I have finally got around to doing it. Energy has been drained but now I am back at it. Ready to roar.
As pregnant ladies do, I made a birth plan. I wanted no drugs, the least intervention as I could get and I was going to birth my baby the way my body wanted to. As we all know, things don’t always work out the way you plan them.
I know what went wrong. For sake of hurting feelings I won’t point it out…just tell you my story.
My mother came down to AZ from AK to see the birth of her grandchild and for some reason I had a feeling we were going to be early, (due on June 2nd) so Mom came down on May 30th. A week passed by and nothing yet. I had all the common questions, “When is the baby coming?” “How long are the going to let you go?” “Hurry up and have that baby already.”
I know most first time moms go over, but all these repetitive questions made me feel anxious and kind of angry people were expecting me to know when the baby was coming. Like I was in charge of when I birthed.
As the time started getting closer to Mom leaving we started looking at natural ways to trigger labor. We walked and walked and walked.
On June 10th, Thursday, we went to Metro Center Mall and walked around for a couple of hours. I walked stairs, sat in the vibrating chairs, got a foot massage and contractions started. They were getting closer and closer together so we decided, being five minutes away from the hospital, we were going to go. When we got there and I got hooked up to the monitors, the contractions started spacing themselves further apart. Six minutes, seven minutes, so they sent me home. I really at this point just wanted to have the baby. When the nurse in triage called Tiffany, (the midwife on call) I told her I wanted to get my water broken to get things started. They told me to come back in the morning and we would be scheduled for an induction. So we went home still pregnant.
That night, I thought about it. This whole pregnancy I didn’t want any intervention. I hadn’t even taken Tylenol for headaches. Why now at the very end had I chosen to have an induction? Why have the baby come when everyone else wanted the baby, not when the baby wanted to come? I told my mom who was supposed to be leaving that Sunday, “I want to have the baby before you leave, I don’t want your trip to be for nothing!” She said, “Well don’t get induced on account of me leaving, the baby will come when she comes.” (We didn’t know what the sex of the baby was, but she wanted a girl, to have three girl tiger Gemini’s in a row. Her, me, and baby.) So when she said that, I thought ‘you know she is right! Baby will come, forget everyone else.
The next day we decided to go to Arizona Mills, another mall and walk some more. We met up with my cousins there and walked around the mall for four hours. We heard pineapple helped induce labor so I was eating that all day while we walked. We walked and walked, but I didn’t feel any contractions. When we went home our feet were so tired. Husband got home from school and we went about our night.
At 12:35 I felt my first contraction. Out of nowhere they came on and so I decided to time them. Five minutes, seven minutes, six minutes, but they were getting regular. I waited for a little while to make sure it was for real this time, and at 2:30am I decided to wake my mom. It was time, guess baby was waiting for daddy to be able to be there. It was the weekend.
So I called my cousins and told them it was time and we went to the hospital. I got checked in triage and I was at 4 cm almost 5, so they decided to keep me. I went walking. We walked around labor and delivery and contractions got to the point where we had to stop now and again to work through them.
My room was finally ready and I was hooked up to the monitors again for five minutes to check and make sure the baby was doing okay still. When we were done, I got up and walked around the room for a while, was able to get into the tub and labor in there for a while, then I went back into the bed to rest. This went on for like 8 hours. Lisa, the midwife decided to come in and talk options. At this point my water hadn’t broken. I was dilated to 5. We decided to break my water. There was a little meconium in my water, which is normal for overdue mothers. Lisa wasn’t concerned so we continued to labor.
Then my mother in law showed up.
Her, Husband’s sister and Aunty wanted to come into the room and watch. Something I didn’t think was a great idea. I felt it was a private moment, and for those who know our history, it wasn’t something that felt “right.” Husband was torn. He wanted to share this moment with his Mother, at the time I didn’t realize that but he was ready to leave me if I didn’t let her in the room. She made it about her. I was getting at a point where contractions were unbearable, 12 hours of pain without meds, and now I wasn’t progressing. I was stuck at 5 cm. I went to the toilet, and when I came back to sit on the bed more water came out. This time it gushed and was dark with meconium. Lisa came in to talk to me about what we were going to do. It was about the baby now and at this point I was barely able to get through anything. Baby was moving away from the external monitor, so they put an internal monitor in me.
We decided it was time for pitocin to get contractions rolling and cervix dilating. I know from all the birth stories that pitocin makes contractions very painful, so I opted for the epidural. With the epi came the catheter, and oxygen mask. After I got it, I was in heaven compared to the last 12 hours. I told Husband his mom could come in now. I felt no pain, and wasn’t embarrassed anymore. Husband and I were able to get some sleep and even though I couldn’t feel the contractions, I felt some pressure in my anal region. They told me that was the baby’s head and contractions. So I could still feel them, just not as strong. By 6pm I felt urges to push. I asked to be checked and I was fully dilated! I was ecstatic. They told me we would start to push about 6:30pm because we had to wait for a doctor for the baby because of the meconium. Time finally came around and we started to push with the contractions. I couldn’t even feel the baby moving down. People were all around me telling me I was doing great and things were going well, but I couldn’t tell!
7:30 rolls around and they finally could see the head emerging. Seven minutes later I hear, “It’s a boy!” It was such a fantastic feeling getting him out. The pressure was released and I was so happy to hear I had a boy! Half the family was hoping for a boy, and the other half a girl. Guess you can’t go wrong with 50/50 chances! I was just hoping for a healthy baby.
Julian James Cleveland was born on June 12, 2010, weighing in at 7 lbs 12 oz, 20 1/2 inches long. He is a lovely addition to our new family and we love him dearly.
Showing posts with label epidural. Show all posts
Showing posts with label epidural. Show all posts
Monday, June 21, 2010
Wednesday, February 17, 2010
Guest Post: Victoria's Birth
From Katie DiBeneddeto's Journal
Monday October 19th 2009
This morning I met Victoria & Tyner at Baptist for Victoria's induction. We got settled into a room and then a nurse came in to do her IV, which sucked because the nurse couldn't do it. Victoria said this always happens though and they always end up having to get the head nurse to come in. Victoria did appreciate though that the nurse quickly realized she couldn't do it and had no problem bringing in someone else. I felt bad for her though because her poor arm was bruised from the couple sticks that didn't work out. Poor thing! A super sweet older nurse was sent in, and Tiffany! I just love Tiffany. She just has such great energy. This was about noon and Tiffany had office hours from 1 to 5 so I guess she was just stopping by before she had to head over and see other moms. The nurse that was brought in was totally rockin and got the IV in on her first try. I told Victoria that next time she should just straight up say "Look honey, I'm sorry, but I know you're not going to be able to get this IV in. Please just skip even trying, get over yourself and bring in your star nurse ASAP". So anyway, once they got the IV in they started a bag of fluid. Pitocin was started a little after 1.
She managed to stay comfortable for the first few increases and then they just started getting stronger and more regular, but she never lost control. I really admired that about her the whole time. Around 2 o clock or so her in laws came for a visit. They were a super sweet couple - they're in from Corvallis, Oregon. They were very encouraging and didn't really intrude at all. Although they did start sort of obsession over the monitor. I know it's hard for people not to do that, but it's still one of my peeves. I always encourage people to look at the mom - that's your best indicator of what's going on. Plus it messes with your head - like a placebo pill or something - "Oh that was a big number (on the contraction monitor), that must have hurt!" and I'm like...."Well look at her face! She's doing just fine". I guess people just take the monitors so literally sometimes. I guess Tyner was motioning or making faces at Victoria or something to see if she wanted his parents to leave, but she wasn't getting it. But Tyner just said to his parents "So, thanks for visiting..." and then took the hint and left. How refreshing!
Then she wanted to eat lunch and of course at first the nurse said no, but then said she'd ask Tiffany and of course Tiffany said yes - it was so early and she could eat whatever she wanted. So she did. We ordered lunch and it was decent for hospital food. We asked a couple of different people for birth balls and Tyner said he never knew whether or not to keep asking. I said I usually just kept asking until I get it. You never know how many patients they have. Once we got it Victoria wanted to get on it just to practice and get the feel for it before things really got intense. She got on and really liked it. We took turns rubbing her back. It was a really nice time too - I got to hear all about how they met and how he proposed and everything. It was so cute to hear them share all of their stories and I'm sure it was a nice distraction for Victoria. They are a really sweet couple. And he was just the best husband (soon to be anyway...) that I had ever seen. So much non verbal communication. She had to use the bathroom a couple of times and one of the times she had a very intense contraction - being on the toilet was not comfortable at all for her.
Tiffany came back around 5:30 and checked her and she was still a 2. Not that that's bad, but I felt so bad for her. I know she was hoping to have been farther along and I knew she was running out of steam. I kept reminding her that her body was doing so much work that couldn't be measured just by checking her cervix. She was also incredibly congested. It took forever to get sudafed. Our nurse was totally out of it. Then Tiffany went to have dinner and said she'd be back later. Victoria ordered some dinner and Tyner went across the street to get some. I stayed with Victoria. She was back on the ball and I was behind her rubbing her lower back. Her dinner came and she sat up in bed and ate it and had a couple of hard contractions during. She is such a friggin trooper though. Then it was shift change and guess who came in? Rian!! I was psyched! And she remembered me too. She is so great. And she got us sudafed in like 15 minutes. She is so incredible awesome.
Soon after my rice sock became Victoria's best friend. I kept running out to heat it up and then Tyner and I took turns putting pressure on her hip while she was laying on her side. Tyner was so fantastic. I've never seen a sweeter partner. He was perfect. They are so good together. She decided to get some stadol because things were just getting to be too much. The nurse started her out real slow and said she'd give her another dose if she wanted it later. Victoria was hilarious after that. It was like she was drunk. Tyner and I were going to sort of nap, but Victoria was like "I'm being so funny right now and you guys are wasting it napping". She is hilarious. Then she said it didn't make the pain go away, it just made it seem farther away. She said it was like her pain was wrapped up like a present. It was in really pretty paper so that's what made her want to open it, but then she would open it and it would be painful and she would tell it to go away. But then the next one would come and it would be wrapped in pretty paper and the whole cycle started over again. It was hilarious, we were all dying with laughter. She told everyone who came in and I think Tyner even got it on video.
Then she got an epidural a bit later. She was in a lot of pain. It's always hard to watch when it gets to that point. But we talked about it a lot and it was what she really wanted, it wasn't like a spur of the moment for no good reason decision. And she had been at it for so long, she was just out of juice. Anybody would be. The anesthesiologist said I'd be trapped back there (in view of the epidural insertion) and Tiffany said it was ok, I was cool. She's so funny. And it was actually fun to watch from that angle. It's so scary though! I can't believe women so readily do it. After that it took a bit for it to kick in, but she was ok. Then Tyner and I napped on and off after she got comfortable.
We woke up a bit later and then all of the sudden there were a bunch of people in the room. That is never good. Apparently the heart rate was dipping and everyone was getting scared. Then Tiffany said they had to do a c section. Victoria was freaking out - I felt so bad for her. She had to sign all these consent forms really fast. It was a horrible situation. But I totally trust Tiffany so I wasn't questioning the c section - that's a really nice feeling. I know Victoria and Tyner did too. I helped Tyner get suited up and then I grabbed their cameras just in case. I asked Tiff, but she said I wouldn't be allowed in. I followed them anyway. As we were walking out I told Tyner I couldn't come in, but I'd be right outside if they needed anything. They wheeled her in and both Tyner and I had to wait outside for the first little bit. There was one chair and Tyner sat in it. I came and stood next to him and asked how he was doing. He just sort of reached out for me so I moved closer to him and held his head against my chest. He wrapped his arms around my waist and I was just overwhelmed. He was so scared and so vulnerable and it was so sweet the way he had just reached out. It took everything in me not to cry. I just held his head really tight and told him everything would be ok and that I knew that waiting was the hardest part. And I just stood there with him. And we waited. Then Tiffany came out and said the heart rate was steadying so they were just going to observe her for a minute. Then they brought her back into the room! I was soooooo relieved. Tyner went over and kissed her. She was shaking though. i can't imagine how scared she must've been. Tiffany siad it just sucks because in a home birth that would have just been no big deal and may have even gone undetected, which isn't a bad thing because variations in heartrate are normal - but in a hospital, where there's huge accountability you can't ignore a heart rate abnormality because of the off chance of something bad actually happening and then you've got record of a dip in the heart rate and no one did anything. It just sucks. After things calmed down we all dozed again.
Then we woke up and she was 10 and it was time to push. It was about 5'o clock in the morning at this point. They got the squat bar and she used that for a bit. Tiffany was at the edge of the bed and Rian and Tyner were helping her hold her legs. They had to give her oxygen at one point just because she had been pushing and was so out of breath. I was trying to stay coordinated with the camera and the video camera at the same time. She was a great pusher and he came out in no time though. It was amazing. I gave Tyner a big hug and put my hand on Victoria's forehead. He was born at 6:05am Tuesday, October 20th. It was amazing. This will never get old. He was such a sweetheart too. And they didn't go out and tell anyone for a while. It was just the three of them for the first hour and they never took Oliver away. It was fantastic.
After a little while they took him to the warmer to get him cleaned up a bit. Then Jesse came in - Victoria's 12 year old son. That was really sweet. Then they invited the grandparents in. I ordered them breakfast. The grandparents didn't stay for too long which was nice. A new nurse came in though and she was not as cool (but no one is as great as Rian). This nurse helped her breastfeed, which is always hard to watch. I wish people didn't make such a big deal out of it. Jesus, he's been out an hour. He's not going to starve himself. Once they were settled I said my goodbye's and headed home. I never even went to sleep. I was too psyched. What a great birth!
Monday October 19th 2009
This morning I met Victoria & Tyner at Baptist for Victoria's induction. We got settled into a room and then a nurse came in to do her IV, which sucked because the nurse couldn't do it. Victoria said this always happens though and they always end up having to get the head nurse to come in. Victoria did appreciate though that the nurse quickly realized she couldn't do it and had no problem bringing in someone else. I felt bad for her though because her poor arm was bruised from the couple sticks that didn't work out. Poor thing! A super sweet older nurse was sent in, and Tiffany! I just love Tiffany. She just has such great energy. This was about noon and Tiffany had office hours from 1 to 5 so I guess she was just stopping by before she had to head over and see other moms. The nurse that was brought in was totally rockin and got the IV in on her first try. I told Victoria that next time she should just straight up say "Look honey, I'm sorry, but I know you're not going to be able to get this IV in. Please just skip even trying, get over yourself and bring in your star nurse ASAP". So anyway, once they got the IV in they started a bag of fluid. Pitocin was started a little after 1.
She managed to stay comfortable for the first few increases and then they just started getting stronger and more regular, but she never lost control. I really admired that about her the whole time. Around 2 o clock or so her in laws came for a visit. They were a super sweet couple - they're in from Corvallis, Oregon. They were very encouraging and didn't really intrude at all. Although they did start sort of obsession over the monitor. I know it's hard for people not to do that, but it's still one of my peeves. I always encourage people to look at the mom - that's your best indicator of what's going on. Plus it messes with your head - like a placebo pill or something - "Oh that was a big number (on the contraction monitor), that must have hurt!" and I'm like...."Well look at her face! She's doing just fine". I guess people just take the monitors so literally sometimes. I guess Tyner was motioning or making faces at Victoria or something to see if she wanted his parents to leave, but she wasn't getting it. But Tyner just said to his parents "So, thanks for visiting..." and then took the hint and left. How refreshing!
Then she wanted to eat lunch and of course at first the nurse said no, but then said she'd ask Tiffany and of course Tiffany said yes - it was so early and she could eat whatever she wanted. So she did. We ordered lunch and it was decent for hospital food. We asked a couple of different people for birth balls and Tyner said he never knew whether or not to keep asking. I said I usually just kept asking until I get it. You never know how many patients they have. Once we got it Victoria wanted to get on it just to practice and get the feel for it before things really got intense. She got on and really liked it. We took turns rubbing her back. It was a really nice time too - I got to hear all about how they met and how he proposed and everything. It was so cute to hear them share all of their stories and I'm sure it was a nice distraction for Victoria. They are a really sweet couple. And he was just the best husband (soon to be anyway...) that I had ever seen. So much non verbal communication. She had to use the bathroom a couple of times and one of the times she had a very intense contraction - being on the toilet was not comfortable at all for her.
Tiffany came back around 5:30 and checked her and she was still a 2. Not that that's bad, but I felt so bad for her. I know she was hoping to have been farther along and I knew she was running out of steam. I kept reminding her that her body was doing so much work that couldn't be measured just by checking her cervix. She was also incredibly congested. It took forever to get sudafed. Our nurse was totally out of it. Then Tiffany went to have dinner and said she'd be back later. Victoria ordered some dinner and Tyner went across the street to get some. I stayed with Victoria. She was back on the ball and I was behind her rubbing her lower back. Her dinner came and she sat up in bed and ate it and had a couple of hard contractions during. She is such a friggin trooper though. Then it was shift change and guess who came in? Rian!! I was psyched! And she remembered me too. She is so great. And she got us sudafed in like 15 minutes. She is so incredible awesome.
Soon after my rice sock became Victoria's best friend. I kept running out to heat it up and then Tyner and I took turns putting pressure on her hip while she was laying on her side. Tyner was so fantastic. I've never seen a sweeter partner. He was perfect. They are so good together. She decided to get some stadol because things were just getting to be too much. The nurse started her out real slow and said she'd give her another dose if she wanted it later. Victoria was hilarious after that. It was like she was drunk. Tyner and I were going to sort of nap, but Victoria was like "I'm being so funny right now and you guys are wasting it napping". She is hilarious. Then she said it didn't make the pain go away, it just made it seem farther away. She said it was like her pain was wrapped up like a present. It was in really pretty paper so that's what made her want to open it, but then she would open it and it would be painful and she would tell it to go away. But then the next one would come and it would be wrapped in pretty paper and the whole cycle started over again. It was hilarious, we were all dying with laughter. She told everyone who came in and I think Tyner even got it on video.
Then she got an epidural a bit later. She was in a lot of pain. It's always hard to watch when it gets to that point. But we talked about it a lot and it was what she really wanted, it wasn't like a spur of the moment for no good reason decision. And she had been at it for so long, she was just out of juice. Anybody would be. The anesthesiologist said I'd be trapped back there (in view of the epidural insertion) and Tiffany said it was ok, I was cool. She's so funny. And it was actually fun to watch from that angle. It's so scary though! I can't believe women so readily do it. After that it took a bit for it to kick in, but she was ok. Then Tyner and I napped on and off after she got comfortable.
We woke up a bit later and then all of the sudden there were a bunch of people in the room. That is never good. Apparently the heart rate was dipping and everyone was getting scared. Then Tiffany said they had to do a c section. Victoria was freaking out - I felt so bad for her. She had to sign all these consent forms really fast. It was a horrible situation. But I totally trust Tiffany so I wasn't questioning the c section - that's a really nice feeling. I know Victoria and Tyner did too. I helped Tyner get suited up and then I grabbed their cameras just in case. I asked Tiff, but she said I wouldn't be allowed in. I followed them anyway. As we were walking out I told Tyner I couldn't come in, but I'd be right outside if they needed anything. They wheeled her in and both Tyner and I had to wait outside for the first little bit. There was one chair and Tyner sat in it. I came and stood next to him and asked how he was doing. He just sort of reached out for me so I moved closer to him and held his head against my chest. He wrapped his arms around my waist and I was just overwhelmed. He was so scared and so vulnerable and it was so sweet the way he had just reached out. It took everything in me not to cry. I just held his head really tight and told him everything would be ok and that I knew that waiting was the hardest part. And I just stood there with him. And we waited. Then Tiffany came out and said the heart rate was steadying so they were just going to observe her for a minute. Then they brought her back into the room! I was soooooo relieved. Tyner went over and kissed her. She was shaking though. i can't imagine how scared she must've been. Tiffany siad it just sucks because in a home birth that would have just been no big deal and may have even gone undetected, which isn't a bad thing because variations in heartrate are normal - but in a hospital, where there's huge accountability you can't ignore a heart rate abnormality because of the off chance of something bad actually happening and then you've got record of a dip in the heart rate and no one did anything. It just sucks. After things calmed down we all dozed again.
Then we woke up and she was 10 and it was time to push. It was about 5'o clock in the morning at this point. They got the squat bar and she used that for a bit. Tiffany was at the edge of the bed and Rian and Tyner were helping her hold her legs. They had to give her oxygen at one point just because she had been pushing and was so out of breath. I was trying to stay coordinated with the camera and the video camera at the same time. She was a great pusher and he came out in no time though. It was amazing. I gave Tyner a big hug and put my hand on Victoria's forehead. He was born at 6:05am Tuesday, October 20th. It was amazing. This will never get old. He was such a sweetheart too. And they didn't go out and tell anyone for a while. It was just the three of them for the first hour and they never took Oliver away. It was fantastic.
After a little while they took him to the warmer to get him cleaned up a bit. Then Jesse came in - Victoria's 12 year old son. That was really sweet. Then they invited the grandparents in. I ordered them breakfast. The grandparents didn't stay for too long which was nice. A new nurse came in though and she was not as cool (but no one is as great as Rian). This nurse helped her breastfeed, which is always hard to watch. I wish people didn't make such a big deal out of it. Jesus, he's been out an hour. He's not going to starve himself. Once they were settled I said my goodbye's and headed home. I never even went to sleep. I was too psyched. What a great birth!
Monday, November 9, 2009
Share With Women - Epidurals
SHARE WITH WOMEN - American College of Nurse-Midwives
EPIDURAL ANALGESIA
There are many options for managing pain during labor. You might decide before you begin labor that you want pain medication, or you may not want any medications. This handout discusses epidural analgesia.
What is Epidural Analgesia?
Epidural analgesia is a local anesthetic placed in a part of your back where it numbs the nerves that go from your pelvis and legs to your brain. The anesthetic is like the kind you get when you go to the dentist. With an epidural, you get an injection into the space around the nerves in your spine that makes your body numb below the site of the injection.
How Does an Epidural Work?
All of the nerves of the body send their messages to the brain through the spine. Anesthetics are
medicines that block the messages from traveling up nerves to the brain. When the pain messages are blocked before getting to your brain, you do not “feel” the pain.
How is an Epidural Done?
There is a very small space around the nerves in your spine. This is called the epidural space. A specially trained doctor or nurse places a thin tube, called a catheter, into this space. You will have to sit on the side of the bed or curl up on your side on the bed. The nurse or doctor will give you a shot of Novocain in your back. Then the nurse or doctor will put a long needle through the area that is numbed into the epidural space. When he or she has found the space, the thin tube will be threaded through the needle, and the needle is removed. A pump is then set up to deliver the anesthesia through the tube into the epidural space during your labor. After birth, the tube will be taken out. The numbness will begin to go away. You will be able to move your legs and walk in a few hours.
How Well Does an Epidural Work?
For some women, an epidural works very well. Within 15 to 20 minutes of starting the anesthesia, they lose feeling below the waist. Many women are so comfortable they can talk, watch television, or even sleep. Occasionally, the epidural does not work as well, and you may continue to feel pain or pressure even though your legs are numb. There is no way to guess who will get a “pain free” epidural and who will have an epidural that does not work completely.
Are There Risks Associated With Having an Epidural During Labor?
Your labor progress depends on lots of things: the size of your pelvis, the size of your baby, the
position of your baby, and the strength of your contractions. Most of this is out of your control.
Sometimes an epidural can help and sometimes it makes labor longer and more complicated.
Risks of Insertion and Placement of Anesthesia in the Epidural Space
● The epidural is inserted sterilely, but there is a small chance of infection at the site where the needle is inserted. A serious infection could cause paralysis or, very rarely, death.
● The needle could hit a nerve and cause nerve damage or paralysis. In most people, the spinal cord is above the area where the needle is placed, which is why this problem is rare.
● If the epidural is incorrectly placed too high in your back or into spinal fluid, you may lose the
sensation of your breathing and need help to breathe regularly.
Risks During Labor
● If your bladder is full, you will not be able to feel it, so you will need a catheter to drain the urine.
● Women who have an epidural have a higher chance of getting a fever during labor, and then the baby may need additional blood work and observation to rule out infection.
● Women who have an epidural are more likely to need medication to make contractions stronger.
● Your legs will be numb. If your baby gets stuck in a “crooked” position, you will not be able to move around to “jiggle” the baby into a good position. This may increase your chance of needing a cesarean section.
● It may be hard to feel your contractions when you need to push. Pushing takes longer.
● Women who have an epidural have a higher chance of needing a vacuum or forceps to help give birth.
Risks Afterward
● The most common risk of an epidural after the baby is born is a “spinal headache.” This only happens one or two times for every 100 epidurals that are used. This is a terrible headache that comes 1 to 2 days after the epidural is removed. If you get a spinal headache, you will need to return to the hospital to have a special procedure called a “blood patch.” The patch usually helps right away.
● Your baby may have a harder time getting started breastfeeding.
● Many women report ongoing back pain after an epidural, but we do not know if this is because of the epidural or because of other things that may have happened during their labor.
● There is a very, very small risk of permanent paralysis—loss of the ability to move your legs.
What Are the Benefits of an Epidural?
● If the epidural works well, you will not feel the intense pain.
● Sometimes—especially with a first baby—early labor may be long. An epidural can give you a
chance to rest so that you can gather your strength for active labor and birth.
● If you are very anxious, an epidural may help you relax. In some women it appears that the epidural may actually make your labor go more quickly.
● If you need a cesarean section, your epidural can be used to make you numb for the surgery.
● Women with twins or babies in a breech position who plan a vaginal birth may use an epidural so they are prepared for a cesarean section if their baby (or babies) have problems during labor or birth.
FOR MORE INFORMATION
Childbirth Connection:
Options: Labor Pain (Epidural and Spinal)
EPIDURAL ANALGESIA
There are many options for managing pain during labor. You might decide before you begin labor that you want pain medication, or you may not want any medications. This handout discusses epidural analgesia.
What is Epidural Analgesia?
Epidural analgesia is a local anesthetic placed in a part of your back where it numbs the nerves that go from your pelvis and legs to your brain. The anesthetic is like the kind you get when you go to the dentist. With an epidural, you get an injection into the space around the nerves in your spine that makes your body numb below the site of the injection.
How Does an Epidural Work?
All of the nerves of the body send their messages to the brain through the spine. Anesthetics are
medicines that block the messages from traveling up nerves to the brain. When the pain messages are blocked before getting to your brain, you do not “feel” the pain.
How is an Epidural Done?
There is a very small space around the nerves in your spine. This is called the epidural space. A specially trained doctor or nurse places a thin tube, called a catheter, into this space. You will have to sit on the side of the bed or curl up on your side on the bed. The nurse or doctor will give you a shot of Novocain in your back. Then the nurse or doctor will put a long needle through the area that is numbed into the epidural space. When he or she has found the space, the thin tube will be threaded through the needle, and the needle is removed. A pump is then set up to deliver the anesthesia through the tube into the epidural space during your labor. After birth, the tube will be taken out. The numbness will begin to go away. You will be able to move your legs and walk in a few hours.
How Well Does an Epidural Work?
For some women, an epidural works very well. Within 15 to 20 minutes of starting the anesthesia, they lose feeling below the waist. Many women are so comfortable they can talk, watch television, or even sleep. Occasionally, the epidural does not work as well, and you may continue to feel pain or pressure even though your legs are numb. There is no way to guess who will get a “pain free” epidural and who will have an epidural that does not work completely.
Are There Risks Associated With Having an Epidural During Labor?
Your labor progress depends on lots of things: the size of your pelvis, the size of your baby, the
position of your baby, and the strength of your contractions. Most of this is out of your control.
Sometimes an epidural can help and sometimes it makes labor longer and more complicated.
Risks of Insertion and Placement of Anesthesia in the Epidural Space
● The epidural is inserted sterilely, but there is a small chance of infection at the site where the needle is inserted. A serious infection could cause paralysis or, very rarely, death.
● The needle could hit a nerve and cause nerve damage or paralysis. In most people, the spinal cord is above the area where the needle is placed, which is why this problem is rare.
● If the epidural is incorrectly placed too high in your back or into spinal fluid, you may lose the
sensation of your breathing and need help to breathe regularly.
Risks During Labor
● If your bladder is full, you will not be able to feel it, so you will need a catheter to drain the urine.
● Women who have an epidural have a higher chance of getting a fever during labor, and then the baby may need additional blood work and observation to rule out infection.
● Women who have an epidural are more likely to need medication to make contractions stronger.
● Your legs will be numb. If your baby gets stuck in a “crooked” position, you will not be able to move around to “jiggle” the baby into a good position. This may increase your chance of needing a cesarean section.
● It may be hard to feel your contractions when you need to push. Pushing takes longer.
● Women who have an epidural have a higher chance of needing a vacuum or forceps to help give birth.
Risks Afterward
● The most common risk of an epidural after the baby is born is a “spinal headache.” This only happens one or two times for every 100 epidurals that are used. This is a terrible headache that comes 1 to 2 days after the epidural is removed. If you get a spinal headache, you will need to return to the hospital to have a special procedure called a “blood patch.” The patch usually helps right away.
● Your baby may have a harder time getting started breastfeeding.
● Many women report ongoing back pain after an epidural, but we do not know if this is because of the epidural or because of other things that may have happened during their labor.
● There is a very, very small risk of permanent paralysis—loss of the ability to move your legs.
What Are the Benefits of an Epidural?
● If the epidural works well, you will not feel the intense pain.
● Sometimes—especially with a first baby—early labor may be long. An epidural can give you a
chance to rest so that you can gather your strength for active labor and birth.
● If you are very anxious, an epidural may help you relax. In some women it appears that the epidural may actually make your labor go more quickly.
● If you need a cesarean section, your epidural can be used to make you numb for the surgery.
● Women with twins or babies in a breech position who plan a vaginal birth may use an epidural so they are prepared for a cesarean section if their baby (or babies) have problems during labor or birth.
FOR MORE INFORMATION
Childbirth Connection:
Options: Labor Pain (Epidural and Spinal)
Thursday, October 15, 2009
J's Birth
J was sent over from the office to the hospital for a NST (non-stress test) and to check the fluid around the baby as she was 41.2 weeks pregnant. The plan was for her to come in the next morning to have her water broke as a means of getting labor started. Her cervix was 4cms in the office that day with the baby's head quite low in the pelvis. Diane had called me to let me know she was coming. Diane would be on call the next day.
J had previously had epidurals with her other children. From what she told me, it sounded like she would get to transition then was offered an epidural, where her response was yes. Then she would deliver 30 minutes later. Her previous children were all caught by doctors. She very much wanted to do this natural.
When J arrived and was put on the monitor in triage, I was a little concerned. I didn't like how the baby's heart rate looked so opted to just keep her for the night. Well, I may have jumped the gun because once she came back to L&D, and was on the monitor, the baby looked fantastic. She was also contracting about every five minutes but feeling just a bit crampy with them. I asked her what she wanted to do...stay and break water tonight, stay and do nothing tonight, or go back home. Her and her husband had already made arrangements for their other children (a set of twins and a singleton) and they lived a fair ways away. She decided to stay.
We discussed breaking her water versus not, and she decided to have me check her first. Her husband wasn't there yet but would be in about an hour. She asked if breaking her water would cause her to deliver before he returned. I told "oh no, you won't go that fast!".
Famous last words.
She was 4-5/100/0 when I checked her so she opted to have her membranes ruptured. We even waited until after the nurses' shift change (maybe 20 minutes) before we did it. Once her water was broke, I asked her to walk a bit. She was also looking forward to getting in the tub and trying the birth ball. I went to do some paperwork and saw her walking a bit in the hallway. In hindsight, she looked a bit out of sorts, but at the time I didn't think too much of it.
A few minutes later she went back in the room and the nurse came and asked me if she could have something to eat as she was feeling light-headed. I went in to check on her and she was sitting on the edge of the bed. She told me this was what she didn't like about labor last time either...I suggested some protein as well as carbs. I told her I would be right back to check on her. I went to another patient's room to check in on her. While I was in there the nurse came and stuck her head in the door to tell me that J was asking for an epidural.
I was like "what???" She was doing fine when I had just been in there. So I tell the nurse not to do anything, I'm coming to check on her first. When I get to the room, she's still sitting on the edge of the bed. She tells me I can't do this. Then she grunts and bears down.
I'm thinking "what the heck?" I told J, let me check you before we make any decisions, you haven't tried the tub yet, and it sound slike you are getting close. She was spontaneously bearing down with each contraction. I checked her and she was 9 and a half cms! I said no epidural. She wanted to get in the tub so she squatted in the tub. I sat at her side holding her hand. I started worrying that her husband wasn't going to make it. I don't think she was in the tub more than 10 minutes when she started pushing again. She told me that the baby was coming. I checked and she was certainly correct - she was completely dilated and the baby was at a +2 station. I asked her if she could get out and maybe squat by the bed for delivery (we aren't supposed to do waterbirth although if she hadn't been able to get out, oh well). She was able to move over by a chair in the room. My thought was that she could lean on the chair and I would catch the baby from behind. Not quite how it worked out.
She squatted while I sat on the floor. She had one arm around my shoulders with her other hand on my leg for support. The nurse stood near by, not really sure what to do. She wanted to listen to the baby's heartbeat but I said not to worry about it, we could listen when the baby came out. I could not see what was going on as my head was crushed against J's chest. It was kinda funny :) I kept talking her through her contractions. She would talk completely normally in between contractions, asking what to do. I had one hand at her vagina, where I could feel the head crowning. She slowly and gently pushed the head out. It was such a thrill to not be able to see what I was doing but feel the head being born into my hand. We had a little trouble with the shoulders but nothing that wasn't remedied by me getting both hands involved. She gracefully pushed out the rest of her baby. I brought the baby up to her arms and the nurse threw a blanket over them. The baby was doing absolutely fine as was momma. We helped her move to the bed where she could rest while latching the baby on to the breast. Her husband walked in literally five minutes after the birth.
She pushed out her placenta just as gracefully. She had just a small perineal tear requiring no stitches.
Congrats J on a beautiful birth!
J had previously had epidurals with her other children. From what she told me, it sounded like she would get to transition then was offered an epidural, where her response was yes. Then she would deliver 30 minutes later. Her previous children were all caught by doctors. She very much wanted to do this natural.
When J arrived and was put on the monitor in triage, I was a little concerned. I didn't like how the baby's heart rate looked so opted to just keep her for the night. Well, I may have jumped the gun because once she came back to L&D, and was on the monitor, the baby looked fantastic. She was also contracting about every five minutes but feeling just a bit crampy with them. I asked her what she wanted to do...stay and break water tonight, stay and do nothing tonight, or go back home. Her and her husband had already made arrangements for their other children (a set of twins and a singleton) and they lived a fair ways away. She decided to stay.
We discussed breaking her water versus not, and she decided to have me check her first. Her husband wasn't there yet but would be in about an hour. She asked if breaking her water would cause her to deliver before he returned. I told "oh no, you won't go that fast!".
Famous last words.
She was 4-5/100/0 when I checked her so she opted to have her membranes ruptured. We even waited until after the nurses' shift change (maybe 20 minutes) before we did it. Once her water was broke, I asked her to walk a bit. She was also looking forward to getting in the tub and trying the birth ball. I went to do some paperwork and saw her walking a bit in the hallway. In hindsight, she looked a bit out of sorts, but at the time I didn't think too much of it.
A few minutes later she went back in the room and the nurse came and asked me if she could have something to eat as she was feeling light-headed. I went in to check on her and she was sitting on the edge of the bed. She told me this was what she didn't like about labor last time either...I suggested some protein as well as carbs. I told her I would be right back to check on her. I went to another patient's room to check in on her. While I was in there the nurse came and stuck her head in the door to tell me that J was asking for an epidural.
I was like "what???" She was doing fine when I had just been in there. So I tell the nurse not to do anything, I'm coming to check on her first. When I get to the room, she's still sitting on the edge of the bed. She tells me I can't do this. Then she grunts and bears down.
I'm thinking "what the heck?" I told J, let me check you before we make any decisions, you haven't tried the tub yet, and it sound slike you are getting close. She was spontaneously bearing down with each contraction. I checked her and she was 9 and a half cms! I said no epidural. She wanted to get in the tub so she squatted in the tub. I sat at her side holding her hand. I started worrying that her husband wasn't going to make it. I don't think she was in the tub more than 10 minutes when she started pushing again. She told me that the baby was coming. I checked and she was certainly correct - she was completely dilated and the baby was at a +2 station. I asked her if she could get out and maybe squat by the bed for delivery (we aren't supposed to do waterbirth although if she hadn't been able to get out, oh well). She was able to move over by a chair in the room. My thought was that she could lean on the chair and I would catch the baby from behind. Not quite how it worked out.
She squatted while I sat on the floor. She had one arm around my shoulders with her other hand on my leg for support. The nurse stood near by, not really sure what to do. She wanted to listen to the baby's heartbeat but I said not to worry about it, we could listen when the baby came out. I could not see what was going on as my head was crushed against J's chest. It was kinda funny :) I kept talking her through her contractions. She would talk completely normally in between contractions, asking what to do. I had one hand at her vagina, where I could feel the head crowning. She slowly and gently pushed the head out. It was such a thrill to not be able to see what I was doing but feel the head being born into my hand. We had a little trouble with the shoulders but nothing that wasn't remedied by me getting both hands involved. She gracefully pushed out the rest of her baby. I brought the baby up to her arms and the nurse threw a blanket over them. The baby was doing absolutely fine as was momma. We helped her move to the bed where she could rest while latching the baby on to the breast. Her husband walked in literally five minutes after the birth.
She pushed out her placenta just as gracefully. She had just a small perineal tear requiring no stitches.
Congrats J on a beautiful birth!
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