An epidural is a tool that’s available to you in a hospital setting to support your birth. Not everyone wants or needs an epidural, though! Unmedicated birth is totally a realistic birth path if that’s what you want!
Reasons to get an epidural:
You want one
You’re exhausted and would benefit from sleeping, but contractions are too strong for you to sleep
You’re not coping well with the contractions, and holding lots of tension. It could help you relax!
There potentially could be an emergency based on the current situation, so having an epidural could ensure you stay awake during a cesarean birth. Ex/ could include baby’s heart rate is concerning but not emergent enough to call a C-section.
You Want One
The biggest reason to get an epidural is because you want one! It is a tool that is available to you if that is your birth desire, which is a totally valid way to plan for birth.
It’s important to note that you will still likely need to work through a few contractions before you receive an epidural, so know some comfort measures can be helpful!
Planning for when to get an epidural can be helpful, as well! It may take some time to receive one depending on if anesthesia is assigned to the labor and delivery floor or the entire hospital; if there are any cesarean births happening; or if other patients are wanting an epidural at the same time.
So, allot for at least an hour before you even receive one can be helpful. Also note that you usually need to receive some fluids, or at least have them started, to receive an epidural so you will need an IV to have been placed!
Exhaustion
If you have been laboring for a long period of time with little to no rest, exhaustion can start to affect labor progress. Our uterus is a muscle and with fatigue may slow contractions, or stall labor, in an attempt to rest. If you are noticing a stall in labor due to fatigue, or if exhaustion is affecting your ability to cope with contractions, then an epidural may be helpful to get some sleep.
I’ve had clients who have gotten an epidural after days of laboring, slept for a few hours, and woke up 10cm and ready to push!
Relaxation
If you find you are fighting contractions or tensing up with every contraction, an epidural could help you relax!
The more we fight contractions, the longer and harder labor maybe, but we also don’t expect complete relaxation either! If you are much further on the tension side of the spectrum, an epidural could help you relax and release with the contractions.
I’ve also had clients who were fighting labor, get an epidural, and then finally see labor progress because they were finally relaxed! I was one of them!!
Potential Emergency
If there is not an emergency yet, but potentially could be one in the future (such as baby’s heart rate was concerning but not concerning enough to call a C-section), then an epidural could ensure you stay awake IF it becomes an emergency.
If there is an emergency in labor, such as fetal distress or maternal distress, the type of pain relief already administered or not can determine what type of cesarean birth you may have.
Please note, each situation is unique and will be decided on a case by case basis, but a consult with anesthesia could be help you better understand the current situation and your options.
Read the comments below on our IG reel from Dr Stephen Freiberg, anesthesiologist, for an overview on what to expect.
If you do not have an epidural catheter placed, depending on the emergency you may need a general anesthesia cesarean, where you are put to sleep and your partner is usually not allowed in the OR.
If there is enough time, though, they can sometimes place an spinal if you did not have a epidural.
But, if vaginal birth is still likely, or you are going to still labor, having an epidural placed could allow you to still labor but also have the opportunity to stay awake during a potential cesarean birth.
We break down the epidural and other pain relief options + different ways to still move with an epidural (and without one) in our childbirth education courses!