on epidurals

one of our friends just gave birth a few weeks ago.. she tried going into normal delivery with epidural but eventually ended up having a CS..

and a few more weeks before that, another friend gave birth through vaginal delivery without using any painkillers.. (yikes!) for 36 hours!

just thinking of these deliveries scares me *sigh*

and as if im not already freaked out enough, i got this information regarding epidurals from babycenter.com

• An epidural provides a route for very effective pain relief that can be used throughout your labor.

• The anesthesiologist or nurse anesthetist can control the effects by adjusting the type, amount, and strength of the medication. This is important, because as your labor progresses and your baby moves farther down into your birth canal, the dose you've been getting might no longer cover the pain, or you might suddenly have pain in a different area.

• Since the effect of the medication is localized, you'll be awake and alert during labor and birth. And, because you're pain-free, you can rest if you want (or even sleep!) as your cervix dilates. As a result, you may have more energy when it comes time to push.

• Unlike with systemic narcotics, only a tiny amount of medication reaches your baby.

• Once the epidural's in place, it can be used to provide anesthesia if you need a c-section or if you're having your tubes tied after delivery.

• You have to stay in an awkward position for ten to 15 minutes while the epidural is put in, and then wait another five to 20 minutes before the medication takes full effect. This may seem like a minor inconvenience, though, when the tradeoff is hours of pain relief.

• Depending on the type and amount of medication you're getting, you may lose some sensation in your legs and be unable to stand. Sometimes, particularly in early labor, so little anesthetic is needed to make you comfortable that you have normal strength and sensation in your legs and can move around without difficulty. (This is called a "walking epidural.") Still, many practitioners and hospitals won't allow you to get out of bed once you've had an epidural, whether you think you can walk or not.

• An epidural requires that you have an IV, frequent blood-pressure monitoring, and continuous fetal monitoring.

• An epidural can slow your labor, in which case you may need Pitocin to get it back on track.

• An epidural often makes the pushing stage of labor longer. The loss of sensation in your lower body weakens your bearing-down reflex, which can make it harder for you to push your baby out. You may want to have the epidural dose lowered while you're pushing so you can participate more actively in your baby's delivery — but it may take time for the pain medication to wear off enough that you can feel what you're doing, and there's no evidence that reducing the epidural dose actually shortens this stage of labor

• Having an epidural makes it more likely that you'll have a vacuum extraction or forceps delivery, which in turn increases your risk for serious lacerations.

• In some cases, an epidural provides spotty pain relief. This can happen because of variations in anatomy from one woman to the next or if the medication doesn't manage to bathe all of your spinal nerves as it spreads through your epidural space. The catheter can also "drift" slightly, making pain relief spotty after starting out fine. (If you notice that you're starting to have pain in certain places, ask for the anesthesiologist or nurse anesthetist to be paged so your dose can be adjusted or your catheter reinserted.)

• The drugs used in your epidural may temporarily lower your blood pressure, reducing blood flow to your baby, which in turn slows his heart rate. (This is treated with fluids and sometimes medication.)

• Narcotics delivered through an epidural can cause itchiness, particularly in your face. They may also bring on nausea — though this is less likely with an epidural than from systemic medication, and some women feel nauseated and throw up during labor even without pain medication.

• Anesthetics delivered through an epidural can make it more difficult to tell when you need to pee. Also, if you can't pee into a bedpan (which for many people is harder than letting go on a toilet), you may need to be catheterized.

• An epidural raises your risk of running a fever in labor. No one knows exactly why this happens, but one theory is that you pant and sweat less (because you're not in pain), so it's harder for your body to dissipate heat generated by labor. It doesn't boost your or your baby's odds of getting an infection — but since it's unclear at first whether the fever is from the epidural or from an infection, you and your baby could wind up getting unnecessary antibiotics.

• Epidurals are associated with a higher rate of babies in the posterior or "face-up" position at delivery. Women whose babies are face-up have longer labors, tend to need Pitocin more often, and have a significantly higher rates of c-sections. (There's controversy, though, over whether having an epidural actually contributes to babies ending up in this position or other factors are at work.)

• In one in 100 women, an epidural causes a bad headache that may last for days. (You can reduce the risk of headache by lying as still as possible while the needle is being placed.)

• In very rare cases, an epidural affects your breathing, and in extremely rare cases it causes nerve injury or infection.

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i guess ive to have a long discussion with my OB regarding our delivery options..