If You Have an Epidural: How to Keep Your Body and Labor Moving

Epidural anesthesia delivers a combination of anesthetic (numbing) and narcotic medication into the epidural space outside of your spinal cord. The medication creates a loss of feeling from your midsection on down to your feet. Depending on the dosage of an epidural and how your body responds to it, you may have complete loss of feeling and movement in your legs, you may be able to feel the pressure of contractions but not pain and have limited movement in your legs, or you may able to feel pressure and some discomfort from contractions and be able to move and put weight on your legs with support (though most hospitals will not allow you to walk due to the risk of falling). There is also a chance that an epidural does not "work" for you, which means it will not provide pain relief from contractions.

It can be easier during pushing if you have an epidural that is lighter in dose so that you can feel the urge to push during contractions, which can make pushing more effective and shorter. You can discuss dosage preferences with the anesthesiologist who places the epidural.

Some people prefer to use an epidural for their pain relief/coping method. It helps to learn all of the many ways you can relieve pain and cope with the pain of contractions by reading a quality book on childbirth or taking a comprehensive childbirth education class.

In some cases, you may need an epidural during your birth. You may need an epidural if:

• Your labor is very long and difficult and you need to rest
• You have a cesarean
• Your blood pressure is very high
• You don't have good labor support
• Your birth site restricts your ability to find comfort in other ways
• You can't move beyond your fear of labor pain

If you have an epidural, it is important that you keep your body moving as much as possible during labor. Staying mobile during your labor encourages your body and baby to work with gravity and movement, helping your baby descend and encouraging your labor to progress.

Usually, your nurse is in charge of helping you rotate/flip/change positions every 30-60 minutes after you have an epidural placed. To make sure you're moving frequently, set a timer and enlist help from your nurse, your partner, and your doula.

How, exactly, do you move with an epidural? Renowned author, doula, childbirth educator, and birth counselor Penny Simkin, PT, created what she calls the "Rollover" technique (shown in the image below) to help women stay as mobile as possible during labor with an epidural. The positions used in this technique make use of an adjustable hospital bed and props like pillows and a yoga ball to move your body and open your pelvis, both of which help progression of labor.

Tell us: did you have an epidural? Did anyone help you stay mobile during your birth with an epidural? What made changing positions easier? Did you have a favorite position?