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Women and pregnancy: What to know if you opt for an epidural as pain relief when giving birth

When his wife and his sister-in-law were each pregnant and about to give birth, Dr Christopher Chong advised them to consider an epidural. This would give them pain relief during labour, the obstetrician and gynaecologist from Gleneagles Hospital said.

However, both women wanted a “fully natural birth” that required no medication, so they decided not to opt for an epidural.

Dr Chong’s wife successfully had a medication-free birth, so no epidural. His sister-in-law, on the other hand, asked for an epidural an hour into her contractions to cope with the intense pain.  

An epidural involves injecting anaesthetic into the space around the spinal nerves in your lower back, to alleviate the pain from birth contractions. It is administered by an anaesthetist at the initial stages of labour.

“I always share this anecdote because each woman’s birth and pain experience will be different, even if they are sisters, and no two births even from the same woman are completely the same,” said Dr Chong. 

“While it is ultimately up to the mother, I recommend every woman to consider an epidural because opting for less pain is better than taking the risk of having a very painful and difficult birth.”

THE BENEFITS OF GETTING AN EPIDURAL  

Pain relief from an epidural also helps the woman conserve her energy to push, Dr Chong said. 

Using an analogy, he said that a birth is dependent on three things. The first is Passage, or the mother’s body and bone structure, which can’t be changed immediately. Secondly, Passenger, which is the baby and its position through the passage. 

And finally, Power, which refers to the woman’s strength, This, he said, “can be controlled slightly with medication”.

Dr Chong explained: “When the mum exerts too much power without any pain relief, it can be draining and painful especially towards the later stages of labour, demoralising her throughout the process as she may feel her efforts are fruitless.”

THE SIDE EFFECTS AND RISKS OF AN EPIDURAL

If you had earlier decided to try for a medication-free delivery, but like Dr Chong’s sister-in-law, realise that you do need pain relief during labour, know this: While there’s no specific “too late” moment for women to ask for an epidural, receiving one late in labour can be dangerous for both the mother and the baby.

“When the baby is close to your rectum, its head will already be pressing down on your back and it will be tough to block any pain,” Dr Chong said. “And when you’re in distress, you also wouldn’t be in a position good enough for the anaesthetist to administer the epidural.”

In this case – and in other situations where labour progresses very quickly and there isn’t time to provide an epidural – the healthcare team will assess your situation and make a decision, Assoc Prof Sng said. 

At KKH, this team consists of nurses, anaesthetists and obstetricians, who can provide alternative pain relief like Entonox (nitrous oxide, also called laughing gas) or pethidine, a pain-relief injection in the thigh.

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THE MYTHS SURROUNDING EPIDURALS

This next myth is not even particularly medical, as it’s related to a social perception that women who opt for an epidural are considered “weak”, “not strong enough” and did not experience a “proper birth”. 

Dr Chong rejects the notion, emphasising that every woman’s situation is unique – and the method of giving birth should not diminish the authenticity of the experience. 

“Using pain relief to make childbirth more comfortable and beautiful doesn’t make a woman weaker or diminish the genuine nature of her birth experience,” he said.

Related:

4 common injuries mothers may face while giving birth: How to spot the signs and how they're treated

Back pain in women: How chiropractic, osteopathy or physiotherapy can help

DISCUSSING PAIN RELIEF OPTIONS WITH YOUR OB-GYN

Being aware of your pain relief options is helpful as circumstances differ for every woman, added Assoc Prof Sng. You can get information via your birthing hospital’s antenatal programme or by discussing it with your obstetrician during your clinic consultations. 

“When you know all your options, you can make an early informed decision about your birth experience and increase your chances of having a smoother delivery,” he said. 

Some postpartum stories to read:

'Mum brain' is real: Why mothers become forgetful after giving birth and what can help

This postpartum doula in Singapore supports mum and baby for up to 1,000 days from the time you're pregnant

From doughnut pillows to silver nipple cups: A postpartum checklist that puts mum’s recovery first

CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.

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