Remaining active with an epidural

Epidurals certainly have their place in labour and there are two schools of thought on why there is a slightly increased risk of either an instrumental delivery or a caesarean section.

Firstly, are you in need of a higher form of pain relief because of the possibility your baby has got into a difficult position such as back to back. This is where the baby’s spine is resting upon yours and his face is looking towards your tummy.   In some cases, this can cause complications due to the baby being unable to tuck the head and chin down enabling easier passage through the birth canal.

It can also cause significant back pain and draw the labour out… So, If the baby is in an awkward position, would you have required assistance with the delivery in the first place?

Or, the second school of thought is, are you at an increased risk of an instrumental delivery or caesarean section because you have opted for an epidural and, due to lack of mobility and gravity, things have potentially slowed down.  You may hear this referred to as ‘slow progress’ and mum’s still get exhausted!

Pushing the baby out can also have its difficulties when an epidural is on board. On occasion, is may be necessary for your midwife to provide some ‘direct pushing’.   Directed pushing requires women to take a deep breath, hold it to the count of ten and push as hard as possible. Another breath is taken, held and the pushing begins again. The midwife may also place a finger in the opening of the vagina to check you are pushing in the right place.  Baby’s passage through the birth canal is one of negotiation and movement can sometimes be key!

So, the jury is out and unfortunately there is a lot of conflicting advice with little scientific evidence to suggest either to be correct or justifiable.

This is where here at The Naked Midwives we come in…

We are currently in the process of raising awareness of all of the above by starting the ….




We are very passionate about our teaching and creating positive birth for all regardless of the mode of delivery. It’s important to feel you remain in control of your labour and birth and make the right informed decisions at the right time.

Following an epidural, you will find you are comfortable and hopefully pain free. Your baby will continue to feel the effects of labour, however, don’t panic…although babies do get tired, they are developed to cope with labour and have plenty of reserves on board.   This is why if you do opt for an epidural you will be continuously monitored.

As stated before, the mechanics of labour and birth can be complex and unpredictable, especially if you haven’t had a baby before.   Epidurals certainly have their place in maternity care and it’s saddening as both a woman (who has had an epidural) and a midwife to hear women say they feel they have failed when they choose to have an epidural.

We highlight this because if your expectations of labour are idealistic then this is where the sense of failure can overcome you!

If you are well informed with a realistic outlook and an open mind then an epidural could work really well for you, as long as you remain active and in control of your labour; midwives don’t deliver babies…women do!

Throughout the years, epidurals have moved on greatly and are managed much more efficiently so from the perspective of the midwife………. why hasn’t our care of them?

Unfortunately, we still see women on labour ward, semi-recumbent in a bed when an epidural is in situ. This is what we at The Naked Midwives are trying to change.

The equipment that we use is much more technological now, for instance the beds on labour ward. In most units the beds are now more like transformers!    You can achieve a more upright position by simple adapting the bed. Gravity is really important so let’s facilitate that.

In addition, a narrowed pelvic outlet is another potential difficulty that we can overcome by the use of a ‘peanut birthing ball’. This is a tool we have introduced to maternity units within the area, in the hope that it encourages both women and midwives to keep active in labour especially in circumstances when an epidural is the chosen form of pain relief. The ‘peanut birthing ball’ is as you would think; and the shape of a peanut. It is used for many different things, from assisting baby into a good position in the last few weeks of pregnancy and throughout labour and birth.

Its shape is key and is able to keep the pelvic outlet open ensuring babies have the maximum amount of space to negotiate the pelvis and descend further into the birth canal.

We see time and time again, a woman comfortable with an epidural clock watching until the next vaginal examination to see what progress has been made.

Unfortunately, the majority of these women will have been semi-recumbent, with little movement and a narrowed pelvic outlet. All thing’s we know can hinder progress of the labour.

This is why both good education and keeping actively involved in your labour is so important! Ask the midwife to adapt the bed to aid with gravity, discuss your pelvic outlet, use a peanut ball, change position at regular intervals and then see what progress you have made.

Hopefully you will be seeing a lot more of our campaign to ‘keep active with an epidural’ in the near future.  Its something we are very passionate about and truly believe it could make a real difference to both women’s experiences and maternity care in the whole.

Look out for us and look into a ‘peanut birthing ball’!


The Cranny, 43 Queens Road, Mudeford, Dorset.  BH23 3HH

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