Post by scribellesam on Sept 17, 2014 10:08:31 GMT -5
I was a "wait and see" person and got the epi about six hours in to a 14 hour labor. It was amazing and I loved it! No complications and it was light enough that I could still move my legs and feel the urge to push - I even pushed on my hands and knees for a while.
I will say that I don't know anyone IRL who managed to go med-free without some serious preparation beforehand - taking a class, studying hypnobabies at home, etc.
Post by underwaterrhymes on Sept 17, 2014 10:09:38 GMT -5
I also just want to say that I spent a LOT of time (and I do mean a lot) researching all the different ways labor could go and trying to figure out how it would be for me. In hindsight, I wish I had cut out all of the speculating. It's going to happen how it's going to happen.
I wanted med-free, but was in labor for 24 hours and couldn't get on top of the contractions so I welcomed the epidural. A friend of ours was in labor for 3 hours with her first child. She wanted an epi, but there was no time because she delivered 45 minutes after she got to the hospital.
Since you know you'd like to try med-free, take some classes and read up on techniques and practice them starting now. But please just know that your baby's birth can be beautiful and special and amazing regardless of whether you're delivering naked in a kiddle pool in your living room or with an epi in a hospital gown.
Post by karinothing on Sept 17, 2014 10:09:41 GMT -5
I had a med free labor. I think if everyone had a labor like me there would be no need for an epidural. Seriously, I just hung out at the mall eating milk shakes for a good portion of it. Then I went home watched, TV and napped. I kept calling my midwives who said I didn't sound like I was working hard so I should stay home. After 24 hours of labor I figured I would just go in to get checked out and I was 8.5cm.
Then I just hung out in the hot tub, till it was time to push. Pushing was AMAZING. It did not really hurt just felt kind of uncomfortable, but it was impossible not to be vocal. The only pain I really remember was when his head came out (and I tore). But it wasn't not unbearable. I remember being highly alert during pushing (I apologized for pooping on his head, since I was on my hands and knees).
I have no clue waht would have happened if my labor hadn't been so easy. However, I did not give birth in a hospital so an epi wasn't really an immediate option for me. I personally didn't really want it to be an option because I did not want temptation.
Why can't you prepare for med-free and go with the flow. Labor and delivery are not something anyone can predict. Recovery is the same way. I went into both with a "go with the flow" mentality. I was disappointed in any part of my L&D, even though I ended in a c/s for both.
ETA: I WASN'T disappointed. Whoops.
This is my plan. I would really like to avoid an epidural. Not because I am some sort of masochist, but honestly? I spent too many years working for Plaintiff's medical malpractice attorneys to really want ANYTHING injected into my spinal cord.
That being said, if it ends up being what happens, it ends up being what happens. These boards are full of stories of what the plan or goal was "supposed" to be only to have those plans thrown completely out the window when the time actually came, and I am prepared to have to tackle labor issues on the fly as they arise. So long as nugget is healthy that is all I care about.
Post by thebreakfastclub on Sept 17, 2014 10:12:29 GMT -5
I took a 2 Saturday class with a doula and found it very helpful to understand the process of labor and all the possible outcomes.
I had awesome blood pressure the whole pregnancy...right up until I got pre-e at 39 weeks and was induced. It spiked to 200/100 which required me to be on my left side. I lasted 4 hours on pitocin without the epi. No one could have predicted that my son's head was pointed left and the pushing was all for nothing, and I had a C/S.
The more you learn, the more you will be ready for whatever does happen.
I had a med free labor. I think if everyone had a labor like me there would be no need for an epidural. Seriously, I just hung out at the mall eating milk shakes for a good portion of it. Then I went home watched, TV and napped. I kept calling my midwives who said I didn't sound like I was working hard so I should stay home. After 24 hours of labor I figured I would just go in to get checked out and I was 8.5cm.
Then I just hung out in the hot tub, till it was time to push. Pushing was AMAZING. It did not really hurt just felt kind of uncomfortable, but it was impossible not to be vocal. The only pain I really remember was when his head came out (and I tore). But it wasn't not unbearable. I remember being highly alert during pushing (I apologized for pooping on his head, since I was on my hands and knees).
I have no clue waht would have happened if my labor hadn't been so easy. However, I did not give birth in a hospital so an epi wasn't really an immediate option for me. I personally didn't really want it to be an option because I did not want temptation.
I'm not going to go point by point about these articles that you posted, but saying that these articles show that epidurals lead to negative outcomes is misleading.
Statistically, women who get epidurals have greater negative outcomes. There is also evidence for a causal relationship, not just correlation. True, not every woman who has an epidural has any or one of these negative outcomes, but as many have pointed out, there is no way to predict what will happen to any individual during L&D. Personally, my priority was to reduce the risk of those outcomes over reducing the pain of labor. OP will obviously choose as she sees fit.
I am a huge proponent of med free birth and I also think these are somewhat misleading, even though I get what you are saying. I look at it this way. A med free vaginal birth is baseline. It has the least amount of risk associated with it. So you get an epidural. That adds the risk of vaginal birth + the risk of an epidural. Then you add pitocin. So then you have the risk of vaginal birth + the risk associated with an epidural + the associated with risk of pitocin and so on and so forth.
So it isn't that an epidural = negative outcomes. It is just that it introduces for risks (because the epidural itself has risks of its own, that compound on top of the basic risks associated with med free vaginal birth). But that is basically the case whenever you take any medication or have any medical procedure done.
Listen, I never wanted NOT to get an epidural and I'm disinclined to be swayed by scare tactics about statistical likelihoods that AT BEST do not and cannot speak to any one person's experience (ahem). So I was never in your mindset. A very good friend was, however, and went drug-free (in a hospital) for her first. She had a very long labor and difficult recovery (because her baby was sunny side up, nothing to do with being drug free), but she felt like a warrior afterwards. For her, it was worth it for that feeling and because she liked that she made a plan and stuck to it (she's not sanctimonious about it in the slightest).
For me, the epidural was smooth both times and I could watch (on the monitor) and feel my contractions (that's a cool sensation when they aren't hurting, lol). So I felt MORE in touch with my body in some ways because I wasn't distracted by the pain and what if the pain gets worse and omigah what if it gets WAY worse and it's too late for an epidural and I can't do it and blah blah blah. I wasn't out of it at all, and while I had a "window" where the epi didn't take for L's birth, it wasn't a big deal because even that pain was manageable.
I think it's a matter of knowing your own mind. Everyone likes to be all "you NEVER know how you'll be in labor!!!!" But you at least have a sense. I thought I wouldn't want strangers around--I was right. I was pretty sure the whole "omigah, modesty goes out the window, you'll show your vagina to anyone" wouldn't apply to me--I was right (I had them kick out some looky-loo nursing students). I figured I wanted an epidural--I was right. I thought there's no way I'd want a mirror--I was wrong. So, you know, 3 out of 4 ain't bad.
Think about how you are in stressful situations (not pain situations, because labor pain isn't like breaking an arm). How do you react? What makes you feel the most in control? How do you like to plan for them? How do you handle being sick? If you trip and fall down, do you want help or do you want everyone to leave you alone and pretend they didn't see? Let THAT be your guide for your plan. Then make a choose your own adventure plan so that you already feel prepared for how to handle a deviation from what you think you want
I got one, it ran out 2 hours into pushing, and I pushed 2.5 hours longer. So my delivery was almost med free. It sucked but at least there was an end to the pain. I had an easy recovery. I absolutely plan to have another epi even if the same thing happens again (which I will try to make sure does not)
Post by CajunShrimp on Sept 17, 2014 10:17:24 GMT -5
I want laughing gas. They just started using it at a hospital affiliated with the one I am delivering at, and I am hoping they will be doing it at mine when the time comes for me. The effects are gone within a minute of them shutting it off, and you can still be up and about. You know it hurts, but you don't give a fuck.
Post by autumnfire on Sept 17, 2014 10:23:04 GMT -5
You don't have to make a decision now. Personally I'd just wait until Labor starts then gauge everything from there.
I went in thinking I was going to get the epidural. Which would have been splendid but they wouldn't admit me due to slow progress, but I stayed there for basically a day and a half under observation. Turns out I had this thing called Bendls ring (my uterus stayed contracted around DD's shoulders so it wasn't allowing her to move at all. It was so bad that it took 30 minutes for the docs to get her out via c-section and that was with doing an inverted T incision to release the contracted section of my uterus) that was preventing progression. 42 ish hours into labor my water finally broke and I was admitted. 48 hours into labor I finally had my Epi after they started pitocin to try and get me to progress.
I say all of this because it doesn't hurt to be prepared for either option to happen. I'm glad I had some techniques that DH and I had practiced (lamaze and hypnobirthing. I used a combo of both. Swaying with H on every contraction and just focusing) to help get through each contraction because at that point I literally had no choice and had to go without for that time. I got through it, but I wish I was able to get the epi sooner.
I went into labor with a go with the flow attitude with a desire to have a med free birth. I had a doula, husband, doctor and nurses supporting my decision. I read every book under the sun until I convinced myself that the baby could get out med free. On the days of my.labor the stars aligned somehow and I had a easy quick birth. Some parts sucked but they were over quickly. Given my circumstances I think med free is totally possible for everyone. If I had to labor for one more minute than I did I would have had an epidural. A med free birth is amazingly empowering and now being on the other side I am very proud of myself for having done it but I would be no less proud of myself had I had an epidural. Do what is right for your family and what is right for the moment. Also empower yourself with as much information as you can and support as you can get for any decision you make.
Post by lovelovelove on Sept 17, 2014 10:29:07 GMT -5
Definitely go with the flow and remind yourself that there are many ways your labor & delivery can play out. Healthy baby & mom is the goal.
Personally, I was so scared of the pain and unknowns of labor that I knew I would get an epi. I labored at home for a long time though and I got to the point of "there's no way I can let this get much worse". I was 4 cm and progressing really well by the time I got to the hospital about 15 hours into labor and asked for the epi right away. Then I had other complications- for me, it was so nice to be able to focus on the other issues coming up without also being in pain. I had terrible anxiety about labor and it was good for me to have one thing off the table so that I could think clearly and process my emotions about other things that came up.
I kept telling myself during the whole process that I just wanted me & my baby to come out of this ok. Everything worked out fine Holding the baby at the end is the best, no matter how you get there!
I had a completely different experience vs her friend, as an induction/unplanned C/S mom. And I was in rough shape after labor for a good 2-3 weeks. But 12 weeks later, I played in a softball game and completely forgot I'd had the C/S and was running around like normal. I thought about what I had been through in the car afterwards, and I felt like I warrior too. I was/am so proud of my recovery.
Raising a child is a badass endeavour no matter how they get there, be it vaginally (unmedicated or not), surgically or adoption.
I had a lot of fears and reservations about the epidural, in part because going into labor I had never even had an IV so the idea of a giant needle in my back was intimidating. But I was also scared of med-free because I've never broken a bone or experienced intense pain so I had no idea how I might react. I had a very good talk with the anesthesiologist while I was in labor, and he completely put me at ease. By the time my water broke and I was 6-7cm dilated, I was yelling for the epidural.
My only labor regret was not getting the epidural sooner. It was amazing.
I don't dilate without the epidural. I really wanted to go med free as long as possible with my first, and I was at 1 cm for about 5 1/2 hours of seriously painful, excruciating labor. I got the epidural still at 1 cm, and I was at 10 cm and pushing within two hours.
With DD2, I got to the hospital at 3 cm and knew I wanted the epidural right away, but when I laid down my contractions spaced out, so they wanted me to get up and walk around to dilate a little more and bring my contractions closer together. Two hours of walking later and I was still at 3 cm. I got the epidural, and exact same thing: within two hours, I was 10 cm and pushing again.
I tried for a med-free delivery. I still believe its a worthwhile thing to try for. After 24 hours of hard labor though, my body was tired and I was miserable. I got an epi, slept for 3 hours, woke up ready to push. It was a walking epi, so I felt enough to push, but there was no pain.
When he was born, I was rested enough to really be present for it, if that makes sense. It was not painful, and I was fully focused on him and my husband, not the pain. My thoughts on epidurals definitely changed after that experience. Natural birth advocates tend to push this idea of a drugged out mom, but I would have been in rougher shape if I had been in so much pain, and so tired. The epidural made it into a more reverent moment for me, and for that, I am so very grateful.
You don't have to make the decision now. You can plan for a med free birth, but know the option of the epidural is there should you decide to opt for it.
I had an epidural and could have gotten up after delivery and walked around (I didn't because I was light headed and my nurse wanted me to stay in bed). I could move both my legs the entire time I had the epi. They turned down my epidural so I could feel my contractions to know when to push when it was time.
“Life is not orderly. No matter how we try to make it so, right in the middle of it lose a leg, fall in love, drop a jar of applesauce.” - Natalie Goldberg
I want laughing gas. They just started using it at a hospital affiliated with the one I am delivering at, and I am hoping they will be doing it at mine when the time comes for me. The effects are gone within a minute of them shutting it off, and you can still be up and about. You know it hurts, but you don't give a fuck.
Yeah, do any healthcare people know why they don't really use it in the US? Because it sounds awesome.
Oh, I actually tried laughing gas when I was in labour with Sofia, but it was horrible. Honestly, it didn't work at all and it just made me throw up. I only used it twice.
I didn't want to go med free. I wanted to be calm and relaxed and that wasn't going to happen for me being drug free. I had control over my epi, taking as much (that was allowed) or as little as needed. I had as I needed to be comforTable but not so much I couldn't feel my lower half at all. And I actually did better controlling my pain than I thought I would. They had to numb me to stitch up my small tear because I could feel too much of it and I didn't need a catheter(yay!) since I had control over my bladder. It really worked out great.
I'm not going to go point by point about these articles that you posted, but saying that these articles show that epidurals lead to negative outcomes is misleading.
Statistically, women who get epidurals have greater negative outcomes. There is also evidence for a causal relationship, not just correlation. True, not every woman who has an epidural has any or one of these negative outcomes, but as many have pointed out, there is no way to predict what will happen to any individual during L&D. Personally, my priority was to reduce the risk of those outcomes over reducing the pain of labor. OP will obviously choose as she sees fit.
I was mostly commenting on the quality and relevance of all the articles you posted. It seemed to be a bit of a scare tactic. One was from 1989, one wasn't exactly saying epidurals lead to negative outcomes. I think the way you worded your post is a bit misleading.
This is an updated committee opinion from acog in 2013:
Since the last Committee Opinion on analgesia and cesarean delivery, additional studies have addressed the issue of neuraxial analgesia and its association with cesarean delivery. Three recent meta-analyses systematically and independently reviewed the previous literature, and all concluded that epidural analgesia does not increase the rates of cesarean delivery (odds ratio 1.00–1.04; 95% confidence interval, 0.71–1.48) (11–13). In addition, three recent randomized controlled trials clearly demonstrated no difference in rate of cesarean deliveries between women who had received epidurals and women who had received only intravenous analgesia (5–7). Furthermore, a randomized trial comparing epidurals done early in labor versus epidurals done later in labor demonstrated no difference in the incidence of cesarean delivery (17.8% versus 20.7%) (5). The use of intrathecal analgesia and the concentration of the local anesthetic used in an epidural also have no impact on the rate of cesarean delivery (5, 13–15).
Therefore, ACOG reaffirms the opinion it published jointly with the American Society of Anesthesiologists, in which the following statement was articulated: "Labor causes severe pain for many women. There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician's care. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor" (16). The fear of unnecessary cesarean delivery should not influence the method of pain relief that women can choose during labor.
I really wanted to go med free. I mostly didn't want the epi because I didn't want the IV or catheter, and I thought I could handle the pain. Then I had back labor and I felt like I was being stabbed with each contraction. I progressed so quickly that by the time I ended up getting the epi, I was at 10cm. They didn't even hook up the epi. I just got the bollus (sp?) and then they took it out when they realized I was ready to push. So I made it through the worst part of labor, but it was truly awful.
I ended up with a spinal headache that required two blood patches and a trip back to the hospital the day after we got home. Not fun, but I'm still planning on an epi this time around. It was worth it.
Post by chickenlittle on Sept 17, 2014 10:50:02 GMT -5
I went into labor wanting meds (my hospital didn't do epis at the time, so it was just a one shot spinal numbing injection that lasts for 2-3 hours at best). I dilated from 3 to 10 in 45 minutes and missed my window for drugs. At the time, it was mind numbing, animalistic pain, but I also had no idea I was in transition. So I was med-free, but not by choice, although I mentally felt really kick ass and empowered after the fact.
With that said, I'm really struggling with whether or not I should get an epi this time around. I'm leaning toward getting one because I really felt completely out of control the first time, and while labor/delivery is never really in your control, I was so full of panic and anxiety by the time I had to start pushing, it was really hard to focus (delivery was a whole other shit show).
TL, DR: It's a game time decision--there's no shame in any decision you make. Healthy baby, healthy mama. There aren't any awards given for how you labor and deliver.
I was pretty set on going med-free and did. The epi never appealed to me because I wanted to move around during labor/be in the water and not be confined to the bed. I also wanted to feel in control (not that people can't feel in control with an epidural, but I knew I wouldn't). There is a good chance I would have had a c-section if I had an epi because L was OP/face up making it extremely hard to push her out. Obviously that isn't the case for everyone, I was glad I chose to go med-free. Even though I had a hard birth, there was instant relief the second L was out and I was up and moving right away. I felt great.
I read HypnoBirthing: The Mongan Method by Marie Mongan and listened to the CD every night as I fell asleep (yes, the positive affirmations are kind of cheesy, but they really helped me relax). The method really helped me not fear birth and gave me the confidence I needed to face labor and birth. I definitely did not have a pain free birth like some hypno people claim, but I do think it helped me have the birth I wanted. My nurse in L&D actually used hypno-birthing when she had her babies, so she was amazing and would whisper relaxation techniques to me during labor. She was wonderful.
Even if you end up getting an epidural, I think hypno-birthing methods would still be beneficial in preparation and in labor. It might be something to look into if it interests you.
Post by swimmette on Sept 17, 2014 10:57:17 GMT -5
I think that cville gave great advice, only you know your body and your pain tolerance. I do not tolerate pain well and once I am in pain it's all I can focus on. I went into labor knowing I was getting an epi with absolutely no doubts. Unfortunately I failed two epis, through no fault of the CRNA or the procedure itself - I have a nerve condition that essentially metabolizes numbing medication very, very quickly. I ended up with a c-section, and am scheduling a c-section with this baby, but if I were to do a VBAC I would hands down get an epi again.
My only advice is that if you decide to try med-free with being open to an epi, make sure that you make that decision before OR start times (which are usually 7 or 7:30 AM through the busy time of 10AM). It will take the CRNA so much longer to get to you because they must remain in the OR during the whole case. I got my epi before the OR start times, but when it failed it took for freaking ever for her to come back up to administer another one because everyone was stuck in the OR.
Post by indianchica on Sept 17, 2014 11:01:16 GMT -5
I have epis with both of my labors and I was very glad I did. For the first I was physically exhausted by the time I finally got checked in to the hospital. With the second I was emotionally (un)prepared for there to be big problems with her breathing (thankfully she was/is fine).
Post by Velar Fricative on Sept 17, 2014 11:03:16 GMT -5
I really really wanted a med-free birth (hired a doula, read all the books, read all the websites, etc.) but in the end DD just didn't want to come out so I had to be induced. After 24 hours of no progress or contractions with Cervidil and a small amount of Pitocin, my OB recommended a last-ditch suggestion of upping the Pitocin and breaking my water simultaneously and see if that gets something going. He said it was going to hurt like a motherfucker and that he recommend I get the epi. I was scared of the epi process but my doula 100% supported and agreed with my decision to get it and it was AMAZING. It was exactly what I needed to jumpstart labor and she was born 8.5 hours later. My recovery was ridiculously easy, but I think it helped that I'm 5'11" with wide-ish hips and DD was an average 7 lbs 7 oz.
Having said that, I'd like to try to go med-free again next time just to have that experience too since I never felt a single contraction and thus I still don't know my pain threshold, but because of my wonderful experience with the epi, I will have no qualms asking for one if I want/need it.
I say go med-free as long as possible and just see what happens, since you can opt to get the epi almost any time but once you get the epi there's no going back.
I did absolutely everything one can do to prevent an epidural, and my midwife ended up basically insisting on it. I laboured for two days without it. I was just exhausted and I needed the rest. You just never know, and my advice is to prepare for all eventualities. I wish my H and I would have discussed c-section and other issues. We were mostly just prepared for the ideal. Just to expand on what GOAB said- I also had all of those incredible feelings of strength and beauty throughout my labor, even though I didn't push her out. Pushing was a primal experience and nothing can prepare you for the way your body just takes over, it's amazing. I have positive feelings about the whole experience, even though it didn't all go according to plan. I think that's because my mind was open, if not necessarily prepared, for other outcomes.
Yes, and I don't want anyone to think I'm saying you can't have those feelings if you choose meds, or end up with a c-section, because that's absolutely not true. Labour is a beautiful thing no matter how it happens. I'm sorry if it came across that way.