Interview: Epidural for pain relief in labour

To me, giving birth is a natural act. That was why I did not really want to give birth in hospital. I planned to give birth in a birth centre and so from the start I had decided against an epidural.

One friend of mine thinks the epidural is a great medical advance. She believes that every woman should have an epidural so that they do not have to suffer any more. But I know other women who say that you just need to get through the pain, and that it has a metaphysical benefit. Neither of these positions was really what I felt. I decided against an epidural. I wanted to give birth in a birth centre because I didn't want any unnecessary medicalisation. Another important reason was that I could have the midwife I knew, who had been caring for me.

I think the way you approach pain has a big impact on how you experience pain. My opinion was that birth was certainly going to hurt, but that you can get through it. Many other women have gone through it before me.

I spoke beforehand with some women who already had children. I was really impressed when they said that it is different to other pain, because you know it has a purpose. In the end, something good comes of it. That made sense to me.

In my experience, people didn't really talk about labour pain. It is kept a bit secret. People would often say "It was pretty bad" or "I don't want to go into it". Beforehand I thought that I would get more anxious as the due date got closer. But that wasn't the case. Somehow I kept getting calmer. I thought to myself, "It will just happen."

Three days before the due date I suddenly had pains. They were already pretty strong. I find it hard to describe. It started during the day and it was very irregular. They were cramp-like pains and I thought - oh, this is pre-labour.

I had a bath and then I started packing my suitcase, just in case. I still had not done that. They were cramp-like pains, like a wave, not like a constant pain - more like a cramp. It hurt for a short time and then stopped. I got back into the bath. That felt good, but the pain did not go away. Then it was clear that this was the real thing, and labour had started. At that point it was a bit comparable to period pains. But it wasn't terrible pain, not at all.

Then it started to go quickly. The contractions came every three or four minutes. That was like really heavy period pain. It was already fairly painful. We went to the birth centre then. When we got there, the contractions were coming every two minutes. My pain management was not really working well. It was really quick and I could not quite get on top of it. My main problem was that I didn't know how to use my breathing techniques properly.

At the birth centre I got back into the bath. That felt good. Then an idea occurred to me. I can breathe particularly well when I sing. So I started singing loudly. The midwife had said beforehand that I could go ahead and scream if I needed to, but I thought that would be a bit much. When the pain got really bad, my singing turned into a bit of screaming. That worked well. I could also use a few breathing techniques, and I found if I sat this way or that, then it felt better. I could do something and work with it. That felt good.

At some point the midwife said that we needed to go to hospital, because the baby was not down in the birth canal and the head was turned to the side. We tried several things to get the baby to turn, but nothing worked. I was in a lot of pain. It wasn't as though I couldn't stand it any more, but somehow I felt that it wasn't quite right. The pain did not feel like it should. The contractions were not as effective as before. So I thought going to hospital was a good idea.

At the hospital I got an epidural. I knew what it was, but I had not really found out much about it. But I thought that they do it very often in the hospital and it is the standard and it would go well.

I still had contractions, but the intervals between had gotten longer. I was really tired. After they put the epidural in, they suggested I could have a rest and maybe sleep. I did that. It was just short, but I recovered a bit. When I woke up I went to the toilet and I could turn myself from side to side again. That had been really hard before.

I had thought that with an epidural you didn't feel anything, and that you wouldn't experience any of the birth. That was one of the reasons why I didn't really want an epidural. But it wasn't like that. You could still feel the contractions. It just wasn't so painful. You could feel it, as though the muscles were working. It wasn't pain in the sense of pricking or stabbing. You could feel the contraction and work with it. The team in the delivery suite kept me really well informed about everything. It wasn't at all unpleasant. They did it really well, it was really calm, and they were really nice. It was a really positive surprise.

The doctor came and said that we needed to make a decision. The cervix had been open a long time and we had to start thinking about a caesarean section. I was really surprised, because I thought we could have tried a bit longer. I had not prepared myself for that at all. But it was a good discussion with the doctor. He answered all my questions and informed me really well. At that point I wasn't under a lot of pressure to decide. The baby and I were doing well. But I thought to myself that that could quickly change. It was just a feeling. And so I decided for it, partly because I had the feeling that the midwife was not really convinced that we were going to be able to get the baby's head to turn.

Nevertheless it was a big psychological burden for me, to go from a planned birth centre birth to a caesarean in hospital. But I really felt I was in very good hands. And it went very well. They only needed to add some more anaesthetic, because I already had the epidural. That was good. As far as the pain went, it was not so bad at all.

The caesarean did not hurt, that really has stayed with me. I was afraid of having an experience like my sister, who had had a lot of pain when the placenta was removed. And I was very happy when my son was born and that he was so healthy and so beautiful. Even though it went differently than I had imagined, it all worked out well, and that was what mattered for me. When we got home I was really happy.

If I have another baby I would go to the birth centre again. That I would do again. But I would find myself a childbirth class where I could practice breathing techniques. That wasn't done in my course, or else I missed that class. And I would pack my suitcase sooner (laughs). And I would not make myself crazy. Everything works out somehow, even if a lot of unexpected things happen along the way, as they did with me.

You can get a handle on the pain. You just need to find out what helps you. You can get something out of every option. The epidural is one way of coping with the pain. Every woman needs to decide for herself. I believe every woman knows that birth is painful. It is just a different situation than when you suddenly have pain for another reason. You can find out about it and you can prepare yourself.


ACKNOWLEDGEMENT

This real-life story was gathered during an interview with a woman who generously shared her experiences with us. We are very grateful to all our interview partners. All of them have given their permission for these stories to be published here.

The opinions and comments in these stories are the opinions of individuals. They are not necessarily shared by IQWiG and are not intended to serve as recommendations to help people make decisions.

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