Are epidurals necessary to get through birth?
When I was preparing to give birth to my first baby, my plan was to get through as much of my labor as possible without an epidural. I had heard that anesthesia could slow contractions, and more importantly, I wanted to cut down on the amount of time I spent strapped to the bed with an IV (which is compulsory for the epidural). I imagined panting and pacing the hospital hallways in my nightgown and slippers until the last minute. Still, I had a distinct fear of the pain involved in actually pushing without drugs, so I was clear that a needle in my spine and an anesthetic were in my future regardless. That’s more or less the way it unfolded — with most of my labor taking place on a yoga ball instead of in the hallway, and an anesthesiologist riding in like a knight in shining armor when I couldn’t take it anymore.
The second time around, though, I wondered if I needed an epidural at all. It wasn’t that I disliked medication or saw it to be bad for the baby (I felt confident in the epidural’s safety and I witnessed it first-hand with my perfect, bright-eyed, and healthy firstborn). This time I was really just curious about the limits of my own body and figured that since we planned on only two kids, it would be my last opportunity to find out what a natural birth was like. I had made it through most of labor with deep breathing and my ice chip-delivering, steady-handed husband — maybe it was possible to make it through that final stretch without the epidural? Women with natural births told me that the contractions were the worst part, and the pushing almost felt like a relief.
— Ashley Weeks Cart
— Ceridwen Morris
— Molly Thornberg
I wasn’t alone in thinking about a drug-free second birth. A few of my friends shared my curiosity about going into their next baby’s delivery without medication; having been through it before, they were feeling less scared of the whole process overall. A few felt overly guided toward medical interventions the first time around and wanted to call the shots with the second. Apparently, it’s a national trend: According to the CDC, 68 percent of first-time moms have an epidural, but the percentage drops to 57 percent for second deliveries and beyond.
One of the reasons for the drop could be that second-time births tend to go blessedly faster than firsts. The average firstborn labor lasts between 12 and 20 hours, with one hour of pushing, while second-time births average around eight hours, with 20 minutes of pushing. I heard story after story of speedier and overall less-complicated deliveries from second-time moms and felt sure I was headed in this direction myself.
The only one who didn’t seem to be on board with my drug-free plan was my doctor. At a routine check-up I posed the question to her: “Could I do this with no epidural?” She looked me squarely and said, “I wouldn’t recommend it.” She described a birth she had recently attended in which a mom was writhing and climbing up the side of the hospital bed in pain. “Could you do it? Yes. But why would you put yourself through that?”
If I had been more attached to my birth plan, I would have been irritated. Instead I considered her advice seriously and asked friends and friendly strangers for their input. It was hard to find moms who, like me, were open to natural births, but also didn’t see it as a must, and who had no judgment about medication, either. I found them, though. In a coffee shop one day, a mom struck up a conversation with me and it turned out she shared my middle-of-the-road mentality. She recounted her second birth without an epidural and, to my surprise and amusement, went so far as to get down on the floor and demonstrate a helpful labor position. “Just see what happens,” she said. “And don’t let your doctor pressure you.” Another good friend with a speedy, drug-free second birth sent me supportive text messages: “You got this, mama. You’re gonna be great.”
Five days after my due date, at 8 p.m., I went into active labor. I arrived at the hospital an hour later, six centimeters dilated, and told the midwife (standard at my hospital for uncomplicated births) I’d hold off to see how quickly I progressed. By 10 p.m. I was eight centimeters, and before the nurse could check me again I was broadcasting (in non-PG language, no less) that I was ready to push. Fifteen drug-free minutes later, my baby girl was born.
Afterward I was shaking and slightly traumatized (my husband reminds me that the post-trauma feeling seemed to last for 10 or so hours), part of me still wondering whether opting out of meds was a good call. No amount of deep breathing or the supposed relief of yoga poses had made a dent in the pain. It was scary, and if it had been a longer labor, I would have summoned the anesthesiologist once again. And yet, I came out the other end glad that I had done it. In fact, looking back, I appreciate both types of births so much. My first birth for the unbelievable relief and safety net of the epidural; it allowed me to go into the process with an escape hatch, and without fear. My second birth for being the most intense experience I’ve had, and for the ability to see and feel the natural course of things — from the first telltale belly tightening to the last movie-birth, hear-it-down-the-hallway scream. In the end, of course, my two tiny, crying, perfect babies made their way into the world. That miraculous fact makes the details of their passage pale in comparison.