• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Dr Sarah Buckley

  • Home
  • Books
    • Book Reviews
  • Articles
    • Attachment Parenting: An Introduction
    • Pain in Labour: Your hormones are your helpers
    • Epidurals: risks and concerns for mother and baby
    • Ultrasound Scans- Cause for Concern
    • Leaving Well Alone: A Natural Approach to the Third Stage of labour
    • Getting a Good Night’s Sleep: Another Perspective
    • Mothering, Mindfulness and a Baby’s Bottom: An Introduction to Elimination Communication
    • Ten tips for safe sleeping
    • Lotus birth – a Ritual for our Times
    • Giving Birth at Home
    • Healing Birth, Healing the Earth
    • Maia’s Birth- a family celebration
  • Blog
  • About Sarah
    • More of Sarah
    • Sarah’s Schedule
    • Frequently Asked Questions
    • Contact Sarah
  • Shop
  • Sign up to Sarah’s Newsletter

Epidurals in Labour (Part 1)

March 28, 2017 by Sarah Buckley

 

What do you know about epidurals and their risk and benefits?  In this blog (Part 1) , Dr Buckley explores the impacts of epidural on oxytocin and the flow of labour, and what this might mean for mothers and babies.

Epidurals are a very effective method of pain relief for labouring women, and are often encouraged by caregivers, even before labour begins.

Like all interventions, epidurals have benefits and risks for mothers and babies. Possible risks include the potential to disrupt the processes of labour for mother and baby. There are also unanswered questions about possible impacts through to motherhood, including effects on breastfeeding and bonding.

These FAQs will help you to balance the benefits and risks of epidurals for yourself and your own unique situation, so that you can make the choices that are right for you, your baby and your family.

What is an epidural?

Epidural analgesia involves an injection into the lower back that pierces the outer coverings (”epi-dura”) of the spinal cord. Drugs are injected close to the nerves as they come out from the spinal cord. Usually this involves a “local anaesthetic” (LA) drug such as bupivacaine, along with an “opiate” drug (related to morphine, pethidine/meperidine etc) such as Fentanyl. Epidurals are used in many types of surgery and procedures, and also sometimes administered to relieve pain outside of childbirth.

How do epidurals work?

Just like a dental anaesthetic, LA drugs block the sensory nerves, causing numbness, and also inevitably block the motor nerves, giving some degree of paralysis. Opiate drugs are added to an epidural to increase the effectiveness of the LA, so that there will be good pain relief with less motor block.

What are the benefits of epidurals?

Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective analgesia, epidurals also reduce stress, and stress hormones, in labour. This can be beneficial when women are experiencing very high levels of stress and pain, which can slow labour progress.

Is labour stress harmful?

It is important to realise that some degree of stress is inevitable in labour, and actually beneficial for mother and baby. For example, high levels of the stress hormone cortisol contribute to a new mother’s euphoria, and help with bonding with her newborn. For the baby, the “stress of being born” switches on biologic processes that help with breathing at birth, among other adaptations. (See below for references)

Are epidurals good if I need a caesarean?

Epidurals also allow you to be awake and alert, but pain free, when procedures such as caesareans are needed. You will be able to see and hold your baby soon afterwards. In this situation, you and your baby will also be exposed to lower levels of drugs than a “general anaesthetic.”

What are the side-effects of epidurals?

Many of the side-effects of epidurals are due to effects on your  birthing hormones. These are the calming, pain relieving, and stress-reducing chemicals that your body naturally produces to make labour as easy, safe and rewarding as possible. (See my Ecstatic Birth ebook for more info).

How do hormones help in labour?

The hormone oxytocin is particularly important because it causes the uterine contractions that drive labour and birth.

During a natural (physiological) labour and birth, the sensations of uterine contractions are transmitted to the labouring woman’s brain, and drive the oxytocin “positive feedback cycle” (Ferguson reflex). Within this cycle, uterine sensations trigger oxytocin release, more contractions, more sensations, and more oxytocin release. This strengthens labour and also helps the baby to be born quickly and easily.

As the diagram shows, this positive feedback cycle also increases oxytocin release into the brain, where it has calming and pain relieving effects. (Very welcome in labour!)  Oxytocin also turns on reward and pleasure centres in the brain during labour and birth, in preparation for mothering. (More about this in part 2)

Why do epidurals slow labour?

With an epidural, your labour sensations will usually be completely abolished. This means that there is no sensation to drive this oxytocin feedback cycle, and your oxytocin levels will decline.

This explains why labour usually slows, and sometimes even stops, in the hours following epidural administration. You will probably require an infusion of synthetic oxytocin (Pitocin, Syntocinon) to compensate for the loss of your own oxytocin, and to strengthen labour again.

More epidural resources

Epidural FAQs part 2.

What are the consequences of missing the oxytocin peaks for mothers, babies, breastfeeding and bonding? How can we fill in the hormone gaps when epidurals are needed? Part 2 Coming soon!

Epidurals: Risks and Concerns for Mothers and Babies Chapter from Gentle Birth, Gentle Mothering (2005)

Undisturbed Birth DVD Dr Buckley’s workshop on DVD. Discover the “ecstatic hormones” of labour and birth and the impacts of interventions, including epidurals

Hormonal Physiology of Childbearing Dr Buckley’s in-depth report (2015) has all the scientific detail and studies. See particularly sections 3.2.5, 4.2.5, 5.2.6 and 6.2.5 .

Filed Under: Blog

Reader Interactions

Comments

  1. Reese Leyva says:
    April 26, 2017 at 4:28 am

    Thank you so much for this! I’m seriously looking forward to part 2 and learning about missing the oxytocin peaks!

    • DrSarahBuckley says:
      April 26, 2017 at 8:40 pm

      Thanks Reese, and I’ll be sharing how to fill those oxytocin gaps too!

      • Reese Leyva says:
        April 27, 2017 at 7:15 pm

        Amazing! Thank you so much for the work you do and the information you share! Thank you thank you!

Primary Sidebar

  • Facebook
  • RSS
  • Twitter

Reap the lifelong benefits of a Transformational Birth. find out more.

Sarah Buckley's Online Store
All of my books, DVD's and more!

Recommended Resource

Happy Healthy Child DVDs

Happy Healthy Child Video

Happy Healthy Child- the Ultimate Childbirth Course! Parenting is changing-- have you noticed? The old paradigms from our parents' generation are transforming. Our new values, built around love and … Read More... about Happy Healthy Child Video

Footer

Sarah’s Qualifications

Sarah is a Medical Doctor, with an M.B Ch.B from University of Otago, New Zealand, equivalent to MB BS (Australia) and MD(US). She also holds a Diploma of Obstetrics (University of Auckland) and a Diploma of Family Planning (Family Planning Victoria).

Reap the lifelong benefits of a Transformational Birth. find out more.

On this Site

  • Privacy and Security
  • About Sarah
  • Sarah’s Schedule
  • Books
  • Membership
  • Shop
  • Subscribe to Sarah’s Updates
  • Contact Sarah

© 2023 · Sarah Buckley · Built by 3E Innovative

Ecstatic BirthsDiscover the science and pleasure of Ecstatic Birth!

Receive your free Ecstatic Birth ebook and sign up to Sarah’s newsletter (No spam ever!)

Read the Gentle Natural Birth Privacy Policy

“Ecstatic Birth was the only piece of reading I did at all for the birth of my first baby…Thank you for writing something so sensible, so believable and so life changing”- Julianne