When I thought about labor, I wasn't concerned. But what no one told me was that sometimes epidurals don't work.

By Rachel Morgan Cautero
Yeji Kim

I thought childbirth would be easy. (Are you laughing yet? Because postpartum me is definitely laughing.) But all signs pointed to things going smoothly. I got pregnant after about six weeks of trying. My pregnancy was relatively routine. I was one of those women who really enjoyed being pregnant, often cradling my baby bump or rubbing it absentmindedly while I worked or watched TV.

So when I thought about labor, I wasn't concerned. My plan was to wait for contractions to kick in, get an epidural, push for a few moments and—voila!—my new baby would arrive. But what no one—not my OB-GYN, anesthesiologist, or the nurses at the hospital—told me was that sometimes epidurals don't work.

My son was nearly nine pounds at birth. He was also in the posterior position, also called sunny side up, which means instead of facing my spine during labor, he was facing my abdomen. This meant my labor, despite receiving an epidural, was incredibly painful. I could feel every last thing, from each contraction to the midwife checking to see where the baby's head was in between pushes, to yes, even those lovely post-birth stitches.

I can vividly recall desperately asking the anesthesiologist if he was done yet, mid-epidural, as I was bent over on the edge of the hospital bed with a giant needle in my back, trying to avoid moving while contractions ripped through my body just minutes apart. I was in so much pain that I couldn't talk, and was only able to emit deep, primal noises that eventually resulted in me losing my voice. Since I had gotten the epidural, I wasn't able to get up and move, either, which only made the pain and intense pressure worse. And since I had planned on a pain-free birth, I hadn't researched any other pain management methods.

As it turns out, my experience wasn't completely out of the ordinary. Around 61% of women get an epidural or spinal anesthesia for pain management during labor—and research shows epidurals don't work 12 percent of the time. That's usually due to the placement of the epidural, the anatomy of a woman's central nervous system (yes, really), or labor progressing more quickly than anticipated.

And if moms-to-be choosing an epidural are like I was, they probably aren't doing a lot of research or preparation for other pain management techniques. Why? Because they don't think they have to. After all, epidurals are frequently referred to as the "gold standard" of pain management. So why would there be any reason for first-time mothers to doubt their effectiveness?

Well, experts say it's a good idea to be prepared for this worst-case scenario.

"I tell all my clients, even if you want an epidural, it's good to know pain coping strategies because I know that epidurals aren't foolproof," says Carrie Murphy, a certified birth doula in Albuquerque, New Mexico. "There are also other situations that could happen around getting an epidural—your labor could be too fast to get an epidural, [or] you could have to wait a really long time to get an epidural."

Her recommendations for other pain management techniques include nitrous oxide, hydrotherapy (immersion via bath or shower), massage, position changes or movement, using a birth ball, visualization, hypnosis, the use of a TENS machine, which delivers small electrical impulses to help treat pain, and even IV pain medication.

After 12 hours of labor, my son made his entrance into the world. He was big, healthy, and boasted a head full of red hair. Thanks to the help of a peanut ball (which I contemplated throwing across the room more than once), he was able to turn during labor and I delivered vaginally.

A year later, I finally feel like I've both recovered from birth, both physically and emotionally. My husband and I are even thinking about baby No. 2. This time, I'm contemplating skipping the epidural altogether and hiring a doula to be in the hospital with us during labor and delivery. I'm also going to thoroughly research other pain management techniques to use in case I need them.

If I'm being honest, I hesitated even writing this piece. My son is healthy, my body is back to normal, and comparatively speaking, my birth experience wasn't that bad. Do I really have anything to complain about? But that's exactly the kind of thinking new mothers should avoid, Murphy says.

"Birth trauma is incredibly common, but it's not something that is really PC to talk about," she says. "We have this motherhood martyrdom complex where as long as the baby is healthy, everything is fine. You're just supposed to soldier on."

But, as she adds, "many women come out of birth with a lot of trauma." That's why we need to be able to talk about our experiences in a real way.

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