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The Mother of all Pain Reliefs

Updated: May 12

This topic never gets old.


“Are you choosing to have an epidural?”

“Should I go with an epidural or not?”

“Don’t take it! If you do, you’re cheating!”


As with all of my posts, let’s start at the very beginning...(*enter "The Sound of Music" soundtrack - and if you have no idea what I'm talking about it's okay - I've just given all of you an insight to my age)

What is an epidural?


An epidural is a local anaesthesia that’s administered via an injection in a space around the spinal nerves in your lower back. This is where this spinal block gets its name because it goes into space right outside of the membrane that protects your spinal cord - known as the ‘epidural space’. The anaesthetic is targeted at the nerves that carry pain signals. Hence, you’ll still be able to feel pressure which is great - especially when you need to feel part of the contractions to push. It’s important to note that this is a ‘blind’ procedure, meaning, the anaesthetist does not have a visual when the needle is inserted. Administering an epidural thus requires experience and a good, steady hand, which explains the anaesthesiologist’s fees. Also, this is why she (or he) would ask that you stay absolutely still when administering an epidural.


In Singapore, we don’t have the walking epidural at hand unless you contact one privately and have made arrangements prior to the date of delivery. So most women who opt for an epidural would be advised to remain in bed once it is administered as they can’t feel their legs. This anaesthetic is introduced into your body via an IV attached to a machine where the nurses can adjust the dosage accordingly.

The pros and cons

I can't go on without stating my stand: there is absolutely no crime in asking for an epidural and no woman should be judged for taking one. Your choice of having an epidural should never equate to a lesser birth or you feeling like you've not really birthed. A birth is still a birth and the welcoming of a new, little life into the world is effort and work - regardless of the path you choose. My peeve is when women are offered one and make the decision to take it with no questions asked. If I were to put this into perspective, I'd ask you:


"Would you allow someone to stick a needle into you without knowing what it was about? "


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While reading about the birth experiences of others may help, I highly recommend and suggest understanding what is involved and having the facts at hand so that you can make an informed choice. To help, here's a quick cheat sheet so that you can look at the pros and cons side by side:


Just to provide a little bit of elaboration to the image above:


1) Most government hospitals have anaesthetists on-site so you might not have to wait too long before an epidural is administered. However, if you're in a private hospital, do factor in at least 30 minutes before you can receive one as the anaesthetist will need to be contacted and come down to attend to you. Hence, if you're thinking of receiving an epidural, it's always good to include it in your birth plan so that your healthcare provider can make provisions and place one on standby. You could even ask if you can request for an anaesthetist of your choice if you'd like. Planning ahead always gives you more options.


2) Not being able to feel your legs also means not being able to walk to cope with labour or go to the bathroom - hence, limited mobility and the urinary catheter.


3) Regarding the relationship between epidurals and C-sections, this takeaway from a research article written by Henci Goer explains it best:


What Goer means to say is that because epidurals do not allow for mama's mobility (which limits mama's choices in comfort measures which have proven to be effective in labour), there may be a direct relationship between having an epidural and the chances of having a caesarian section. In my opinion, I would share the same sentiments regarding epidurals and their relationship with assisted deliveries.


4) Some mamas who have received epidurals mention they have a sleepy baby after birth which may affect breastfeeding. A little more about this here:

https://www.breastfeeding.asn.au/bfinfo/epidurals-and-breastfeeding


So at the end of the day, would I recommend an epidural?

My answer would be - the decision is yours to make. For mamas who are fully in touch with their bodies and recognise their threshold of pain, or know that it’s tough for them to relax, I would absolutely recommend an epidural. I’ve experienced mothers who told themselves that they would not, under no circumstance, take an epidural. Under this immense pressure, this expectation caused so much stress which caused labour to slow. However, once they allowed themselves to be open to the possibility, that they had the option, even if they didn’t receive one, labour progressed once more as mama was more relaxed and the oxytocin was flowin!


To end this article, I’d like to suggest that you be true to yourself when writing your birth plan - you know you best, so you do you. There isn’t a report card for birth and it isn’t going to be tattoed on your chest like a Scarlett Letter. Surround yourself with those who fan your flames, build your village and brave on mamas!


Love always,

Jamz


Recommended articles for reading:

https://evidencebasedbirth.com/epidural-during-labor-pain-management/

https://www.ncbi.nlm.nih.gov/books/NBK279567/

https://www.parents.com/pregnancy/giving-birth/epidural/epidural-side-effects/


Credits for articles and images:

https://www.webmd.com/back-pain/what-is-sacroiliac-joint-dysfunction www.mayoclinic.org

www.aboutkidshealth.ca

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718011/


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