From Giving Birth with Confidence.

• Seeking relief from labor pain without drugs protects your baby and your body from injury, helps labor progress and facilitates breastfeeding, bonding and other postpartum adjustments.
• Having an epidural requires an IV, continuous EFM, restricted mobility and it relaxes vaginal muscles. All of these factors can prolong labor.
• Epidural use increases the risk of instrument delivery and may increase the risk of cesarean.
• Epidural use raises the risk of fever and postpartum separation to rule out infection.
• Epidural drugs do reach your baby. Both of these factors can make breastfeeding initiation harder.

You May Need an Epidural If...

• Your labor is very long and difficult and you need to rest.
• You have a cesarean.
• Your blood pressure is very high.
• You don’t have good labor support.
• Your birth site restricts your ability to find comfort in other ways.
• Your fear of labor pain is extremely intense.

How to Avoid Unnecessary Epidural Use

• Labor at home as long as possible.
• Choose your caregiver and birth site carefully.
• Discuss your desires with your caregiver.
• Make sure you have excellent labor support.
• Use all the non-drug comfort measures you can.
• Be patient and remember that your body knows how to give birth.

How to Navigate Labor if You Have an Epidural

• Use a wide variety of other comfort measures for as long as possible, so you don’t need an epidural for your entire labor.
• Let your epidural wear off before pushing (“labor down”).
• Ask your helpers to massage your hands and feet and help you stay as active as possible.
• Be patient with your breastfeeding baby and spend as much skin-to-skin time together as possible.
• If your baby doesn’t latch well at first or you have other breastfeeding problems because of your epidural, ask hospital staff (preferably a lactation consultant) to help you express colostrum and feed it with a small cup or eyedropper.
• To avoid aggravating breastfeeding problems, tell the hospital staff not to feed your baby formula or use bottles or pacifiers.