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“Just Get The Drugs” — Do I have to get an epidural if I give birth at the hospital?

More than one friend has told me that it’s virtually impossible to deliver in a hospital and not get the epidural and that I should basically accept that. Is this true? – just get the epidural

Dear Just,

Women do have non-medicated births in hospitals. They really do. It happens. It’s happened to people we know. It’s happened to people we know who had hard labors, back labors, long labors, hellish inductions and lousy labor support. So it’s not impossible.

But going to the hospital and not taking the epidural can be like going to a pizza place on a low-carb diet. It can be frustrating. As one woman we know put it, “the only way I won’t get an epidural is to be far the f*ck away from it.” This is one reason women who are adamant about avoiding medication plan to give birth at home or in birthing centers where epidurals are not available.

The epidural is the hospital’s big offering when it comes to pain relief. When the agony kicks in, the resident will probably not suggest changing positions, massage your lower back and offer gentle encouragement. There probably will not be a tub. Unless you brought a birthing ball, you won’t have one to rock on. And the fetal monitor will likely be strapped around you for some period of time, limiting your ability to lean or sway or rock through contractions. But you will be offered medication. Probably more than once. The hospital staff wants to help, after all. And they all see, time after time, the relief on their patients’ faces when the drugs kick in.

What they don’t see a ton of is a supported non-medicated birth. So, if you want that kind of experience you need to bring your own alternate labor strategies. These can include a really good labor doula, a supportive and knowledgeable partner, an understanding of and trust in birth (including the part about it hurting like hell) and whatever other tools for relaxing and focusing you may have gleaned from books, classes, or anywhere else. If you do birth in a hospital and definitely don’t want meds, stay at home until you are clearly in active labor. The later you get there, the less time there is to consider various interventions.

This is ultimately your choice. The hospital can’t force you to get an epidural. In fact, you’ll have to sign a consent form to have one. If you don’t want it, you don’t want it. The women who get epidurals get them because they want them – whether that was in the original birth plan or not.

We’re all about the real deal when it comes to what to expect. So we can see why your friends are giving you this “just face it” rap. It can be very disappointing to spend nine months mindfully meditating on your glorious drug-free birth and then come up against an environment that is not conducive to your plans. Being set up to fail is not good for anyone.

What is incredibly important is to remember that there is no failing here.

Your ideas about your birth before the fact are real and important. They’re also happening before you enter an unpredictable experience. So we urge you to be open to whatever means of coping seems right to when you get there. Meds are one of many tools for dealing with pain in labor. Learn what your options are and then do what you need to do at the time, whether or not it was what you had in mind in advance. Trust yourself: you’ll make the best decision you can based on the birth you get and what tools are available to you.

Have a question? Email beingpregnant@babble.com.

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