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, you may have complete loss of feeling and movement in your legs, or you may be able to easily feel the pressure of your contractions and be able to move your legs (though most hospitals will not allow you to walk due to the risk of falling). You can discuss your dosage preferences with the anesthesiologist who places the epidural. Ideally, in order to feel how and when to push your baby during birth, you will have an epidural that provides relief, but not complete loss of sensation. 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 to descend and progressing your labor. Usually, your nurse will be in charge of helping you rotate/flip every 30 minutes to an hour. It may help to set your own timer to ensure that you keep moving regularly. You can enlist help from your nurse, your partner, and your doula to move. But how 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 and explained in detail here at Spinning Babies) 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.
- Labor at home as long as possible.
- Choose your caregiver and birth site carefully.
- Discuss your desires with your caregiver.
- Make sure you have excellent labor support.
- Use all the non-drug comfort measures you can.
- Be patient and remember that your body knows how to give birth.