Labor should you get an Epidural

Labor pain is so intense that it’s hard for most women to resist drugs when they’re offered. This is especially true near the end of labor, just before it’s time to push.

Nature’s blueprint for women giving birth includes pain, and this pain is purposeful. Pain is experienced when stretch reporters in the dilated cervix send signals to your brain, calling for more oxytocin be released-which in turn fuels labor and increases dilation. The sensations you’re experiencing are part of an ingenious feedback mechanism which is essential to normal labor and birth.
The pain and sensations of labor tell you what positions is best for you and how to move in labor to get your baby out. Of course, such information would no longer be useful anyway, because after an epidural you are immobilized and hooked up to machines (epidural pump, IV and fetal monitoring) and restricted to lying on your back. Pain also raises endorphins levels in your body, while analgesic drugs and epidural anesthesia lower them. This is a significant because endorphins level is relieved through an epidural, this stimulus for endorphins production is eliminated, and its levels fall.

This change is often accompanied by a group in oxytocin, thus slowing down labor and dilation. Once you’re completely dilated, your baby’s head will descend deeper and deeper into your pelvis, stretching the muscles in your pelvic floor. This stretching stimulates the urge to push.

But if you have epidural anesthesia numbing the pelvic nerves, the urge to push is weaker, or absent altogether. That’s why women with an epidural have a greater likehood of having their baby pulled out by a vacuum extractor ( suction) or forceps, and an increased chance of Cesarean for what is erroneously assumed to be a baby too big to come out.

Even though drugs initially ease pain, when the analgesia or anesthesia wears off, the pain re-experienced will be (suddenly) greater and more difficult to manage then before. This is because when the epidural was first administered, natural endorphins were still present, easing the pain somewhat.

However, anesthetics (epidural) send a message to the brain that it no longer needs to produce endorphins. So when the epidural wears off, there are no endorphins available to buffer the intensity of the returning pain. Once a mother accepts epidural “to take the edge off” (especially in early labor), it is difficult to move away from dependency on epidural for pain relief during the rest of labor.