Latest / The Birth Lounge Podcast / Ep. 497: Before You Get an Epidural: 5 Things to Know About Timing, Positions, and Your Anesthesiologist

Transcript

Ep. 497: Before You Get an Epidural: 5 Things to Know About Timing, Positions, and Your Anesthesiologist · The Birth Lounge Podcast

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  A lot of hospitals will want to lay you flat.
• 0:02
  You'll have your epidural administered, and then they're gonna want you to lay flat in the bed.
• 0:07
  And I highly, highly recommend that you consider your other options, which would be not laying flat and instead doing what I call the rotisserie chicken.
• 0:55
  Hello, and welcome back to another episode of the Birth Lounge Podcast.
• Did you know that doctors and nurses and actually midwives and your anesthesia team, your entire care team in the medical system actually practices simulation births? Did you know that? They go through and they practice different situations, different deliveries, different positions, different tools that they have, different scenarios that might happen in labor.
• And this allows them to bridge that gap between actually knowing what to do and being able to do it in the moment, in that high intensity, high pressure environment there's actually quite a bit of data out there that says the more that our healthcare providers are provided this environment that they can practice these skills, the more confident they are in actually doing those skills when the time comes, which actually obviously gives us better results for both moms and babies.
• So it's like a natural thing.
• It's the natural next step to getting better results.
• And then I started to think, what if you could practice a simulation? What if you could actually practice going through labor before you were actually giving birth? That way, you could show up with that same confidence that your, your doctors and your nurses and your midwives and your anesthesiologists get to show up to your birth with.
• But this is your birth, so how come everybody in the room is prepared and has done simulations about this moment except you? I didn't like that at all.
• I really want everyone to come with the same preparedness so that we can continue to center you in this process.
• And so I created a place that you can actually run through a birth simulation.
• It is the Labor Live Challenge, and it's a live simulation of three days of what your birth could actually be like.
• It's based on a real birth.
• And so for three days, you're gonna get these prompts that step you through each stage of labor and decisions that you're gonna encounter conversations that you're gonna need to have with your healthcare team and choices you're gonna need to make.
• And I'm gonna help you understand how do you take the knowledge that you've gotten in childbirth education and all the reels you've watched and all the podcasts you've listened to and the books that you've read and the friends that you've asked, how do you take all the things that you've learned and actually make it work for you in labor and apply it? 'Cause remember, you're gonna be in labor, so you are gonna want this to be a muscle that you have just worked so incredibly intentionally that it's a reflex when you get into labor You will know what you want, how to advocate for it, how to be flexible if things need to change, and what your options are if things pivot away from your original birth plan The challenge starts on November 1.
• You can go to joinlaborlive.com
• to sign up.
• I'm super stoked for this.
• We do this inside of The Birth Lounge in my closed paid community, and it has done so well, so I wanted to bring it out to everybody.
• Joinlaborlive.com,
• and I will see you at the Labor Live Challenge on November 1.
• All right, before you agree to an epidural, these are the things that you need to know.
• Number one, the skill of your anesthesiologist matters a ton.
• I have learned a lot from the Instagram account, safepartum.
• She is an OB anesthesiologist, and so she does a lot of education around epidurals and the medications that are used in epidurals and different diagnoses that you might see.
• And I have learned a ton.
• Now, her content is primarily for medical providers, but I have learned a ton as a consumer of understanding the medications and the way that epidurals work and the way that they are administered.
• And I just think she has a really beautiful way of laying things out.
• So one of the things I have learned from her is that the skill of an anesthesiologist really matters, and the reason being is everyone's body is very different.
• Obviously, duh, we know that.
• Anesthesiologists are well-trained on that.
• However, as people's bodies change throughout the decades, if you have not kept up with newer research, then you're actually still operating on old research about everything, the chronic disease in America, body shapes and sizes, health conditions, different medications.
• Dr.
• Vibha does a really great job of educating around consent as well, which is something else that I really love from her page.
• So the takeaway there is that ask questions before you are actually in labor.
• So take the time in your prenatals to ask these questions to your OB and ask about the anesthesiology team and protocols and policies at the hospital that you are giving birth at Tagging along to policies and protocols and procedures is number two.
• A lot of hospitals will want to lay you flat.
• You'll have your epidural administered, and then they're gonna want you to lay flat in the bed.
• And I highly, highly recommend that you consider your other options, which would be not laying flat and instead doing what I call the rotisserie chicken.
• So you are going to make sure that you're actually rotating your body.
• So instead of being flat on your back, you could get on hands or knees.
• You could lie on your left side, and then you could get on your right side, and then you might sit up for a little bit.
• Think about your epidural as a medication that is gonna, like, trickle down your spine and be able to give you that relief that you want, okay? But the thing about an epidural is that it's always gonna follow gravity.
• So if you lay over on your left side, your left hip is down, your left hip is about to go to sleep.
• Because that's down, gravity's gonna follow, okay? And so one of the things with an epidural, in order to reduce your chances, it's not gonna avoid it altogether and it's not like a surefire thing, but it certainly sways the cards in your favor, that is to keep your body rotating so that medication can, as evenly as possible, disperse amongst your body so that you can get that relief that you were hoping to get by getting the epidural Number three, every hospital has their own cocktail of medications that they use in the epidural, and sometimes within the same hospital, different anesthesiologists will have what they are trained in and comfortable and most commonly use.
• If that's important to you to know, if you have allergies, if you have concerns, if you have any individual factors that need to be discussed with your team, I would bring that up in your prenatal appointment, and I would also have your doctor make a note in your chart.
• You could also request a meeting specifically with anesthesia, either the team, the head of anesthesia, or an anesthesiologist representative on the team.
• The other thing that you might want to bring up concerning the cocktail of medications that are used in an epidural is the effects that you are trying to have.
• Another really great thing to mention is exactly what your goals are.
• Are you hoping for total relief? Are you hoping for just to take the edge off, but you still want to have as much control over your legs and feet as possible? Are you trying to get higher up on your belly, or is the pain primarily lower in your belly and in your pelvis region? If that matters to you, if you want to have those discussions with your anesthesiologist team, hopefully your anesthesiologist has the skill to kind of give you somewhat of a tailored experience based on the things you're telling them and the goals that you have Do keep in mind that it is a medical procedure, so there's only so much flexibility and, like, customizing that you can do with an epidural.
• But if your provider, if your anesthesiologist is just giving you a general epidural, but you have specific goals, you have questions about what you're going to be getting, you're a little nervous about the procedure, you want to share why you're getting the epidural and exactly where you're feeling the pain, then your anesthesiologist should be not only comfortable, but kind of eager to hear those things.
• It, it should give them more information on how they can give you a better placement of your epidural.
• That's another thing I have learned from Dr.
• Vibha over on Instagram Wanna know something absolutely disgusting? Did you know that most coffee on the market is filled with mold and toxins that can drain your energy and stress out your adrenals? No wonder so many of us feel jittery, anxious, exhausted, and tearful after we have that little pick-me-up coffee.
• Honestly, this is one of the biggest reasons that about six to eight months before I got pregnant, I switched to Purity Coffee, and I did a lot, and I mean a lot, of research on coffee brands to find the best one.
• I landed on Purity Coffee very confidently because it's third-party tested and certified mold-free.
• It's also regeneratively farmed.
• It's also pesticide-free, USDA certified organic, and sustainably sourced, which means the people who are growing and picking your coffee are actually paid an actual living wage, and they provide full traceability, which means you can check them on this.
• The other thing that I love is that when Purity Coffee is roasted, it's not burnt to a freaking crisp where you lose all the health benefits.
• And if you're like, "Well, what health benefits?" There are actually chlorogenic acids that are actually healthy for us.
• You know how you kinda find the studies every now and then that are like, "Oh, a cup of coffee a day keeps the doctor away"? Well, it's true, but it's not true for all coffees.
• It actually matters what kind of coffee you drink, and that's why I love Purity Coffee.
• I can tell you that within one week of switching from, mm, let's call it Smar Smugs coffee to Purity Coffee, I felt less anxious, I was more productive during the day, the brain fog went away, I slept better at night, and all those jitters that used to come in the early morning after I had my coffee were completely nonexistent.
• Not to mention, it genuinely tastes delicious.
• You guys know that I would never, ever, ever share a product that I didn't really love and really use.
• Also, if you follow me on Instagram, you know that I tag them all the time because it is such great, high-quality coffee, and it is delicious.
• Head to puritycoffee.com
• and get your health-focused coffee without compromise, and you can use code HeHe, H-E H-E, to save some money.
• Oh, and if you're looking for what I drink, I love the Ease.
• It's my favorite.
• I drink it every single day, and I also have Flow for the days that I feel like I might not necessarily need a whole dark roast.
• Oh, and one other thing.
• Not only do they have whole bean coffee that you can grind up and use in a regular coffee pot, but they also have pods too, which is what I use in my Keurig every single morning.
• One more time, head to puritycoffee.com,
• use code HeHe at checkout, that's H-E H-E, and get your best coffee now that's completely mold-free and actually gonna help you have health benefits.
• Cheers.
• The next one may shock you, but it is to ask for the epidural before you actually need it.
• A lot of people will wait, wait, wait, wait, and by the time they actually need it, they're like, "I need it now."
• And a lot of times, depending on the hospital, the epidural is not available right this moment.
• Sometimes it is, and those are like chef's kiss type of situations.
• But if you're at a hospital that only has one or two anesthesiologists on staff, maybe that anesthesiologist, again, depending on the hospital, they may not even have to be on the grounds at all times.
• They can go home.
• And so if you need an epidural, your team is actually gonna have to call an anesthesiologist, and they'll have to come in and then prep everything, and then administer your epidural.
• Sometimes you get in a situation where you're having a baby at a really busy time, and your hospital may have a couple anesthesiologists on staff, on grounds, and they're all busy.
• They are all in a surgery already, and so you have to wait, right? You want to be having this conversation preemptively.
• Now, here's what I will tell you, especially if you have goals of an unmedicated birth and you're, you've been thinking this whole time, "Well, I'll just wait until I can't take it anymore."
• There is a way to go about this, okay? I think that as you start to have these ramped-up contractions, being honest with your support people, your doula, your partner, your nurse if they are supportive of your birth goals and they are trained in unmedicated birth, these people can help you remain unmedicated, but it's already on their radar we might be moving in the direction of an epidural.
• That is helpful information for everybody.
• If you're having shame or guilt around it, just know that an epidural is a tool.
• It's neither good nor bad.
• It's neutral.
• It is for you to use in a situation that you need it, and there are many a situations that we might need an epidural.
• You get to decide whether you want to use it as pain relief in your birth or not.
• And so when we wait until we're absolutely at the just the brink of it, if it's not available, that can actually leave you with some birth trauma.
• I want to avoid all of these situations because I want you to walk away with no birth trauma.
• That's my goal.
• So any of the birth trauma that we can reverse engineer and extract different pieces and replace them so that we can avoid birth trauma, I want to do that for you.
• I've been a doula for 10 years.
• I've been in a lot of rooms, a lot of births with a lot of women and a lot of preferences and a lot of different outcomes.
• And so I can help you know how to arrange certain decisions, how to think about certain choices, how to have specific conversations so that you can avoid the things that you don't want and you can have the things that you do want, and therefore all of the risk of that unknowing piece of labor, that unpredictability, we have now controlled the pieces that we can control.
• There are pieces that aren't going to be controlled, but that's nature.
• That's normal.
• That's labor.
• That's the human experience.
• That's part of the birth process.
• You having to release and let go.
• But for the things that we can control, we have controlled.
• Now, one little note about choosing the epidural is that I think it's really important for you to get super clear on why you want an epidural and in which scenarios you would be okay with one, and that is something to communicate to your care team.
• The other tidbit I will tell you is that if it still is like, eh, maybe, I guess I could get it now or I could go a little bit longer, you should go a little bit longer.
• When you get the epidural, it should be a, "Hell, yes, I want this," but not quite a, "I've waited too late, I need it ASAP or I am not going to be able to make it any further."
• You can see how this is a spectrum of experiences and decisions, and so I want you to be able to understand where do you fall on this spectrum and based on the scenario that you're in birth, you may be on different places of that spectrum of scenarios and decisions that come along with that.
• I want you to be prepared for all of those when you go into labor Which leads me right into number five, you need to practice.
• You need to think about these different scenarios.
• You need to understand why would you want an epidural, which situations would you be okay with getting an epidural, and which situations are you absolutely not okay and you don't want your staff to mention it, you don't want your partner to suggest it, you don't want to hear the word epidural.
• You feel confident in yourself that when you want the epidural, when you want pain relief, when you're starting to feel like these contractions are too strong for what you are wanting to experience, you will bring that up to your team.
• You can ask them to trust you with that, and then you can trust them to honor your boundary of not speaking about it, not bringing it up, not suggesting it, and holding that space for you to just be uncomfortable, but be in control of your birth experience right there in that moment.
• And you know what? That's the hardest part for a lot of people, is watching a laboring woman be in those sensations, be in pain, if you like to use that word, be in that experience if you don't like to use the word pain.
• There's so many things you can use to describe labor, but watching someone labor and knowing that you can only do so much, that at the end of the day, the person having that baby is the only person that can actually go through this experience and deal with it, that is so powerful, but it's really uncomfortable to sit and witness that if you are not prepared to do so So this practice is not just for you.
• You need to be practicing different scenarios, and then you need to be communicating that with your partner, and they need to be practicing supporting you That practice is crucial because you have so much education that has come from your childbirth education, you have so much knowledge, but you are unsure if you're actually going to be able to apply it in the moment, in your labor, when it counts.
• Are you gonna be able to say the thing, whether it's no, or I wanna talk about alternatives, or I'd like the time to think about this, I want some time to discuss this.
• Are you gonna actually be able to say that? Are you gonna be able to access the information that you've read on social media and all the posts that you have saved? Are you gonna actually be able to flip through all of that Rolodex of information and truly bring out what you need to say? Or are you gonna just freeze? Are you just gonna go with the room, go with the flow? Someone is telling you what they want you to do, and you just freeze.
• you're not sure.
• You can't think of anything.
• You almost black out.
• You're just like, "Yeah, yeah, yeah, whatever," because you're so uncomfortable.
• You have so much anxiety about speaking up for yourself because you've never practiced.
• That is why that practice is crucial, and I built exactly what you need to be able to practice.
• It's called Labor Live.
• It's a three-day challenge.
• It is going to give you updates in real time from a real labor and let you practice.
• At the end of it, you're gonna get this birth confidence score.
• Your birth confidence score is going to tell you what you answer, where you hesitated, and where you still have knowledge gaps that you need to fill in order to go into birth confidently knowing that you can advocate for yourself and having all the information to do that.
• But remember, having information is different than being prepared.
• Information does not equal preparation.
• You want to be informed, but you also have to have the action in order to put that information to use, and that action is self-advocacy Labor Live is the place that you get to practice that muscle of speaking up, of asking questions, asking for alternatives, and then confidently sharing what you'd like to do in your birth.
• The challenge starts on the first of the month.
• I can't wait to see you there.
• The link to join is below Thank you so much for tuning in today.
• I love hanging out with you, and it is an honor to be your go-to gal when it comes to preparing for your baby.
• If you've enjoyed today's episode, please leave a five-star review and tell others why they should be listening to the Birth Lounge Podcast too.
• You deserve to have a birth that you love with a provider that values your autonomy and respects informed consent without all the trauma that you so commonly hear about on social media.
• New episodes air every Wednesday and Friday.
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• I'm HeHe, and this is the Birth Lounge Podcast.