Welcome to the world of labor and delivery! If you’re considering or have already chosen to have an epidural for pain relief during labor, it’s important to understand that you still have options for movement and positions!
An epidural DOES NOT equal laying on your back.
While the epidural can provide great comfort, it doesn’t mean you need to stay in one position throughout the entire process… especially not your back! In fact, changing positions can help progress labor, reduce the chances of a cesarean section, and make your birthing experience more comfortable (read more about the importance of changing positions in childbirth in this article!)
In this blog post, we’ll explore various labor positions with an epidural that can help advance your labor, reduce the likelihood of a C-section, and make you more comfortable along the way.
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Labor Positions during Early Labor
Even if you plan on having an epidural for pain relief during labor, it’s essential to have labor-coping techniques in your toolbox.
Before the epidural is placed, you will likely have contractions for some time – maybe even hours. Having coping techniques during this period can help you manage the discomfort and maintain a sense of control.
Breathing exercises, relaxation techniques, visualization, and the support of your birth partner can all be beneficial during this early stage. By having these coping techniques at hand, you can navigate through the contractions more effectively and build confidence as you await the placement of the epidural.
Every contraction brings you closer to meeting your baby, and having labor pain management in place will help you feel confident and empowered throughout your labor, even before the epidural!
Before the epidural is placed, you have unlimited freedom to move around and try different positions to manage contraction pain. You can check out our post on labor positions, or read a few of our favorites to try out during this early stage here:
- Walking: Walking helps to keep you upright and encourages the downward movement of your baby.
- Standing or swaying: Find support from your partner or a birth companion, and gently sway your hips from side to side. This can help alleviate discomfort and encourage the baby to descend.
- Sitting on a birthing ball: Use a sturdy exercise ball to sit and gently bounce or rock back and forth. This can help open up the pelvis and create more space for the baby to move down.
- Leaning forward: Find a table, counter, or the back of a chair to lean on while standing. This position takes the pressure off your back and allows your belly to hang, providing relief.
When and How an Epidural is Typically Placed
An epidural is usually administered when you’re in active labor, typically around 4-6 centimeters dilated. For some women (especially first-time mamas) that might not be until more than 5-10 hours after labor has started.
So again, those labor coping techniques are crucial for the first stage of labor! An anesthesiologist will place a small catheter in your lower back, through which medication (typically a local anesthetic combined with a small dose of an opioid) is delivered to relieve pain. The procedure is quick and typically done while sitting or lying on your side.
Here’s a general overview of the process:
- IV line insertion: A small tube will be placed into your vein, usually in your hand or arm, to administer fluids and medications if needed.
- Positioning: You will be asked to sit up or lie on your side with your back curved outward. This allows the anesthesiologist to insert the epidural needle into your lower back properly.
- Local anesthesia: Before the epidural needle is inserted, a small area on your lower back will be numbed with a local anesthetic to minimize discomfort.
- Epidural placement: The anesthesiologist will insert a thin catheter into your epidural space, through which the medication will be administered.
How Long Does It Take for the Epidural to Work?
After an epidural is administered, it typically takes around 10 to 20 minutes for the medication to take effect and provide pain relief. However, the onset time can vary from person to person, your body is unique! Some women may experience relief sooner, while for others, it may take a bit longer.
During those initial 10 to 20 minutes, you may notice a gradual decrease in pain and sensation in the lower half of your body. The epidural medication works by blocking nerve signals in the area where it is administered, which is what helps alleviate pain during labor.
It’s important to note that while the epidural can provide significant pain relief, it may not completely eliminate all sensations or pressure. Some women may still feel pressure or mild discomfort during contractions or when pushing. This can vary based on the dosage of medication given and individual responses.
Your healthcare provider and the anesthesiologist will monitor your progress and work with you to ensure that you are comfortable throughout the process. If you have any concerns or questions about the timing or effectiveness of the epidural, don’t hesitate to communicate with your healthcare team. Their job is to support you and make adjustments as necessary.
Can You Walk with an Epidural?
In most cases, walking is not recommended after receiving an epidural due to potential safety concerns and the increased risk of falls. However, you can still change positions within the bed or use aids like birthing balls, peanut balls, and other positioning tools to optimize your labor experience. We’ll cover these options soon!
How Long Does an Epidural Last?
The duration of an epidural’s effectiveness during labor can vary from woman to woman… every woman is unique, after all! Generally, an epidural can provide pain relief for several hours. However, the specific duration depends on quite a few factors, including the type and amount of medication used, your individual metabolism, and how your body responds to the epidural.
In most cases, an epidural can provide continuous pain relief for around 1 to 2 hours, and in some cases, it may last longer. After this initial period, a maintenance dose is administered through the epidural catheter to help sustain pain relief throughout labor.
It’s important to note that the effectiveness of the epidural may gradually decrease over time. In some instances, the anesthesiologist may need to adjust the dosage or provide additional medication to maintain adequate pain relief.
Your healthcare provider and the anesthesia team will closely monitor you and work with you to ensure optimal pain management during labor. It’s essential to communicate with your healthcare provider and inform them if you experience any breakthrough pain or if the epidural seems to be wearing off. And as much as I hate to be the bearer of bad news, the epidural does not work for everyone.
So, again, arm yourself in advance with coping techniques so you are prepared to handle any unexpected curve-balls!
Labor Positions with an Epidural
Although you may not have the same range of movement with an epidural, there are still so many great positions you can try to help progress your labor. Make it your goal to change positions every 30-45 minutes!
- Side-lying: Lying on your side can promote optimal blood flow to the baby and help alleviate discomfort. This also helps to relieve pressure and encourages the baby’s descent.
- Semi-reclining: Adjust the head of the bed to a semi-reclining position, with your upper body elevated at about a 45-degree angle. This position can help with breathing and relaxation.
- Supported sitting: Prop yourself up with pillows behind your back while sitting upright. This can aid in gravity-assisted labor progress. Hospital beds have those handy buttons that let you adjust the incline position – use them!
- Peanut ball: Place a peanut-shaped exercise ball between your legs while lying on your side. This helps open the pelvis and encourages the baby’s descent. Be sure to switch back and forth from one side to the other every 30 minutes or so.
- Hands and knees: Positioning yourself on your hands and knees can help relieve back pain, encourage optimal fetal positioning, and allow your baby more space to move. This labor position will require help from your nurses or birthing partner to get into safely.
- Modified lunge or kneeling position: You can modify the kneeling position by partially supporting yourself on a raised surface, such as a birthing stool or a padded kneeler. This can provide some of the benefits associated with kneeling, such as opening up the pelvis and facilitating a more favorable baby position while still maintaining the safety and stability provided by the epidural.
Remember, these positions can be adjusted and modified to suit your comfort level and needs. Don’t hesitate to ask your healthcare provider and birth support team for help – that is what they are there for!
Pushing with an Epidural
When it’s time to push, you might not feel the same intense pushing urges and sensations as without an epidural. This is one of the reasons coached pushing is more prevalent with epidurals. However, pushing can still be effective, and you have many pushing positions to choose from:
- Semi-reclined: Utilize the adjustable bed or pillows to find a comfortable semi-reclined position for pushing.
- Side-lying: Lying on your side with assistance from your birth partner can help focus the pushing efforts.
- Hands and knees: This position can help alleviate pressure on your back and allow gravity to assist in the downward movement of your baby.
Your birth team can help you get in and out of different pushing positions, do your best to communicate to them what you want so they can best help!
The Bottom Line?
Using different labor positions with an epidural allows you to remain active, comfortable, and engaged during childbirth.
By being open to trying different positions and staying active with the help of your support team, you can increase the chances of smoother labor and minimize the likelihood of interventions like C-sections.
By avoiding prolonged periods of lying on your back, you can enhance labor progress and decrease the likelihood of a cesarean section. Remember, each labor experience is unique, and discussing your preferences and options with your healthcare provider is essential. Embrace the power of movement and find the positions that work best for you.
Stay positive, and trust your body’s ability to birth your baby.
You’ve got this, mama!
Jess
