10 Reasons NOT to Get an Epidural

I don’t know if I can do this,” I whisper it into the blurry room. The contraction begins to rise and I scream, sing, breath, and pray simultaneously. With a final push, the crescendo, her body slips through mine. I catch her and bring her to my chest, elated.

Three natural childbirths later and I have no regrets. Each time, I was afraid. Each time, the baby slid out into my arms and the pain evaporated, replaced by pure relief and indescribable joy.

Please note as you read this article that I am not against the epidural. On the contrary, I am simply FOR more education for women. I’ve heard too many stories from new mothers who express deep sadness about their labor & delivery experience and the repercussions of choosing an epidural. The information presented here is meant to serve as a guidebook of data and a compilation of experiences so that you can make the decision that is right for your family.

The first epidural to be used for childbirth dates back to somewhere in the 1930’s and 40’s. The precise date is disputed. We do know, however, that they did not gain wide popularity for pain relief in labor until the 1970’s. Epidurals as a pain management option for childbirth is relatively new – less than 45 years old.

The U.S. Centers for Disease Control National Center for Health Statistics published a report about the use of epidurals in 2008. Based on data collected from 27 states that track the use of anesthesia for labor, six out of ten women with a singleton birth received an epidural or spinal anesthesia. In my own hometown of Tucson, Arizona, hospitals report epidural rates between 65-85%.

While epidurals may be a good option for some women, it would be folly to discount the risks and side effects – for both mother and baby. The needle provides temporary pain relief, but it also can lead to a slew of unwanted interventions and a slower recovery.

Consider these 10 reasons why you may want to think twice before calling for the anesthesiologist.

Reasons not to get an epidural 10 Reasons NOT to Get an Epidural

(1) Epidurals restrict movement.

Because epidurals require IV fluids, bladder catheter, and full time electronic fetal monitoring, mothers are unable to be in control of the natural progression of labor. Deena Blumenfeld, a Registered Prenatal Yoga Instructor and Lamaze Certified Childbirth Educator in Pittsburgh, explains, “The epidural restricts mom to bed, and it restricts her movement. When mom’s movement is restricted it can cause a number of complications, including: fetal distress, low fetal heart rate, and inability for baby to rotate to the anterior position (optimal and normal for birth).” Ultimately, she says that the “use of the epidural can be a direct cause of c-section.”

(2) Epidurals increase the risk of fever. 

It is not uncommon for epidurals to increase the mother’s body temperature. A recent study pinpointed that over 19% of women who received an epidural experienced a fever of 100.4 or higher. Fevers, in turn, can increase both the mother’s and baby’s heart rate. Since fetal heart rate can be a sign of distress, doctors often react with the suggestion of a C-section. Even if a C-section is not the outcome, the heightened heart rate often leads to further investigations of the baby after birth (which can include blood and spinal fluid samples). This can lead to days of separation, observation, and possibly antibiotics – which inhibits mother-baby bonding and the establishment of a strong breastfeeding relationship. Kelly Whitehead, author of High-Risk Pregnancy: Why Me?, had this very experience. After a spiking fever, she had to leave her baby behind at the hospital for a few days after her discharge as a preventative measure. She commented, “It was extremely hard emotionally to leave my daughter behind. Breastfeeding her kicked off with a rough start since I was separated from her moments after birth. Though the hospital lent me a pump, I found that difficult, especially being a first time mom.”

(3) Epidurals may cause the mother’s blood pressure to drop.

A sudden drop in blood pressure is one of the most common side effects – which is why blood pressure is taken every 5 minutes when the epidural is initialized and every 30 minutes thereafter. A drop in the mother’s blood pressure affects how much of her blood is pumped to the placenta and can lead to less oxygen being available to the baby.

(4) Epidurals have been known to cause headaches.

Many women with epidurals report having persistent and/or chronic headaches post-delivery. Blumenfield says that this happens when the epidural needle is inserted too far, “...it can release spinal fluid up to the brain, causing a spinal headache. These are severe and often debilitating, lasting for hours or days.”

(5) Epidurals can slow labor.

Epidurals often slow the second stage (or pushing stage) of labor by interfering with the natural hormone of labor (called oxytocin), as well as reducing moms’ ability to push effectively. Since the mother is numb, she is unable to get in the most helpful positions to help guide the baby’s descent.

(6) Epidurals increase a woman’s risk of having a delivery with the aid of instruments.

The gold standard of medical reviews, a Cochrane Review, came out with this research in 2011. Epidural babies were more likely to be delivered with the “help” of  forceps, a vacuum, or other tools that increase pain and discomfort for both mom and baby (Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD000331. DOI: 10.1002/14651858.CD000331.pub3). The use of instruments also increases the likelihood of a woman having a more serious tear and/or receiving an episiotomy.

(7) Epidurals increase the risk of Cesaearan Section.

Nick Angelis, a nurse anesthetist and the author of How to Succeed in Anesthesia School, states this matter-of-factly, “statistically, the chance of getting a c-section increases with each medical intervention [including epidural].” He also points out that mothers seeking a natural childbirth experience would be wise to avoid labor augmentation drugs such as Pitocin since it is known to make contractions less manageable for the new mother.

(8) Epidurals = a slower recovery.

Elizabeth Chabner Thompson, MD, is a New York mom of four. A graduate of John Hopkins Medical School, she initially did an OB/GYN internship, but ended up changing specialties to focus on oncology. Two of her babies were delivered with an epidural, two without. She far preferred her non-medicated births, “A woman delivering without anesthesia recovers much faster than with anesthesia. I tore much less — I could feel everything so I was able to pay attention to my pushing.” She even went on to say that she, “was up and running behind the stroller within a week after delivering without anesthesia…it was much easier to care for my other children.” Though perhaps not all new mothers will be jogging at one week postpartum, there is certainly something to be said for being able to get up and around quickly.

(9) Epidurals sometimes interfere with the early stages of breastfeeding.

Studies have shown a link between epidurals and breastfeeding rates among new mothers. Whitehead explains that this is “due to neurobehavioral effects in the baby in regards to initial rooting and suckling behaviors.” Note that epidurals also interfere with the natural production of oxytocin (as stated above)…the hormone which causes the let-down effect in breastfeeding and promotes healthy bonding between mamas and their babies.

(10) Epidurals may cause other unpleasant and dangerous effects for babies and mothers.

Women have reported nausea, itching, backache, and incontinence. Little is known how the epidural effects the baby, but we do know that the drug does enter the baby’s bloodstream. It seems contradictory that many women take great precautions to avoid deli meat, coffee, wine, and tylenol throughout their pregnancies…and then proceed to take in a heavy anesthetic agent right before meeting their babies for the first time.

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Scientist Kelly Whitehead correctly points out that “There is a time and a place when epidurals are needed and necessary, such as for C-sections, moms who are having very long, hard labors or those moms who are truly not managing well during labor.” She notes, however, that pain, crying, and yelling don’t necessarily mean that the mother isn’t managing well. Those can all be “normal” during the laboring process.

Kimberly Jacobsen Nelson, a freelance reporter from Oregon, has had three babies – the first with an epidural, the second two without. She describes the epidural as a “massive mistake” and wishes she had been better informed about the risks. In contrast, she says her two natural births were “the most amazing thing I have ever done…so rewarding. [My labors] were fast – 4 to 6 hours – and the babies came out so much more alert.

Elizabeth Greenwell, a doctoral candidate at Harvard School of Public Health, completed a study about epidural use and fevers which involved more than 3,200 women delivering a full-term baby at Brigham and Women’s Hospital in Boston in 2000. She concluded, “It’s clear that from our data that about 20 percent of the term infants born to mothers who received epidurals experienced one or more adverse outcomes after birth.” Twenty percent is certainly enough to give a new mother pause before requesting drugs.

Share your experience! What would you change about your labor & deliveries (if anything)? Did you experience any side effects related to using the epidural?

  • Sharon

    I don’t remember an epidural even being an option with either of my 2 children. Might have been policy of military hospitals back then. I also had relatively short labors and used midwives and Lamaze for the first and hypnosis for the second.

    • http://stephaniesheaffer.com/ Stephanie Sheaffer

      Tell us about Lamaze versus hypnosis. Did you take classes for either of those approaches or did you “teach yourself” through a book? Which pain management technique “worked” more effectively?

  • http://twitter.com/simplycathi Cathi

    I delivered all four of my children natural. My deliveries were fast and I was up moving around immediately. That was long ago. My youngest is 31 years old. I’m actually surprised with the amount of people having epidurals. But I’ve been out of the loop for 30 years. We had to wait for the epidural to wear off before my daughter-in-law could start pushing with our second grandchild. And I have a friend who is the lactation consultant for our local hospitals. She’s an RN and mentioned that its because of epidurals that she has the job of lactation consultant. I do understand why people choose epidurals though. Let’s face it. Labor and delivery hurts. The reward is mighty precious though! ;)

  • JulieK

    Both my children were born without epidurals. And my labor time was semi lengthy. ( 11hrs the first time from the start of hard labor.) the second baby they gave me pitocin against my desire bc 15 hours after my water breaking I stalled at 5 cm. I had no midwife bc none of them were on call that night! Next time I am getting a doula to advocate for me. After the pitocin, WOW the contractions started in seconds and were so incredibly intense, that I don’t think I could have even had a coherent thought to ASK for an epidural! LOL…my baby was born 90 minutes later. Yay!!

    I have never wanted an epidural for all the reasons listed above! But yeah, childbirth is excruciating!!! LOL so I can see why women want it!

  • Janette

    I think it is good to have a discussion. I ended up have an epidural and then a c-section when I was dilated to 8 and felt a little pressured by the medical staff. I am also very petite 4’11 and though the contractions were manageable, the back pain was intense for me. I do regret having done this, but am so glad the baby was healthy and I was able to breastfeed, and was up and walking within a few hours. I think the recovery time may have to do with being in good health too.

    • http://stephaniesheaffer.com/ Stephanie Sheaffer

      Excellent points, Janette. Good health (regular exercise, nutritious diet, low stress level, adequate rest) or lack thereof is sure to have a significant effect on labor, delivery, and recovery outcomes.

  • Jen

    Wow – I had a completely different experience. My first son was born naturally, and the pain was terrible. I was so weak afterward that I could not even hold my new baby as they wheeled me into the recovery room. With my second son, I opted for the epidural before the pain from the contractions even began. The whole experience was amazing. I was completely pain-free and enjoyed every minute. My labor was short and both the baby and I did great! I did not notice any negative side-effects what-so-ever. Breastfeeding went well. Just another perspective – I feel like there is so much negative attention re: epidurals.

  • http://stephaniesheaffer.com/ Stephanie Sheaffer

    Thanks for your comment, Stephanie.

    There have been several studies on the link between epidurals and a decrease in oxytocin levels:
    * Oxytocin deficiency at delivery with epidural analgesia http://1.usa.gov/XfoyQK
    * Plasma oxytocin levels in women during labor with or without epidural analgesia http://1.usa.gov/YshfIa

    Childbirth Connection also suggests that one way to “promote your body’s production of oxytocin during labor and delivery” is to “avoid epidural anaglesia.” http://bit.ly/A4fCd

    Perhaps other doctors, midwives, nurses, researchers, and/or mothers will weigh in with links as well. Stay tuned as the conversation continues.

    • Marge

      These are correlational studies that you are giving causal statements to.

  • http://www.facebook.com/profile.php?id=551812218 Beau N. Kelly

    I had many of the same experiences you stated above, happen to me. First time, had horrible back labor, fetal distress, dilated to 8ish and they insisted a C-section cause the epidural had stopped my contractions from being effective. I was also never able to rest with the epidural, for some reason, it kept me awake. 2nd kid, I waited and walked…and cried in pain!! I finally let them give it to me at 6 centimeters, then labor slowed and the epidural only took on one side. Argh!! I finally had her with help from a vacuum! Poor thing! 3rd child, I said NOOOO! I got demurral twice and had no problem. I was able to sleep and my body did it all by itself. She came out almost 2 lbs bigger then her siblings and were shocked! I should also point out, the staff bullied me repeatedly to have a epidural! Finally, a great anesthesiologist came in. ( He had 4 children of his own. ) He said that no woman chooses painful labor after 3 children unless they have had a horrible experience so I let him give me one when I was dilated to 9 and a half since they kept bulling me. He gave me a quick boost at first so it would tapper off quick. It was great! I was walking 2 hours later!
    Everyone is different. For me, I always seem to react different then they say on any medicine. I would take that into consideration when deciding what to do.

  • Brandi

    I had a spinal headache for a week after my epi. I had to go back to the hospital for an epidural blood patch. So, two babies,three epis. Also, my epi went up and down so my WHOLE entire body was numb including my throat. I could not swallow and started having a panic attack. It was awful and stalled labor tremendously. I will NOT have do it again!!

    • http://stephaniesheaffer.com/ Stephanie Sheaffer

      So sorry to hear about the spinal headache and epi side effects! Hope your future birth experiences are much more peaceful.

  • SoarAway

    I had my first baby naturally and I was very against any pain management. I AM SO GLAD. He was born beautifully, naturally, and with no complications in a wonderful water birth. When my next one arrives, please G-d, in a couple of months, I cannot wait to have him/her in a natural water birth, too. I am so grateful to my doula for keeping me so informed and teaching me so much about the risks of epidurals and other painkillers, so that I was able to make this informed decision for myself! (Thank you also to the midwives who attended my birth, who were so supportive and attentive to my birth plan, and never tried to tempt me with painkillers… midwives and doulas are the best!)

  • allison

    Awesome post Stephanie! I had the same experience as Jen. I wish I had known how awful Pitocin makes your contractions. I felt like my spinal cord was being electrocuted for over 8 excruciating hours. So with baby #2 I opted for the epidural immediately! However, it did slow down my labor, they had to use “the vacuum”, and my recovery was longer……but NO PAIN! I am not that tough. :)

  • MZFORTREZZ

    Thank you for the information, not everybody’s body will act the same way but from what I heard and this article I know some to be true so I’ll go for the natural now, I just don’t want any back problems lol

  • modern human

    I think it is unwise to quote a Lamaze educator (who may be very good at her job but is clearly not a scientist) when trying to state scientific evidence. It is a little like asking a former Playboy Playmate to weigh in on her opinion about vaccines.

    “…it can release spinal fluid up to the brain, causing a spinal headache.” anyone who knows anything about medicine can tell you that this statement doesn’t even make sense. Spinal fluid continuously surrounds the brain. That is why its proper term is cerebrospinal fluid. Headaches are an unfortunate possibility of epidurals when the dura is punctured during the procedure (which is done purposely for spinal anesthesia – similar but different).

    “use of the epidural can be a direct cause of c-section.” There is no proof of this. It is complete hearsay.

    What good is it to live in 2013 if you want to have the same experience as women giving birth in the year 13? Child birth is often the measurement used to compare all other painful experiences, and if you really want to impress someone, you state “my pain is worse than childbirth.” Perhaps the woman who was up and running within a week enjoys pain – most people do not. It is true that virtually all medical procedures involve some risk, although the risk associated with epidurals is small. We will expose ourselves and our children to a countless number of potentially unhealthy things over the course of a lifetime, many of them completely avoidable, but to do otherwise would be inconvenient. For instance, motor vehicle accidents are a major source of injury and death, but will you never allow your child to drive in a car? Will you grow all your own food to avoid the problems of that particular industry? Will you move to the country to avoid pollution? The use of an epidural should involve an informed decision by the mother. I think it is unfair to give them bogus information from biased sources to influence this choice.

  • BS

    Such minimal research gathered by you yet you have such an expert opinion! Do more reading and research. Then you can come lecture us on epidural cons. Going all natural doesn’t work for some people. Due to mental health conditions, unrelaxed pelvic floors which can obstruct labour. Try studying at uni and then lecture us or talk to Anaesthetists!

  • Brent Ramsey

    I am a CRNA, and this “Scientist” chick that wrote this story, is VERY ambiguous. I could offer up the statement, “If I play on the freeway, I will get hit by a milk truck!” Blood patches are shown to be 99.9% effective in curing the post-dural puncture headache. Also, I guess “inducing” labor is the natural way to go? More like get ‘em in, pop it out, ship them out! bill their asses!

  • julia

    Yeah, that wasn’t my epidural experience(s) at all. I appreciated my pain-free labors.Though I will say, I felt like Xena Warrior Princess after having my third son without an epidural (esp. at 10 lb 8 oz., yikes.) And I guess I had an unpleasant experience with the anesthesiologist continually hitting a nerve during placement of my epidural for my second birth, I was scared to death she was going to leave me paralyzed!

  • Rachel

    I can’t say I had any negative side effects caused by the epidural. It was the nurses who were in control of it who were the problem. The drip rate was way too high, preventing me from feeling the urge to push. I was told I should be sble to feel pressure but not pain. Despite repeatedly saying I couldn’t feel anything, they did not turn off the epidural flow. Only once all else had failed (trying different pushing positions) did she think to turn it down. Once it started to wear off, my daughter was born in 3 pushes. Never getting one again with my next baby. I vowed that night that I would go drug free so the nurses couldn’t tell me it was my inability to push properly slowing things down. Before I got to pushing, I was just forgotten about in the hospital room. They pushed the dose too high, and left me alone, unable to feel if I should call the nurse because it was time. Things started stalling as a result of being fully dilated and just left there, not even knowing I was dilated. Only after my second complaint of starting to throw up, did anyone decide to listen and check me.

  • megan

    I want to give a positive epidural story. My total time in labor was 2.5 days, I went into labor naturally but my body didn’t want to progress. I originally planned to have an all natural childbirth. After a day and a half of labor and constant pain I was given an epidural. With having this they were able to monitor my baby internally which was quite necessary and enabled me to not have ac-section. Long story sorry I had the epi, petocin, and iv drugs. When it came time to push I could still feel what I was doing just not the pain. I had no adverse side effects, my daughter was breast feeding within minutes of being born and I was walking around that day. I am glad that I had the epi and was able to experience c hild birth without all the pain I had in the beginning. Also I think a lot if women should realize that just because an ob recommends a c-section doesn’t mean you have to have one. The dr wanted me to have one but I refused because my baby was not in distress.

  • Eric

    As an anesthesiologist, I would caution anyone to take this authors opinions with a grain of salt. It’s a good idea for any mother to have a discussion with her physicians before making any decisions regarding your medical care. I would certainly not let the blog post of a “writer, traveler, entrepreneur” (i.e. someone who has zero medical training whatsoever) influence your decision making.

  • Anonymous

    I believe that everybody should watch “The Business of Being Born.” It feathres many trained medical professionals from across the world who actually provide statistics and real medical evidence about the cons towards epidurals. Men and women who have been in the medical industry delivering uncoutable children for 20+ years. It really talks about how child birth is in the new age, and how different it really is. It is an amazing documentary. I encourage everybody to watch it! It is very true based on every expierience I have known of while being induced and receiving the epidural. It goes over almost every point that was made above, and if you don’t believe her based on her perfession, then I’m sure you will Elise them.

    • Same person

      Damn iPhone. Still getting use to this phone. Fill in the awkwardly placed words with your best guess to what the actual word it… Madlibs everybody!

  • Solange

    The research in your article is outdated. Epidurals now do NOT restrict you to bed. There are epidurals available (at least in Canada). called “walking” epidurals and you can move, walk, even urinate with it in. I know because I had three.

    Some of these facts are fear mongering, not “educating”. A lot of women who choose epidurals also are induced – and induction has been proven to increase interventions. Where is the reaearch cited on that? How can it be proven that it is the epidural and not the induction drugs causing these interventions?

    Epidurals are a GOOD choice for pain management – they do not cross the placenta whereas drugs such as morphine do.

    From a mother who has had 3 epidurals, 3 intervention FREE births, and three BREASTFED babies who latched IMMEDIATELY.

    Every baby and every mother is different. Don’t scare a mother into a drug free birth with posts like this.

  • Melissa

    My epidural caused me to die on the delivery table. I hope more people read this and think before they decide.

  • MelissaA

    I’m always so put off when someone says I need to be educated! Do you think that just because I did have an epidural I am uneducated? What I have learned after having two children and my sisters each having two kids, all within the last 5 years, is that this is a personal choice and their needs to be less judgment on moms by other moms. Moms who breast feed judge moms who use formula. Moms who put their babies in their nursery when they get home judge moms who co-sleep. And moms who don’t get epidualrs judge those who do. Instead of trying to “educate me” why don’t you try supporting me? If it was really that big of a risk, do you think I would risk the life of my child and self?
    As far as recovery, I felt just fine after giving birth with both of my children. I nursed them immediately and had no trouble whatsoever. The nurses and doctor were great about helping me with whatever I needed. I was up, taking a shower and walking the halls later that day.
    And as far as the running a week after giving birth, you should probably hold off on that. There’s a reason why your doctor wants you to wait six weeks!

  • Kaytee

    I didn’t want an epidural, but when my contractions became stronger and stronger, to the point that I couldn’t stand anymore (even while holding myself against my bed), my already low blood pressure was dropping and I felt my life force leaving me (I described it as “fading”). I can take a lot of pain, but somehow this one was defeating me and I seriously feared for my life. While I’m not proud, part of me thinks I may not have made it if they hadn’t given me that emergency epidural. And I wouldn’t want my husband to raise our kid alone. Drugs (mainly sedatives based on past surgeries), alcohol, etc flush through me quickly, so I didn’t suffer many of the bad side-effects like numbness, can’t walk (I was able to take different positions and walk around my room), stuck in bed (I walked a few times after the delivery to change the baby and get myself breakfast in the morning). It did slow down the delivery as I lost my contractions, but they came back an hour or two later. They also, says my chiro, messed up the removal as the first time I tried to walk without the epidural in place, I huge shock in my lower back made me fall to my knees. I’ve had some lower bad pain, but it’s getting better after 2 years, thanks to my chiro!

    • Kaytee

      Also, breastfeeding didn’t go so well, so if that is true, that would be my real beef against epidural.
      Frankly, I think that without the epidural, they might have had to give me a C-section… That’s even worst!