Your Epidural Playbook: Tips, Choices, and Practical Advice | 89

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Any of that. Anyway. Okay, you guys, so we're gonna talk about epidurals. Are you guys, excited? Someone say hello. Tell me how far along you are. Tell me what number, baby. All the things. Let me see who's out there. So we are going to talk about epidurals and then I want to tell you that we have a sweet little guide for you guys. 


First baby, 19 weeks. Congratulations. Hello. Seven months, baby number two. So excited. Let me make sure that I have Everything ready. I do. If you reply to a story or comment on a post, hashtag Epidural, you're going to get our Epidural Essentials Prep Toolkit. That is a Mouthful. And it's got a lot of third trimester things in there. 


So an epidural is a procedure that numbs the lower half of your body during labor. Obviously, it is anesthesia, so you will be considered to have anesthesia on board, and it is administered through a catheter into your spine, into the epidural space. Now, the difference between an epidural and spinal is that an epidural is going to be continually pumped in. 


The plan that I would have and part of your free little toolkit that we made for you guys are questions to discuss with your provider ahead of time. So you want to be discussing the option of an epidural with your healthcare provider before your due date. So that you can chat with them and ask him all your pressing questions. 


So we, inside of your epidural toolkit, we have questions like, What is your experience? What is your feelings? What are the hospital policies? So on and so on. And they just can break it down in more detail and you'll get them to sit down and actually talk to you for a little bit. Anyway, you are inside that epidural toolkit is that list of questions. 


And if you follow our labor rules that we teach you inside of call mama, confident birth, or the V back lab, then typically. Our students get to the hospital. Now, our unmedicated students, on average, get to the hospital at eight centimeters. But our mamas that are wanting epidurals usually get to the hospital between six and seven centimeters, which is a fantastic time to get your epidural. 


Now, the thing about the epidural timing, and this is what I tell my patients in person is if you're planning on an epidural and you start thinking, holy smokes, I need my epidural I need it. It's time. Tell your nurse, because it takes us a little bit of time to get you prepped and ready. Most facilities require that we bolus in a whole bag of IV fluids. 


We have to make sure all your labs are back. We need your platelet, all platelet count your blood type, all of this stuff needs to be back. So if you roll in real quick, we've got to get you ready and get everything in line. So once you tell your labor and delivery nurse that you're ready for your epidural, then she's going to bolus a bag of fluids. 


Now, once the anesthesiologist has your labs, they gather their car, your nurse will get some stuff and you have your fluids in, we also usually have you get up and go and empty your bladder. Your bladder can act. Like a roadblock for baby to move down into the pelvis. So we want to get it empty because once the epidural is in effect, you can't empty it yourself, which is why we put in a Foley catheter. 


So the placement process is usually we'll get you up, go to the bathroom. When you come back, I've got your bed padded, everything ready, especially if your water's broken. And I will have you sit on the edge of the bed with the back of your calves hitting the bed. So you're right on the edge, but you're secure. 


And then what I personally do is I will pull up the big garbage can that has the flip top lid. I will put a blanket on it so you don't touch it and a chucks pad and I have my mamas put their feet on that. So I lift the bed up, she puts her feet on the garbage can and that just gives a little more security for when you get into position. 


is we want you to keep your spine still. So when you move your head, you move your spine. When you're talking, you tend to move your head. So the most that I want you doing is chin to your chest, shoulders relaxed, and I want you just to be doing your deep breathing. That usually will keep you from moving. 


We usually, some hospitals don't let your partner stay in the room, but I would combat that. You have a right to have someone with you, and they can stay on the side where I'm at. I'm not sterile. If I'm not sterile, they don't need to be. So it is a sterile procedure, so you can't reach behind you. I always tell my patients, don't touch anything that's blue, because that's sterile. 


ThEy clean your back, it feels nice and scratchy, and then they're going to inject the nummy medicine, the lidocaine. What I've been told, because I started this little teaching saying, I am scared to death of needles. So my very first baby, I did not have an epidural because I was scared of the needle, but then I loved unmedicated birth. 


It's not going to be horrible. But you got to decide, do I want labor pain or do I want this numbing pain? So the place, then they're going to insert a catheter, they're going to insert a catheter, thread, or they're going to insert a needle and thread the catheter through that cannula, and then they're going to pull out the part, the one part, and leave the catheter. 


And they're going to ask you some questions and just to make sure it's in the right spot and all things are, kosher. So once we get your catheter running, we're going to tape it up over your back, hook it to the pump, and then we're going to lay you down. So you're going to lay down and on a tilt, tilted to one side. 


Now, obviously that's because we don't want you laying flat on your back. And the reason that we don't want you sitting up is because the medicine flows and works on gravity. So whatever is the dependent part of your body, so if you're sitting up, that's going to be your bum, all the medication is going there, and you don't want a numb bum, you want a numb abdomen. 


We're going to be doing your vital signs. So your vital signs, we're going to be doing your blood pressure, your pulse, and we're going to be checking that every five minutes for the first 30 minutes or so. And then it'll be every 15 minutes. Depending on your facility, but you do have anesthesia on board. 


So we have to watch. How are you reacting to that? So during that initial process, I'm also going to be making sure the reason I'm watching your blood pressure is because one of the most common Problems per se is a block or a drop in mama's When your blood pressure drops, then the baby's going to most likely have a reaction as well, which is usually a fetal deceleration. 


And they're going to give you some medicine to. up that blood pressure. So usually around 30 to 40 minutes after we place it, we're going to put in a Foley catheter. So I told you before, the reason we use a Foley catheter is because you cannot empty your bladder and we need it to be emptied. Some people have an epidural for up to 12 18 hours. 


But once you're stable, here's my big pro tip. Once you're stable. Take a nap. This is not when you invite all the family in, your Aunt Mary, and your cousin Kathy, and all the people to come in and hang out with you, because remember, you got some sleepless nights coming, and you've been laboring, which is hard work. 


So I want you to take a rest. Now, during that rest time, And it might be the best rest you ever had in your entire life. But during that rest time, we're still going to be rotating you at least every hour and mocking natural movements. This is where the magical peanut ball comes in. We love the peanut ball. 


And your hospital doesn't have peanut balls. Take one. Now, most of them are moving towards having them because it's just obvious that it is such an incredible, non invasive tool to get the baby in the right position and to speed up the labor process. If they don't have one, bring one with you. Get one that's easy to inflate. 


Your partner can inflate it once you get into your labor room. The way that you can find that out, here's my tip to find out anything you want to know about labor and delivery. Call the hospital, ask to be transferred to the labor and delivery station, and then ask whoever answers, Hey, do you have wireless monitoring? 


I Know sure as heck when I say that it's not common, I will get tons of DMs and comments saying we do them or we have them, but I have worked at some of the top facilities in the U. S. as a travel nurse, and I have never once had an anesthesiologist allow a patient to get up and actually walk. What a walking epidural typically means is it is one that you have really good movement. 


But again, you have an epidural on board. It's anesthesia, which makes you a fall risk. And I can tell you 100 percent hospitals are all about preventing fall risks. So they're not going to let you walk around typically. Now, I'm sure I'll get some DMs, but that's okay. So just talk to your provider about these. 


So again, talk to your provider early, get the low down early so you're not like thrown out of the loop when you get to the hospital. If you have low platelets, sometimes if you have some sort of infection or something going on, untoward, you want to talk to your provider. So always ask for A consultation and talk to them. 


Here's the thing. Every anesthesiologist is different. Some have different policies. It also depends on how many babies you've had. So someone like me, who's had a million babies, who's birthed six babies, I'm not necessarily going to be able to get an epidural when I'm 8 or 9 centimeters because I'll probably be 8 or 9 centimeters for like less than a minute. 


So keep that in mind. And that's another question to ask your provider. Another thing that I want to talk about is what happens when your epidural doesn't work. This actually happens. I want you to keep in mind that sometimes your epidural will not work at all. It just doesn't work for you. Other times, you have what we call a hot spot, and that is a section usually on your abdomen where you feel the pain of those labor contractions, and that seems to drive women insane. 


Maybe the anesthesiologist has six mamas ahead of you, and we don't have time to get you one. Or maybe it's too late, and you can't get one. So I want you to practice the coping tools that we teach inside of our classes, inside of our community, because you need to have a plethora of tools. The other obvious reason is I want you laboring at home as long as possible. 


So if you're laboring at home, you're going to need some tools to use. So don't negate the fact that you're getting an epidural. You don't need to know the breathing techniques. You don't need to know the coping tools. You do. Okay. Keep that in your head. You do. You do. So another thing that mamas want to know from me is after you get your epidural, Typically, it wears off in about an hour ish. 


And you're gonna have that questionnaire to print out, and you're gonna have a inside the toolkit, you're gonna have my birth plan template, that's customizable. You're gonna have the hospital checklist, the third trimester prep guide that we put together where we talk. We have a prep. Calendar for you, daily to do list, and we talk about all the ways you can prep your body and your mind for birth. 


Remember, birth is 90 percent mental.