Epidurals
Considered by many to be the holy grail of pain relief in childbirth, it’s important as ever to consider the pros and cons of the procedure.
In essence, and anaesthetist will inject a local anaesthetic into your spine to block the nerves carrying pain signals to the brain. Some hospitals can offer “mobile” epidurals, where you can retain some (if not all) movement in labour, which is great when it’s available. More commonly, you’ll be lying down in bed from the administration of the epidural onwards. You can read more about them in detail on the NHS website, but here’s a summary for quick reading.
Pros:
Most effective pain relief (usually complete, and can be extremely welcome in a long or difficult labour)
Cons:
Lack of mobility has a knock on effect on labour progression, which can impact other outcomes such as baby coping, perineal tearing, increased risk of instrumental or assisted deliveries, and increased risk of c-section.
Coached pushing may be needed if you can’t feel your contractions, which can come with an increased risk of perineal tearing
Hospital policies say they’ll need to do continuous fetal monitoring after an epidural is administered; even if you have a mobile epidural this may impede your freedom of movement. They may use a fetal scalp electrode to monitor baby’s heart rate (look out for the phrase “we’re just going to pop a clip on baby’s head”; what this means is that a “fetal electrode will then be placed by screwing a tiny wire into the top layers of the baby's scalp” (Weiss, 2021). This means you can move more freely if you’ve got a mobile epidural, but does cause tissue damage to baby’s head and has its own risks, as does everything!
Longer labour and pushing stage
1 in 100 people get an “epidural headache” (decribed by many as the worst pain they’ve ever felt). Easy to remedy, but unpleasant to experience.
Difficulty urinating
Other, rarer risks are listed on the NHS website.
