In Jessie James Decker‘s new book, Just Jesse, the country singer traces some of her most meaningful life experiences. And, as the mother of three revealed in a new interview, the most difficult chapter to write was the one in which she details the experience of giving birth to her daughter Vivianne (now four) after her epidural failed.
“I thought I was going to get to the hospital and push and plop, she was going to be out. I didn’t know I was going to be in labor for so long and throwing up between every single contraction,” she told Us Weekly. “The epidural didn’t take. I felt everything.”
Most of the time, an epidural goes smoothly. But there are situations that make it more difficult to get right.
As SELF wrote previously, an epidural is pain-blocking procedure during which medication is injected into a small space outside the spinal column via a catheter. Once it’s in, the medication can affect the nerves that are responsible for sending signals related to pain. As a result, the lower half of your body is numb and you don’t feel pain—or that’s how it’s supposed to go, at least. For the record, “the vast majority of patients will get the comfort they need,” Siu Fung (Will) Chan, M.D., assistant professor of anesthesiology and pain medicine at the University of Cincinnati, tells SELF.
However, because anesthesiologists can’t see inside you to make sure they’re inserting the catheter into the right spot, there’s a chance that it won’t be right on target. Everyone’s body is a little different, and it’s possible for the needle to simply not be in the right spot or to go a little to the left or right, Dr. Chan explains. When the needle is pointed a little more to one side than the other, you’ll likely feel numb on that side of your body, but not the other.
“Even when everything is said and done, there’s no way to know in the epidural space where the needle will end up,” Dr. Chan says. And, as you might expect, it’s pretty hard to sit still while you’re in labor (fair), which can also make insertion difficult, Dr. Chan explains.
In certain situations, the catheter may be in the right place, but just not deep enough. So, when the patient moves during labor, it can get pulled out, Medhat Mikhael, M.D., pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., tells SELF. “In that case, the medication would work initially and then stop working,” Dr. Mikhael says.
If something like this does happen to you, there are ways to get things back on track.
At first, the anesthesiologist may test to see if you’re getting relief by putting a dose of local anesthetic in the catheter, Dr. Mikhael says. “If the patient feels a little bit of numbness, you know you have it in the right spot,” he explains. “But if you inject some medication and the patient feels like nothing has changed, you know the catheter is not in the epidural space.”
If the epidural is in but you’re not feeling any pain relief or only getting relief on one side, the anesthesiologist may try pulling the needle back a little to see if that can correct things, Dr. Mikhael says. And if that doesn’t work, they may also try removing the needle completely and starting all over again—provided you’re not ready to push, Dr. Chan says.
Once you’re at the point in your labor where you’re ready to push the baby out, in some cases, the anesthesiologist can do what’s known as a combined spinal epidural or a “walking epidural,” Dr. Chan says, which combines a single shot of anesthesia with the continuous analgesia of the epidural. But, sometimes, they just may not be able to do anything in time.
Most importantly, don’t hesitate to make sure the people caring for you during labor know what you’re feeling—or if you’re feeling way too much.