Even if you've constructed an elaborate birth plan, it's impossible to control every aspect of labor and delivery. Complications can occur, proactive measures might be necessary, and your mind is subject to change when those damn contractions really hit. In other words, even if you don't plan on having an epidural, sometimes it's necessary. In fact, there are some early signs you're going to need an epidural, according to the experts, that every pregnant woman should be made aware of.
According to the American Pregnancy Association (APA), an epidural is the most popular form of pain relief during labor. In fact, more than 50 percent of pregnant women in the United States choose to have an epidural during childbirth. According to the APA, an anesthesiologist will administer the epidural by asking you to "arch your back and remain still while lying on your left side and sitting up." Then an antiseptic solution is administered to minimize the chance of infection, a small area in your back is injected with a local anesthetic to numb it, and "a needle is inserted into the numb area surrounding the spinal cord in the lower back." The same site says there are two epidurals a laboring woman can choose from, a regular epidural or a combined spinal-epidural (also known as a walking epidural).
While there are pros and cons to each type of epidural, or choosing an epidural in general, every pregnant woman should know that, according to the APA, an epidural isn't an option if the patient uses blood thinners, has low platelet counts, is hemorrhaging or in shock, has an infection in the back, has a blood infection, isn't at least 4 centimeters dilated, the epidural space can't be located by a physician, or labor is moving too fact for the drug to be administered.
But if it's safe for you to consider using an epidural during childbirth, here are some early signs that a medicated birth is the right choice for you:
You're Not Good With Pain
It's OK to admit you don't have a high tolerance for pain. In fact, it's admirable. I mean, since when was "I can handle being in pain for a significant amount of time" a badge of honor? That's not healthy, people.
So, if you know early on that pain is something you want to avoid at all costs, make the plan for an epidural. You're part of the majority of U.S. women who go into labor, remember? Today's Parents says that epidurals work for the majority of women, helping them relax and rest at the critical time before they start pushing. You should absolutely do your due diligence and research the possible side effects in going the epidural route, but knowing your pain tolerance level and deciding to mitigate the amount of pain you'll be in during childbirth doesn't make you a bad person. If anything, it makes you prepared.
It's Your First Baby
While every woman's body labors differently, if you're expecting your first child know that it could be harder on you than subsequent deliveries because, well, it's never happened before. In a 2012 article, NPR reported that labor takes longer than it did years ago. When you take the current average of 6 1/2 hours of labor and compare it to, say, your grandmother's solid four hours of labor, it's easy to see why more and more women are choosing epidurals. Babies are being born larger than they used to be, women are older when they give birth than they were in previous generations, and other variables definitely make a longer labor more of an inevitably. Fit Pregnancy suggests that if prenatal yoga and birthing classes don't do much for easing stress, an epidural is the way to go.
The Baby Measures Large
A medication-free labor is definitely possible when delivering a large baby. It's also more than possible for a woman to birth a big baby without a C-section. Plus, there's no concrete way to know the exact measurements of your child beforehand, as ultrasounds are not always 100 percent accurate. But if you want to avoid the last minute decision of whether or not to get an epidural, now's the time to think it through.
Belly Belly says that if a big baby is on the way, the main concern is the "possibility of shoulder dystocia." The site adds that it "occurs when the baby’s shoulders become stuck in the pelvis." While this is rare, occurring in only 0.5 percent - 1.5 percent of all births, there's also the possibility your hips aren't large enough to accommodate the baby's passing. Either way, if it looks like your baby might be on the bigger side, an epidural might be the way to go.
You're Battling Anxiety
If you're anxious by nature, or feeling especially stressed in the days and weeks before delivery, take it as a sign that an epidural might be necessary. Because stress directly affects the baby, it's important you find ways to de-stress and eliminate delivery fears. Meditation, breathing, and visualization techniques are great ways to help prevent delivery day complications, but if you're feeling worried about the eventual pain, choose an epidural.
You Can't Get Your Breathing Under Control
If you're not an active person, or haven't taken birthing or lamaze classes, finding your breathing rhythm might be difficult when those contractions start. The APA recommends a patterned breathing technique, described as "the act of breathing at any number of possible rates and depths." But depending on how anxious you are, and how much pain you're in, during labor, you might not be able to breath in a way that assists your body during childbirth. In that case, opt for an epidural.
The Labor Is Prolonged And/Or A C-Section Is Imminent
Sometimes labor and delivery ends up taking a lot longer than anticipated. This occasionally happens when an induction has taken place. If, during the early stages of childbirth, labor feels especially challenging, or it's starting to take too long and your doctor is considering a C-section for the health of you and baby, think of an epidural as part of the process. If it's going to take longer than necessary, or if surgery is going to happen, better to have the pain subsided as soon as possible so you're left feeling like you have some control over your original birth plan.
Early Attempts To Ease Contractions Aren't Working
If you've taken the classes, read the books, done all of the breathing and mediation techniques, and you're still obsessing over labor and delivery, don't rule out an epidural. While there are always risks to consider, if pain is your biggest concern an epidural can help alleviate at least that particular stressor so you can focus on the important parts — like staying safe so you can deliver your baby.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.