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Our Your Choices Blog Feature discusses your options for pregnancy, labor and birth using the B.R.A.I.N. Acronym. You can download a printable version of our Using Your Brain Handout HERE.

In Calgary, more than half of the people giving birth choose to have an epidural. Known as the Cadillac of pain relief for labor and birth, epidurals can completely take away the pain of labor, allow a tired laboring person to rest, and are what allows the birthing parent to be awake during a cesarean birth!

An epidural is administered by an anesthesiologist. Your anesthesiologist numbs the area by injecting a local anesthetic. A needle is placed into the numbed area around the spinal cord in your lower back. Then, a small tube or catheter is threaded through the needle into the “epidural” space. Epidurals are generally safe for use throughout labor but like any medical intervention, it has some risks. We recommend our clients use the B.R.A.I.N. acronym to consider the risks and benefits of their choices in labor when they feel unsure about what is best for them. We encourage you to speak to your doctor, nurse and anesthesiologist to gain any information you need while working through the acronym. Let’s have a look at the pros and cons of epidural use for pain relief during labor and birth:
This is not a comprehensive list of the potential benefits and risks of an epidural. You should always talk to your doctor about the benefits and risks involved before committing to any medical procedure. 

​BENEFITS OF AN EPIDURAL

  • can potentially eliminate all physical discomfort during labor and childbirth
  • reduced discomfort may result in a more positive birth experience
  • allows you to be awake for a cesarean delivery
  • in the event of a long labor an epidural can allow you to get the rest you need
  • may help you to relax if you are anxious about your birth

RISK ASSOCIATED WITH EPIDURALS

Some possible side effects include:

  • shivering
  • backache
  • ears ringing
  • tenderness at the insertion site
  • nausea
  • difficulty urinating
  • you may be unable to walk for a few hours after the delivery
  • may interfere with breastfeeding
  • lack of sensation may cause difficulty when pushing and lead to a higher possibility of assisted delivery (forceps, vacuum assistance, cesarean section, etc)

More serious complications are rare. In some cases (less than 1%), patients have experienced severe headaches that require an additional procedure to correct. Sudden drops in blood pressure may occur and need to be treated with medications and oxygen. If the epidural is incorrectly placed toxic side effects may occur (1 in 2,800) such as slurred speech, extreme drowsiness and convulsions. Permanent and temporary paralysis are very rare and  sensationalized risks that can occur. You should speak to your doctor about these risks for more information.​

Occasionally, clients come to us after hearing scary stories about new parents dying following an epidural. Death caused by obstetric epidural is very rare, but possible as a result of respiratory failure, heart failure or an epidural abscess.

Further considerations that pose risks or challenges:

  • you will need to be at least 4 cm dilated and in active labor to get an epidural
  • continuous fetal monitoring will  be required
  • you will be confined to bed
  • you will need an IV and a urinary catheter

ALTERNATIVES TO AN EPIDURAL

If you are delivering in Calgary or High River you have a variety of options for pain relief during labor. Morphine, and Demerol are additional common pharmacological choices for pain relief. Other options include continuous labor support (Yep! That’s a doula!),  the use of hydrotherapy such as taking a bath, or using a shower, aromatherapy, massage, rebozo techniques, position changes, and more. What helps you to relax or relieves pain for you in your day-to-day life? Talk to your doctor, midwife or your doula about the many options available to you!

WHAT DOES YOUR INTUITION TELL YOU ABOUT HAVING AN EPIDURAL?

As doulas we can’t assist you with this! The intuition part the B.R.A.I.N. process is for you and your partner. Do you have a gut reaction to having an epidural?

NEED TIME OR NOTHING

Many of our clients would prefer to have an unmedicated birth but are open to using medical pain relief if they find labor is longer or more intense than they expected. If you planned a “natural” birth and during your labor are considering an epidural, you may choose to wait a few more contractions, try some alternatives, or position or activity changes. There’s nothing wrong with taking your time to make a decision, talking it over with your partner, asking questions. You may decide that an epidural is not for you or you may decide to wait a little longer and see how things progress before making a decision to have an epidural.

“AFTER A PREVIOUS SHORT AND EASY UNMEDICATED BIRTH, I WAS SURPRISED WHEN MY LABOR WAS LONG. EVENTUALLY, I WAS EXHAUSTED AND UNABLE TO COPE. THE EPIDURAL ALLOWED ME TO REST. I BEGAN DILATING FASTER, AND WOKE UP FROM NAPPING WITH AN URGE TO PUSH!” – JAMIE PORTLAND*

Calgary parents have an abundance of choices when giving birth. We know that so many options can be overwhelming and confusing. A doula can assist you in navigating all of these options so that you can make the right decisions for you and your family. Take comfort in knowing that your doula will be by your side with knowledge and resources should you need to make decisions in the delivery room. Contact us us today to meet with a doula.

​*name changed for privacy
Image Credit: Aaron Fulkner | Cropped | Licence at creativecommons.org/licenses/by-sa/2.0/legalcode

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