Expert: Dr Ian Jackson - please note UK based - 8/8/2007

Question
Hi Dr. Jackson,
I am 39 weeks pregnant, about to have my third child.  I delivered twins vaginally two years ago.  I was given an epidural which I found to be rather excruciating.  The anesthesiologist performing the epidural kept commenting on how swollen I was and was upset at how much I was bleeding during the procedure.  (I had pre-eclampsia.)  It took two wide-eyed nurses to hold me down.  They even commented after he was done that he probably hit a nerve.  To throw salt in my wounds, the epidural ran out one hour before the first twin was born and I was refused any more medication.  The second twin was born three hours later.  The pain of childbirth was nothing compared to the pain of the epidural.  My question is, are epidurals always that painful or did I have an unusual experience?  I really would rather have pain medication than be a frontier woman and tough it out.

Answer
Hi Lori
The answer is that epidurals are not always painful. In the past we always asked our mothers how painful it was by comparing it to the IV that was inserted into their arms. Over 90% always said the IV was more painful but there was always a few who found the epidural more painful but very very few ever thought it was excruciating.
So I suspect it was a mix of circumstances, the oedema (swelling) you had plus the fact you had twins making feeling your back and positioning difficult making the procedure more difficult linked perhaps to a relatively inexperienced anaesthetist. I do not understand why it ran out - as we just continue to top up the epidural either with a pump (which can be refilled) or with bolus doses.
So bottom line..
Epidurals are not always as bad as your experience - indeed I would say it is rare for them to be like that, I would make it clear to your doctors how bad your experience was the last time and that you would like an epidural but do not wish to experience anything like that again!
Best of luck for what should be a very happy day.
Dr Ian Jackson