When Should I Get An Epidural?

This question is one I get frequently from new moms wanting to make the best decision possible about getting an epidural. This is an easy and tough question all at the same time, so I will share my general guidelines from what I have seen in the hospital.

For first births I recommend waiting as long as possible simply because first births can take awhile so if you get it too early you could end up lying down for hours and prolonging your labor. If you are looking for dilation, I would recommend waiting until you are at least a good 4 cm dilated before getting an epidural for the same reason. If you are able to wait until 6 or 7 cm this is ideal because you will be getting it right around transition, which is the hardest part of labor, but is generally quick compared to the rest.

What if you are having trouble dilating? These recommendations are thrown out the window. If you are having trouble dilating, it is likely that your body is struggling to relax to dilate. In this case, an epidural may be very beneficial in helping you to dilate. This is not a, "I haven't made any progress in an hour" recommendation. This is a, "I have been stuck at 5 cm for a few hours" recommendation, because the first part of labor can be long and slow and can take quite some time to get to 5 or 6 cm, especially if it is your first.

Trouble dilating could also indicate there is some kind of complication, and having an epidural may be a good idea in case a c-section becomes necessary.

If you are being induced, then it does not matter as much when you get an epidural because your labor is being done for you. The question you need to ask yourself is how long to I want to be stuck in bed?

For subsequent births, there is a little more ambiguity. Your first birth will likely give you a good indication of when you should get an epidural with your next.

As with everything else, pray about when the best time to get an epidural is because everyone is different. These are my recommendations based on years of experience. Often times you will know if and when you need it, even with your first.

How did you decide when to get your epidural?

What Should I Put In My Birth Plan?

This is completely up to you. I have seen very detailed birth plans with very specific instructions for any and all circumstances and those that have the bare minimum. From what I've seen I would discourage the overly detailed birth plan and if you are going to take the time to write one be thoughtful and do not write one that would just cover standard practice.

So what should you include?

If you are not wanting any medication, write that you do not want to be asked about pain medication and that you will let them know if you need something. Know that they have to tell you your options, so allow them to tell you your options, but then you can nicely say, "Thank you for letting me know, I will tell you if you need anything."

If you do not want an episiotomy, make that clear.

Feel free to list your room preferences such as lighting, music, temperature, etc.

If you have strong feelings on induction or breaking water include them in your birth plan.

Write down any preferences for what you would like to do during labor and pushing.

Include anything for newborn care that is different than what is standard practice, such as not wanting them to have they eye ointment or the vitamin K shot.

Write if you are wanting them to breastfeed only or desiring formula.

Write if you want your baby boy circumcised or not.

These are the basic things you can include. As with other things be kind and gracious in how you approach it and know that things can go differently than expected.

Here and here you can find two types of check off birth plans. If you have any good resources for these please share them below.

What do you put on your birth plans?

What Is A Birth Plan? Do I Need One?

A birth plan is a document that tells your healthcare providers what your preferences for labor, delivery and newborn care are. You can pull check off lists from the internet. Two different ones I have found are here and here. There are many out there and sometimes the hospital you are delivering at will give you a generic one to fill out if you so desire.

You can also write your own after deciding what your preferences are. If you decide to write your own be gracious in how you write it.

This document is not legally binding and will not hold up in court if something is done outside of your birth plan.

It is up to you if you want to write one or not. Some people find this helpful to communicate what their expectations are to others. You may find it easier to stick to your plan if it is written down. This is not needed, but can be beneficial.

Do you write out a birth plan?