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If I get an epidural, I won't feel anything. Can I just lie there peacefully and relax while the baby just slides out on it's own or do I have to push?
The pushing part seems so violent, and I'm worried about tearing as well.

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    possible duplicate of Risks and benefits of natural birth – anongoodnurse Feb 3 '15 at 6:50
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    Niv, welcome to Parenting.se. Did anyone actually tell you that about an epidural? If so, please take whatever they say with a grain of salt. Also, this is quite similar to your previous question about natural childbirth. If you have a different question, can you ask about your concern specifically? Otherwise the answers will cover much of the same material. Thanks! – anongoodnurse Feb 3 '15 at 6:52
  • An epidural is far more likely to result in tearing than other methods of pain control. It is, however, the only way to completely avoid pain. – Stephen Feb 19 '15 at 6:29
  • Also, bear in mind that pushing is only a very small part of the labor process. Most of labor does not require you to push. Pushing only occurs during the very last stages of labor. – Stephen Feb 19 '15 at 6:32
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Epidurals are a regional anesthesia, also referred to as local anesthesia. This means that it blocks pain, but not all sensation.

Epidurals are not a muscle relaxant, and for good reason! Childbirth requires the use of pelvic floor muscles (and some others, such as those used to involuntarily to dilate the cervix).

However, some women still have trouble effectively feeling the pressure that indicates the need to push, requiring additional assistance from those performing the delivery (such as doctors, midwives, and nurses).

It's very important to push, and the epidural may make it harder to do so properly. Research shows that epidurals can actually increase labor time and pushing stage time. The fact that pushing stage time can increase during epidurals shows that, yes, pushing is still required with epidurals.

Furthermore, the baby will definitely not slide out "on it's own." The same research above that indicates epidurals can increase labor times also show that they can lead to an increased chance of assisted vaginal birth. Assisted vaginal birth refers to the use of objects like vacuum suction devices and forceps. This is evidence that an newborn can't just naturally make it's way out of the mother. The mother needs to push properly or external tools become necessary. It may even require a Cesarean section. Your healthcare provider should be able to give you some literature about the risks and benefits of the epidural, and what methods they use in case of complications.

Pushing and labor is often displayed in media as being incredibly painful. When we see women giving birth on TV or in movies they're almost always shown as: 1) "Hormonally" angry 2) Screaming and crying 3) Demanding of drugs.

This is not an accurate depiction of most deliveries. It's merely what makes for easy TV (but not good, in my opinion). This poor portrayal of labor and delivery often increases the fear and anxiety in mothers, which plays negatively into the Fear-Tension-Pain cycle. As a mother anticipates more severe pain than what she might actually endure she becomes more tense, which may actually increase her sensitivity to pain or cause certain activities to be more painful, as she's using tense muscles to do them.

It's important to have a proper expectation of the delivery process, and to be aware of your available pain-management techniques. If you're planning on having an epidural, you likely won't have to worry about much pain during delivery.

As far as perineal tearing goes, research shows that it's better to have natural tearing than to have an episiotomy. Natural tearing tends to heal more quickly and be less severe (as the body naturally tears only as much as necessary). The cuts from a doctor for an episiotomy can be too long, or increase the chances of excessive tearing.

It's important to understand that perineal tearing happens based on the size of your newborn's head or body, not how much you push. As the name implies, it's a natural process. If a tear happens and it causes too much discomfort, it can be treated with pain medication.

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    +1 for mentioning the largely unrealistic TV birth scenes. I'd like to add that the Hollywood-typical "laying on the back in a hospital bed, perhaps even with the feet in the air" position is not exactly the best choice... Gravity is your friend at childbirth and unless you had an epidural (which renderes your legs practically useless) you might discuss other, more upright or bent forward positions with your midwife/nurse/doctor. – Stephie Feb 3 '15 at 19:46
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    My epidurals made the contractions mild - I could feel them, but they were not painful. It helped me push at the right time. I also went to a seminar (offered by they hospital) by a PT with specialization in 'vaginal' muscles (forgot correct medical term), and it was somewhat silly but helpful. Some of it was about not 'over pushing', but push and relax, push relax with contractions. The nurse/midwife/doctor at the birth can be very helpful, I had a stellar nurse with my first, made all the difference. – Ida Feb 3 '15 at 23:43
  • My wife had an epidural, but was still able to do some of the gravity assisted positions (basically squatting). She couldn't walk exactly, but she could move enough to get up on the bed in a better position to get an assist from gravity - ended up with about an hour of pushing for our first, but that seems normal. – Joe Feb 4 '15 at 15:35
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Epidural anesthesia article on wikipedia

I think your doctor will be able to confirm what they will use.

Epidural analgesia is just for pain relief. You will feel the pressure and the compulsion to push but you will not be able to feel most of the pain. How much you need to push will depend on the size and position of the baby and whether or not the head is engaged.

Epidural anesthesia will not only take away the pain but will also take away muscle control this means you will not be able to push.

As for the violence and tearing, most first time mothers opting for natural delivery experience a perineal tearing. Again, your doctor may decide to perform an episiotomy to prevent tearing. You can reduce the risk to some extent by performing regular perineal massage.

Hope that helps.

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    +1 for perineal massage to stretch the passage before labor. – Acire Feb 3 '15 at 11:48
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    Please not that the episiotomy is your choice! Be informed about them. They are not always needed! – Brian Robbins Feb 3 '15 at 15:20

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