One of the most common questions expectant mothers ask about labor is "When can I get an epidural?" They might even rush to the hospital way too soon if they think that the window for getting pain medication will quickly close.
While babies can come quickly for some mothers (especially in second or later births) and it can be tricky for the mother to get an epidural before her baby is born, these situations are rare. How can you get the timing right if you are planning to have an epidural?
When is it too early to get an epidural?
It is more likely with your first baby that you may need to labor for awhile before receiving pain medication. Some care providers prefer that the mother's labor contraction pattern is well-established and that the mother's cervix has dilated to about 3-4 centimeters prior to an epidural being administered.
There is some advantage to the concept of waiting until close to active labor before receiving pain medication. One is that having pain medication prior to active labor can slow labor contractions down. Another good reason to wait for a bit longer is that the mother's body uses gravity and upright positions to bring the baby down and to rotate in her pelvis. If the descent and rotation happen before she receives an epidural, it will be less for her body to have to accomplish while she is in bed on her back.
When is it too late to get an epidural?
There are a few instances where the medical staff may simply not be able to get pain medication to the mother in time before the baby comes. One example of this could be if the mother's labor progresses quickly after she has been at the hospital for some time and/or the anesthesiologist is occupied with another patient. Another situation might be if the mother's labor is fast from the start and she is close to pushing when she arrives.
If the mother's cervix is 8 cm or more when she arrives at the hospital and labor is progressing quickly, there simply may not be adequate time for the medical staff to admit her, draw blood, monitor the baby and get enough IV fluid in before she starts to push. On the other hand, if the mother has been admitted to the hospital and all of the pre-anesthesia work is finished and the anesthesiologist is available, she may in fact be able to get an epidural even late in labor. It actually has more to do with how quickly the staff can attend to the mother, rather than a certain number of centimeters dilated that prevents her from getting pain medication.
Coping without Pain Medication
Let's say you are caught in the dynamic of having a fast labor and recognize that there is no time for an epidural or other pain medication when you had planned to use it. What are some ways you can cope with this unexpected turn of events?
- First of all, remember that this too will pass! Be grateful that your baby is coming quickly and easily and that you are not having a labor that is lasting for days. Your recovery will likely be much easier after a fast labor.
- Next, be sure you have other options for pain relief ready to use such as breathing exercises, relaxation techniques, massage techniques, position changes, etc.
- Try to stay out of the hospital bed during labor. When your labor is moving rapidly, it will typically feel more comfortable if you are upright, sitting on a birth ball, standing and leaning on your labor partner or doula. Lying down in bed rarely feels better; however, you may need to talk to your care provider ahead of time if they will insist that you give birth in the bed.
- Be sure your labor partners are also prepared to support you during a fast labor, including using the "Take Charge" routine described in Penny Simkin's book, The Birth Partner.
- If your baby is coming quickly during the pushing stage, be sure to blow or pant through the urge to push to prevent tearing.
