4 Reasons to Get an Epidural… and They're Not What You Think!

By Katie

Getting an epidural in labor is a personal choice.  I am going to give you the reasons I chose to get one that you may not have considered. 
As an OB, I have this conversation often, so I thought it could be useful to the masses (or at least the 10 people who might read it). 
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First time mamas: be forewarned, I am discussing topics that may freak you out if you haven’t heard about them already.

1. Lacerations.  Many women tear, especially if it’s your first baby.  Usually it’s a small to average tear (see 1st or 2nd degree laceration, if you want to learn more).  Sometimes it’s a really big tear… like all the way through your rectum (see 3rd or 4th degree laceration).  Those need to be put back together.  Putting that back together can take a lot of time… and needles… around your rear end.  It’s really nice when you don’t feel that and you can enjoy your new baby while you’re doctor is hard at work on the puzzle that is your vagina.
    
2. Shoulder Dystocia.  This is when your baby’s shoulders are so big that they get stuck after the baby’s head comes out.  This is a medical emergency and requires some (usually painful) maneuvers to help get the baby out.  You being relaxed and comfortable can really help it go quicker and help restore oxygen to your baby's brain.  
   
   
3. Postpartum Hemorrhage.   Your uterus’s job after delivering your baby and placenta is to continue contracting so you won’t bleed too much.  Sometimes after delivery, your uterus is as tired as you are.  It stops doing its job and you bleed.  If you bleed too much, your doctor may need to do an exam where they literally have their arm inserted up to their elbow in your vagina to help get the bleeding to stop.  It’s nice for both of you if you can’t feel your bottom half while that’s happening.
   
   
4. Emergency C-Section.  That is obviously never the goal, but is a real possibility, no matter who you are.  If you don’t have an epidural, there is often no time for regional anesthesia (spinal or epidural) and that means you go to sleep.  Intubated, sedated, and asleep.  You can’t have anyone in the operating room with you (husband/boyfriend/baby daddy/girlfriend/mom/dad/sister/friend… no one).  You can’t see your baby fresh out of the oven (usually not until hours later).  Not to mention, general anesthesia is riskier to you and the baby.  If you already have an epidural (and it’s working well), they give you a higher dose of medicine, and you can be awake and have your “person” in the operating room with you.
   
   
5. THE PAIN! Ok... so, those WERE my 4 reasons until I had my 3rd baby.  As an OB, those were my biggest fears because I see them.  I always figured I could handle whatever pain came with labor.  I have seen many women do it with such grace and even smiles on their faces (something I will admittedly never understand).  Insert baby #3.  I had been contracting on and off for weeks (the anticipation is the worst part, amiright?).  Then my water broke at home.  Finally… it was time.  The contractions I had in that car ride to the hospital finally taught me what my 10/10 pain was.  You could have swung a baseball bat at me and I don’t think I would have hurt more.   I got my epidural and delivered like 15 minutes later.  #worthit.  Turns out labor hurts and/or I’m a big wimp.  ​

That smile is at the peak of a contraction.  Zero pain.  

Bonus!  The nap after an epidural is glorious.  Labor is exhausting, so that rest can be really helpful!  Both my husband and I were very disappointed we missed out on this bonus with baby #3.  Good thing he’s cute.

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