Epidurals – When To Say Yes

Over the last five decades or so the use of an epidural during the labor and delivery process has become far more widespread. In fact, many expectant mothers expect as a matter of course that they will get one at some point during labor. Like any procedure though there are pros and cons associated with epidural use and its important that Mums to be understand what these are before their due date arrives.

What is an Epidural?

Epidural anesthesia is designed to block pain to a certain area of the body, providing pain relief without the need for complete anesthesia. The idea behind giving a woman in labor such a treatment is that it will provide her with analgesia – pain relief – with anesthesia which would numb her body completely and leave it void of sensation. An epidural injection blocks nerve signals to the lower half of a woman’s body which decreases sensation and the amount of pain she can actually feel.

What Medications are in an Epidural?

There can be several medications delivered as in an epidural. The medications belong to a  class of drugs known as local anesthetics and include bupivacaine, chloroprocaine, or lidocaine. These days these local anesthetics are often combined by are often delivered in combination with narcotics,like fentanyl and sufentanil, so that the dose of anesthetic can be smaller so the effects on the progress of labor and Mum’s overall awareness of it are as minimal as possible.

How is an Epidural Given?

Before the epidural injection is given an IV of simple fluids is started to make sure Mum stays hydrated. The epidural injection itself is usually given by an anesthesiologist, or a nurse-anesthetist but some OB doctors prefer to place them themselves. After the area is cleaned and numbed a needle is inserted into the area that surrounds the spinal cord in Mum’s lower back. A small catheter is then inserted so that the epidural drugs can be administered over a period of time. Once this is in place the needle is removed.

The Pros of an Epidural

There is no doubt that for many women in labor there are a number of benefits to be gained from opting for an epidural:

• If yours is a long labor an epidural can help you rest and regain some of your energy.

• An epidural will provide you with pain relief without preventing you from being an alert and active participant in the birthing process.

• The pain relief that an epidural provides usually means that a Mum has a more positive “birth experience”

• If you are delivering your baby by c section an epidural will make sure you do not feel the operative pain and discomfort but will allow you to remain awake to witness the moment he or she arrives.

• Many mums to be attend classes while they are pregnant that are designed to teach them all kinds of breathing techniques and ‘coping techniques” to help them deal with the labor process. In the case of a long labor though sometimes those techniques just fail, however hard you are trying and panic and fear and even just plain old exhausting sets in. an epidural and the pain relief it provides can allow you to “regroup”.

The Cons of an Epidural

• In some cases when an epidural is administered Mum’s blood pressure take a sudden drop. You will be constantly monitored for this the drop may mean you will need more medications.

• After the epidural is in place your movement will be limited. Usually you will be told to remain lying on your side and you will be hooked up to a fetal heart monitor that will keep constant track of Baby’s heartbeat.

• Epidurals can slow your labor down. In some cases this leads to a change in the birthing plan as Pitocin ( a drug that induces and encourages labor) or in some cases a c section becomes necessary if baby shows signs of stress.

• Some women experience some unpleasant side effects from the epidural while they are still in labor. these often include feeling very cold, a ringing sensation in the ears or nausea.

• For a few hours after you have give birth your lower body will still feel rather numb, meaning that you will not be able to walk unaided and urinating might become difficult.

• On rare occasions, in less than 1% of women, a leakage of spinal fluid causes a very severe headache. When this occurs a procedure called a blood patch has to be performed to relieve the pain.

The Effects of an Epidural on Baby

Their baby’s health and safety is a big concern for Mums in labor so that they are worried about what opting for an epidural could do to their baby is normal. While the baby is still in utero there is a possibility that their heart rate can become erratic which is why Mum is hooked up to thee fetal heart monitor. If it remains erratic or slows then often a c section is ordered to minimize the stress on the baby and the risk of total heart failure.

After the baby is born it is not yet clear if the epidural has any long term effects. a few studies have suggested that babies whose Mum did have an epidural have more difficulty “latching on” when they begin breastfeeding but there is no conclusive evidence that that is really the case.

Choosing an Epidural

Providing there is not a complication that prevents it the decision whether to have an epidural or not should be Mum’s. Some doctors disapprove of them, preferring “natural childbirth” but they are not the ones actually in labor. More often though it is Mum’s family and friends who cause the confusion.

For example, your partner may want you to have an epidural to see you out of pain but you may not, or you may have a family member who feels strongly that medications should not be used. In the end though it is a decision for you to make with the doctors and nurses who are attending to you and there really is no “right” or “wrong” just the right, and safe, choice for you. It often makes the decision easier if you discuss the issue of epidurals with your gynae or obstetrician before hand as well.

Epidural is one of the many pain relief methods available for the mother to choose from. Stay tuned for future articles by subscribing to the newsletter.