause too much of a problem. Some people are more sensitive than others to the medications that make up the epidural. It can be difficult to determine exactly what caused certain reactions. Fentanyl (a narcotic) is one component of the epidural, though not the largest. For the most part, the medicines in an epidural do not cross the placenta. Therefore “drugging your baby” is not a big concern. Your baby will be fine! Straight narcotics through the IV can cause respiratory depression in a baby. So IV pain medicine should not be administered during active labor or pushing. They can be given as a short-acting dose during early labor to help someone sleep.

3. Is there a reason to get an epidural even if you didn’t plan to?

Absolutely! Long labors can totally benefit from an epidural to get some sleep and rest up for pushing. It is totally reasonable to make an unmedicated birthing plan and a medicated birthing plan. Then you can use whatever preferences from each plan that you end up needing. Your childbirth educator and doula can both help you create these birthing preferences! Doulas support all outcomes. If you know for sure that you are likely to receive an epidural during labor, doulas are for you, too! All birthing people and their partners benefit from compassionate encouragement during their pregnancy, labor, birth and postpartum time. Come meet us during our Meet the Doulas night! We’d love to tell you more about the support we offer. And also join up with our FREE support group: Doula Support for the DC Metro Area. We go live weekly with some helpful tips or information. Check out the full video of epidural questions: what to expect!