Childbirth is a momentous journey, and many expecting mothers opt for an epidural to manage labor pain. If you’re planning on or considering an epidural, it’s helpful to understand the best evidence-based practices for pushing your baby out smoothly and safely. Here is what you need to know about the essentials of pushing with an epidural, ensuring you feel empowered and informed for your birthing experience.
What is an Epidural?
An epidural is a type of anesthesia commonly used during labor to provide pain relief. It involves injecting medication into the epidural space around the spinal cord, numbing the lower half of the body. While an epidural can significantly reduce pain, it can also affect the sensation of contractions and the urge to push.
Evidence-Based Practices for Pushing with an Epidural
1. Laboring Down
What It Is: Laboring down, or delayed pushing, involves waiting for the baby to naturally descend into the birth canal before actively starting to push. This approach allows the body to do some of the work with the help of uterine contractions.
Benefits:
- Reduced Fatigue: By allowing the baby to move down on its own, mothers often experience less exhaustion when it’s time to push.
- Decreased Risk of Injury: This method can reduce the risk of perineal tears and other injuries.
- Shorter Pushing Phase: Laboring down can result in a shorter and more efficient pushing phase.
Evidence: Studies have shown that laboring down can be beneficial, especially for first-time mothers, leading to better outcomes and a more positive birthing experience.
2. Positioning
What It Is: Optimal positioning can make a significant difference in the effectiveness of pushing. With an epidural, you might not have full mobility, but there are still several positions that can be helpful.
- Side-Lying: Lying on your side with your upper leg supported by a partner or a nurse can help open the pelvis and aid in effective pushing.
- Semi-Sitting: A semi-reclined position with support behind you can be comfortable and allow for gravity to assist in the pushing process.
- Squatting with Support: With the help of a squat bar or support from your birth team, squatting can be effective even with limited sensation from the epidural.
Positions to Consider:
Evidence: Research indicates that various positions can enhance the pushing effort and improve outcomes, even with an epidural.
3. Guided Pushing Techniques
What It Is: With an epidural, you might not feel the natural urge to push, so guided pushing can be beneficial. Healthcare providers will offer instructions and support to help you push effectively.
Techniques:
- Directed Pushing: Your healthcare team will instruct you to push during contractions, often using a counting method to maximize the effort.
- Open-Glottis Pushing: Instead of holding your breath, open-glottis pushing involves exhaling and making sounds while pushing, which can be more comfortable and effective.
Evidence: Studies support the use of both directed and open-glottis pushing techniques in enhancing the effectiveness of the pushing phase with an epidural.
4. Continuous Support
What It Is: Having continuous support from a partner, doula, or nurse can make a significant difference in the labor and delivery experience.
Benefits:
- Emotional Support: Continuous support can reduce anxiety and increase confidence.
- Physical Assistance: Your support person can help you change positions and provide comfort measures.
Evidence: Research shows that continuous support during labor can lead to better outcomes and a more positive birth experience.
Preparing for Pushing with an Epidural
- Discuss Your Birth Plan: Talk to your healthcare provider about your preferences and learn about the options available for pushing with an epidural.
- Stay Informed: Attend childbirth classes and read up on evidence-based practices to feel prepared and empowered.
- Practice Breathing Techniques: Learn and practice different breathing techniques that can help during the pushing phase.
Final Thought
Pushing with an epidural requires a combination of evidence-based practices and personalized care. By understanding the benefits of laboring down, optimal positioning, guided pushing techniques, and continuous support, you can make informed decisions that align with your birth plan. Remember, every birth is unique, and the goal is a safe and positive experience for both you and your baby.
Wishing you a smooth and empowering birthing experience!