If the woman does eventually have an epidural in her labour, there are some support strategies that she and her partner or support people can use to minimise its potential side effects and contribute to making the use of it a positive experience.
Some support strategies can include:
Lying on your side
Emptying your bladder
Cooling the woman
Delay having the epidural
Delay pushing and let the epidural wear off
Keep supporting her
Be aware of her positioning
Negotiate for time
Lying on your side. It is important that the woman lies (or sits supported) on her side (right or left) after she has an epidural. This is presuming she is not walking around with a narcotic epidural. Lying on the side avoids further lowering of the blood pressure through compression of the major blood vessels lying behind the heavy uterus (known as 'aorto-caval compression').
Lying on the side also encourages the baby's head to rotate around from a posterior to a more favourable anterior position. Usually the opposite side the baby is lying on is best for this, but bear in mind it is also good to change the women's position to the other side periodically. If the woman has some strength in her legs then kneeling over some pillows or a beanbag is ideal (at least for short periods if possible).
If you need to lie on your back to have a vaginal examination or a catheter inserted into the bladder, lie with a small pillow under one side of the back to 'tilt' you to one side. This will help avoid compressing these blood vessels.
Emptying your bladder. Try to remember to empty your bladder before the epidural is inserted and attempt to do so every 1 to 2 hours after it is inserted. Ask to try to urinate on your own first if a catheter is being proposed. You may or may not be successful but it is worth trying. Some caregivers recommend catheters routinely, as it is possible to have some nerve damage if the bladder becomes overfull. This is discussed in depth in