Epidurals Take Time
In a perfect world, the Labor and Delivery department would be brimming with amazing support staff (OBs, Nurses, Anesthesiologists) lined up outside your door waiting for their call to action. The reality is, nurses are responsible for multiple patients at one time, OBs quickly pop in and out throughout the labor process with the lion’s share of their time with you as the baby is coming out and there is normally only 1 or 2 Anesthesiologists for the entire Labor and Delivery floor. Which means there is a fluid queue for epidural requests and if another patient requires emergency intervention they are understandably bumped to the top.
In addition, there are many steps that must occur prior to receiving an epidural. General diagnostics, administration of fluids, and more. Translation: It could be 1-2 hours or more from the time you make your request, to the time you are feeling the relief of an epidural. So having some other support techniques (meditation, breathing exercises, affirmations, etc.) to cope with the pain while you wait can be a figurative life saver.
Epidurals Don’t Always Work
As much as it is hailed as the miracle pain reliever in labor, an epidural does not always give 100% relief. Each body is different, some have curves in the spine, and some are sensitive or desensitized to pain meds – all things that effect the relief you might receive.
According to Reviews in Obstetrics and Gynecology, “epidural anesthesia has a 12% failure rate. In some of these instances, a simple manipulation of the epidural can be a fix, but in other instances a full replacement is needed.” So it can be a waiting game, which means that you are moving through the process of childbirth with no medicinal pain support – its right about that time that most moms wish they remembered their childbirth class breathing techniques.
A precipitous birth is one that lasts around 3 hours or less. For those moms who have taken a longer path to meeting their baby this may sound like paradise. Alas, precipitous births can feel very traumatizing; the body moves through the stages of labor very rapidly, rarely giving your pain relieving endorphins the opportunity to catch up. It can feel confusing, emotional and chaotic.
While only about 7% of first time mom experience this intense and expedient form of labor, your chances increase with second (approximately 21%) and third labor (approximately 25%), indicated in a study done by the The Journal of Clinical Medicine. So if you are looking to replicate your first blissful, epidural filled labor experience you may be in for a big change of plans.
If Precipitous Birth is the tortoise, then Prodromal Labor is the hare. Prodromal labor is when you body is going through the act of contracting (sometime lighter than normal labor and sometimes with the same intensity) but it is not making change to the cervical effacement, dilation or baby’s postion. It can happen in any birth for any number of reasons (maternal stress, fetal position, etc.). This situation can prove to be complicated, as most hospitals will not admit a laboring patient without a certain number of centimeters dilated, no admission means no epidural pain relief and you are on your own.
Your Blood Work
In some cases, unfavorable lab results can prevent you from receiving the epidural you planned for – always consult your doctor ahead of time and clarify anything that may prevent you from going forward with your original plan. By doing this in a prenatal visit, you may be able to take certain action and ensure your body is prepared and compatible with this procedure.
It is for all these reasons and more that it is vital the laboring couple take a comprehensive childbirth class series covering all topics from epidural anesthesia to pain support techniques. Taking the time to fill your labor tool box with different methods, approaches and moves can help you remain calm and connected to this most transformative experience.
Stay tuned for a future blog where I discuss daily and weekly rituals that can prepare you for a wonderful birth experience.
Please note: While this blog is fact based, it is not medical advice and does not substitute an informed conversation with your OB or Midwife.
Arendt K, Segal S. Why Epidurals Do Not Always Work. Reviews in Obstetrics and Gynecology. 2008;1(2):49-55.
Suzuki S. Clinical Significance of Precipitous Labor. Journal of Clinical Medicine Research. 2015;7(3):150-153. doi:10.14740/jocmr2058w.