Epidurals During Labor: Pros and Cons

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The Epidural Through History

Using epidurals for pain relief during childbirth can be traced back to the early 20th century. In 1901, the use of anesthetics in the epidural space was first reported. Fidel Pagés was a pioneer of the epidural, promoting it for surgical purposes through his article published in 1921.

However, it wasn't until the 1970s that epidurals gained popularity for labor due to advancements in medical technology and improvements in technique. The development of the epidural catheter allowed for a continuous flow of anesthesia, enhancing control over pain relief during labor. This marked a new era in the history of childbirth, as more women began to consider epidurals as a viable option for managing labor pain.

Throughout the latter half of the 20th century and into modern years, the number of women using epidurals has continued to rise. Today, around 70% of laboring women use an epidural. As childbirth has shifted into hospitals and become more and more of a medical procedure, many women see the epidural as a non-negotiable and as the “normal” way to manage labor pain.

Pros and Cons of Epidurals

Pros:

  • Pain Relief: Epidurals are very effective in easing pain, allowing mothers to get more rest during labor and feel less exhausted. For a mother anxious about childbirth pain, an epidural may look very appealing.

  • Flexibility: Epidurals provide a more controlled and adjustable pain relief approach, with the ability to administer additional medication if necessary.

  • Easier Medical Interventions: The pain relief provided by epidurals can facilitate medical interventions such as forceps or vacuum-assisted delivery if complications arise.

Cons:

  • Reduced Mobility: Epidurals limit a woman's ability to move and change positions during labor, often slowing down natural progression. Walking, standing, and swaying are some of the best ways to speed up labor.

  • Increased Risk of Medical Interventions: When labor is slowed down, there is a higher chance you will require medical interventions to help it progress. Pushing is sometimes more difficult with an epidural in place, so this can increase the risk of needing forceps, vacuum-assisted delivery, or a c-section.

  • Potential Side Effects: Epidurals can lead to side effects such as low blood pressure, back pain, headache, and nausea - see next section for more information.

  • Worse Postpartum Recovery: Many women complain of experiencing a worse recovery period due to their epidural. Epidurals can often increase the risk of tearing since a doctor has to guide you when to push and you aren’t able to listen to your body.

  • Pain Medication in Baby’s System: A small amount of the epidural does cross over and enter the baby’s system, remaining there for at least the first 30 days of life.

  • Possible Breastfeeding Issues: Exposure to pain medication often dulls a baby’s initial feeding behaviors. Epidurals also inhibit the mother’s release of natural oxytocin and can delay the milk coming in.

Common Epidural Side Effects

While epidurals are generally considered safe, women often experience side effects, including:

  • Low Blood Pressure

  • Headache

  • Nausea and Vomiting

  • Back Pain

  • Perineal Tearing / Swelling

  • Urination Problems

  • Elevated Temperature

It’s true, epidurals are effective in reducing labor pain - but there are several natural pain management techniques to consider that allow you to avoid unwanted side effects and feel empowered by using your own strength.