Birth Snapshot: The Epidural

Labortrials got an epidural?!  Oh me oh my.  Yes, friends, I consented (begged for, even) to the bleepin’ epidural.  How did this happen, and how do I feel about it now?  Well . . .

I arrived at the hospital worried that something was wrong.  The labor contractions came fast and painful, and I knew that less than 24 hours previously I was not dilated but a smidge.  I also felt as strange ‘pop’ down there and knew it wasn’t my water, so that in conjunction with the scary contractions (tetanic, perhaps) sent me packing to the hospital quickly.

The OB arrived, checked me, and found me to be 2cm dilated, but the baby was high.  According to the monitor, the baby was not handling the contractions well.  (She was having late decelerations.)  The OB restricted me to laboring on my side; the labor nurse told me I had to relax my body in order to dilate.  The contractions really were more than I could handle with the position restriction.  The OB checked me a few hours later, and I was still stuck at 2cm.  I knew that as soon as I could get an epidural that I needed to have it put in.  There was no way I was going to withstand the contractions, restrict my movement, and relax enough to dilate without pain management.

Interesting that this evening on my twitter feed, I saw @RobinPregnancy’s tweet about epidurals:

Did you ever have an #epidural that didn’t work quite as well as you’d hoped? http://ow.ly/6ejKI #pregnancy #About

I had an intrathecal with an epidural placed.  The idea was that the intrathecal could possibly get me through the next several centimeters of dilation more quickly and would wear off.  If and when I wanted the epidural, it would be ready and waiting for me.  The intrathecal improved my quality of life dramatically, and indeed I did progress quickly from 4cm to 8cm dilation.  Then I got stuck at 8cm and for a few hours, so I wanted the epidural.

However, the epidural was slow to work, and when it did, it didn’t provide enough relief.  My labor was not progressing very well, so I was concerned that if the epidural didn’t work and I needed a cesarean, that I’d feel the surgery.  I was terrified, actually.  This caused me to over-react.  The anesthesiologist gave me a bolus of something (yes, it’s horrible that I can’t recall this information), and when that didn’t seem to give me enough pain coverage, I received another bolus of something (nope, can’t remember what that was either).

So, when it came time to push, and thank God I got to that point, I couldn’t feel a darned thing.  I could sense when a contraction was beginning, but that was about it.  I had some sensation in my toes.  I had no idea where my vagina was or how to push.  That was terrible.  My OB was a tremendous labor coach, so he talked me through every contraction . . . every push.

Ideal?  I suppose that depends on how you look at it.  The purist in me says “technically, you had a vaginal birth, but you missed the whole darned thing.”  The practical-ist in me says “honey, if you hadn’t gotten that epidural, who knows if you’d have dilated quick enough for the OB, or if the epidural is what helped calm the baby’s response to the labor contractions (stressed mom can lead to stressed baby), or if you would have outlasted the pain.”  No one made me get an epidural.  I told them on entry that I wasn’t interested, and they left me alone.  I asked for the epidural – it was my request; my choice.

People can be sooooooo judgmental about the use (or refusal) of epidurals.  Read this woman’s story over at Unnecessarean.  Don’t miss the comments which are QUITE polarized.  Given what I’ve been through, you may laugh at my comments.  Would I recommend an epidural to my closest friends and family members?  Yes, with caveats.  Would I recommend my closest friends and family members NOT accept an epidural?  Yes, with caveats.  Would I recommend epidurals for VBACs?  Yes, with caveats.  Is the epidural the beginning of the end in terms of natural childbirth?  Yes and no.  Does the epidural cause a cascade of interventions?  Yes and no.

Yes.

and

No.

Yes, it’s not that simple . . .

Why oh WHY would you say that to a pregnant woman?

I’m ready to lighten the mood just a little bit, I suppose.  I found a link to this serious but cheeky post about what pregnant women really think when you say ridiculous things to them via @DarleneMacAuley on Twitter.  Ok, so maybe I should add the caveat that not all pregnant women react like this, but at least Mama Birth and I do!

Here’s one of hers:

Quote 5:
(Said when out in public with ‘gasp!’ all three kids and pregnant belly.)
“Wow. You are going to have your hands full.” ~Must be said in a voice that is a mixture of shock and horror.~

What I say:
“Oh….haha!”
(Why is my response almost always a smile and nervous laughter?! Seriously, my parents are not this polite!)

What I am thinking:
(On a bad day.)
“Are you kidding me, my hands ARE full. I am secretly freaking out, wondering if my sanity will survive and more importantly, if my kids will turn out to be functional adults. Can you get the door for me, load the groceries in the car (even after I say I don’t need help) and then help push me into my Suburban that conveniently has a four inch lift?”

(On a good day.)

“I love my kids! I couldn’t imagine life without them! They are the best thing that every happened to me and in no way a burden. Why does everybody seem so afraid of children? They are awesome.”

This is often said to me, especially when my big pregnant self is carrying a toddler twin on each hip!  (Mama Birth, I don’t have a Suburban; thankfully, a very practical Honda Odyssey!)

Here are a few more in my own voice:

Random persons: “Oh, you’re really carrying high.”

My responses:  (1) “Not really – here are my hip bones.” (2) “Really?  I haven’t thought about it.”

What I’m thinking: “That’s the last freaking thing I need to hear because what I do hear (it’s that small little nasty voice) is ‘yeah, the baby will never drop, never engage, never descend, mwhahaahahaaaa!‘”

Random persons (with my twin pregnancy): “Wow, you’re smaaaaallll for carrying twins!”

37.5 weeks with the twins

My response: “Huh, thanks?”

What I’m thinking: “I imagine she thinks that’s a compliment, but I don’t really appreciate having my twin pregnancy minimized.  I’m friggin’ huge but thankfully handle it well.”

Random persons (with my current singleton pregnancy): “Wow, you’re biiiiiiiiiiiiig!”

27weeks

My response: “Well, most women look bigger sooner when they’ve been pregnant before.”

35 weeks

What I’m thinking: “Eff you I do not either!!  I look fantastic!!!”  I also then think that people shouldn’t ever make comments about how big or small they think you are for whatever stage of pregnancy you’re in.

Various friends: “You’re not going to the hospital?  Wow, you’re brave!”

My response: “Hmm, well I think women who go to the hospital are brave.”

What I’m thinking: Unfortunately, most women take it for granted that they’ll be safe in the hospital and that their births will go normally.  I’m thinking that women don’t really consider their choice of birth venue as seriously as they should.  In my town, low risk women have access to a regional hospital (with a cesarean rate reflective of the national trend), a birth center (run by a CNM), and home birth.  Do women really know the pluses and minuses of each of these birth venues?

Random & Non-Random people: “Well, my baby would have died if we hadn’t been in the hospital because he/she was in distress!”

My response: “Wow, I’m sure that was really scary!”

My thoughts:  Normal, physiologic birth usually (sure, not always) does not lead to distressed babies.  When someone tells me their babies were in distress, I immediately wonder if they had: (1) AROM? (2) non-medically indicated induction? (3) non-medically indicated augmentation of labor? (4) epidural (which most hospital births involve epidurals).  We all usually study the “cascade of interventions” in childbirth education classes, but in the heat of the moment, lots of us forget that information and do whatever is required of or recommended to us.

These are a few of the random and usually not appreciated comments directed at me when I’m pregnant.  What are yours?