Monday, February 15, 2010

Even if You Want an Epidural....

It is not my business to tell someone how they should have a baby. If someone comes to me saying they are hellbent upon an epidural the second they go into labour, I figure I have some work ahead of me to outline the risks, and to help build up her confidence so she feels that "going natural" is something normal and healthy, not just for those "other" ladies with the unshaved armpits and granola crumbs in their braids. Or those ladies who have high pain thresholds. Or those ladies who have really fast births. Or those ladies who are brave. If she hears my shpiel and still makes the choice to use pain relief, I've signed up to support. I'm still invested in her having a great time and feeling good about herself. I want her to be a triumphant, happy mother. My sour puss about not having "sold" someone on the benefits and joys of physiological birth is not going to help anyone.

I do, however, make it very clear to women choosing an epidural that learning some tools to help them cope with the sensations of labour is crucial. Why, if they plan on eradicating the pain? Well, as birth workers know, the Epidural Fairy doesn't just magically appear and wave a Pain Relief wand the second a lady feels like it's time to bite the bullet. Here are some things to consider:

1)What if you are experiencing an escalating intensity of your labour pain, and the person doing epidurals that day has to attend 2 C-sections in a row at the same time you're wanting your pain managed? This might mean a wait of 3 hours before pain relief is available, whether or not you've decided to "order" your epidural the minute you get into the hospital. Things arise beyond our control, and sometimes you won't get what you want when you want it. True, this is not a fair scenario to someone really invested in obtaining relief, but there you go. It happens. I have seen it. It's not too uncommon. Your baby could conceivably be born before you receive the epidural.

2)What if you get an epidural and.......it doesn't work? It happens.

3)What if you get an epidural and it's really "patchy", meaning you're numb everywhere except for a 2cm area on your lower abdomen, which feels ALL the sensation of labour? Yikes, to me this would be far worse than feeling it the way it's supposed to be felt.

Now just to reassure those readers who might be really gung ho about the epidural, these things don't happen too often. Normally, you get the epidural in due time and it relieves the pain fine. I don't want you to be freaked out. What I do want, is for you to be aware.

The above scenarios bring up an important issue: How wise is it to depend entirely upon external influences to cope with the sensation part of the birth experience? Where does your real power lie, in your own abilities, or in your expectation of a series of circumstances you take for granted will happen according to plan? What if you give birth during a really busy day at the hospital? What if your labour goes so fast you birth in the car? How are you going to deal? I want you to be able to cope just great, even if it's not something you want to do. Knowing how only increases your personal power, giving you access to greater possibilities. Even if you get the epidural right when you want and you don't have to experience any pain, having pain/stress management techniques to use in your life is never a bad thing.

Believing the epidural safety net is going to be available upon reaching the hospital in labour can lull one into a false sense of security. This may make a couple feel like there is no need to prepare. Most standard hospital prenatal classes don't focus on managing the sensations of labour. In fact, a lot of the classes in my neck of the woods hardly mention dealing with pain, never mind actively preparing couples for these strong birthing waves, yet will spent literally 2 hours on a lecture on anaesthesia. Without some kind of preparation for labour, mixed in with the expectation pain WILL be controlled when the woman feels it's time to request pain relief, a couple may be setting themselves up for trauma. They may feel afterwards that the sensations were the most terrible things in the world, that it is barbaric to give birth naturally, and that no woman should have to be subjected to that kind of evil.

Yet, it is NOT the sensation itself which is traumatizing. It is the BELIEF you wouldn't or shouldn't have to experience it which is at the root of the trauma. These expectations of pain relief can make you fight the sensations the entire way in anger, stress, and frustration at having to go through them at all, focusing all your energy on getting that epidural NOW, instead of relaxing, letting go, breathing into them, and allowing them to do their important job. Your partner may not have any clue how to handle you feeling the real pain extreme stress in labour can cause, and may be terribly anxious himself. The birth of your baby has the potential to be coloured by memories of terror and helplessness. It doesn't have to be this way.

So sure, if an epidural is the right choice for your birth experience, embrace it and own it. But have a backup plan. Even with epidural, labour is not rendered sensationless. At the very least, practice deep abdominal breathing and releasing tension from your body. You CAN meet these normal sensations with confidence. Know deeply in your heart that even though what you are experiencing is pain, it is not the kind that will damage you. It is simply a pain with great purpose, a strong intense sensation that will ultimately, if things are going normally, bring your baby to you whether the epidural arrives on time or not. You can do it!