There have been many studies looking at the impact of epidural anesthesia on childbearing, from the possibility of temporarily delaying the labor process (making it longer)  to interfering with the newborn’s ability to suckle at the breast after birth.

It is well known that a mother’s physical movement during reduces the amount of time she is in labor as it hastens the process.  By using positions such as standing, sitting, rocking, squatting, sitting on a Birthing Ball, walking and leaning, laboring mothers also help the babies complete the series of movements necessary to exit the mother’s body. Upright positions are known to enhance labor as they all use gravity to have the baby’s head settle down on the cervix and increase effacement (thinning) or dilating (opening).  Frequent position changes of about every 20 minutes also encourages the baby to move down in the pelvis more rapidly!

With an epidural, the laboring mother’s movements are dramatically limited.  For some mothers with heavy epidurals, the movement is restricted to only rolling from side to side.  Even going to the bathroom is restricted and a urinary catheter may be put in the bladder.  Mothers with heavy epidurals often have a lower rate of spontaneous (without the use of forceps or vacuum) vaginal births.

For mothers with lighter epidurals, sitting in the bed and perhaps even getting on hands and knees in the bed (with support!) may be an option.  Mother’s with posterior babies benefit greatly from being on hands and knees, as this pulls the baby back into the sling that the belly muscles make, and then tilting the pelvis back and forth (the Pelvic Rock exercise), causes posterior babies to turn anterior 85-90% of the time.

One of the most interesting medical studies recently published looked at

1,562 women to evaluate changes in baby position during labor by using ultrasounds.

Of babies that were posterior late in labor, many were posterior at birth. This demonstrates strong association of epidural with posterior position at birth and represents a mechanism that validates the lower rate of spontaneous vaginal birth consistently observed with epidural.

Consider all of your options and alternatives when choosing medications.  Make informed decisions and this will help you have the best birth possible.

Resources:

Lieberman E, Davidson K, Lee-Parritz A, Shearer E. Changes in fetal position during labor and their association with epidural analgesia. Obstet Gynecol. 2005 May;105(5 Pt 1):974-82