What Does it Mean to Have an Empowered Epidural Birth?

How does one have an empowered epidural birth?

No one should suffer in labor.

This is important. There are ways to labor without pain medication, so you can stay away from a suffering cycle. Yet, if you cannot connect with your body, your breath, or your baby – and the contractions are overwhelming you – then it may be time to use an epidural as pain management.

I encourage clients to wait until active labor has fully established itself before getting an epidural. This means that your cervix is dilated to at least six centimeters and that you are having strong, regular contractions, at least five minutes apart. When you wait until active labor has established itself, the epidural is less likely to slow down labor and lead to other medical interventions.

Instead of defaulting to an epidural, a more empowering mindset can be: “I will get an epidural if and when I need one. I will allow my body to lead me. I will use natural coping techniques as long as I can. When these techniques no longer feel effective, I am open to medical pain management.”

There is a way to make things feel less medical in the birthing room. Although you are using an epidural, it doesn’t mean that you still don’t have hard work to do. There is no easy way to have a baby!

A well-placed epidural takes away contraction pain, but it does not take away the other sensations and experiences of birth (i.e. hot/cold flashes, nausea, labor shakes, emotional responses, and the pressure of baby descending).

You can manage these symptoms through natural coping techniques. Cold washcloths can help with nausea or hot flashes. Physical touch can help ground mothers who are experiencing anxiety or the labor shakes. Breathing techniques can help with breakthrough pain, whether it be pressure or contraction pain. Using all of these tools can help you feel strong and empowered throughout birth.

Listening to birth affirmations or your favorite music can also help manage fear or anxiety. Dim the lights, and make it feel good in your room!

It is important to remember that once an epidural is in place you cannot get out of the bed. However, it is still important to change positions within the bed. Most hospitals have a tool called a peanuts ball; this is a peanut-shaped ball that a woman can use in bed to help create space in her pelvis to encourage the baby to descend.

With or without an epidural, you want to change positions about every 45 minutes in labor. When your epidural is first administered, you will lie flat in bed for about 20 to 30 minutes, so the medication can spread evenly throughout your body, giving you the best possible coverage. After those initial 30 minutes, you are free to shift positions as often as you’d like, with your nurse’s help.

Remember: once an epidural is in place, you are connected to a lot of medical equipment, and you may not have full movement of your legs. So, if you are going to shift positions it is crucial to receive help from your nurse or doula.

There are a variety of positions you can use in bed with an epidural. Getting an epidural does not mean you have to push while lying down on your back. As a Lamaze childbirth educator, I always teach the Lamaze 6 Healthy Birth Practices. Birth practice number five is: pushing in an upright position.

Depending on the strength of your epidural and its effects on your legs, you may be able to get into an all-fours position, or you might use the squat bar that attaches to the hospital bed. If these are not options for you, you can push while lying on one side, instead of flat on your back. This creates more room for the baby and feels better for most moms.

While pushing, if you do not feel the pressure of your baby descending (or the urge to push), you can ask your doctor to turn down the epidural. The goal of a well-placed epidural is to remove contraction pain without removing the pressure of the baby descending.

Journal Prompts About Epidurals

  1. Are you planning on using an epidural? 

  2. If you are planning on avoiding an epidural, what is your reason?

  3. Does the idea of getting an epidural make you feel safe or scared? How does your body physically react when you think of an epidural?

  4. Do you fully understand the risks and benefits of getting an epidural?

  5. Do you have a goal of at which point in labor you would like to get an epidural?

  6. What stories have you heard about epidurals?

  7. Do you fully understand natural pain management techniques? Have you created a good support system for yourself in labor?

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5 Ways a Doula can Support you through Pregnancy

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Cultivating Courage for Birth: Induction