Now, before you go saying that I hate “natural birth” >> let me remind you that I also have a post on reasons to avoid the epidural as well. I want patients to have a well-rounded knowledge of what an epidural CAN and can NOT do for them at their birth…. and then make the choice on their own.

Ok, let’s jump into those benefits!

Rest

This is a HUGE thing that a lot of people don’t talk about — the fact that you’ve labored for hours, without good rest and you’re just dying for a nap but those contractions are relentless.

Many people get the epidural because they’re just tired and they need to sleep.

They also know that it’s not like they’ll be able to sleep for weeks after this baby is born, and it might be good to fill up their gas tank a bit with some rest before baby is born.

Honestly, all of that is valid.

If you’re aiming for an epidural-free birth I always encourage people to rest as much as possible in the beginning (perhaps gaslighting themselves into believing they’re not in labor). That is often easier said than done though.

BTW, a recent study showed that hardly any birth classes talk about the unplanned things of birth — unplanned cesareans, inductions and yes — epidurals. That’s why I recommend this. I think you’ll love it (in fact, it’s guaranteed).

Being Able to Pee Afterwards

Now, this isn’t true for everyone — sometimes that epidural lays claim to the muscles that help your bladder relax. BUT I will say the worst cases I’ve seen of patients being unable to pee after birth come from people who get local anesthesia on their perineum at birth (this is often given if you’re tearing or they need to do an episiotomy).

SO, you may have an easier time to pee after baby is born. It’s not guaranteed.

BUT if you’ve heard this as a “risk” it can be better than other options.

Not being able to pee after birth is actually not all that uncommon. Your nurse will have a few tricks she can try to help you (if you don’t pee, there’s a chance you’ll bleed more, so we like to minimize that).

Want to know more about birth? — check out these posts:

• Common Choices During Labor
• How to Push During Labor (What No One Explains)
• What To Do If Labor Isn’t Progressing?
• Secret Keys to Labor that No One Talks About
• What You Need to Know About Wired vs Wireless Monitors in Labor

Decreased Blood Pressure

Some of you may be experienced increased blood pressure, especially as you head towards your due date.

And, as you can imagine the pain of labor can also make that blood pressure drive upwards.

One of the big benefits of the epidural is it can help manage that blood pressure as well.

Yes, there are medications that we can give to lower your blood pressure in labor, but sometimes they work or don’t work depending on how you’re experiencing pain.

I’m just here to say that if your blood pressure is trending upwards, it may be something you want to consider. If your blood pressure gets too high it can have serious consequences including heart issues, and possibly a stroke (although super rare). SO, we want to avoid that for sure!

And be sure to check out my article about 5 things you need to know about preeclampsia that goes along with this one!

Not Having to Pee

Clearly, pee is a big deal when a person is pregnant or postpartum.

But a LOT of people really LOVE that we put a catheter in you to drain out the urine once you’re numb from the epidural (or they may put one in every couple of hours depending on your hospital and your requests).

This means uninterrupted sleep! I will admit that when I was pregnant and a nurse, I’d get jealous of my patients who had an indwelling catheter (learn more about catheters here) in — knowing I’d be up a few times in the night to pee!

Some of you might be thinking that’s a big NO THANKS to an epidural — because a catheter doesn’t sound fun. I have a whole post on if you can refuse a catheter — because you DO have options!

I’m just here to say a lot of people are big fans of it!

Everyone is so different — this is why having a birth plan can be so helpful to know what’s important to you:

Helps Your Body Relax!

This is the big one, my friends.

Imagine the last time you were in a lot of pain — maybe it was a kidney stone, or a bad bout of tummy troubles? Did you find yourself wanting to relax into that pain — or did you tense up like a ball of tinfoil around your body?

Most people don’t find relaxation easy in labor.

If you’re unable to help relax that pelvic floor you’re not going to let baby descend into the birth canal, or let that cervix dilate.

Which is super tricky. Honestly, learning to relax is important in all parts of labor, even early labor or ligament pains. That’s why I recommend a birth class that covers natural pain management (this one does).

However, sometimes all the breathing and relaxation in the world just doesn’t help that pelvic floor relax and an epidural can be a great option to help with that.

Often, in patients who aren’t progressing we will recommend an epidural to see if it can help them relax, and help baby move down into the birth canal. Often I’d check that patient an hour later and baby will have moved into the pelvis nicely — they just needed some help relaxing.

This is the part where I remind you that you can’t tell yourself that “Sally down the road was able to relax — why can’t I?”

We don’t know what Sally was doing, or how her baby was positioned, or how big it was. All you can do is make the right choice for you, and also know that both natural pain management and an epidural have proven to be effective and safe for labor pains. Anyone who says otherwise is misinformed.

That’s honestly all an epidural is – it’s a little help. It often ends up being the villian or the hero in labor stories but it is just a little help!

Want to know more about epidurals? — check out these posts:

• Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief
• Why People Get An Epidural Even When They’re Not Planning On It
• Why Labor Pain Can Feel So Different For Each Person
• 5 Simple Tips for a “Natural” Labor & Delivery
• Is an Induction More Painful than “Regular Labor”

So, as you can see there are benefits to an epidural that we don’t talk about. I’m not saying that any of these are a reason to get the epidural — and honestly, I don’t think you have to make up your mind on your plan right now either way. I have a whole post on What to Do If You Can’t Decide if You Want an Epidural or Not? << and the spoiler alert is, that’s fine….

Get educated on what it will be like, when you might want it or not want it, and look forward to a great labor day.

Most of labor is like that. Education is key, and learning to make choices in the moment will be a huge skill both in labor and postpartum to help you thrive as a new family.

So, did you learn anything new about the epidural in this one? Tell me in the comments!

The post The Benefits of an Epidural No One Talks About appeared first on The Pregnancy Nurse®.

This is part of my Complete Guide to Epidurals — so if you have more questions don’t miss that!

I also have a video on this topic:

Before we jump into this I see a lot of people who have literally no business speaking about epidurals online. Most often this is chiropractors who really love to scare patients and feel like it’s their place since it is placed in your back. Please take your advice from an expert in the field — someone who places epidurals, or sees LOTS of laboring patients (that’s me!), or manages their postpartum medical care. Please don’t take it from someone who uses scare tactics to build their social media following (and often sell you something). I’m not here for that. I hope you’re not either.

Ok, let’s get going on the myths!

You Have (Get) to Decide Today

I feel like people on social media want you to decide the minute you get that positive pregnancy test if you want an epidural that day. The reality is you should:

• Learn about the epidural
• Get some natural pain management tools & techniques (don’t worry, talking about that more)
• Be open to what happens as you’re in labor

Remember labor comes in all lengths, and pain levels.

Some people have excruciating labor from the first contraction on, and some people manage it pretty easily until they’re into active labor.

That doesn’t mean that one is weak and one is “strong” — it’s just different — how baby is positioned, the nerves they have in that area and how much sleep they’re able to get.

I’m a huge fan of deciding based on the facts when labor happens.

But I am ALSO a big fan of thinking through what you’d like, and any preferences you have (like scared of needles, or not being “tied” to the bed)….

That’s why I have a birth plan mini series that’s totally free for you right here:

I actually have a whole post on what to do if you can’t decide if you want an epidural that will give you more on that topic. And remember, all of this is after seeing patients from all cultures, and walks of life for 20 years in the labor room. Plus three kids of my own. I get this.

Long-Term Back Pain With It

Ok, this is the biggest one “I had back pain” after the epidural.

Here’s the truth:

1 — You will likely have some back pain at the site of insertion for the first few weeks after birth.

This would be normal any time we puncture the skin with a needle and bug the surrounding area as we place it. You’ll also have this type of pain where your IV placement is. However, studies show…

2 — Those who get the epidural don’t have rates of long-term back pain higher than those who didn’t.

People come back and say it’s “right at the spot where they placed the epidural” but the reality is that particular area gets the worst of our expanding bellys and our bodies trying to stay upright for MONTHS of pregnancy.

Our backs take a huge burden during pregnancy, labor, birth and life with baby (looking at you giant car seat). They need some TLC after baby is born.

• Make sure that you’re using good posture and lifting techniques with breastfeeding, baby gear and baby tasks.
• Use mild stretching once you feel up to it postpartum, and work into a good core program after baby is born
• Possibly using physical therapy to help (I wish a physical therapy appointment postpartum was a standard of care and I won’t rest until it is).

I never did well at this — and I’m working my way through the Mommy Tummy Fix right now. When you’re ready — Join with the FREE 7-day trial. See what you think, the cancel and join the lifetime option and use code NURSE30 to get $30 off the lifetime access (bringing it to $119). It’s never too late to help our backs my friends! (this is a partner link)

Yes, with any procedure there is a chance of having some irritation to the areas surrounding it, but when done correctly the epidural doesn’t cause long-term back pain.

That baby did, and you just need to take care of yourself to rehab it “back”. I hate this, but it’s true. For many of us, this is a life-long persuit.

Want to know more about epidurals? — check out these posts:

• Why People Get An Epidural Even When They’re Not Planning On It
• Do You Need a Birth Class if You Plan to Get an Epidural
• 3 Tips to Using Movement During Labor WITH an Epidural
• Epidurals During Pregnancy & Labor
• How Many CM Do You Need to Be to Get An Epidural?

Slows Down Labor

People say the epidural will slow down your labor — but studies don’t bear that out.

This Cochrane review showed that it may increase it by about 15 minutes. It did show an increased instrumental delivery (but that may be for a variety of reasons including that people with a mal-positioned baby are more likely to get an epidural) but not that it prolonged labor.

Source: Anim‐Somuah M, Smyth RMD, Jones L. Epidural versus non‐epidural or no analgesia in labour. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD000331. DOI: 10.1002/14651858.CD000331.pub3. Accessed 19 January 2026.

Honestly, in some case that I have seen, it does seem to “slow” it a bit — in my mind I’ve always thought it was because of the increased amount of fluids we gave prior to giving it. You’ve got to think that “dilutes” the amount of oxytocin in your blood stream — but once that’s taken care of labor most often chugs along nicely. And in some cases, we end-up start Pitocin to make it keep going. I think that’s a risk you do take with the epidural.

AND in some cases I think it speeds it up by quite a bit. Patients are finally able to relax, which allows baby to descend (sometimes quickly) into the birth canal.

So, “overall” statements about this doesn’t help anyone. We have to take it on a case by case basis, and know that we’re not quite sure what our body will do with the epidural.

Increased Cesarean Rate

I hear this all the time and honestly — like I said before this may be true because:

• People who are being induced early tend to get an epidural due to the length of labor
• Early inductions come with a medical reason which may increase their need for a cesarean overall

However, that same Chochrane review didn’t show an increased cesarean rate. I would guess that they may have eliminated people who had risk factors for a cesarean before showing the epidural alone didn’t increase your risk.

This one did show some correlation in increased cesarean rate if you get it before active labor, or 4 cm. It showed it increases malposition — which is why movement in labor is so important. Honestly, I’m also a fan of waiting until you’re at least 4 cm to get it — which is why everyone needs some natural pain management techniques — more on that coming (but I recommend this).

These studies contradict themselves a LOT — there doesn’t really seem to be a clear-cut answer for a lot of this, which is why I prefer the Cochrane review that pulls out big themes across many studies. That, and deciding what’s right for us based on those big themes.

I hope this article is helping you realize there’s a lot more to “getting an epidural” than just being “weak” or lazy…. I hear that sometimes online and it just makes me angry. There is no room for that kind of talk in my life.

I liked this quote from that Cochrane study:

We found substantial heterogeneity for the following outcomes (meaning in patients who got the epidural –they saw): pain relief; maternal satisfaction; need for additional means of pain relief; length of second stage of labour; and oxytocin augmentation. This could not be explained by subgroup or sensitivity analyses, where data allowed analysis. No studies reported on rare but potentially serious adverse effects of epidural analgesia.

Meaning:

• Women who got an epidural had better pain relief (100% agree with this)
• Longer pushing time (looks like by about 7 minutes)
• More needed Pitocin to keep labor going
• No real serious side effects noted.

Their final conclusion:

Epidural analgesia appears to be effective in reducing pain during labour. However, women who use this form of pain relief are at increased risk of having an instrumental delivery. Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with pain relief and long‐term backache and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia on women in labour and long‐term neonatal outcomes.

And, if you’re looking for more info on instrumental delivery — check out this video on forceps and vacuums.

I am a HUGE believer that much of the increased risk happens because patients aren’t adequately assisted in moving after getting an epidural. And frankly, some patients just don’t want to move. Please make sure that you’re using movement in your labor. It. is. huge. I also think partners can be a huge help for movement. I talk about that a lot in here.

Want more studies and info — I found this article very helpful as well! It links to a bunch of them — just be mindful the data is all over the place!

Inductions do increase epidural rates, mostly for how long labor ends up being — and a lot of patients aren’t expecting it. If you’re considering an induction grab my induction checklist so you’re prepared for what to expect for yours:

The Scary Needle

I hear a LOT about the scary needle, and how people are afraid of needles.

The reality is that needles can look awfully scary, but they do something that takes away a LOT of pain, and I’ll just say that good amount of people very quickly get over a fear of needles when labor pains are happening.

Which is fine. Needles are scary, if I wasn’t in pain I’d say no thanks — but when I am in pain, let’s take away the pain!

Your “Pain Tolerance” Will Get You Through

I see a lot of people in the comment section saying they have painful periods and they think they will be fine with the pain of labor.

All I am here to say is that if you hope to go without an epidural, you need some training on how to do that. I have a class I recommend that includes it.

I also think you need training on how to manage your labor. Waiting for your water to be broken, not adding Pitocin. I think all of those are important skills to have if you’re wanting to not get an epidural.

And I think that last part is overlooked, unfortunately. And yes, that class also talks about managing your labor, making the right choices for you in the moment. Because sometimes it IS right to break your water, and sometimes it will sabotage not wanting an epidural — and knowing what’s right for you can make all the difference!

If You’re Planning on an Epidural You Don’t Need a Birth Class

I don’t know where we got started on that but everyone needs some natural pain management

And everyone needs a class that helps them manage their labor and make the right choices for them.

The reality is that if you’re planning on an epidural you don’t need a bad birth class — that is correct, but you will want one that:

• Teaches natural pain management techniques (so many stop with just this)
• Helps you know what to expect as you get the epidural (because it can be scary)
• Helps you make choices in labor that are right for you.

All pregnant couples need a birth class, and yes — I said couples because you’re in this together. This is the one I recommend.

While we’re here — the epidural isn’t your only option. I go over all the options here:

Harder Recovery

I hear a lot that people had a harder recovery with the epidural.

And honestly, that varies birth to birth.

After 24 hours I don’t think, as a nurse, I’d be able to pick who got an epidural and who didn’t by just taking care of patients without a history on them.

Yes, the first couple of hours (sometimes longer, sometimes less) as the epidural is wearing off will be very different as we wait for your legs to be able to hold your weight.

But, honestly — after that. I don’t see it.

Often people get it on their first, and then not their second and then are like — gosh, that was so much easier, but the reality is that first babies tend to be harder and that is with an epidural or without.

Want to know more about epidurals? — check out these posts:

• Weird Side Effects from The Epidural That No One Talks About
• What to Do If You Can’t Decide if You Want an Epidural or Not?
• Should You Get the Labor Epidural Before They Break Your Water?
• Is a “Walking Epidural” A Real Thing?
• How Bad Does the Epidural Hurt? What to expect during placement.

Better Births Without It

Finally, I hear this one a lot. Baby does better, mom does better — they’re happier.

Honestly, again — I see this going both ways.

Some people like the “high” they feel accomplishing something they’ve worked for.

Some people get so stressed during labor they almost collapse after baby is out and have an out-of-body experience when baby is born (and don’t get to enjoy that hard work).

Better births come from preparation, and making the right choices for yourself. They don’t come from the pain management you choose. That, I can say as fact after watching birth after birth for 20 years in labor and delivery.

I’m glad you’re here learning the truth with me… it means a lot. And, I think it will make for a better birth for you.

So, what myths have you heard? I’d love to hear them in the comments. Maybe this post will need a part two!

The post Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief appeared first on The Pregnancy Nurse®.

I also have a YouTube video on this same subject:

As a note, the epidural isn’t the only thing you can get for pain — I go over some of the most common pain management options right here:

They’re Exhausted

This is one I see a lot.

You’ve had false labor for days

You haven’t been able to sleep.

The anxiety of “when” has been killing you and you really need the rest.

So they get an epidural.

And honestly, this is smart! If you’re exhausted, and it’s available I think it’s smart to get. You’ve got pushing in front of you and then managing a newborn. It’s a LOT!

It’s REALLY hard to sleep during labor, although if you think just one small nap would do wonders, sometimes IV pain medicine can help out with this too.

Far too many people stay up timing contractions in early labor, my best tip is to ignore them until you can’t — and sleeping is one of my favorite ways to ignore them!

Want to know more labor tips? — check out these posts:

• How to Feel Confident Making Choices During Labor
• What To Do If Labor Isn’t Progressing?
• Secret Keys to Labor that No One Talks About
• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Labor Anxiety? These 3 Things Help You Feel in Control

They’re Being Induced

The reality is that you start your induction from minute one in the hospital.

Which makes it hard to:

• Ignore (you’re just sitting there, like a “watched pot”)
• Sleep through (the hospital is HORRIBLE for sleep)
• Get comfy — because we have to have the monitors on the baby in order to induce you (and this is something you can’t refuse)

Often inductions are very long too. Clearly, it depends on what your cervix is when you come in (see my article on Signs You’re Ready to Be Induced for more info).

Inductions are just trickier to make it through without an epidural for a variety of reasons. That isn’t to say you can’t make it – but it is important to know it’s hard.

I think it’s important to know what you are facing (because it’s different for everyone). That’s why I made this induction checklist:

And, if you’re looking for some positivity, check out this podcast from someone who was induced without an epidural:

They Came In Too Early

Some people think the minute contractions start, it’s time to pack that bag and head into the hospital. I mean, that’s how it happens on the movies, right?

I’m here to say that for most people, the best place for you to be in early labor is at home.

Don’t forget to use your provider — it’s great to call them and check in, tell them what’s happening and get their advice on when you should head in. As an experienced nurse I could tell by your voice if it was time to head in (most often).

The thing is, this is scary. It’s especially scary for partners. They feel like you’re paying the hospital and your provider to manage the labor — so, why not use them?

Well, the hospital just isn’t relaxing, it doesn’t let oxytocin flow in early labor. It doesn’t have your people, your things, your food, your smells. It also has medical staff poking and prodding you…

So, it’s important to get some tools to help you wait at home for a bit in early labor. What to do, what to eat, and what to watch for…

I’m so glad that you’re here, but this is one partners can use some education on too. That’s why I recommend this. It has a whole chapter on early labor and managing it at home. It’s so helpful — for both of you!

They Weren’t Prepared

So many think they can muscle through labor, like they have for cramps since puberty — but I’m here to say that you really need to get prepared.

And, like all good preparation, you have to practice. It takes time and effort, and often a good teacher to get you both prepared (because you want a partner in this, not just a cheerleader).

This has a whole natural pain management bonus video included that has proven to help people manage labor pains and make good choices for themselves in the hospital. So helpful!

It’s there!

The reality is that at home, there’s no epidural.

If you deliver at a birth center, there’s no epidural.

But at the hospital it is there.

I see people all the time telling their partner not to let them get it — but honestly, my friend. You’re an adult. If you make the choice to get it, then get it. You don’t need someone holding it back from you like you’re a toddler. You can really make that choice. Epidurals have been proven to be effective, safe ways of pain management.

Lots of people are awfully scared of epidurals, which is a shame. There’s a chapter in here that explains about how they work and even walks you through it using some common household items to make it less scary. I think you’ll love it.

The reality is that you can have a lot of hopes and wishes (and preparation) about your birth, but until you’re in the actual situation it’s hard to know what is really the best choice for you. So, staying open to things is the smartest thing you can do.

Want to go over your hopes for a perfect birth – -check out my free birth plan series:

It’s important to know what you’d like if things are working out, but also know how to make choices on your own when the time comes. This teaches you both how to do just that. I think you’ll love it (in fact, it’s guaranteed).

The post Why People Get An Epidural Even When They’re Not Planning On It appeared first on The Pregnancy Nurse®.

Before we get started, let me remind you that pain is something that can be managed in the hospital. There are a few different options and I share them here:

Ok, but why do I think certain people feel things differently — let’s explore it together.

Pain Tolerance

Let me say that I don’t believe in pain tolerance. I hear a lot that someone has a “really high pain tolerance” only to see with my own two eyes that they don’t. Maybe they do have a high pain tolerance when they run, or break a bone — but labor pain is different.

As a nurse who’s seen a lot of people in different types of pain, including broken bones, dying, birth and more — not everyone experiences any type of pain the same.

So, we all experience different types of pain in different ways. That’s it, end of story.

Whether it’s a broken finger, a broken heart, or an appendicitis — we’re all different.

Also, people outwardly show pain in VERY different ways.

Some are noisy, and swear with every movement. Some are quiet and keep it all inside. Honestly, there’s no “right” way to experience pain — but it’s important to let your providers what you are experiencing. It doesn’t do anyone any help when we ask you your pain scale and you say none and it’s excruciating — it’s not helping anyone.

You have to remember we can only hear about people’s pain — so we have to take them at whatever they say. I’ve heard moms tell family their birth was “so painless” — but I wouldn’t have described their birth that way. Everyone gets to share their own perception, most often AFTER the event!

Want to know more about birth pain? — check out these posts:

• 4 Things to Know About Birth Pains
• Is an Induction More Painful than “Regular Labor”
• Fun Ways to Use the F-Bomb in Labor.
• Can I Be Induced at 37 Weeks Due to Pain
• What Does Round Ligament Pain Feel Like

Your Past

The reality is that birth (and frankly, the hospital) brings up a lot of feels.

It could be previous trauma, other medical things.

I always appreciate it when people tell me as much as they are willing about what this is stirring up within them.

You might be embarrassed to tell me:

• You’ve had previous abuse in that area that is making all of this worse
• You’ve seen or had horrible things done at the hospital and that is making all of this worse

But there isn’t any reason to feel that way. The more we know about you, what helps you feel safe and seen the more we want to do that.

The more you let your partner/support person know what you’re thinking the better it can be too — this isn’t a time to keep secrets, the more they know they can help more too!

The crazy thing about patients is that one person will really like it when we limit vaginal exams, and someone else wants to know what’s going on with their body to feel in control. And you really just can’t see it from their point of view — you think that EVERYONE wants it that way.

But, everyone’s different, and we want to help.

You may feel silly, but the more specific, the more helpful!

Example: Is it just seeing the IV in your arm that is killing you (maybe because your dad had an IV in his arm when he died), we can work to cover it up, or saline lock it if that’s an option!

Your Future

I call birth like a wedding and a major medical event happening simultaneously.

Meaning, your life, from that moment, will be different — and your body is also going through SO much (we shouldn’t forget this truly IS a major medical event — even if we sort of pretend that it isn’t).

With birth comes a lot of that stress about the future.

Is your partner going to be what you need as a co-parent and helping you to recover?

Will the baby (and you) be OK after birth?

There is a lot of unknowns.

And once again — the more you can tell us what’s worrying you, we can discuss it and we may even have things that can help you feel better.

We can ALSO tell you those important things to watch for postpartum to help you stay safe. That’s so important — and if you want to know them in advance come join me in Postpartum Care Made Easy.

Much like a wedding we spend a LOT of time preparing for the “event” and not so much thinking about what life will be like with that spouse after…

Also, none of us can tell the future, and I think hope helps a lot. It gets me through many a day as a parent, and I hope it can help you too. Positive affirmations help me do that…

Different Neurons

I’m here, with my almost 30 years of experience with patients, to say that some people just have different neurons.

I had a patient (and I’m talking ONE patient in 20 years) who literally felt “mild cramps” at 10 cm dilated.

She hadn’t prepared anything special and was even open to an epidural but she really just didn’t feel much. Honestly, it was real freaky to me to have a patient where I’m saying “you’re complete” and they’re like “huh — that’s so weird” in a 100% calm voice.

And then came the after birth pains.

She started screaming like we were pulling her arms off.

I ended up giving her pain medication after baby was born.

Why did this happen?

I have no idea, but I really think different people have different neurons. Some have extra in some places, and some have less — and I don’t know how that all works but I just think it after seeing people in pain sine 1997.

We can NEVER judge how someone else is reacting to pain. We have no idea what’s going on behind the scenes. In addition to different neurons I also think these things play a part….

A reminder that for MANY years we’ve been told that women don’t feel anything on their cervix, only to now notice that thousands of women have suffered with the IUD placement. Personally, I didn’t feel it much at all (after having 3 babies) but I know a lot of women feel it a LOT. We’re all different, and the beauty of medicine is that we can treat each person with what they need!

Different Situations

There’s a lot that plays in to labor pain.

One of the biggest one is baby’s position. If baby is OP a lot of times people have excruciating back pain that doesn’t go away until baby turns.

It can also be your pelvic floor, how quickly things are progressing, baby’s size, any issues with your cervix or uterus.

All of those things can change how you feel labor — even if it’s the exact same labor that someone else is experiencing.

We can’t judge labor pains, we can’t judge pain in general — is that clear enough yet (this is also one of the very early lessons you learn as a nurse — that patient’s rate their pain scale on their own).

Right as I wrote that bit about the pain scale I was very aware that sometimes I’d have someone come-in with their pain a 10 on the pain scale, and I would tell them that it was going to get worse, and they might have to adjust their pain scale — it’s not very nice, but true. I was glad to know that they were in that much pain, but I also needed them to know they were early in things…. and things were very likely to get worse.

Different Labors

While the studies don’t really point to the fact that inductions are more painful — I am here to say they are often longer, and there are parts of it that can feel absolutely extra miserable.

What I do know is that normally oxytocin has a bit of a “love” effect on us when it’s made in our brains, but when we pump it in through the IV it doesn’t have that same effect because it can’t reach our brains (due to the blood brain barrier). I think that early labor, especially, can be just much more miserable (and boring) with an induction.

Plus, you’re in the hospital the whole time — without the comforts of your people, your things, and your foods.

Want to know more about inductions? — check out these posts:

• Pumping To Induce Labor? Will it work?
• 5 Things NOT to do Before Your Induction
• Pitocin to Induce Labor
• Inducing Labor at 39 Weeks: Pros and Cons
• What to Expect at A Foley Bulb Induction

Preparation

Being scared can be a huge amount of the pain — and there’s lots of reasons that people might be scared….

• Where the pain is going from here
• How baby comes out (you’d be shocked by how many people have just NO idea what’s going to happen at birth)
• Not loving their provider (and concerned they’ll be “pushed” into something they don’t want)
• How to put on the hospital gown

You guys might laugh at the last one but there is just a LOT in the hospital that can be intimidating and a bit scary.

In my last hospital we had the weirdest faucets and people couldn’t figure out how to turn them on. I always felt so bad because I knew it was just one more thing that felt crazy about what was going on. When I remembered I tried to let them know how to turn it on in advance.

A lot of labor is like that. Personally, I had no idea how scary it would be when my baby’s heart rate went down, how hard they might pull with forceps and how tough my recovery would be.

I took a birth class that didn’t prepare me for any of that, unfortunately.

The good news, is there are a LOT of birth class options anymore. The foundation you will get in here will be a game changer for feeling prepared in the labor room — check out the glowing reviews on that page. I’m so glad that we have resources like that for parents to feel more confident in their birth.

When birth is less scary, it hurts less. Plus, in that class there’s a whole bonus video on natural pain management options as well as medical pain management options should you need them. You’re prepared for ALL of it (including inductions or cesareans) — because the truth is no one can predict what type of birth you’ll have — and being prepared makes your birth better. Get started today!

What did you learn about birth pain in this post? I’d love it if you told me in the comments. Hopefully it helps you to know that everyone is different, and that’s OK!

The post Why Labor Pain Can Feel So Different For Each Person appeared first on The Pregnancy Nurse®.

While we’re here, if you’re in your 3rd trimester, be sure to grab my checklist just for you:

What does “Natural” Mean to You?

I think we each know what “natural” means for US — but as a provider, it’s really hard to know what it means. I think it’s really important to pinpoint what it might mean for you. Most people think it means one of these:

• No medical pain management
• No induction of labor
• Neither of those things

So, when you’re talking with your provider make sure that you define what it really means for YOU.

I also think it’s OK to be like “I’d like to avoid those things if possible — but I will manage each step as it comes”. Honestly, I think that is the BEST way to manage labor — so if that’s you, high five!

Prepare Your Cervix

We tend to think a lot of things are out of our control in the birth sphere, but studies have proven that there are a few things you can do to help your cervix soften to prepare it for labor.

I have a whole post on 4 things you can do to prepare your cervix for labor << and you really need to read that post to know what/if it’s right for you — but in case you’re wondering what they even are they are:

• Sex
• Primrose Oil
• Dates
• Pumping

Keep in mind that those things are NOT (I repeat NOT) going to PUT you into labor, but the studies have shown they can prepare your cervix, and make it softer as you head into your due date.

This can possibly make labor easier and less-likely to have a failed induction if you need one.

So often I see people who think a “natural” labor will just happen — but it does require some prep on your side. These aren’t HARD things to do, but they are things I think you should consider.

Use a Midwife

Ok, this doesn’t work for everyone — but using a midwife can really help. If you’re not using a midwife, you might want to consider a doula (although the price of a doula is tough for most families).

Studies have shown that midwives are more likely to have less interventions (those tend to veer away from “medical”) than OBGYN’s.

If you have a low-risk pregnancy, and you’re before 30 weeks you may want to consider looking around to see if there are Certified Nurse Midwife (CNM) options in your local area.

This may mean you have to change hospitals and it may be a bit of rig-a-ma-roll, so this tip might not be for everyone, but I am a huge fan of Certified Nurse Midwives and I think they provide tip quality care, while also having the safety of an OBGYN should you need an increased level of care.

There are a few different types of midwives — you’ll want to research a bit about which one is right for you. I prefer Certified Nurse midwives because they have a standard level of care and can deliver in the hospital. However, pick which care works best for you.

Start Practicing Early

Again, a lot of people think they have a “high pain tolerance” and will just be able to manage the pain at the hospital — and I don’t think this option tends to get you very far.

I recommend start practicing your breathing early on. And yes, I’m talking much of your 3rd trimester. It can have a lot of benefits:

• Deep breathing can help make us more mindful and possibly less worried
• May decrease your blood pressure and stress level
• Gives you a chance to check in with your body
• Gets you practiced for when labor comes.

This isn’t to say that if you’re 35+ weeks, all is lost — start now!

While there is a lot of ways to manage pain — breathing is one of my favorites for labor because it also helps your pelvic floor to relax which allows baby to descend.

If you’re tense, your pelvic floor will also be tense, which won’t do you any favors.

And if you’re thinking — Hilary — I have on idea what these even are. There is a bonus video in here that goes through a ton of natural pain management, including breathing that is SO helpful!

Know About 3rd Trimester Testing

This is the one that trips up a LOT of people.

The reality is that we are getting pregnant older, and possibly less healthy than we have before.

Meaning, we start to have bigger issues as we head later into our third trimester, and for many people that means some third trimester testing.

Usually:

• NST
• BPP or Ultrasound testing
• Preeclampsia labs

Most often, these come back normal.

Sometimes they come back very black and white as to you need to be induced ASAP because there is something serious going on.

And, then there’s the grey zone…. often:

• Baby looks big
• Your blood pressures are high, but labs are sort of borderline
• Baby’s BPP wasn’t great, but also wasn’t often

At that point, you have choices. Often people feel “pressured” into getting an induction. BUT if you’d like to hold off a bit, maybe prepare that cervix a bit more for a few more days you often have that choice.

It’s also REALLY important to know what type of an induction you’re headed in for.

If your cervix is already quite open, and soften you may have a pretty quick one. But, more often your cervix is hard and closed and you are looking at a pretty long medicalized labor.

That isn’t to say that sometimes that medical labor isn’t VERY necessary. Having a baby that is too large for your pelvis, or blood pressures that are too high you might have a seizure aren’t things to mess around with.

But, it’s a choice.

Two thoughts with this one:

1⃣ Understand what your induction will likely look like — I have an induction question checklist that is super helpful for this:

2⃣ Talk with your provider about your priorities, but also how to stay safe. Maybe you can hold off for a bit, get some testing again in a few days and then see where you’re at.

It’s just REALLY important to understand third trimester testing, what the results mean and how they could impact the rest of your pregnancy. Most birth classes skip over this section, but I love that this one really dives into it and gets you prepared for something else people ignore (to their detriment, I think).

Get Prepared

It’s really easy to think that you just need to learn that breathing we talked about earlier to prepare for your birth.

However, there is SO much to get prepared for birth. The thing is, you’re a strong capable woman who is used to taking control of things. That’s very different than how your mom gave birth. She was OK giving control over to her provider >> but women in 2025 don’t want that. They want more from their birth.

Which means you’ve gotta PUT more into your birth — and not just watch some social media videos, or read some articles (even high-quality ones like this one). You really need a class from a professional that walks you through 3rd trimester, labor, birth & postpartum life.

I recommend one that is:

• Taught by a professional (people prefer ones taught by labor nurses because we really know).
• Includes interventions like epidurals, inductions, cesareans and more — because all the preparation in the world can’t always stop stuff from happening, and getting prepared is smart.
• Not too expensive >> class prices have gotten out of control!

I love The Online Prenatal Class for Couples. I know it ticks all the boxes you’ll need to prepare you for your upcoming birth — so you can be a strong, confident, prepared patient. You’ve got this (when you get some help!)

It really is crazy that just putting in a few hours can really pay-off a LOT for birth, and the crazier thing is how few people actually do it.

What type of birth are YOU hoping for, and how are you preparing for it? Tell us in the comments.

I also have this post as a video in case you find that helpful:

And just in case you missed it, grab that third trimester checklist right here:

The post 5 Simple Tips for a “Natural” Labor & Delivery appeared first on The Pregnancy Nurse®.

Before we get going, I’m talking about BIRTH pain. Not PREGNANCY PAIN. There’s a big difference, and if you’re having pains in your pregnancy that is 100% worth mentioning to your provider. Here are a few common ones that might help you out:

• Bladder Infections in Pregnancy
• 5 Fixes for Groin Pain During Pregnancy
• What Does Round Ligament Pain Feel Like
• Sharp Abdominal Pain During Pregnancy
• 6 Easy Ways to Get Relief from Hip Pain During Pregnancy

I also have a video of this post:

Ok, here’s 4 things you need to know about birth pain:

As a reminder I’m not just going off my own birth experience. I’m going from the experience of helping thousands of women manage this on their own.

There’s Help If You Need It

I think that we all know this — there is something we can take to help with labor pains — but so often I hear people say that the pain of labor is the thing that is keeping them up at night

Personally, I think that’s effort wasted. The reality is that if the pain is too much you can request:

• IV Pain medicine
• The Epidural
• Nitrous Oxide (at some facilities)

BTW, want to know more about your pain management options I have a whole email I can send you with more info:

I know that a lot of people really WANT to avoid the epidural, but the reality is that it’s there, it’s likely offered (especially in the US) and it has been proven safe.

So, here’s something you can tell your worried self:

I am strong and capable, but if I need something for the pain they have something for it — it’s easy!

And, if you would like more info on the epidural check out my guide to the epidural.

I know it can be tempting to think that just because you plan on an epidural you don’t need a birth class — but I don’t think that’s true at all. I still recommend this one — if you’re getting an epidural, an induction, a cesarean or whatever birth you’re planning on.

It’s Helpful Pain

Labor pain is very different than other pain that we experience in our bodies.

I mean, if you’re having excruciating pain — you most likely have an issue and something needs to be fixed (aka, broken bone or an appendicitis) — but with labor we know this is going to happen and we welcome that pain (sort of — I get it, it’s tricky).

Remember, that labor happens with your:

• Mind says it’s OK to go into labor (things are safe — think about our early ancestors who didn’t need to be eaten by a tiger while in labor)
• Uterus triggers that it’s getting too full and this baby needs to come OUT
• Baby says — OK, I’m ready too!

Remember that I’m talking about TERM labor pains here. We really want to keep your baby inside you as long as we can prior to 36-37 weeks — so, if you’re having labor pains prior to that you need to contact your provider ASAP or go into L&D.

Ultimately, that baby can’t grow inside forever (thank goodness, right) — so it HAS to come out. Ultimately it’s helpful. Even if it sort of feels like your body is under attack at the time.

A good affirmation for this is:

My baby is ready to come out and I am ready to see them. I can’t wait to see what’s on the other side of this pain.

I really think understanding labor pains can help a lot. We talk a lot about that in here so you feel like good things are happening (rather than world war three).

You HAVE to Relax Into It

This is another REALLY weird one about labor pains.

If you clench tightly around the pain it can prohibit that baby from descending into the birth canal. Honestly, if your fear of the pain and what’s going on is so big you could maybe even prevent your labor from progressing (again — think about our ancestors trying not to get eaten by a tiger).

So, you have to relax into that pain. I have a few ways to help that:

Work on Opening Your Pelvic Floor:

I did a lot of prenatal yoga with my last pregnancy, one of my favorite exercises was getting into a deep squat and learning to relax our pelvic floor (think — how it feels when you pee — you relax all those muscles).

I think a lot of us think we need to build those muscles by doing Kegels — and while that might be true, it’s also very important to learn to relax those muscles as well.

As a labor nurse I can see people who can’t relax those or feel like they have to do Kegels in labor and I can verify that is NOT doing you any favors — so learn to relax it too!

Learn Breathing Exercises

Many birth classes are mostly about labor breathing, and while I think that is a vast over-simplification for what you actually need for labor I do think that those exercises can be very helpful to be practiced.

There isn’t particularly a magic to the breathing they teach in those classes. And yes, I teach breathing in here — because I mostly think it’s awesome to practice it, and having a plan helps with that. It’s mostly about breathing in patterns that allows you to relax that pelvic floor (see above).

Take one of those deep, cleansing breaths right now (I’ll wait).

Our body automatically just relaxes that pelvic floor when we do this — it’s really hard to do breathing exercises with a tight pelvic floor — so, that’s why breathing helps.

The little patterns we give you, I also think it just gives you something else to concentrate on besides the pain. Plus, it oxygenates you — so many big wins from one exercise!

Preparation Is Key

This is the thing — if you’re not prepared the “scares” of labor which may include:

• The admission process — the hospital is weird and it’s really annoying to get all those un-ending questions when you’re hurting
• The IV
• Worries about baby’s safety when 5 nurses run into your room
• How on earth you’re going to push that baby out

Can just add to the pain.

So, getting prepared for both the pain (by learning some natural pain management techniques) and be prepared for what’s going to go on is really the key to a great labor!

BTW pain management isn’t just about breathing, there’s a lot more to learn about it too (here’s a clip from this class)

I want to be really honest that often people get the epidural (or even request a cesarean) because they haven’t:

• Slept/rested during early labor
• They had NO idea how long labor (or their induction) was going to take
• Can’t cope with the fears about birth and the hospital

I really think that is why birth classes have been shown to reduce needs for:

• Induction
• Epidurals
• Cesareans
• Assisted deliveries (with things like forceps or vacuums)

I mean, the good news is that you have control over it — today is the day you can start the class and start getting prepared. You don’t have to wait for a spot at the boring hospital class — you can get started in here and get prepared for your upcoming birth today!

In fact, I want you to have this so much I’m giving you $20 off either class right now using code PAINMANGEMENT — the coupon is already applied to checkout right here.

Have other questions about your birth or pain at birth — let me know in the comments — I’m always wanting to know more about ways to help you guys. Wishing you the very best for your upcoming birth!

The post 4 Things to Know About Birth Pains appeared first on The Pregnancy Nurse®.

Before we get started, if you’re considering an induction, you 100% want to grab my induction checklist to really have a discussion with your provider about what to expect, should you have one:

I also have a video on this exact same topic in case you’d like to listen:

Is an Induction More Painful?

If you look this up online you’ll see almost every single website saying that an induction is much more painful. While the studies may not back this up (more on that, keep reading) — there are a few reasons this could be true:

The Blood Brain Barrier

So, in the hospital we often give you Pitocin, which is the exact same chemical make-up as Oxytocin — meaning your body can’t tell them apart. So, it never made sense to me that the contractions would be more painful one way or another.

BUT, I then learned that Oxytocin is made by your brain (in your hypothalamus). Which means it bathes your brain at the same time through your blood supply around it. Oxytocin has a calming loving feeling to it (think attachment to a partner, or a baby). Your body gets that nice bonus as it makes Oxytocin.

Pitocin, is run in through an IV and will not cross the blood-brain barrier. Meaning your brain never gets the happy Oxytocin feelings along with the contractions.

Just the contractions.

I am not exactly sure how much this matters later in labor, but I do think it matters more in early labor when the oxytocin amounts are small and you’re not in as much pain.

Just know there’s some happiness that comes with Oxytocin, and you won’t get that Pitocin.

Want to know more about inductions — check out these posts:

• Pitocin to Induce Labor
• Inducing Labor at 39 Weeks: Pros and Cons
• 5 Reasons to NOT Get Induced
• What to Expect at A Foley Bulb Induction
• What Happens if Your Induction Doesn’t Work?

Fast Start/Slow Ramp-Up

While the hospital does start Pitocin as slow as they can (it’s about 1 drop in 30 minutes) they do ramp it up faster than it would normally ramp up inside your body.

Plus, we double it in that first half an hour. Usually going from 1 to 2 mu/min or 2 to 4 mu/min — which is a lot.

Fun facts: You can control your oxytocin drip. You can tell them to start it at one, and then increase just one milliunit per minute each time they increase it. Nurses don’t always ask, but it’s something you can state right at the very front. I think it helps when you say you react strongly to medications, and you’d like to start slow and have them ask before they increase it.

At home you tend to have a “I just feel gross” feeling for a while, and then slowly it progresses into contractions. But, you have to remember at home you’ve got your people, and your places you love to relax, the foods you like, but the hospital has…. (keep reading….)

Hospitals Suck

When you’re induced in the hospital the nurse is required to keep you on the monitor all the time.

This isn’t something you can refuse — because you’d also be refusing the induction medications.

Yes, you read that right — in order for your nurse to keep her license, if she is giving induction medication, she also has to have you on the monitor continuously.

While there have been some advances in how we monitor the heart rate and contractions. There are:

• Portable monitors
• Wireless monitors
• Waterproof monitors

And while all of those sound amazing… sometimes we can only get baby in one spot, sometimes wireless monitors won’t pick up, and sometimes the water hitting the waterproof monitors makes it impossible to use….

While technology can help us a lot, I hope you know it has lots of flaws…

It’s Not Home

You know that feeling when you get sick or don’t feel well and you just want to go home? You feel safe there, you have your best pillow and it just feels nice to be in your space.

Also, the hospital just isn’t as comfortable as home. It doesn’t have as many distractions as home and I feel like that ultimately just makes it much more uncomfortable.

Does this mean I’m pro-home birth? No. But I get it, I do.

What do studies show?

No one likes it when I bring this up — but in the Arrive Trial — where they studied if 39 week inductions were safer than “expectant management” where they just watch you to see if there’s a reason to induce otherwise you go into labor on your own.

They did ask people to rate their pain. Those who were induced, vs those who went into natural labor. The people in the induced group reported less pain and more control during their induction, than those who went into natural labor.

Now, you can decide what you want about all of that — but I think it’s solid evidence that some of this may well be in our minds (aka — you think it’s going to be worse, and the it is) vs reality.

Length of Time

The reality is that induction takes longer than natural labor — most of the time.

I think that a lot of it is due to us skipping that whole “I’m miserable…. oh wait, is this labor?” part.

Often we call that “generalized malaise” during that timeframe. You just don’t feel great — but in reality that’s getting your cervix ready for those harder contractions.

In the hospital that might be similar to the time that we’re using something like Cytotec or Cervidil — and you’re feeling contractions while laying in the bed, and there’s nothing to distract you like folding baby clothes, making some brownies, cleaning your house, taking a nap in your own bed, or laying on the couch with a heating pad.

The Arrive trial did show the length of labor, in general, was longer in those who were induced. I actually made a deep dive of the study in here to help you decide if an elective induction was right for you.

The length of time of an induction is probably the #1 thing that catches couples off-guard with an induction. That’s part of my induction checklist that I 100% recommend you review with your provider before planning an induction:

I did just write a post on a few things you can be doing in your last few weeks to make your cervix more favorable:

Patient Experiences show…?

Ok, I agree that data can only show us so much, but what do to real people say?

I’d say that about 70% say that it is more painful than “natural” labor.

However, there’s 30% who say it’s awfully similar — and I have to say that I’m in that camp. I had entirely natural labor on my first baby, I went into labor on my own on my 2nd but then was augmented once I got to the hospital, and then on my 3rd I went in for an induction. You can read more about my own induction here.

I felt like it was very similar to natural labor. But I was bored, and stuck in a miserable bed. Not fun, not fun at all.

But frankly, “natural” labor wasn’t that fun either!

The reality is that most people just prepare some breathing for birth and maybe learn the stages of labor, and how to change a diaper and then feel like they’re prepped for birth.

However, studies show that type of education falls short of what you actually need to know about birth.

In fact, most birth classes don’t even cover inductions, even though LOTS of people will need one. Nor do they really share what you need to know about a cesarean.

I’ve even found that many glaze over postpartum life and don’t really give you the tools and resources you need to sail through that phase a bit better.

I know my own birth class with my first baby didn’t prepare me at all for my forceps delivery which ultimately made me tear (a lot) and my postpartum anxiety had me in a grip I wasn’t ready for at all (and had no tools to help myself). I’m so glad that there is this now to make it so much easier to get prepared!

I recommend starting it ASAP — I think you’re going to get a lot out of it and really feel so much better about your upcoming birth!

SO, what do YOU think? Are inductions more painful? Tell us in the comments. I bet people would love to hear from other people what they thought!

The post Is an Induction More Painful than “Regular Labor” appeared first on The Pregnancy Nurse®.

While we’re here — you clearly have some birth plans, but have you written them down? Grab my Birth Plans Made Easy series right here (it’s free):

Important Things To Know About Birth Classes

If you’re thinking about this question — I need to reveal two truths about birth classes

Before I share them, let me remind you I’ve been at thousands of births in my 20 years of bedside L&D nursing — so I really know what you need to know!

1. Every birth class should include some natural pain management. I think it’s important — and we will talk about why.
2. A birth class should cover much more than just natural pain management. If it only covers that — you aren’t prepared for birth.

Ok, let’s talk about why these things are true?

Why does everyone need some natural pain management techniques?

Yes, even those planning on an epidural, or even those who are planning for a cesarean — I think all of us need some natural pain management coping skills.

Why? I’m glad you asked….

100% of births (and/or pregnancy) have some pain associated with it.

That could be:

• Before you get an epidural (especially laboring at home for a bit before the hospital)
• Ligament pain during pregnancy (I can vouch for those sometimes being worse than contractions)
• Pain during the cesarean
• After-birth pains of your uterus cramping back down
• Managing the pain of healing your body after pregnancy & birth

Natural pain management helps you to not tense-up around that pain.

I think most of us tense-up naturally around pain, but often tensing-up around pain makes it worse. When you learn to breathe through it, relax, maybe not panic — it makes it better.

While I wish there was a pill that could take away all the pains during this period of our lives, there is not.

And I also have to give a plug for nonpharmalogical pain management when it works. The more narcotics you take, the more like you are to get addicted, you can’t drive, and it adds to your already sleepy state.

That isn’t to say that pain pills are bad, but when they can be avoided I think it’s a win.

SO, with this — no matter how you’re planning on having your birth (or how you end-up giving birth) having some pain management techniques is smart.

Want to know more about birth — check out these posts:

• YOUR Birth Priorities: How to make them clear
• How To Have A Natural Hospital Birth
• What a Birth Plan Can ACTUALLY Do For Your Birth?
• What do People Wish They Had Known About Before Birth?
• Alternatives to Hospital Birth Classes

Birth Often Doesn’t Go to Plan

So, you’re planning on an epidural, but labor goes fast and suddenly — you don’t have time to get one.

Let’s say your baby has been breech for months but suddenly you go into labor, you go into L&D and they’ve switched to head down. You’re having a vaginal delivery and it hurts.

I really think it’s important to prepare for all types of birth, because you really just don’t know what type you will end-up having. That includes:

• Cesarean (for real — I think everyone should have a basic understanding of it and what to expect)
• Inductions
• Non-medicated birth
• Epidurals

And yes, I do recommend a birth class that includes all of that (this one) — we’ll talk more about it in a bit — keep reading!

What Else Should a Birth Class Include?

I think most people envision a birth class that just includes you on the floor with your partner breathing… but that isn’t what the majority of a birth class should include.

In fact, like physical therapy — a birth class should teach you how to manage it, and encourage you guys to practice it on your own — not include hours of practicing it with you.

In fact, in a recent study they showed that most birth classes only included “planned” things — like the stages of labor and natural pain management — but did not included those unplanned things — and that did NOT do the couple any favors!

In addition to what we talked about above, your birth class should also cover:

• Common 3rd trimester testing, and what it can mean for your pregnancy moving forward (and making choices based on the results)
• How to labor at home for a while
• Common interventions in the hospital like 3 nurses running in and turning you
• How to know something is going wrong in your recovery and where to seek help

Most birth classes just don’t cover these things — honestly because they sometimes make you a more “difficult” patient to deal with at the hospital (not just going along with the doctor’s orders).

But also the people who teach people how to teach about birth don’t cover these things, and those people don’t tend to know much about them because it takes an expert to know about them. Frankly, someone like a nurse.

So, yes — I do recommend The Online Prenatal Class for Couples.

It does have a natural pain management bonus video that will give you lots of ideas and tricks to try for that.

It also goes over what to expect in labor, the stages of labor and the “natural progression” of labor (and how it may feel quite unnatural).

But it also goes over all those things we’re not thinking about — like I mentioned in here.

The reason it can do that is because it’s taught by a very capable labor and delivery nurse who really cuts down on fluff, and really just shares what you need to know.

The reality is that most people who are traumatized by their birth have it happen because they weren’t prepared to make choices in labor. They end-up feeling “bullied” by the labor staff when they could have easily learned to speak up for themselves.

Learning about birth isn’t hard, but it can’t be done just through random articles (although I’m glad you’re here), or watching a few social media posts — it needs to be purposeful. That’s why I recommend this class.

Can I also give a shout-out for a class that doesn’t think there is a right way to birth. You want one that is evidence-based, prepares you for whatever kind of birth you have, without the extra birth of guilt. No one needs that. This one definitely fits that bill.

Ok, so have you taken a class yet? Do you feel more prepared for all of this? Tell us in the comments!

The post Do You Need a Birth Class if You Plan to Get an Epidural appeared first on The Pregnancy Nurse®.

As a labor nurse for 20 years I definitely saw epidurals used right, and WRONG. I think some people think they just sleep til’ baby comes out, and while that is sometimes true there’s more to it than that. So, let’s get started on your complete guide to labor epidurals.

While we’re here, a reminder that while in the US the epidural is definitely the most popular form of pain management — but there are other options — happy to share those with you as well. This also talks about IV pain medicine and that is VERY much mis-understood so I’m here to clarify that too:

We’re gonna start at the very beginning. First off, a man and a woman love each other very much… Ok, maybe we’ll fast forward to when you’re actually in labor.

When can you get the epidural?

First off — to get an epidural you definitely have to actually be in labor (although, you can get an epidural prior to a version — but that’s a very different case). I will admit when I was a pregnant labor nurse, I was jealous of the epidurals. That sounded pretty darn nice. BUT you gotta be in labor to get one.

I really do recommend getting the epidural once you’re in pain, although some people do request the epidural before their induction starts. AND if they’re just going to break your water, a lot of people recommend getting the epidural before they break your water.

Frankly, I am still a fan of you having some pain (and promoting movement) until you feel like you’re ready for it — vs just getting the epidural in advance of the pain.

But, How Many CM Do You Need to Be to Get An Epidural? — is a question a lot of people ask. I will say that when I started in L&D it was very normal for providers to say that patients couldn’t get the epidural until 4 cm or something along those lines, but that isn’t really the case anymore.

Studies have shown that the epidural is best given when the patient wants it. If you’re really wanting to pick the best time for you, I’d recommend this post: The Best Time to Get an Epidural During Labor

While we’re here, talking about your hospital stay — have you thought about packing your bag? Grab my packing list right here:

Is it ever “too late” to get the epidural?

In a word, yes. But it’s complicated. I go into more in this post

What you really need to know is that on your first baby there is a very wide span of when you can get an epidural. Mostly because you likely have 1-2 hours of pushing ahead of you, and that is still a safe time to get an epidural.

However, on your second baby those last few centimeters can go much quicker and pushing time is very reduced. Often we say that about 7-8 centimeters is when you really need to decide on a 2+ baby.

Note: That would be a 2+ VAGINAL delivery — if you are having a VBAC with no prior vaginal deliveries it would be the same as first delivery.

Really quick — have you started your birth class? If not, there’s still time — I recommend this one!

How Is the Epidural Put In?

Ok, so I bet a LOT of you wonder how the epidural is put in. Totally normal. I actually go through the whole process with a doll, using common (less scary) household supplies to show you how in here:

But, I bet one of the questions most of you wonder is — How Bad Does the Epidural Hurt? << that post has tons of info, but most people think it’s actually less painful than the IV stick.

Pro Tip: You WILL need an IV to get an epidural (although it can be run as a saline lock until you request an epidural as long as you’re low-risk).

You may also wonder — who Administers an Epidural? Most often it’s an anesthesiologist, but it may be a CRNA (sort of like a nurse practitioner for anesthesiology). It’s important to know that it is NOT your OB — that isn’t their specialty, so it is given by another provider.

And, as a ANOTHER pro tip — you’re welcome to ask to speak with the anesthesiologist well before you want the epidural if you have questions to ask them. Many of them love to come in and have a conversation about risks and benefits with you before the pains get too much — so that’s something to consider as well.

There are a couple of types of epidurals — Epidural vs Spinal: Which is best for you? The reality is that it’s best to get whatever kind the provider giving you the epidural is good at. I just think it’s good info to have.

Now, if you’re really worried about the needle or the pain of the epidural I have a good podcast episode for you:

Tailoring Your Epidural to YOU

This is a real pro tip that not a lot of people talk about. You may have heard of the walking epidural…

but I gotta say that while MOST hospitals don’t provide a “walking epidural” there is actually a lot that we can learn from walking epidurals.

Mostly that the epidural can be tailored to what you need.

Most often the anesthesiologist will just ask us to set the epidural pump to a “rate” and then they leave (that rate being the same for everyone). However, if you’re feeling too numb or you’re feeling TOO MUCH you can ask just to change that rate. I like to think of that as a “starting” rate — and then we can adjust as needed (especially after you get a nap in for some energy).

The good news is that pump can go up and it can go down. Depending on your hospital you may need to speak with the anesthesiologist to change the rate — but that’s your right.

The real sweet spot of an epidural is when you’re still able to move, but only feeling about 20% of the pain. And you can really tailor that epidural to YOU!

If you, right now — are thinking, huh — I never knew that? I’m right there with you. I either had epidurals that left me in a lot of pain, or so numb I had no idea I even had legs — I couldn’t move them at ALL.

But, pro tips like tailoring your epidural to YOU are what can truly make your labor extra good. I learned so much in here — I think you will too! Tons more pro tips like this one in there!

Does Labor Still Hurt with an Epidural?

The thing is, as you tailor an epidural to what you need — there is likely going to be some pain.

And honestly, they really want you to be able to feel SOMETHING. That allows you to be able to move some in bed, and also get some feedback that baby is moving down the birth canal and when it’s time to push.

I do have a whole article on this:

However, labor has several stages, so it’s good to know what to expect as you advance through them (especially right at delivery) — I think you’ll find these articles helpful.

• Can You Feel the Baby Coming Out With the Epidural?
• Do You Feel the Ring of Fire With an Epidural

That being said, I always sort of wondered — What Does Having an Epidural Feel Like? << that post has tons of info, but it is very similar to how your leg feels when it’s fallen “asleep” — you just don’t get that pins and needles feeling as it “wakes” back up — it just stays asleep. Sort of numb.

It think it’s important to remember that the epidural isn’t designed to completely take the pain away. Because, this is the case — it’s important to remember that breathing is an important tool to have, to learn to relax even when it’s hurting. This is true both before the epidural and afterwards (and frankly, as you raise that sweet babe).

I think any good birth class should include breathing. This one has a whole natural pain management bonus video to help you learn both breathing and some other awesome techniques to help. I recommend everyone watch it — planning on an epidural or not.

That being said — I often see a LOT of gas-lighting from anesthesia that it’s “just pressure” that people are feeling — not pain. This is them, not really wanting to do their job….

What to do if your epidural doesn’t work?

If you’re feeling more pain then you’d prefer I’d 100% ask to see them (you may have to be insistant). I have a whole post on what to do if this is the case:

Ok, let’s get into the nitty gritty of the epidural:

How long will the epidural last?

A LOT of people wonder if they get the epidural too early, will it “run-out” before the baby is born? I answer that thoughly in this post:

The good news is that the epidural continuously pumps in similar to an IV pump. We just change the bag if it’s out of medication, and it keeps infusing.

They used to give epidurals with like large bunches of medication that would slowly wear-off — and that isn’t the case anymore (but you might hear those stories from your mom).

Now, the longer the epidural is in the more likely it is to have issues that cause it to not work — so, that is something to consider, but that’s up to your anesthesia team to help you troubleshoot if there is an issue (scroll up to that post on what to do if the epidural doesn’t work for more info on that).

Thinking that you’d prefer to wait as long as you can is a great thing to consider as you make your birth plan. I have a free printable here that gets you started on yours:

Epidural Side Effects

You might be wondering what the side effects might be. The most common side effects I have seen are:

• Shaking
• Itching
• Blood pressure dropping

I think it’s really important to know that these aren’t unusual at all (and for the blood pressure dropping one we attempt to stop it by giving you extra IV fluids in advance).

But, there are a few other ones that I talk about in this post:

As you can imagine some of these side effects can be upsetting when they just happen — but if you KNOW you may shake uncontrollably for a bit after the epidural you’re not freaking out when it happens, and you can even just nap through them (which often makes them disappear).

Pro Tip For Shaking In Labor: Stick out your tongue. I have no idea how this works but it often stops the shaking. The hard fact is that trying to “stop” the shaking often makes it worse so just “going with it” is sometimes your best bet if the tongue thing doesn’t work.

Honestly, labor is a lot like this — a LOT of it can be upsetting — but it doesn’t have to be when you’re prepared.

What to do WHEN You have the Epidural?

Most often the first action is to nap. You’ve been in pain and likely haven’t slept well for a while. A nap is also a great way to let your body relax and let baby to descend into your pelvis.

BUT once that nap is done (or at any point you wake-up) you want to MOVE.

Now, movement with the epidural does look different than the movement you might imagine if you didn’t have the epidural. There’s no lunging or slow-dancing with your husband to the pain.

This looks more like rotating in bed, and using supplies to help open your pelvis while you’re safely in bed. I have a whole post that gives tips to using movement with the epidural:

That post has some very important tips that help incorporate movement into your labor.

I can testify that this really DOES make a difference in helping baby to descend and you to progress towards a vaginal delivery (instead of a c-section).

The thing is, if you don’t know tips like this, often your nurse will take the easy road out and just let you sleep or stay in one position. However, just asking her to help you move ever 30 minutes while awake will awaken her to the fact that you want to move and help out — and I bet she’ll become the MacGyver of getting that baby to descend.

It’s also an awesome job for partners to help out with. They finally feel like they can do something and be really helpful to the process. Tips for both you AND your partner is what this class is full of. I think you’ll absolutely have your best labor if you take that class!

Post Delivery With the Epidural?

We turn the epidural off once they’re finished with the delivery and any repair that is necessary. It normally takes 1-2 hours for that to wear off, but I think it’s important to know that some people it takes a while longer (and some a bit shorter). But, I go into more detail into it with this post: How Long Does It Take for the Labor Epidural Anesthesia to Wear Off?

Back Pain After The Epidural?

Now, a lot of you may have heard that an epidural can cause long-term back problems:

That post reveals the fact that studies do not show an increase in back pain between those who got the epidural vs those who did not, long-term.

There is some short term bruising that you’d expect with a needle going in your back.

The reality is that pregnancy, labor and birth really cause our bodies a LOT of stress and I am 100% on board with making sure to get some physical therapy after birth to help our bodies adjust afterwards.

Want to know more postpartum tips — check out these posts:

• First Poop After Delivery: Make it less-hard (literally)
• Your Guide to Your Postpartum Plan with Free Template
• Self Care During Postpartum & Pregnancy
• C-Section Recovery: Tips You’ll Need
• Postpartum Essentials for a Great Recovery

What if you need a C-Section?

Ok, so you get the epidural, and then it turns out you need a cesarean section.

Most often they can just add new drugs to your existing epidural and make it work for a cesarean section.

Honestly, it’s one of the big perks of having an epidural in — if there’s an emergency, they can just dose it up extra, rather than having to put you to sleep.

And while that might sound better — I have a whole post on Cesarean Section Anesthesia that you’ll find helpful as to why we normally pick a spinal vs general anesthesia.

Avoiding the Epidural

Maybe you’re one of the ones who wants some info about the epidural, but you really don’t want to get one if you can avoid it.

Honestly, I think that’s smart. Any time you can avoid medical intervention, there are less risks overall. I have a few articles that might help you out on that:

• How To Have A Natural Hospital Birth
• Why Not to Get an Epidural: 10 Reasons to consider other pain management in labor
• What to Do If You Can’t Decide if You Want an Epidural or Not?

That last one is where most people are. I think they come-in thinking they would prefer not to, but aren’t sure how they’re going to move forward.

The good news, you really don’t have to decide all the things in advance. I think it’s smart to learn about them and know your options, but then take labor as it comes.

AND in case you’d like some reasons people DO get the epidural I have a post on that too.

Like I said — you want to know your options, and be prepared for what you might face, but also be flexible knowing you really don’t have all that much control over what will happen that day.

There are studies that show that most birth classes really only cover very normal things, but most don’t cover things that might go wrong, or how to navigate the pitfalls of birth.

In my experience, that’s true. My own birth class that I took with my first sort of painted labor in sunshine and rainbows, that were only brighter once you went home.

The reality is that you will maybe face things like:

• 3rd trimester testing that may have results that are different than you’d hoped
• Needing/wanting an induction
• Possibly needing a cesarean

The BEST news is that you have time to learn about these things — and I’m not saying that you need that 22 hour Saturday birth class marathon (ew, no). In The Online Prenatal Class for Couples you can learn in just a few hours what you need to know about navigating your own birth. And the best part is that your partner will also be on the same page with you (rather than you having to explain all of it to them as you’re making choices on your own).

In just three hours you can feel prepared and confident about your birth. Sounds pretty great, right? Come join me!

Oh, and as a bonus for joining while we already know so much about the epidural — use coupon code EPIDURAL to save 10% on the class!

The post Your Complete Guide to Epidurals in Labor: Everything You Need to Know appeared first on The Pregnancy Nurse®.

Before we get going, I want to remind you that there are a LOT of tips that help make your labor better. This one holds the tips you need from bump to bassinet.

This is part of my Complete Guide to Epidurals — so if you have more questions don’t miss that!

A Note on Movement With an Epidural

Every now and then I run across someone on social media talking about how you can still squat with an epidural… or even get out of bed. I want to be clear that at probably 95% of facilities they do NOT want you to get out of the bed with the epidural.

In fact, they will likely turn off the epidural and they find you out of bed…. It’s too much liability for them to keep running medication that’s meant to make you numb. If you want to know more about varying the amount of epidural you have going in — check out my post on the walking epidural.

I am a huge fan of having a bit less epidural medication to make sure you can incorporate movement more. I juts don’t want you to think that it’s going to look the same as someone who doesn’t have an epidural.

The Good News? Movement doesn’t really have to be squats or standing — even small movements, and changes in your pelvis can make big changes in how baby descends.

Want to know more about movement in labor– check out these posts:

• 3 Proven Labor Secrets You Don’t Want to Labor Without!
• YOUR Birth Priorities: How to make them clear
• Advocating For Yourself in Labor

Ok, let’s jump into my three tips:

Use the Bed

That labor bed has a lot of good options that can help you move your body into a variety of ways.

• The head can go up and down
• Side Rails can be used to prop pillows/balls on them
• Foot Pedals / stirrups can be used to place legs on
• Handles can be used to hold onto or prop supplies on (see more below)
• The bottom of the bed can move down
• Most hospitals have a “squat” bar that fits into the bottom of the bed

For instance, sometimes I’ll have the patient (with an epidural) sitting on the edge of the bed with the bottom of the bed down with her feet on it. I also have the squat bar set up that she can hold onto with her arms and make sure she’s steady on her bed.

It’s really close to a squat position. It’s definitely opening your hips in a similar way. But, it’s safe with an epidural!

Don’t forget to use the bed like origami — let it help you achieve the positions you want. That can be really helpful when you….

Add Supplies

Heads up! There may be affiliate links in here – I might earn a smidge with your click. No cost to you, just good vibes! Check my boring stuff for deets.

There’s lots of other “supplies” in the room which I have used to get patients into great labor positions.

My first couple of hospitals did NOT have peanut balls, so we often used other things in the room to achieve this. Judge away, it’s fine. I cleaned all the items before we used them….

Things I have used:

• Step Stools
• Doctor’s stool (usually at the bedside to put a foot on wtih something behind it to make sure it doesn’t move)
• The garbage (no jokes here)
• Pillows. Tons, and tons of pillows. and blankets — think princess and the pea.

Most hospitals now have a couple of things that are awesome to use as well (you can also bring your own if you’d like).

• Birthing ball (or yoga ball as the rest of the world calls it)
• Peanut ball (looks just like a peanut) – usually in varying sizes

Here is the big secret, are you ready for it:

Nurses are QUEENS at McGuyvering it. If you feel like you want to be in a specific position, talk to them about it.

Let’s say you want to do hands and knees…. but those legs are still pretty numb.

Nurses can use supplies to get you safely into that position.

I’ve used the peanut ball between their legs, with the indent allowing their belly to rest in that with their upper body resting on an inclined back of the bed.

Now, I want to be really clear that position is NOT comfortable for long. Your hips really start to feel painfully unstable after about 5 contractions, but the good news is that moving into that position for 20 minutes can really make a big difference!

SO, when your nurse is using other stuff in the room to help position you, don’t freak out. We’re doing that for your safety and comfort, it just may not always feel that way.

Understanding more about how the hospitals and nurses work can be a HUGE advantage as you go in for labor. I recommend this for learning more about it!

Partner Help

This is a HUGE tip for partners, and movement in general. If your partner is a willing participant in helping you to move it can make a BIG difference.

Reality: when you have an epidural, you’re heavy. As an RN when we’re hoisting human bodies and moving you for you it can really place a toll on our bodies (especially our backs). We usually try to get another nurses in there to help us to prevent us (and you) from getting hurt, but sometimes that’s not possible.

SO, when a partner is willing it helps a lot. And honestly — they feel a lot more engaged in the whole process when they ARE able to help out. Many really do want to do something — so this is something they can help with! If your partner wants more tips — I recommend this!

You don’t need previous experience. Moving people is very similar to moving other items, and shoving pillows in the right place is something every adult can do.

Also, if you do the big work, the nurse can fix the details after the big work is done.

So, having a willing partner who asks “how can I help” is one of the BIGGEST things you can do to move more during your labor.

I see some people online frustrated that their partner or family needed to help. In this instance, it’s not “necessary” — you’re safe without it. BUT when they are willing and able it can help a lot!

So, those are my three biggest tips for using movement when you have an epidural, but I do have one more…

Bonus Tips: Small Movements

Don’t feel like you have to do GIANT movements like hands and knees. Often we can get similar effects by using the birth ball or a large peanut ball and rotating you from side to side without the issues with your hips.

Even just being fully on your side, and then turning to more of a “tilt” can make a difference.

SO, don’t feel like it has to be big – small changes (even with the angle of your knees/hips) can help!

What About Sleep?

Great question. One of the BIGGEST benefits of an epidural is that it allows you to sleep as your baby descends into the birth canal.

I 100% recommend sleep. If you truly CAN sleep I think it’s one of the most productive things you can do. It helps your body relax and that includes your pelvis.

BUT in those spots where you wake-up (because hello — blood pressure cuff, and the nurse will still be in frequently) ask to turn. And again — you don’t need giant movements.

One of my favorite circuits to put patients through is left sims (that means all the way to your side almost onto your belly with your top leg up at a 90 degree angle), right sims, and Buddha (same pose as the guy). I can still let you sleep in Buddha but putting pillows next to the side rail to rest your head on.

So, if you CAN sleep do it. but if you’re not asleep I really want you moving at least every 30 minutes, if not more frequently (but I do think you want at least 5 contractions in every position).

What if you hate a position?

I will say that sometimes I put people in position and they are not fans initially. I always encourage them to try to make it at least 3 contractions in it.

Pro Tip: Sometimes a vaginal exam can really help us know what position might help baby descend better (not always, but sometimes). Be sure to get your nurse’s thoughts on what position they think would be best. They’re a wealth of info, but often don’t want to shove their opinion on you.

Of course, if they are suddenly feeling a lot of pressure I’ll check their cervix to see they’re ready to have a baby. I will say that is the goal of these positions — to get that baby into the birth canal, and make labor faster.

The other thing to consider is if your epidural is still working. If you are suddenly feeling contraction pain I would recommend my post on what to do if your epidural isn’t working (but the cliff notes is to have anesthesia come check you).

I will say that so many people think they’ll get an epidural and then labor will be sunshine and roses an that just isn’t the case. You may need to troubleshoot the epidural, you need to keep moving and there may be increased interventions you’ll need to understand with an epidural (like an IV bolus, increased turning etc).

We’ve talked a lot about how your family and nurse will help you in this process, but understanding the basics of birth is your job in this one. The best way to do that is to take a high quality birth class.

I recommend The Online Prenatal Class for Couples it:

• Takes just a few hours — so you don’t have to devote your life to it.
• Is taught by an expert — so you’re not missing anything important
• Is meant to help your partner — so you get a teammate, not just a cheerleader (including how they can help more during labor instead of just turning you).

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.

The post 3 Tips to Using Movement During Labor WITH an Epidural appeared first on The Pregnancy Nurse®.