Birthing with an Epidural
At Foundations Pelvic Health, we are a team of perinatal and pelvic floor physical therapy specialists. We are dedicated to helping women feel empowered throughout their pregnancy and feel prepared for labor and delivery, as well as postpartum recovery!
Let’s chat about epidurals and their role in your labor and delivery experience:
What is an epidural?
An epidural is the most common type of pain relief used for childbirth in the U.S. It is administered by an anesthesiologist who places a catheter into the epidural space in your low back, and this is where the medication is delivered through. The procedure is usually performed while you’re in a sitting position or lying on your side.
With an epidural, you’ll have some loss of feeling in the lower areas of your body, but you will remain awake and alert.
How does pelvic floor therapy help with birthing with an epidural?
At your birth prep visit with your pelvic floor PT, your PT will review what types of pain management options you’d like to utilize during your labor and delivery. An epidural is one of the most common types of pain control during labor and birth and is extremely effective.
You and your OB or midwife can work together to make a decision of when to administer the epidural during labor. Epidurals can help the birthing person not only with pain relief, but also with the ability to relax and rest more. On the other hand, if you prefer the ability to move around during earlier labor, delaying the epidural can be a great option.
What happens after I receive the epidural?
Once you have an epidural, most hospital policies require you to stay on the hospital bed for safety purposes (it’s hard to walk if you can’t feel your legs!) But that doesn’t mean you have to stop moving! We recommend that patients change positions at least every 30 minutes to continue to promote progression of labor. Your support person and the nursing staff can help you adjust your position as you may have difficulty moving your legs.
Your PT will review ways that your support person can help during your birth prep visit, as well as show you ways to utilize the peanut ball. If you are not feeling the epidural equally on both sides of your body, it is important to communicate with your providers. They may encourage adjusting your position as well.
Pushing with an epidural: breathing and positions
With an epidural, you won’t be able to feel your pelvic floor….which is kind of the point! But this can sometimes make it difficult to feel what you’re doing during pushing. Your pelvic floor PT will review pushing techniques with you during birth prep visits to ensure you have the proper coordination.
Your PT may also give you breathing techniques and abdominal cues to pay attention to - what’s happening at the abdomen can give us an idea of what’s going on at the pelvic floor. If your abdomen is pushing down and out, so is your pelvic floor!
A common misconception is that you have to push on your back if you have an epidural. This is not true! Although you may need help to get into other birthing positions, you may still utilize other positions that feel most comfortable for you.
As always, it is important to discuss your preferences for your birth experience with your providers and support person! Your preferences can always change in the moment and that can include choices on pain management.
More questions about preparing for labor and delivery?
Our pelvic floor PTs work with women throughout their entire pregnancy to keep you moving and mobile through all the trimesters. Check out our post about how pelvic floor physical therapy at Foundations Pelvic Health prepares you for labor and delivery!