When You Change Your Mind About The Epidural
My patient’s scream ripped through the labor and delivery unit of our small hospital as she clenched my shoulders with a grip that only a woman in transitional labor can doll out.
“I… changed… my… mind,” she gasped between pants. “I want the epidural!”
Almost instantly, her boyfriend was between us, half-heartedly rubbing her back and shaking his head like a little boy refusing his nap.
“No,” he said to her. “You can’t have the epidural. You don’t want it!”
He turned to me with a stricken expression, panic, fear and helplessness written all over his face. “She made me promise!” he exclaimed brokenly. “She made me promise I wouldn’t let her do the epidural no matter what!”
It’s a common dilemma I see for my pregnant patients—boyfriends and husbands who genuinely want to help their partner during labor, but aren’t sure of the best way to help. Clinging to promises they made about pain control well before their partners could anticipate the intensity of labor, I see men stricken over the best way to help. Do they stick to the plan? Support her no matter what? What happens after the baby is born—will she be mad at him for not preventing her from getting the epidural?
While education and childbirth classes can help a woman prepare for how she plans to handle pain during labor and delivery, the fact remains that women should be cognizant of the fact that they may change their mind about their pain control options during labor. It is important that pregnant women and their partners start the conversation about pain control early, before tense words are exchanged in the delivery room and feelings are hurt forever.
Step 1: Explore your pain relief options
There truly isn’t a “one size fits all” pain relief method when it comes to labor. There are so many different options to help you manage your pain during labor, so be sure to explore them all. It’s not simply a question of “epidural or no epidural,” but managing labor pain might be a combination of methods for you, such as spending time walking the halls, using a birth ball, a whirlpool tub, a “walking epidural” (kind of like a one-time shot of an epidural) or IV medications for shorter-acting relief.
Step 2: Never make your partner promise to hold you accountable for your pain relief during labor
In other words, don’t make him swear not to let you have the epidural! Not only does it place him in an unfair position (what man wants to see his wife in pain, only to tell her no?), but the truth is, you may simply change your mind during labor, and only you can make that decision for you. As Katie Rose Fazio, a blogger at Millennial Mom, who is currently pregnant with her third explains, “I tried to get him to make sure I didn’t get an epidural, but when he saw how much pain I was in (and I get scary and mean when I’m in pain) he was relieved when I decided to get it! After I got it, I was calm and the birth was smooth sailing from thereon out.”
Step 3: Make a pain management plan
After exploring all of your options and taking childbirth classes, sit down with your partner and draft a pain relief plan, including a “best fit” plan for pain relief—how you envision your pain control played out in an ideal scenario. Then, go through the worst-case scenario, being honest with what you are both comfortable with and how changing “the plan” would make you feel. Would there be any lingering feelings of guilt? Would it matter to you if you didn’t have an all-natural birth?
Step 4: Be OK if your plan changes
If you do none of the other steps, this is the most important. Have an open and honest discussion with your labor support partner early on during your pregnancy about the very real fact that you may change your mind during labor—and why it is so important for you to be able to listen to what your body needs during labor. As a labor and delivery nurse, I am a firm believer in a mother’s intuitive nature, and I have witnessed countless times that a mother’s ability to listen to what her body needs is the best way for her to get through birth. “I was super adamant about having an all-natural birth the first time and I kind of felt like a failure when I asked for that epidural,” comments Stephanie Hanes of Girl of Grace. “And the circumstances following her birth were very traumatic, so it took me years before I stopped beating myself up about it and just embraced her birth for what it was. By the time our third came along, I learned to listen to my body and be okay with my own limits.”
And the last step? Ask your partner to give you support 100% of the way, with no fast promises.
I’ll never forget the relief on my patient’s boyfriend’s face when I explained to him that the most important thing he could do for his partner during her labor was to support her—no matter what. He transformed from a man riddled with guilt and anxiety, walking on eggshells around their birth plan, to a man who knew how he could help.
Creating an honest pain management plan for your labor and delivery ahead of the game could be the difference between a successful birth plan—or a whole lot of unnecessary pain.
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