12 Things to Try Before You Get an Epidural

I've said it before and I'll say it again: EPIDURALS ARE NOT EVIL. *Gasp*  Are you shocked to read those words from a doula who has given birth twice without an epidural and has supported more than two dozen other moms who have done the same? It's the truth. Epidurals can be helpful and effective tools when used apporpriately. The same is true for IV pain medications used during labor and birth.

When deciding for yourself whether you'd prefer an epidural (or IV pain meds) or not, it is incredibly important to learn all of your options and then all of the risks and benefits of those options.
Then carefully consider those risks and benefits and choose the right path for you. Not the right path for me. Not the right path for your mom. Not the right path for your sister or cousin or neighbor.

Sometimes, for many different reasons, moms who had chosen and prepared for an unmedicated birth decide during labor to get an epidural or have some IV narcotics. And that is OK. I won't leave. There is still plenty I can do to help. The list of labor positions I have in my head is huge and continuously growing. Several of those positions can be done with an epidural in place. I can still get mom and dad drinks and snacks. I can still give mom massages and whisper encouraging words. I can still show dad ways he may be comforting to mom. I can still gather information and answer questions that mom and dad may have. 

Sometimes, mom requests “something” or specifically an epidural and I know that if we can just get her over this “hump” she will do beautifully without one. In those instances, I begin making suggestions of other things to try first. Which leads me to......

12 things to try before you get the epidural:

1. Change positions: Is back labor making you question your decision of an unmedicated birth? Try getting on your hands and knees for a bit. Want to stay upright but your legs are tired? Try sitting on the birth ball, or if you are at the hospital, you can try the “throne” or “princess” position. Feel like your hips are being pulled apart? Ask your doula or partner to try a double hip squeeze.
2. Hydrotherapy: Try a shower or bath. There's a reason the tub is referred to as “the midwife's epidural.”
   
3. Turn on some music: Studies have shown that listening to music you enjoy reduces pain perception/elevates pain threshold, reduces cortisol (stress hormone) and increases endorphins (feel-good hormones). The rhythm of music can cue your breathing, helping you to focus and remain calm. 
   
4. Pray: Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. Philippians 4:6; He gives strength to the weary and increases the power of the weak. Isaiah 40:29; The Lord gives strength to his people; the Lord blesses his people with peace. Psalm 29:11; I can do all things through him who gives me strength. Philippians 4:13
   
5. Massage: As explained in a previous post, tension increases your pain therefore relaxed muscles will lesson your pain. Also, the Gate Control Theory of Pain.
   
6. Visualization: For some, visualization is a very effective coping technique. There are many things you can visualize during contractions. One popular one is as the contraction builds, visualize riding up on a wave to the peak and then letting it crash and recede as the contraction fades away. Another popular one is to visualize the work your body is doing: visualize your cervix melting away and opening; visualize your baby moving down. Visualization during labor will be more effective at helping you cope if you have practiced it during pregnancy.
   
7. Distraction: For others, distraction is a very effective coping technique. Some women like to bring pictures to focus on during contractions. Some women ask their partners to wear patterned shirts. During one of my births, I found myself counting the dots on a hospital gown through contractions. Other forms of distraction can be helpful as well: TV/movies, games, music, a project such as baking or painting or knitting/crocheting. 
   
8. Breathing: Ask your partner or your doula to help with your breathing. There are many different techniques that can be used for this. Guided, paced breathing can be very helpful in allowing you to relax and focus. 
9. Decrease outside stimuli and increase privacy: Your body is doing a lot of work. And, the outside stimulation, especially when in a hospital can overwhelm your nervous system causing you to feel anxious, worried, tense, etc. Also, birth is a private, sacred event and having others in the room can hinder the process. It can be very helpful to block as much of this out as possible. Turn off or dim the lights (battery-powered candles are nice). Create a cocoon or nest for yourself in the bed, wrapping yourself up, even covering your face/head with a sheet or using a sleep mask. The bathroom is a great place to reduce outside stimuli. Many women like laboring on the toilet or in the shower or bath. Turn off the lights, turn on some music and close the door to create a private labor cave. 
10. Essential oils: There are several essential oils that are said to decrease stress and tension and promote relaxation and focus. Diffuse some into the room, ask your partner or doula to massage you with some or place a few drops in your bathwater.
11. Increase oxytocin: Oxytocin is a magical hormone. It is known as the love hormone, produced when kissing and hugging and during orgasm. It's also a hormone that plays a key part in the physiologic birth process, and is released while breastfeeding. Oxytocin is responsible for feelings of love, nurturing, and protection. Ask for some time alone with your partner and do whatever you feel comfortable with to increase your flow oxytocin. 
12. Have a good cry: It really is OK to cry while laboring. Birthing a baby is a lot of hard, exhausting work and there are so many emotions involved. Sometimes, an emotional release is all you need to bring your baby into your arms. It's OK....cry it out....let it go.

As I said before (and I'm sure I'll say again) epidurals are not evil. But, if you are hoping for an unmedicated, low-intervention birth, please try some of these suggestions if you find yourself asking for one. They just may get you through that tough spot and accomplish your goal.