Updated: May 27, 2022
Many women decide to get an epidural in labor for pain relief. When making the decision to use an epidural in labor, it is important to consider the benefits and risk of the epidural. Unfortunately, many women are not told that there is a risk of the epidural not working. Most women are unprepared to cope with a failed epidural. In this article we will talk about what to do if your epidural doesn't work during labor.
Every Mama has a different birth plan.
Some plan to wing it.
Some plan to go as intervention free as possible.
Some plan for “all the drugs”.
But as we all know, birth doesn’t always go as “planned”. We tend to see a lot of pushback against unmediated birth plans, where people insist on reminding the mother to have “realistic expectations” and that “birth can’t be planned”.
But what about when a mother plans to get an epidural? She’s rarely told that her birth may not go as planned. Epidurals can be an amazing tool, and many women love their epidural. But if you’re planning to get an epidural in labor, there’s a little talked about secret you need to know.
Unfortunately, the truth about epidurals is they do NOT always work. Allowing mothers to believe they’ll be able to escape any and all pain of childbirth by utilizing an epidural is doing a major disservice to women. We need to be honest. Ineffective epidurals can lead to traumatic birth experiences.
But you do not need be afraid of your epidural not working. This is where education and preparedness comes in. Contact me to see how I can help you prepare for labor.
HOW OFTEN DO EPIDURALS FAIL?
One study shows that failed epidurals occur in about 12% of births utilizing epidurals. Of these failed epidurals, about 46% are corrected with re-placing the epidural.
WHO IS AT RISK FOR FAILED EPIDURALS?
Anyone can be at risk of a “failed epidural” that is caused by a placement or dosage challenge. Other risk factors can include previous back surgeries that have left scar tissue that interfere with neural pathways.
Now people tend to laugh at this one, but as a redhead, I have to share, there is evidence to support that redheads require more anesthesia for effective dosing and that we can metabolize some of these medications differently than our blonde and brunette counterparts.
That’s not to say that if you’re a redhead your epidural will fail, but it’s something to keep in mind! (Side note: anesthesia has never worked on me. I’ve woken up in the OR during non-childbirth related surgeries on more than one occasion, needed extra anesthetic for dental procedures, and the same has rang true for my redhead brother.)
WHAT HAPPENS IF MY EPIDURAL FAILS?
I remember the first birth I attended where the mother got an epidural but it was not working at all. She was medicated enough that she could not move, but she felt “all the pain”. I imagine that without the option to move in response to the pain, her discomfort was amplified.
Imagine dreaming of a pain-free labor with an epidural, just to have it not work… If you’re not adequately prepared for coping with labor, this can be a very stressful experience and contribute to a fear/stress cycle that inhibits labor.
So what should you do if your epidural doesn’t relieve pain but leaves you immobile?
Tell your nurse!
When you let your nurse know how uncomfortable you are, they will be able to contact anesthesiology to come back and check placement. The Epidural could have been placed wrong. Sometimes re-placing it can improve the effectiveness. Other times, it’s just a matter of adjusting dosage
As we noted earlier, sometimes this doesn’t make a difference and the epidural still doesn’t relieve the mother’s discomfort.
2. Use the peanut ball!
Okay, this is a cardinal rule even if your epidural is working! And it’s great for no epidural too.
Having your support person assist you in repositioning frequently with the peanut ball can be an effective way to respond to the signals your body is sending and continue working with your body through this process.
3. Massage and counter pressure
Your partner should always be prepared to give you a massage in labor, in my opinion. But especially in the case of an underperforming epidural! Knowing how to use touch to support the mother can help her relax between contractions and reduce the perception of pain during labor.
4. Squeezing a comb
Okay this one sounds pretty silly, but many mothers report that squeezing a comb during contractions helps reduce perception of labor pains as it redirects the focus of the pain. There are a lot of theories out there about decreasing overall pain perception by actually “adding” pain.
5. A mobile tens unit
Under a similar premise, a mobile tens unit can reduce the sensation of pain by sending small electrical pulses to the muscles
6. Breathing techniques
Understanding breathing techniques can help women cope with labor. Using relaxing breaths helps prevent the body from tensing up, which can actually increase the perception of discomfort during contractions.
You’ve probably noticed that there aren’t any special tips listed that are much different than what we would recommend for a planned unmediated labor. This is because coping with labor is coping with labor. Every mother, yes, even those planning an epidural, should learn coping techniques for labor because you never know if you will have an intense labor before you’re able to get access to an epidural, and there are no guarantees that your epidural will eliminate pain.
What questions do you have about coping with a failed epidural during labor? Have you experienced a failed epidural in labor? What tips do you have to share with other moms? Comment below!
If you're looking for help preparing for your birth, contact me now to see how I can help you feel confident in labor.
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Jaimie Zaki is an Air Force Wife, Mother, Nurse, Doula, and Lactation Consultant (IBCLC). Jaimie offers in person and virtual support for labor preparation, breastfeeding preparation, and breastfeeding support. Jaimie has personally experienced a cesarean birth, a medicated, hospital VBAC, and an unmediated home birth, and understands how each kind of birth can have unique challenges and how to overcome them. Jaimie’s goal is to help you step into motherhood with confidence! Check out Birthing With Confidence 2.0 today! If you’re looking for pregnancy, birth, or breastfeeding support, reach out to Jaimie today! Jaimiezaki@littlebearlactation.com