Photo: Bryan Mason on Flickr

The majority of people who give birth in the United States have an epidural. It’s a common choice, and one that no person should be ashamed of. We’re lucky to be living in an age where families can have the intention to birth without pain medications or interventions—physiologic birth—or have the intention of taking advantage of modern medical pain relief. I’m sure the generations of women who came before us would have loved the myriad of options we have at our disposal! I don’t judge anyone for their choices—it’s your body and your birth, after all.

That said, I often hear people say things like “My birth plan is to get an epidural.” While it’s awesome to know that you want that pain relief during a hospital birth, I always recommend that people remain open to other forms of pain relief and comfort measures. Why? Well, getting an epidural isn’t always a cut-and-dried plan….so it’s good to have some backup options just in case the epidural doesn’t work out as expected.

Here are a few reasons why that “epidural or bust” plan might not be foolproof:

Precipitous labor: It’s unlikely, but occasionally even first-time moms will have a very fast labor where things happen too quickly to get an epidural. In that instance, it can be helpful to know breathing and relaxation techniques or other ways to cope.

Long wait times:  If you come to the hospital in active labor (what’s generally recommended), it can take a while in triage to get you checked in and into a birthing room. You won’t be able to get an epidural until you have a nurse assigned to you and are settled in a room. This could be as much as an hour or more. In addition, most hospitals have a dedicated anesthesiologist who works on the labor and delivery floor, but occasionally things are very busy and he or she can’t get to your room because they are doing something else (like doing a surgery or administering or checking on other patients with epidurals). Having other options to turn to during this time can make the wait for the epidural much more bearable!

The epidural might not work: It’s very rare—less than 1% of epidurals, according to this piece of literature—but occasionally epidurals don’t “work.” In this case, the medical team will often replace it and try again, but there’s still a chance that you might not get the relief you were hoping for.

You’re not medically eligible for an epidural: This is also pretty rare, but can apply to people who have had scoliosis or people who are on blood thinners. You can discuss your personal medical situation with your provider before labor and learn if this applies to you. But if you know you’re not a candidate for an epidural, having other ways to make labor more pleasant will certainly help!

Even if everything goes swimmingly with a planned epidural, you’ll likely still feel some discomfort during your labor, either at home before you get to your birthplace or while waiting. Knowing some options to cope can make this part easier and more pleasant.

As much as we dream and hope and plan, we can’t know what’s going to happen during our births. Birth is, by its nature, unpredictable. So it’s important to give yourself the tools (and the team!) to cope with whatever might happen during your labor.  Even if you know that you want to go the epidural route, learning about—and using!—alternative comfort measures like massage, hydrotherapy (the use of water), relaxation, breathing, visualization, movement, TENS, and other techniques can be incredibly useful—not to mention empowering!!—for both you and your birth partner. Knowing that you were informed, in control, and using your resources can go a long way towards helping you have lasting positive feelings about your birth.