Labor and delivery is fascinating in that every experience is different. I have a dear friend who couldn't speak of her experience for weeks, because it was traumatic and painful. I have another friend who described her labor as "a breeze," and looked fresh-faced and gorgeous minutes afterwards. While every labor is different, there are certain factors that can determine how painful yours might be. If you have any of these five conditions, you may need an epidural.
No matter how it all goes down, childbirth is an experience that is unique to the person going through it. For some it's incredible and empowering, and for others it's scary and heartbreaking. Some people feel like they're in control during labor and delivery, while others feel as if they're at the mercy of their bodies, their doctors, and their soon-to-be born babies.
There are a slew of decisions every soon-to-be mom needs to make when facing labor and delivery, too, including whether or not to have pain medication or additional medical intervention. Sometimes that decision is made for you, though, which is why it's best to know about every potential scenario before it's "go time." So with that in mind, here are five factors that might end up resulting in an epidural:
1. Prolonged Labor
No matter how many hours you spent on the elliptical during your pregnancy, or how motivated you are when you arrive at the hospital, hours upon hours of labor can tire anyone out. One major benefit of receiving an epidural is that, with pain relief, comes the ability to get some rest. According to an interview with Jessica Dy, an Ottowa based obstetrician, in Today's Parent, this rest can make all the difference for the rest of labor.
"According to Dy, this is one of the biggest bonuses of epidurals. “Women can’t push when they’re exhausted,” she says. Giving moms a chance to rest can be really important, especially during a long labour. “We sometimes have women come into the hospital who’ve been labouring for a long time at home or in a birthing centre without progress, and once we suggest an epidural and give her a rest, very commonly what we see is a vaginal birth resulting from that.”
2. Low Pain Tolerance
Some women have a high pain tolerance, some women have a low pain tolerance, and neither makes anyone particularly "weak" or "strong." It simply means we experience pain in different ways. For women who struggle to deal with pain, an epidural could make a huge difference in their birthing experience.
According to Parents, "A combination of genetics and life experiences determines your pain threshold, or ability to withstand pain, and this also plays a part. Social support (or lack of it), fear, anxiety and even the positive or negative labor stories you've heard can contribute to your perception of pain." Regardless of why our pain tolerance is what it is, it's a major factor that will influence whether or not you choose to receive an epidural.
3. High Anxiety
It's natural to have anxiety around your due date. After all, childbirth is not easy – and if this is your first baby, you have no idea what to expect (even if it's your second baby you're not entirely sure what to expect, since every pregnancy truly is different). Getting an epidural, and planning to get one during your pregnancy, can be a source of anxiety relief for any expectant mother who is overwhelmed at the thought of labor pain.
According to the American Pregnancy Association, "Research has also linked prolonged labor or failure to progress to psychological factors, such as worry, stress, or fear." If receiving an epidural and decreasing your pain will allow you to relax, it can end up helping you dilate and progress, as well.
4. Previous C-Section
If you're attempting a trial of labor after cesarean (TOLAC), your birth will be considered "high-risk." After one C-section, the idea of a a vaginal birth after cesarean (VBAC), can be daunting. According to Anesthesiology, The Journal of the American Society of Anesthesiologists, Inc., "Adequate pain relief may also encourage more women to choose trial of labor." If you've had a previous C-section and are hopeful to deliver vaginally this time around, getting an epidural may be helpful mentally and physically.
Some women are hesitant to receive epidurals because of a belief that they prolong labor and thus increase the chances of needing a C-section. According to the same article in Anesthesiology, "Success rates for VBAC are similar in women who do and do not receive epidural analgesia, as well as in those women who receive other types of pain relief."
Many doctors recommend or even require epidurals for women having twins. With an epidural in place, mom can be quickly anesthetized if a C-section becomes necessary – and because having multiples can mean a more complicated delivery, C-sections are a possibility.
Jeanne Faulkner, registered nurse, explained to Fit Pregnancy, "Since there's an increased risk that a C-section will be necessary (in case the umbilical cord gets in trouble or Twin B can't be delivered vaginally), it's very convenient if the epidural is already in place and ready for a C-section dose of anesthesia." If you are passionate about having an unmedicated birth, if possible, your anesthesiologist can place an epidural tube without administering the medication.
Editor's note: This article has been updated with the correct title of the American Society of Anesthesiologists' Journal.