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Preparing for an epidural

Preparing for an epidural

Epidurals are one of the main culprits in the cascade of intervention.

Nearly 50% of women who choose an epidural go on to have an operative birth — (instrumental assisted vaginal birth by forceps or vacuum extraction plus caesarean delivery.)

If you have an instrumental assisted birth you may require an episiotomy.

An epidural is performed by injecting an anaesthetic normally between the third and fourth lumber vertebrae, numbing the body from the injection point down.

Currently up to 1/3 of birthing women choose to have an epidural, not knowing that a painless birth is not the answer to having a good birth.  Many are also not aware of the many risks that are associated with having an epidural.

Having an epidural means having a catheter inserted in your bladder to pass urine, having a drip in your arm, being hooked up to the continual foetal monitor and having to remain on your back.

Studies show that the use of an epidural is linked to longer labours. Your chance of having a caesarean also increases by 160%.

An epidural can be an alternative to a general anaesthetic when a woman is having a caesarean as it allows her to be awake and see her baby being delivered by the doctor.

The use of epidurals in a normal birth can cause a lot of problems for both the mother and baby. Epidural anesthesia blocks the body’s wisdom and interferes with the two-way communication between mother and baby. This is because it blocks the sensory nerves of the uterus, cervix. pelvic floor and abdomen. As a result, you won’t feel the feedback your body is giving you about how to move in labour to help your baby be born.

Ted Weaver, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said having an epidural anaesthetic – more widely available in the private than the public system – increased the chance a woman would not be able to push out her baby independently.

If the drug blocked all sensation, so the woman had no urge to push, “there’s a pretty high chance – more than 50 per cent – she’ll end up with [a vacuum extraction or forceps delivery]“, he said.

Then, if forceps were used, “most women would end up with an episiotomy”, Dr Weaver said. It was not clear whether women knew about the link between these interventions.
(Sydney Morning Herald, 03/01/09)

Now that I had the epidural, I couldn’t get up to wee, so they inserted a urinary catheter as well. The worst part of the epidural was that I could not move.  I had a nerve pinching in my back that was by far, worse than any contraction I had felt.  I just wanted to shift my weight a little, but I was tied down with all sorts of wires and tubes.  The midwives gave up on the CTG for my daughter, and I had a Fetal scalp monitor inserted.  So here I am, with a IV drip in the back of my hand, an epidural in my back,  a CTG monitor on my belly, a urine IDC in one hole and a scalp monitor in the other hole (sorry for being so crude) and I couldn’t move even if I tried.  The room was bright and full of people (my mum, dad, sister, husband, anaesthetist, registrar, consultant, 2 paed doctors for the babies).  Not exactly how I pictured it.  I had written a birth plan, with allowances for the fact that it may not run smoothly, but my second midwife told me straight out that the staff wouldn’t follow it (my  birth plan contained nothing out of the ordinary — I think she just wanted to be in control). — Josie


66.53% Private Hospital Epidural Rate (NSW)

35.44% Public Hospital Epidural Rate (NSW)

(Source: NSW Mothers & Babies Report 2009)

Check your local hospital epidural rates here in our Birth Services Revealed.


  • Relief from pain
  • Allows a women to rest and relax
  • Allows the mother to be awake for the birth of her baby when having a caesarean.
  • Can help to control high blood pressure
Epidural being inserted into the spine of woman in labour

Epidural being inserted into the spine of woman in labour

thdownNegatives Effects on mother

  • Epidurals interferes with your body’s natural release of oxytocins (the love drug) which may effect maternal bonding
  • You may feel removed from the birth process, more of a spectator than an active participant.
  • Opens the flood gates for the cascade of intervention to begin
  • You are 3 times more likely to be given oxytocin to increase contractions
  • You are 3 times more likely to experience a forceps/vacuum extraction
  • 160% increase in having a caesarean section
  • 1/4 of all women who are given opiates will experience pruitis, or generalised itching of the skin.
  • 30% of women will experience nausea and vomiting
  • 1/3 will experience shivering
  • 1:100 experience prolonged and/or severe headaches
  • 1:500 ongoing numb patches, usually clearing after 3 months
  • 4 -18:10,000 weakness and loss of sensation in the areas affected by the epidural
  • 1:200,000 will be crippled
  • Increased risk of maternal death
  • Restricted movement
  • IV required
  • Electronic Foetal Monitoring required
  • Increased likelihood of bladder catheterization and internal monitoring
  • Risk of Dural puncture
  • Hypotension (29%)
  • Prolonged 2nd stage labour
  • Uneven, incomplete or nonexistent pain relief
  • Feelings of emotional detachment
  • Respiratory insufficiency or paralysis
  • Convulsions
  • Toxic drug reactions
  • Septic meningitis
  • Allergic shock
  • Cardiac arrest
  • Neurological complications
  • Backache (weeks to years)
  • Postpartum feelings of regret, loss of autonomy
  • Faecal and urinary incontinence or bladder dysfunction (inability to urinate)
  • Paresthesia (”pins and needles”)
  • Loss of perineal sensation and sexual function
  • Convulsions
  • Nerve injury
  • Epidural abscess
  • Blood pressure drops
  • Use of morphine also causes oral herpes in 15% of women

Twenty-three percent, or nearly one in four women, given an epidural block will develop a complication. One undesirable complication is death—epidural block for relief of normal labor pain results in a three times higher mortality rate for the woman than labor without epidural block. One out of every 500 epidural blocks results in temporary neurological problems, such as paralysis in the woman; and in one out of every half-million epidural blocks, this neurological damage to the woman is permanent — Marsden Wagner, M.D., M.S., for 15 years a Director of Women’s and Children’s Health, World Health Organization.

thdownNegative Effects on Baby

  • Direct drug toxicity as the drug’s used in the epidural pass through the placenta
  • Foetal distress, abnormal FHR (can lead to emergency cesarean)
  • Drowsiness at birth, poor sucking reflex
  • Maternal fever (impeded thermoregulation from numb skin) leads to foetal hyperthermia and neonatal 
NICU workup (spinal tap, etc.)
  • Poor muscle strength and tone in the first hours
  • Neonatal jaundice
  • Foetal distress from the use of forceps or vacuum including marks and bruises to the head and face.
  • Damaged spine and skull from forceps or vacuum extraction

Epidurals may reduce the short-term discomfort of labour but can cause pain for the baby and long-term discomfort for the mother. They also prevent the mother from being an active participant in the birth of her own baby, leaving a lot of women with feelings of dissatisfaction and regret.

Obstetric care providers have assumed that control of pain is the foremost concern of laboring women, and that effective pain relief will ensure a positive birth experience. In fact, there is evidence that the opposite may be true. Several studies have shown that women who use no labor medication are the most satisfied with their birth experience at the time, at six weeks, and at one year after the birth. In a UK survey of 1,000 women, those who had used epidurals reported the highest levels of pain relief but the lowest levels of satisfaction with the birth, probably because of the higher rates of intervention.
— (Dr Sarah J Buckley MD)

The epidural level was quite high and as I was talking to the nurse, my cheeks began to feel numb and tingly. And that’s not supposed to happen. So suddenly the concern shifted to me. I could stop breathing if the epidural went too high…..They told me that the comedown from the epidural would be a bit nasty and they were right. It really was one of the weirdest experiences. I was lying in observation with all these people coming out of the operations and I had no feeling in any part of my body. I was numb from the neck down. It was surreal. I was lying there surprised that I’d had a boy because I really thought I was having a girl, and at the same time I had uncontrollable trembling. — (Zali Steggall – world champion skier, in Birth Stories, Allen & Unwin, 2005)

Unfortunately, because I had had an epidural, even though I could move my legs easily, the nurses would not let me get on my knees or all fours and I was stuck on my back. — (Art)

Epidural may reduce the mothers short term discomfort, but they cause great pain for the unborn child as most end up being violently pulled out by their heads. — (Sally, Midwife)

Every one was focused on me, helping me breath through my contractions, massaging my back, stroking my head……..once I had the epidural it felt like no one had anything to do including me, we all just started watching television! — (Lucy)

storiesBirth Stories

But by around 2pm I just couldn’t cope anymore – the degree and frequency of the pain was more than I could take, and I asked for an epidural. I felt like such a failure, I remember telling Paul and ND that I was so sorry to let them down but I just couldn’t take it anymore. Read more.


Here is a fantastic article from Dr Sarah J Buckley explaining the risks of epidurals.

Common Side Effects from Epidural – Ways to Minimise the Risks


Check your local hospital epidural rates here in our Birth Services Revealed database.



Kareena Private 84.5%

(Source: NSW Mothers & Babies Report 2009)

Check your local hospital epidural rates here in our Birth Services Revealed.

Photo credit: / CC BY-NC-SA 2.0

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