Epidurals can often turn divisive. Some mothers fall into the camp of “labor hurts, and epidurals exist to relieve this pain.” At the same time, some mothers take a stance in opposition, perhaps for the desire to immerse themselves in the "undiluted" experience. Whichever decisions mothers make, they do so through thoughtful research and consideration. Mothers are sometimes guided by the advice of friends or family, credible organizations, and the deep, vast void that is the internet. Unfortunately, alongside gaining valuable insights, misinformation has a way of creeping into the conversation of epidurals.
Navigating what information is credible from what is not can be difficult- especially when you have some more adamant voices in your life. Consistent with many other delivery conversations, mothers know that other people's opinions, solicited or not, are always abundantly available. So, instead of listening to your Aunt Susie's epidural horror story of her best friends' distant niece- let's get some things clear right here and now.
First, let's define what an epidural is and how it works. Epidurals are one of the most widely used forms of pain relief for labor. The American Pregnancy Association notes that it is requested by name more than any other form of pain relief by laboring women. So, it's no wonder that over 50% of laboring women in the United States utilize epidural anesthesia. Women receive epidurals by having a healthcare professional place a catheter in their spine which will then carry the medicine needed for pain relief throughout labor. It then acts to create a sense of numbness from the belly button to the upper legs. The purpose of this is to alleviate the pain of labor while making sure that mothers both retain their ability to labor and stay awake. All in all, they are very standard and widely used procedures.
However, it is still a decision that mothers frequently grapple with as labor looms around the corner, for various reasons. So, in the hopes of making it easier for you, here are some common myths you should be acquainted with when creating your envisioned birth plan.
Epidurals go into the spine: true. Epidurals will likely paralyze you: false! There is this looming myth surrounding epidurals that they carry a risk of paralysis. As with just about any medical procedure, there are irrevocable risks. However, the risk of an epidural leaving you paralyzed is incredibly slim. The American Society for Anesthesiologists claims that extreme complications from an epidural, including paralysis, are extremely rare. You may experience slight discomfort from the location of the catheter, but that is likely to stop a few days after the time of the injection.
Remember that saying from school, "correlation does not imply causation." It basically means that just because two (or more) things are associated does not mean that one is causing the other. In the case of epidurals and chronic back pain, we have a good old-fashioned lurking variable. In figuring out what it is, it's worth asking why in the first place you sought an epidural. Well, you just grew, carried, and delivered a tiny human. That is quite literally a pain in the back. Not only this, mothers often cite that caring for their little ones, like bending down to pick them up and carry them, can cause pain in their back.
So, when we think about chronic back pain, let's look at the pain more holistically. More often than not, the pain of the epidural will remain isolated to the site of the injection and will dissipate in a few days. Some women report injection pain lasting a few weeks, but there is limited evidence suggesting that chronic back pain is consequent to an epidural in childbirth.
A significant point of hesitation for some mothers when considering epidurals is how epidurals will impact their little ones. However, studies support that there is limited risk for babies when their mother undergoes an epidural. The Institute for Quality and Efficiency in Health Care notes that while it is true that babies will receive this medication through the umbilical cord, there are no long-term disadvantages. It does note that women who take an epidural may take longer during childbirth, given that epidurals may sometimes slow the process of your baby moving into the proper position. The bottom line is that yes, epidurals may impact the course of your birth, but beyond this impact, there is no evidence to support long-term harm for your baby.
For mothers decorated in ink, you may have come across this myth already. Some people warn decorated mothers that the ink of their tattoo will be transmitted through the epidural injection site into their bloodstream. However, there is a very slim chance that this will happen. Mayo Clinic notes that actual reports of problems associated with tattoos and epidurals are very rare. It does say, as a rare exception, that if tattoos are raised, swollen, or recent, anesthesiologists may suggest withholding from epidurals.
Anesthesiologists will try to avoid piercing your tattooed skin and opt for a place that is not pigmented. However, if this is not possible, they will nick your skin before to reduce any (again limited) chance of pigment traveling. If your tattoo is pierced, just know that it may look different than before. Specifically, you may experience minute scarring that could alter its appearance.
While very common and considered to be relatively low-risk, epidurals are not for everyone. According to Johns Hopkins, there are a few conditions that would bar mothers from having an epidural. The list includes:
There are, of course, other reasons that may be at play when consulting with your doctor to decide whether an epidural is best for you. So, as you go about planning your birth plan, try making sure to tackle this question of whether you are eligible at an earlier stage so that you can plan for pain relief methods accordingly.
Uh-oh, that's not fun. It is unfortunate, albeit seldom, true that epidurals sometimes fail. A study notes that variations across a range of factors (anatomic, functional, and technical) can all have their parts in impacting the efficacy of an epidural. More often than not, though, these can be corrected, which is reflected in that 99% of women can expect a successful epidural.
These myth-busters are not to encourage or deter you from getting an epidural. Whichever epidural camp you categorize yourself within is valid; each mother is entitled to her own journey of pregnancy and childbirth. However, navigating information- and misinformation at that- can make preparing for your delivery more difficult. So, we hope this article has set you up along your education journey, ultimately helping you be confident in what things to trust from Aunt Susie and what things not to.