There are a lot of blogs and posts written about “How to avoid an epidural” or “How to have a natural birth” out there. I’ve written a few (here’s one for example)! But what if you are planning on getting an epidural? Are you exempt from needing a birth plan? Of course not! An epidural birth requires the same amount of planning as any other type of birth. I’m going to talk to you about a few things that you should expect and plan for with your epidural birth so you can have a great experience! Because really, I just want you to have a great experience ♥

When to get to the hospital

When you go to the hospital is really your call. If you are at the 4-1-1, you can go anytime. Or you can wait a bit longer if you are comfortable with laboring at home for a little while longer. Be sure you stay hydrated though no matter where you are. 

The time between being admitted to when you get your epidural

When you arrive at the hospital, the nurse will check your dilation and if you are at least 6 cm, you will be admitted and they will place your IV. This is one reason you will want to be hydrated - placing an IV on someone who is dehydrated can be difficult. 

You will need to get an entire bag of fluids before you get your epidural (I’ve seen some allow for only half a bag of fluids, but that’s up to their discretion), so be sure your providers know what your plan is. If you wait until your contractions are getting intense, you will be uncomfortable for awhile until you are able to get your epidural. It’s all about timing here! 

What it's like to have an epidural placed

Okay, so you’ve gotten your fluids, the anesthesiologist has shown up, asked you a bunch of questions, read you the potential risks and side effects and has had you sign a waiver form (yes, even if you are in transitions. See? Timing). They will have you sit on the edge of the bed and have you curl your back out. It’s helpful to hug a pillow and curl around it. If you start to feel a contraction coming on let them know, because they will wait till it has passed before they place the epidural. But first, they will disinfect the area on your back and numb the area where the epidural will be placed. It takes a very short amount of time for the epidural to be placed if all goes well. Once it’s in and you are taped up, you will be able to relax and get into a comfortable position again.

How long it takes for an epidural to start working

It can take up to 30 minutes for you to feel the full effects of your epidural. Sometimes sooner, sometimes longer - it all depends on each person’s sensitivity. In the meantime, you will have to lay on your back with one hip slightly lifted. But once you are numb from your armpits down, you will be able to lay fully on each side. If your nurse doesn’t bring a peanut ball ask for one, and if the hospital doesn’t have any, you can use the stirrups to lift your leg up to open your hips so your baby can descend easier. Anesthesia will flow with gravity because your blood flow does, and if you are in one position for too long, you will start to feel your contractions in the highest point of your belly again. So your nurses will help you change positions every 15-30 minutes to keep the anesthesia flowing evenly.  You will be given a little button to control how much anesthesia you get and how often. Don’t worry - it will not allow you to overdose. 

How will you know if you need to push?

Sometimes an epidural can make labor move along faster than without. This being because your pelvic floor muscles can relax effectively and your baby is able to drop and put pressure on the cervix, causing it to dilate. If you are chilling out on your side with your epidural, peanut ball between your knees and you start to feel pressure like you need to poop, very likely, it’s go time! 

Speaking of pushing, the nurse will likely stop the anesthesia so you can start to feel your muscles and where to push.

Recovery after an epidural

After you give birth, you’ll have about an hour or two before you’ll be able to feel your legs and be steady enough to stand and go to the bathroom. But that’s okay because you will have that time to do skin-to-skin with your baby and start breastfeeding without any expectation to do anything else. Once you can feel your legs and you are feeling steady enough to stand, your partner will be encouraged to do skin-to-skin with your baby while the nurse helps you to the bathroom where you will pee and be outfitted with your snazzy new postpartum mesh panties! 

What are some of the side effects and things you should know about epidurals before getting one?

Listen, I’m not here to talk you out of an epidural if that’s the plan, but to everything there are risks and benefits. You can’t possibly weigh all of the risks and benefits if you don’t know them. I’m just going to touch on them and tell you what those risks are and you can either dig deeper via the internet, or you can have a conversation with your OB or midwife on it. So here we go!

• Lowers Blood Pressure

This sounds like it would be a good thing, right? High BP = bad; Low BP = good. But an epidural can actually bring your BP dangerously low which means your baby won’t get the blood supply they need, which will cause your baby’s heart tones to drop. This is often the reason for emergency cesareans, unless they can flip you around into a position that can get your baby’s heart rate back up.

• risk of Infections

The epidural is a catheter that is placed into the membrane that covers your spinal cord. There isn’t a lot of room for error in this very sensitive space. This also bypasses your body’s natural defenses against infection, giving a direct line to your spinal cord.

• Headaches/Backaches

It is fairly common to experience headaches or backaches for the days or weeks following an epidural. Be sure to mention it to your OB if this happens and they will advise you on what is safe to take for it. Heat or ice packs can be helpful too. But still when all is said and done, some women experience an aching years after an epidural.

• Pushing can be more difficult

This was mentioned above, but definitely something to consider and plan for. Talk to your OB about what coached pushing looks like with an epidural.

• It can cause labor to stall

This is common and not really a “problem”, but if you’re uncomfortable and want this is be over, like, yesterday, it can just prolong your discomfort. If your contractions do slow down, then you will likely be started on pitocin.

• Sometimes Epidurals just don’t work

I’m going to talk about this a little more than the others, simply because if you go into your birth expecting an epidural and it doesn’t work, that is a recipe for a traumatic experience. Let’s do what we can here and now to help you prepare for this “what if” scenario, shall we?

This doesn't happen often, but it does happen. The rates of this happening are 1-2%, so not huge, but there. The reasons for epidurals not working can range from back issues such as scoliosis to the epidural just not being placed at the exact right spot. Depending on the situation, your anesthesiologist may agree to replace your epidural in a different spot, but if not, having coping tools and relief techniques on backup will be helpful!

You will be considered a fall risk, so standing up will be discouraged, but you can get into all kinds of positions without standing. You’ll be able to get on your hands and knees, lay on your sides, have the nurses break the bed up so you can sit, and depending on how much control you have, you may be able to move to the birth ball or use a squat bar. 

This is where having a birth plan is important - because in writing a plan, you explore what your options are and you discover what your values are in birth. Your values never change regardless of what type of birth you have or what happens (that is a blog for another day, friends). This is where having a few relief techniques in your back pocket will help you immensely. 

So if you are planning on getting an epidural, still have an “expect the unexpected” plan on backup.

I have said it a million times - There is no way you can fail at birth. No one is grading you on how you give birth! You are allowed to birth how you want. But knowing the risks and benefits, the tips and tricks, and overall what to expect, will help you have a better experience overall. I gotchu! XO

What questions to you have about planning for an epidural birth? Did you have an epidural birth? I’d love to hear all about it! You can tell me about it in an email at hello@ohbabykc.com or you can post your birth story in my Facebook group for Expecting & New Moms.

Hi, I’m Mary.

You know me. I’ve been  blogging here for almost 4 years. I’ve attended your births, held your babies at night as your postpartum doula, taught you classes and walked you through making decisions as a new parent. You can book me for consultations, advice sessions and digital doula services. Thanks for reading this blog and being a part of our amazing community! I appreciate you ❤