Walking Epidurals
Mobile Epidurals: Transforming Labor One Step at a Time
When it comes to labor and birth, every mother's experience is as unique as the little one they’re waiting to meet. In the realm of pain management during childbirth, a new trend is making waves, promising to empower mothers with more control and mobility. Enter the mobile epidural, also affectionately known as the walking/mobile epidural. Let’s take a look at what mobile epidurals are, their benefits, and the risks involved, so you can make an informed decision about whether this option might be right for you (if it’s available in your hospital and what to do if it’s not).
A systematic review of the current evidence concluded
“Although no clear benefit was observed for mobilization in epidural labor, no detrimental effects were found either, so perinatal care providers should encourage mobilization if the laboring person so desires, throughout the entire childbirth process.”
Although the authors claim there is ‘no clear benefit’ - they later conclude that a mom is less likely to experience an instrumental birth…(forceps, vacuum). Seems like a very clear benefit to those moms! I would love to see some qualitative evidence on this aspect as every mom I’ve spoken to about their experiences with the walking epidural has been very positive. It’s not just about the physical mechanics of birth but how empowered and in control they feel.
Women’s Experiences of a Mobile Epidural
In this video Lisa Campbell shares her experience of the walking epidural at the Coombe Hospital in Dublin, Ireland.
What is a Mobile Epidural?
A mobile epidural is a form of pain relief used during labor that is less invasive than a traditional epidural. It involves the administration of anesthetic drugs through a catheter placed in the epidural space of the spine, but at lower dosages. This allows for effective pain relief while maintaining some degree of sensation and movement in the lower limbs.
The Benefits of Going Mobile
1. Enhanced Mobility:
The most celebrated advantage of a mobile epidural is the ability to move around during labor. Traditional epidurals typically limit mothers to the bed because of numbness in the lower body. However, with a mobile epidural, you can walk, shift positions, and use gravity to help guide your baby down the birth canal, which can be a game changer resulting in more efficient uterine action (shorter pushing stage).
2. More Control Over Your Labor Experience:
Being able to move freely can provide not only physical benefits but also emotional ones. Laboring women often feel more in control of their childbirth experience when they can adjust their body position to what feels right for them, potentially leading to a more positive labor and birth.
3. Potential for a Faster Labor:
There’s some evidence suggesting that the ability to move and adjust positions can help speed up labor. Movement helps the baby to position itself optimally for birth, which can reduce the duration of labor and the need for additional interventions.
4. Decreased Need for Additional Interventions:
As mentioned above with increased control and mobility, studies suggest there is less need for interventions like forceps or vacuum deliveries, which are more common in deliveries where the mother is confined to a bed.
Considering Potential Tradeoffs
While the benefits are compelling, it’s important to consider some of the tradeoffs associated with mobile epidurals:
1. Incomplete Pain Relief:
Because the dose of anesthesia is lower, some women may find that a mobile epidural doesn’t provide the same level of pain relief as a traditional epidural. This can be a significant drawback for those who have a low pain threshold. If you’re also having Syntocinon/Pitocin to induce/progress your labor the low dose epidural may not give you enough pain management.
2. Risk of Falling:
Although rare, there’s a potential risk of falling if you choose to walk during labor with a mobile epidural or you might just feel a bit wobbly on your feet. Hospitals will typically take precautions such as requiring assistance when you move, but it’s something to be aware of when you’re moving.
3. Limited Availability:
Not all hospitals offer mobile epidurals, and not all practitioners are trained to administer them. Availability can be a significant barrier for some mothers who are interested in this option.
4. It Might Not Be Suitable for Everyone:
Certain medical conditions or the specifics of your labor might mean that a mobile epidural isn’t the best option for you. It’s essential to discuss your medical history and labor plan with your healthcare provider.
Making Your Choice
Choosing the right pain management strategy during labor is a deeply personal decision. If you’re considering a mobile epidural, discuss it with your healthcare provider to thoroughly understand the potential impacts on your specific circumstances. Like any aspect of birth, the most important thing is to find what works best for you and your baby, stacking the odds in your favor of having a safe and positive birth experience.
Empower yourself with knowledge and choose the path that aligns with your desires and needs for your birth experience.
Resources:
Influence of Laboring People's Mobility and Positional Changes on Birth Outcomes in Low-Dose Epidural Analgesia Labor: A Systematic Review with Meta-Analysis
https://onlinelibrary.wiley.com/doi/full/10.1111/jmwh.13446
