Why did no one tell me that epidurals don't always work?

When I was a young girl I asked my mother if giving birth was horribly painful. She told me that it was, but it was such a beautiful experience that you forget the pain.

I remembered my mother’s words when I became pregnant with my first child at 35, and hoped they would turn out to be true. As my husband and I prepared for our daughter’s birth, we read books and attended birthing classes, and the more I learned, the more skeptical I became about the idea that beauty could defeat pain. Birth may be beautiful, but I was still going to be pushing a head and shoulders through my vagina.

I decided that if the pain became too much for me to bear, I would get an epidural. I had read numerous stories about women having natural births with no anaesthesia, but knew that I wasn’t that kind of woman. To be honest, this woman who was about to give birth to a baby was a bit of a baby herself. An epidural would be my ace in a hole, my saving grace; a way to a pain-free birth during which my husband and I would gaze into each other’s eyes and shed joyful tears (OK, maybe I was being overly hopeful). 

Exactly one month before my due date, at 6 a.m., my water broke. My husband and I rushed to the hospital, and because contractions hadn’t yet begun, I was put on a drip of pitocin to induce labour. For the next few hours I stood naked in a hot shower while my husband read the paper. When a contraction rolled over me, he’d come hold my hand. But the contractions were mild and weren’t getting closer together.

We returned to my room, and my husband noticed that the drug wasn’t dripping properly; he told a nurse, who literally flicked the vial with her finger. Within minutes the contractions got markedly worse. I was soon screaming for pain medicine, and it seemed like hours (it was actually only minutes) before I was given some kind of narcotic to help take the edge off.

Ten hours later I was dilated enough to give birth and the pain was so severe that I became delirious. At one point, I told everyone that I was done and had to leave. When they told me I wasn’t going anywhere, I cussed out everyone in the room. But then like a beacon of hope the doctor said it was time for the epidural. Though my mind was far away, swimming through the pain, I was coherent enough to remember that I would have to sit very still when the needle was inserted into my spine.

My husband and the nurse held me as I leaned over on the edge of the bed and the anaesthesiologist performed the procedure. Everything became a bit of a blur after that—the pain from the needle rivalled the pain of contractions—but there was a problem. The doctor said he’d have to do the procedure a second time. I never found out what the problem was, but in the end the epidural didn’t work, and I was told we’d have to proceed without it. The second attempt at inserting the catheter hurt so much and was so traumatic that I didn’t have time to reflect on what this would mean. All I could think of was the pain I was in.

This was not an eventuality I was prepared for. In all my months of reading and classes, I never heard of an epidural not working. But, according to the World Federation of Societies of Anaesthesiologists, labour epidurals have a failure rate of nine to 12 percent. However, failure is still not standardly defined, so the rates vary. Reasons for epidurals not working can include catheter placement, patient expectations and low pain thresholds.

Perhaps the last one could apply to me. But it was not the case that the epidural worked a little bit. It didn’t work, full stop. What happened over the next few hours was bloody and excruciating—I cried and I screamed, and I begged my husband to make it stop. My daughter crowned for over an hour—each time my husband told me he could see her head and that it was almost over, her head disappeared again. It was emotionally draining to have my hopes continually dashed, and I felt progressively more defeated.

After nearly 18 hours of labour, the doctor said she was going to use forceps and would need to do an episiotomy. I was frankly terrified at the prospect, but also desperate to have the ordeal over with. In any case, I had no choice in the matter. The pain that followed was more severe than anything I had ever experienced, like my body was literally being ripped apart. But it was thankfully quick. Finally, at 10 minutes before midnight, our perfect daughter came into this world.

The next morning, I awoke and longed to see my girl, who was in the hospital nursery. When I tried to get out of bed, pain shot through my labia, which was stitched and swollen (let’s just say that despite the episiotomy, I still tore). Every movement brought more pain, but I was determined to get to my daughter. I slowly put on slippers and a robe and inched down the hallway. At the door to the nursery I asked the nurse where my daughter was, and she pointed to one of the bassinets.

As I reached in and scooped my daughter up in my arms, I thought of my mother’s words; she was partially right. It’s not that one forgets the pain, it’s that every moment of pain is worth it. I do wish I had known in advance that my epidural might not work. Perhaps I would have been better prepared, perhaps not.

What I do know is that though my daughter’s birth was traumatic for me, and I imagine for her, I would do it all again.

Jaimie Seaton is the mother of two teenagers and has been a journalist for over 20 years. She has lived and worked all over the world, including Bangkok, where she was the country correspondent for Newsweek. Her reported stories and essays have been published in a variety of publications, including the Washington Post, the Guardian, the Independent, Pacific Standard, CNBC, Buzzfeed, CNN, Glamour, Marie Claire, Good Housekeeping and O, The Oprah Magazine. She lives in New England. Follow her @jaimieseaton