Can I Have an Epidural at the Birth Center?

A lot of mothers are wary of labor pain, and rightly so. While giving birth is an incredibly empowering and beautiful experience, it is not exactly easy. Methods like the epidural were invented to try to decrease the pain associated with labor. But epidurals introduce complexities of their own to the labor process.

What is an epidural?

An epidural is a form of hospital-based anesthesia. It is administered by injecting an anesthetic and analgesic directly into your spinal cord and works by blocking nerve impulses that transmit pain.

This results in a numbing sensation and a loss of pain perception in the areas of the body supplied by those nerves, typically the abdomen, pelvis, and legs. The level and extent of pain relief can be adjusted by altering the concentration and dosage of the medication, allowing for tailored pain management during labor.

However, since it is directly administered into such a crucial space, it needs continuous monitoring of your vitals to watch out for side effects. It also needs to be done in a sterile manner to prevent the chances of serious infections.

Why aren’t epidurals offered at birth centers?

Birth centers are designed for unmedicated, low-intervention births. They are run by midwives and nurses who are trained to handle the same.

Epidurals require specific equipment, medication, and skilled anesthesiologists, which are not available in a freestanding birth center. They also don’t have the means to continuously monitor patients or handle side effects that may arise from getting an epidural.

Instead, birth centers prioritize natural comfort techniques such a water immersion or use less complicated interventions.

What pain management is available at the birth center?

While there are no epidurals or strong painkillers, birth centers offer the following methods to cope with pain:

1. Warm water immersion (tubs, showers): This takes away the pressure of gravity in the lower back. The buoyancy from the water also allows mothers to relax and feel through their contractions with less discomfort.
2. Movement, position changes, birth balls, slings, counter pressure: all of these are aimed at taking away pressure from the lower back and easing discomfort that arises from contractions.
3. Hypnobirthing or guided breathing: This technique helps mothers relax and alleviate stress, allowing them to experience less pain during labor.
4. Supportive environment: Having familiar midwives, dim lighting, and a calming space naturally promotes a sense of comfort and relaxation, reducing the need for interventions
5. Emotional encouragement and continuous hands-on care: Midwives are trained to continuously empower mothers through words of encouragement, supporting them so that they navigate this period with relative ease.
6. Nitrous oxide: This is a form of inhaled analgesic that the mothers can take according to their needs. It has relatively low side effects and does not require an IV line.

What if I decide I want an epidural during labor?

We encourage mothers to explore the pain relief options we offer at the birth center first. Many people are surprised by how effective natural methods can be in the right environment.

If someone still wants an epidural, we will arrange a transfer to the hospital. Birth centers are not equipped to administer it, so you’ll have to receive the epidural at a hospital and eventually deliver there.

We will always respect your wishes and prioritize your safety. If getting an epidural is what you decide on, we will do what we can to make it happen.

Tips for Managing Labor Without an Epidural

If you want to avoid an epidural or are planning to have a successful natural birth at a birth center, here’s what you can do to prepare yourself:

1. Take a childbirth education class (especially one focused on unmedicated birth): This will help you understand what to expect from labor and how strong you need to be. These classes also teach you positions and exercises that you can do before labor to strengthen your pelvic muscles.
2. Practice comfort techniques ahead of time: Try labor poses or breathing exercises before labor. You won’t be open to learning new things at the time, so knowing what to do will help you navigate that period with ease.
3. Choose a supportive birth team: Having the right team can make all the difference. Make sure your birthing team understands their roles and is considerate of your birth plan. Consider hiring a doula since they are trained to support you throughout labor

Labor, while challenging, is an incredibly empowering experience. We advocate for mothers to approach natural childbirth with an open mind and to explore natural coping mechanisms before dismissing their efficacy. Nevertheless, we encourage all mothers to do their research and be open to other options should the need arise.