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Labor Without Epidural: Is It Right For You?

Last week, we talked about everything you need to know about having an epidural during labor.

This week, we’re covering the other side: labor without epidural. The decision whether to use epidural is a personal one. If you’re interested in what labor may be like without epidural, keep reading.

What is a natural birth?

The term “natural birth” can have different meanings depending on who you ask. Some women say a natural birth is any vaginal birth. Others say it is a birth where no pain medication, such as an epidural, is used. More inclusivity, some women say a natural birth is any birth.

Why do some people choose not to use epidural?

There are several reasons why a woman may choose not to use epidural during labor.

A woman may not feel comfortable with the following side effects and risk associated with an epidural:

• Increased risk of a vacuum extraction or forceps delivery. If labor isn’t progressing into the pushing stage, you may need help to deliver. These procedures can cause lacerations and may cause your baby to bruise.
• Medication side effects. Medications used in an epidural may lower blood pressure. The narcotic used can make some women feel nauseated or itchy.
• Increased risk of fever. If a doctor wrongly thinks the fever is caused by an infection and not the epidural, your baby may get unnecessary antibiotics.
• Longer pushing stage. Because an epidural numbs the lower body and affects pushing sensations, some women experience longer pushing stages.
• Headaches. About 1% of women report having continuous headaches after delivery. This may happen if there’s leaking spinal fluid.

Some women may also state they are against epidurals because they are associated with c-sections. While this may be true, that doesn’t necessarily mean that epidurals cause c-sections. For example, this association may simply be due to women who have pregnancy complications already being more likely to request an epidural. A 2011 analysis concluded that, compared to other pain medications, epidurals do not increase the risk of c-sections.

In addition, some women believe that epidurals can make breastfeeding more difficult. One study showed that women who used an epidural were more likely to experience difficulty breastfeeding and to stop breastfeeding in the first 24 weeks. Some people theorize this is because epidurals affect the production of body-made oxytocin and therefore may affect let-down. However, other experts say there is not enough high-quality research to draw this conclusion.

For some mothers, the decision against an epidural is because they are afraid of needles or are weirded out about feeling numb. They may simply like the challenge or feel labor without medication is more natural.

For other women, it can be unsafe to have an epidural because they have:

• A bleeding disorder or infection
• Low blood pressure
• A skin infection where the needle would be inserted
• An allergy to anesthetics
• Are taking blood-thinning medication

 

Isn’t birth without epidural the best since it’s natural?

Some women may assume giving birth without epidural is the best decision since it’s more natural. However, this isn’t always the case. Epidural may be a better choice for mothers with a low pain tolerance. For those that are afraid of labor and pain, having an epidural can provide reassurance and a less traumatic experience.

There are a variety of factors you should consider when making your decision. To find out what’s best for you, talk to your doctor or midwife and do your research. It’s about what you’re comfortable with.

How many people give birth with epidural?

Epidural is the most commonly used method of pain relief during labor in the U.S. More than 50% of women who give birth in hospital use an epidural.

How bad is labor pain without epidural?

While contractions with an epidural may simply feel like pressure, without they can feel like intense period cramps. For most women, labor without epidural is very painful, especially when they’re fully dilated. Other women may feel pain but say it’s bearable. Each labor is different depending on the mother, baby and pregnancy.

 

What are the pros and cons of giving birth without epidural?

Pros of birth without epidural:

• Pushing stage without epidural is often shorter.
• Decreased risk of some complications and side effects, as noted above.
• You may feel more normal after birth (some women who use an epidural may have effects such as lightheadedness for up to 6 hours after).
• Can move more freely.

Cons of birth without epidural:

• Other pain relief methods are usually not as effective.
• Can be more tiring because you may not be able to reserve a lot of energy for the pushing stage.
• If you end up needing a c-section, you will need an epidural or anesthetic anyway.

 

When do I need to decide if I want an epidural?

You may find it beneficial to plan ahead of time what time of pain relief you’d like to use during birth. However, you do not need to give your doctor a definitive answer ahead of time. For example, you may decide against using an epidural but change your mind during labor if the pain becomes too strong. As long as your labor isn’t progressing too rapidly and an anesthesiologist is available, you should be able to receive an epidural.

You can also tell your health practitioner that you want to play it by ear, so they know ahead of time that it’s a possibility.

If you are against having an epidural entirely, alert the nurses and doctors of that when you arrive at the hospital.

Are there other pain medications except for an epidural?

Even if you don’t want to use an epidural, you may be able to take other medications to help with the pain:

• Spinal block. Similar to an epidural only it lasts 1-2 hours only. This option can be good for women who are in active labor and need relief quickly.
• Narcotics. Narcotics are also delivered through an epidural, but unlike an epidural, they do not numb the body. You may feel calmer, more drowsy and less pain, but you’ll still have sensation. There are a variety of narcotic drugs you can use for this purpose.
• Nitrous oxide. Also known as laughing gas, nitrous oxide isn’t available in all hospitals. It provides a quick, but much weaker relief of pain.

 

How can I deal with labor pain without epidural or other medications?

Whether or not you want to use an epidural, it’s a good idea to attend some childbirth education classes to learn what you should expect. In these classes, you’ll learn some simple techniques, such as breathing, that may make a natural birth more bearable.

Natural options that may help relieve labor pain include:

• Midwife or doula— Although midwives and doulas aren’t pain-relieving, you may find the experience more pleasant if you have a trusted support person present to walk you through labor. If not, make sure to have your best friends and family nearby—support really helps!
• Lamaze breathing— Lamaze childbirth classes teach this type of breathing and also work to build your confidence surrounding birth.
• Heat packs— Heat packs can provide some pain relief and comfort. They can be used on your back, pubic bone or neck. Another option is to ask the hospital for a heating blanket.
• Birth pool— Once you’re beginning labor, you can sit in a birth pool to help your contractions and body aches.
• Massage— Massage can also provide relief and comfort. Ask your partner, another family or your midwife to give you a massage. Tell them which areas would feel best.
• Aromatherapy— Although they may not relieve pain, some essential oils can decrease anxiety, which may make for a more positive experience. You can try adding a calming scent such a lavender into a diffuser.
• Acupuncture— A 2014 review of research concluded that acupuncture can reduce labor pain intensity and limit the use of epidurals. If you want acupuncture, you’ll want to contact a practitioner ahead of time since most hospitals don’t have them on staff.
• Distraction— During early labor stages, you may wish to distract yourself from the pain by watching TV, playing music, etc.
• Changing positions— You can change positions to help alleviate your pain. In addition, sitting upright and walking a bit may help shorten your labor. Lying on your back during active labor tends to make contractors more painful. To get into different positions, it may be helpful to have different surfaces available, such as a chair, mat, birth ball, etc.

 

Are you using epidural during your labor? Comment below if you’re using medication or having a natural birth. If you have pregnant friends contemplating this decision, send them this post, too!

P.S. Have you tried a fetal doppler yet? These handheld devices allow you to listen to your baby’s heartbeat while he’s still inside the womb. Many mothers find that listening to the heartbeat can be reassuring and anxiety-relieving. Check them out here.

 

References:

https://www.babycenter.com/0_epidural-pain-relief-for-labor_1489911.bc

http://americanpregnancy.org/labor-and-birth/epidural/

https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-1-24

https://www.ncbi.nlm.nih.gov/pubmed/21392241

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072751/

https://www.babycentre.co.uk/a546717/natural-pain-relief-in-labour