You can have an epidural at any time from the beginning of labour, but most women who choose one have it when they're around 5cm dilated, when contractions get more intense and painful.
Does it hurt when your doctor artificially ruptures your membranes? Most people don't feel anything, especially if you are already in labor or got an epidural to manage painful contractions. Your baby also doesn't feel an amniotomy, and it doesn't hurt them in any way.
Hospitals and doctors have their own individual policies for epidurals. In most cases, however, an epidural will not be given until the mother is at least 3-4 centimeters dilated. Once the mother is fully dilated most doctors and hospitals will consider it too late for an epidural to be given.
There is no definite time. You can have it when you want it — at the beginning of labor, in the middle, or toward the end. The anesthesiologist will want to be sure that you are actually in labor and that you can stay still for the few minutes they need to precisely place the epidural catheter.
Does your water always break? Yes, for a vaginal delivery your water must break. However, it doesn't need to break before cesarean delivery. In rare cases, your baby can be born while still inside the amniotic sac.
If your cervix has opened up to at least 2-3 centimetres dilated and the baby's head is well engaged (low down in your pelvis), your waters will be broken (see below under Artifical Rupture of Membranes). If it is not possible to break your waters a second Propess pessary may be inserted if appropriate.
A woman can get an epidural at almost any time in labor if she can remain relatively still; however, an epidural is generally not given if the baby is close to being delivered. Some women have heard they need to be dilated (meaning the cervix opens in preparation for birth) a certain amount before an epidural is given.
There has been a lot of medical research into this and the conclusion is that epidurals do not produce new back pain or make existing back pain worse. You can have an epidural at any time from when your midwife confirms you are in established labour and your anaesthetist has established it is safe for you to have one.
You can get an epidural any time you want. However, you shouldn't wait too close to delivery because you need to make sure the anesthesiologist is available and have at least 30 minutes for it to be administered and take effect.
Based on their findings, Dr. Bouvet and coauthors suggest that a light solid meal "could probably be allowed" for women in labor who are receiving epidural analgesia and considered low risk of cesarean section within at least the next 2 hours.
Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm. Contractions will last roughly 60-90 seconds with only 30 seconds to 2 minutes between.
Complications from epidurals are extremely rare, and pushing with an epidural is generally not a problem because you will still be able to feel pressure (rectal pressure, that is!) despite not feeling any pain or contractions.
With an epidural, you might be able to feel contractions — they just won't hurt — and you'll be able to push effectively. There is some evidence that epidurals can speed the first stage of labor by allowing the mother to relax.
Loss of bladder control
After having an epidural, you may not be able to feel when your bladder is full because the epidural affects the surrounding nerves. A catheter may be inserted into your bladder to allow urine to drain away. Your bladder control will return to normal when the epidural wears off.
With epidural anesthesia, pushing can be delayed up to 2 hours for nulliparous women and up to 1 hour for multiparous women (Hansen, Clark, & Foster, 2002; Simpson & James, 2005). There are two phases to the second stage of labor: the initial latent phase and the active pushing phase (Roberts, 2002).
The numbness and muscle weakness in your legs will probably wear off within 2 hours after the epidural medicine is stopped. You may find that it's hard to urinate until all the medicine has worn off. Your back may be sore.
Rotate from side-to-side while using the peanut ball to really promote labor progress. Women that receive an epidural should be encouraged to use a peanut ball or other positioning aid during side-lying positions for enhanced labor progress.
The potential for a quicker labor, delivery and recovery – For some people, a natural birth may go more quickly. While it depends on several different factors, like how relaxed you may be, in some cases medications can interfere with contractions and prolong labor.
Thanks to one of my colleagues who is a specialist in obstetrical anesthesia at Beth Israel Deaconess Medical Center, Dr. Phil Hess, we now have strong evidence just published in the journal Obstetrics and Gynecology that epidurals do not prolong labor or increase cesarean rates.
You should not feel any pain when your waters break. At most, there may be a mild popping sensation.
Inducing labor should be for medical reasons only. If there are medical reasons to induce your labor, talk to your provider about waiting until at least 39 weeks of pregnancy. This gives your baby the time she needs to grow and develop before birth. Scheduling labor induction should be for medical reasons only.
Induced labour is usually more painful than labour that starts on its own, and you may want to ask for an epidural. Your pain relief options during labour are not restricted by being induced. You should have access to all the pain relief options usually available in the maternity unit.
Bloody show before labor is a normal part of pregnancy, so there's no need for treatment. It's a sign that your body is getting ready for labor. But you don't need to go into the hospital immediately after your bloody show, as labor may still be days or even weeks away.