Never heard of an epidural decision tree? Here’s one

Our takeaways:

1. Epidural has its well-known pros and cons. At the end of the day, it’s a personal decision and every mom should feel very comfortable with whatever she decided.
2. A decision tree can be useful in the epidural decision-making process once you list out all the criteria that matter to you and/or your baby.

Historically, my pain tolerance is known to be zero (if not negative). I still remember the story my mom told me about how the ENTIRE hospital could hear me screaming when they need to stitch my forehead after a daycare accident. So, I have to admit that pain relief is on the top of my list to figure out before giving birth. (Or more precisely, even before getting pregnant).

What is Epidural? What are the good and bad of it?

Of course, the first option that popped out during my research was the popular epidural. It is considered the most effective local pain relief option. And apparently, more than two-thirds of women in the US delivering at hospitals choose it. The most attractive part of it, to me, was it makes the dilation part of labor painless or of little pain. And since the drug goes directly into your epidural space in your spine, rather than your bloodstream, your baby will not be drugged. Sounds too good to be true? Well, this question led me to further research.

Among my findings, there are some well-known side effects, such as postdural puncture headache, increased chance of maternal fever, and greater use of instruments (forceps/vacuum in delivery). Also, there are some commonly mis-attributed side effects that are actually lacking evidence. For example, epidural doesn’t increase the overall C-section rate or the chances of long-term back pain. However, I did find that epidural might impact my other preference to give birth in water. According to What to Expect When You’re Expecting (chapter 11), you won’t be able to labor/deliver in water if you have an epidural. I guess that makes sense just physically to prevent water from getting into your spine? I made a note to myself to ask my OB.

Are there other pain relief options than Epidural?

Oh yeah, plenty of them! Here’s a summary table I’ve made:

There are also natural (i.e: Lamaze) or CAM (Complementary and Alternative Medicine) options such as acupuncture, and massage, but I’m not sure if it will work for me (remember that my pain tolerance is negative to zero) so I skipped them above.

So back to make the decision: Epidural or not?

I found that a decision tree should be the most logical way to go about it given all the facts that I have collected. Green is the path I feel most comfortable about at this moment but who knows if this is going to change as it approaches the due date (I heard that’s common?).

If you want to borrow this tree, make sure to use it with caution (you might have other criteria you want to consider) and consult with your professional health care provider.

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