Sunday, September 26, 2010

To Epidural or Not Epidural? That is the Question!

**I know many women feel very strongly about natural birth vs. epidurals and this is not that kind of post!**

In the last few years of my life, before I was ever pregnant, I felt very strongly about having a birth that was
au natural. And when B was just my boyfriend back then, we'd have "debates" over it. He'd call me c-r-a-z-y, but I always stuck to my guns, saying things like, "My mom did it. I can, too!" 


However, that quickly changed once I actually became pregnant [...among other things. Remember this post?]. I soon began thinking, Well, you don't walk out of the hospital with a 5-foot-tall trophy recognizing all your hard work. You don't even get a Rachel Berry-worthy gold star or button that reads, "I did it naturally." I guess you get bragging rights? But it's not like that's even long-lasting. You just get a "Whoa! Good for you." Or sometimes a, "Why? She's crazy!" behind your back.


So, for the majority of my pregnancy I've been thinking I'd get an epidural. I mean, why go through all the pain? Epidural or not, every woman still walks out of the hospital with a healthy baby, right?


Well... after our Labor & Coping class this weekend, I've since changed my mind... yet again. We had such a wonderful instructor/nurse. She was never ever pushy. But she made me realize that having a natural birth may be a lot more doable [I didn't say easier] than I imagined.


Bare with me while I give you a little lesson. 
There are four different stages of labor: 

Early Labor: 0-3cm dilated and usually lasts 7-8 hours
Active Labor: 4-7cm dilated and usually lasts 3-5 hours
Transition: 8-10cm dilated and usually lasts 1/2-1 hour
Pushing: 10cm dilated and it's GAME TIME, BABY!


We were told that if a woman changes her mind and asks for an epidural it's usually when she's about 6-7cm dilated, or between the Active and Transition stage. Our instructor also went on to say that if a woman can make it through the Active Labor stage, she is more apt to make it through labor without an epidural, since she's basically home-free.... only about 30 to 60 minutes left! Most people think that if it took you eight hours to get to 4cm dilated, then it's going to take you another 8+ hours to get to 10cm. But that's not the case. The farther along you are dilated, the faster labor gets. [This is, of course, in a 'normal' labor.]


That got me thinking. 


If I could make it through the first two stages of labor, then surely I could make it through the rest. 


The first two are the hardest because they last the longest. Our instructor said that if you're thinking of having an epidural during the Active Labor stage, tell yourself to wait another twenty minutes; or work through another few contractions. She said, you may realize that by the time you do so, you're about to enter the Transition stage (~8 cm dilated!!).


So what have I decided?


I've decided that I'd like to try and do it naturally for as long as I can. Our instructor was very objective in her teachings, but you could tell she was pro natural childbirth (after all, she had done it FIVE TIMES herself!). She was very encouraging about 'hanging in there' until about 6cm because once you're there, you only have about an hour left to go. You've made it that far, why have an epidural then? Again, this is of course, if everything is going smoothly with the baby. I'm not even getting into if the baby's breached, transversed, etc. That's a whole other story! 


But of course, if I get to say, 4 or 5 centimeters dilated and absolutely!cannot!go!on! I'm not going to feel guilty, or feel like a 'failure' if I choose to have an epidural. B and I have discussed it, and I told him that if I ask for an epidural, he has to tell me, "Let's wait twenty more minutes." [I will put it in writing, if I have to, to remind myself I really said this because I probably won't believe I did lol] And unless I'm cursing his head off, he said he'd stick to the agreement ;-)


An epidural usually (of course, not always) prolongs labor because the woman is numb and cannot feel when to push. Plus, the woman cannot get up to walk around [due to the numbness]. Getting up and walking, changing positions, rocking in a chair, bouncing/sitting on a medicine ball, or squatting helps move labor along. I want to be able--or at least have the choice--to do the above. Thinking about being confined to a bed because I can't move my legs makes me agitated inside. (Maybe it's the control-freak in me??)


But most importantly, I feel at peace with this decision. For me. At least for now. {lol}



*The latter was simply what I learned this weekend. They're my opinions and does not make me an expert by any means :)

7 comments:

  1. A totally personal decision for sure. I do think that making these decisions are just really difficult beforehand b/c labors are just so different for everyone. I was having freaking intense on top of one another contractions when I was only 1 cm dilated. Like, HARD HARD labor. Some people don't get that hard of labor until later on. I made it until 4cm or so when I got an epidural (from 1cm-4cm was from 2:30pm to 10pm)..so that was a LOT of hours dealing with intense (and omg...you just can't imagine it until you feel it, lol) contractions. So, I got my epidural, and then had about 2 hours of pain-free semi-sleep and rest....and then unknowingly they shut the damned thing off...and I felt every.single.thing...and pushed her out au-naturale all the while thinking "WHY THE HECK IS THIS SO GOSH DARN PAINFUL IF I HAD AN EPIDURAL" (only to find it was turned off! dear god)...

    so yea...

    now that I know I can do it...I dont think next time I'll even bother. But, thats assuming it goes faster too. We'll see.

    Natural isn't fun by any means...but doable..yes ;) haha. and you're right...there is no trophy. NONE. But, i did have a woman ask me as I was being pushed out in the wheelchair when I got discharged, "Is she a Ceasarean baby?"...

    and I like shrieked back (or my vagina did), "NO! VAGINAL!!!!!!!"

    HAHAHA

    :)

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  2. Great plan! I went in with the same sort of mindset with my first, I was going to go natural as long as I could stand it and be open to pain management options should I need it. Just keep an open mind and let your body tell you what it needs! It's such an amazing experience anyway it ends up...natural, epidural, vaginal, c-section. In the end, it all brings about a BABY!! :)

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  3. AHH! I don't regret getting the epidural, but I still wonder if I could have done without one since I didn't feel any pain before I got (got it 5 cm) it. I think it will be a much harder decision next time around if I don't feel any pain in the beginning again. You'll have to let me know how it is if you do it! :)

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  4. Good for you! I hope you are able to do it. My SIL didn't feel any contractions at all. With all three of her babies, she gets to the hospital in just enough time to push out the baby. So no epidural for her. You could be the same way, which would make it even easier to not get the epidural. Me, on the other hand, I'm a wuss. I wanted one as soon as my contractions started. :)

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  5. I would have to debate about the epidural since it can leave some people with back issues and strange sensations... I would probably lean to the natural side of things.... Though, if the pain prolongs your labor because you're afraid of more pain to come, then I think it's best go the epidural route than try to tough it out. The husbands sister labored au naturale for like 30 something hours AFTER being induced. It was too long and our nephew had a small part of his lung collapse... I think the important thing is to go in with an open mind. Lean towards one or the other initially but be honest with yourself when you're in labor and you'll know if you can go 100% without an epidural or if you need the epidural.

    It's a big decision (like most pregnancy things which is one reason why I'm holding off on making babies...I suck at making decisions) think about it but ultimately do what feels right for you at that moment.

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  6. Girl, let me tell you that I've had this conversation with myself about a billion times in the last few months. In the beginning I was all about "no thank you" about the whole having an epidural thing, and honestly it wasn't even because of the properties it has but simply because I am gosh darn TERRIFIED of having a needle in my back. But the closer I get to my due date, and the more birth videos I watch (don't ask me why I do this to myself), the more I'm considering having one. Plus, I am a whole lot more scared about the pushing this child out of me than I am of the contractions. I keep on thinking that "Ok, I will make it through my contractions and than I'm just going to want to kill myself during the pushing part and I will not be able to have an epidural anymore because it will be too late," since they won't hook you up with the good stuff after your active stage. Also, I know that epidurals have a tendency to slow things down, however, I also know multiple people who were not able to dilate and move onto the next stage for hours and hours because they were so tense from all the pain, and as soon as they got the epidural they dilated to 10cm within a couple hrs or under. Therefore, there is a lot to think ( and freak out... at least for me) about. But it's a very personal choice, and I don't think either one is the wrong choice. Beside, every woman has a different labor experience, and what ones contractions may feel like at 10cm, I would feel at 4, so don't be telling me to chill out! Just sayin'...
    Anyhow, good luck with your decision. Let us all know what you've decided when the time comes :-)

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  7. You have a very good mindset going into this! Most people do not :)

    Since I work in and around this area as a nurse, I’ve heard and seen a lot of stories. Some good and some bad. I would offer up a few things: I would AVOID being induced with pitocin for as long as possible, and unless medically necessary. It prolongs labor, usually and increases the chances of needing an epidural or a C-section. Also AVOID induction with Cytotec!! There is *usually* no need for induction unless severely post-term or the baby is in trouble etc. The body has a natural process and some women take longer than others. That’s it. Don’t let the doctor rush you and convince you of pitocin with the pretense of "speeding up labor".

    The second point: I fully I agree with going natural as long as you possibly can. Take a few things into consideration though...

    1) Estimated size of the baby. There is always a potential for severe lacerations with a bigger baby and no epidural is going to make those unbearable. Not a reason to NOT get an epidural but a point to consider. I'm talking 9-12lb baby range here too.

    2) If your cervix begins to SWELL and they offer you an epidural. Seriously consider it at this point. I had one patient who was SO wonderful and really did awesome with the natural labor. She walked around, she took showers, she sat on a labor ball etc etc. She hit 7cm and just stalled. Her cervix then started to swell. The doctor offered her an epidural. She didn’t want it. Another more experienced nurse went in and talked to her and said that she could negotiate with the doctor: have an epidural briefly....to let the swelling and pressure go down on the cervix and when it was near time for her to push the baby out (she had progressed to about 9cm) they would stop the meds through the epidural so she could feel the birth as much as possible. Otherwise she was likely going to go to a c-section which she really did not want. She ended up going with the cutting the epidural off option. Labor progressed faster and she ended up loving her birth experience and was SO thankful she didn’t have a c-section. So keep that though in mind. Most doctors should be okay with that plan of action. It helped that we got everything ready for a C-section and put all the c-section supplies outside of her door when we saw her stalling.....it usually wards off c-sections! haha!

    Sorry if that was rambling :) You're going to do great...you have the right mindset. Also, might be a little over the top for what you want but the movie "The Business of Being Born" might be interesting for you to watch.

    Also...just my opinions :)

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