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Birth & More | Pain Relief

Epidural: Everything You Need To Know

Labour pains are unpredictable and very different from woman to woman. While a few lucky ladies might give birth in no time at all, others struggle with painful contractions for hours and hours before even moving on to the stage where they can start pushing. Back in the days a natural birth was the one and only option, but today pain relief is available to the majority of women worldwide – the most common being an epidural. Although many still choose to give birth without medication, more and more opt to let an epidural help them through the worst of it. Let’s take a look at frequently asked questions related to epidural anaesthetic pain relief in order to try and make your decision slightly easier. Keep in mind, however, that even if you plan to manage your labour pain without medication, you should prepare yourself for the fact that you might need it should an emergency rise.

epidural

What is an epidural?
An epidural is a local anaesthetic that numbs the nerves in the part of your body that feels pain during labour. With an epidural you remain alert because the medication doesn’t travel through your blood, which in turn means it won’t affect your baby. The aim of an epidural anaesthetic should be pain relief rather than complete numbness and lack of feeling; a low dose epidural can leave you with enough feeling to push with your contractions and even allow you to walk around during labour.

How is an epidural administered?
When you have an epidural you will be asked you to curl forwards and sit completely still while a small area on your lower back will be numbed by injecting a local anaesthetic. It’s vital that you remain motionless in order to prevent problems and for the needle to be successfully inserted in the correct way – increasing the effect of the epidural. The needle is inserted into the area surrounding the spinal cord in your lower back, and a small tube is threaded through the needle into the epidural space. The needle is then removed, which allows medication to be given through the tube whenever necessary. The tube will be taped to your back to prevent it from slipping, and the frequency and amount of medication can now be easily adjusted.

What are the different types of epidural?
There are a few different varieties of an epidural – mainly based on the dosages as well as the combinations of medication used. A traditional or regular epidural sees a combination of narcotic and anesthesia given through the tube and into the epidural place whenever necessary throughout labour and birth. A variation of the traditional epidural is a patient controlled epidural, where you are able to control the doses you receive by the push of a button and don’t need a doctor or midwife’s assistance. A walking epidural is a light epidural which allows you to move more freely as it only numbs the nerves of your abdomen, while a spinal epidural is an initial dose of narcotic, anesthetic or a combination of the two – injected beneath the outermost membrane covering the spinal cord, and inward of the epidural space. The spinal epidural unfortunately wears off quicker than a regular epidural and there is no tube in place that allows for more medication to be injected.

Is it ever too late to have an epidural?
Most doctors or midwives prefer their patients’ contractions to have an established pattern and the cervix to be dilated to around 4-6 centimetres before they administer an epidural. Theoretically, after this stage, it’s never too late. However it might be more difficult to stay still during the administration of the epidural in late labour – when your contractions are coming closer together. And if the epidural is requested when you have started pushing, you might have to lie on your side rather than sitting up as the baby will have moved down towards the birth canal already. Always keep in mind that as soon as you have started pushing, it shouldn’t be too long before your baby is born. So if you choose to have an epidural at this stage it might not even come into effect before your baby is born. On the same note, if your labour progresses quickly and your cervix is already 8cm when you arrive at the hospital, there might simply not be enough time to administer the epidural – it takes about 15-20 minute to administer, and another 15-20 minutes for the medication to come into effect. Also, if you haven’t decided on having one in advance, but change your mind at the last minute, there might not be an anesthetist available straight away. The best advice we can give you is simply to be prepared to put your trust in and listen to your doctor or midwife, as they are experts and will know what’s best for you in any specific situation.

What are the advantages of having an epidural?
Let’s take a look at a few advantages of having an epidural anaesthetic:

  • Because the pain medication doesn’t go directly into your bloodstream, your baby is unlikely to be affected.
  • If you are going through a long labour, the epidural allows you to rest more and to prepare yourself for the birth.
  • An epidural will manage your labour pain effectively and allow for less discomfort.
  • Pain relief means you can breathe more easily and there is less stress on your heart.
  • Because an epidural is a local anaesthetic you can still be alert and awake to experience the birth of your baby.
  • If you have high blood pressure, the epidural benefits you by lowering it.

What are the disadvantages of having an epidural?
Let’s take a look at possible risks associated with an epidural anaesthetic:

  • Patients with some neurological or bleeding disorders, evidence of severe infection or those having had major back or spine surgery, can’t have an epidural.
  • Your epidural can cause your labour to slow down and also make your contractions weaker, which in turn means pushing can be difficult and your baby might need assistance to come down the birth canal.
  • The epidural reduces your ability to go to the toilet or walk around, and might take quite a while to wear off once it’s all over – depending on the dosages.
  • Epidurals can cause your blood pressure to drop, which means that you and your baby’s heart rate need to be monitored.
  • You might experience a severe headache caused my leakage of spinal fluid.
  • In rare instances permanent nerve damage, or infection of the area where the epidural was inserted, can occur.

How can an epidural affect my baby?
This is a controversial issue and research is to some extent ambiguous. Whether the medication affects your newborn baby or not varies according to factors such as dosage, type of medication and how long labour takes. Although the medication is very unlikely to harm your baby, studies claim that possible side-effects could be that while in-utero, some babies might have trouble getting into position for delivery, and once born some babies might have problems related to breastfeeding – such as latching on.

Should I or shouldn’t I?
As discussed above, there are both advantages and disadvantages of having an epidural. But at the end of the day there is no right and wrong, and it’s entirely up to you to make a decision you feel is the best one for you. Take your time to think about it and discuss it with your partner as well as your doctor or midwife. Try to make up your mind well in advance of the birth – which means there is one less thing to worry about when you’re in the middle of it and perhaps not in a position to think straight. Even though you have made up your mind beforehand, you are still allowed to change your mind once you are in the middle of labour and really don’t know what you were thinking when you made your decision a few months ago. Just keep in mind, however, that if you haven’t planned to have an epidural but change your mind once you are in labour, it might not be available to you at that point.

References:
www.webmd.com
www.babycentre.co.uk
www.americanpregnancy.com

4 Responses to “Epidural: Everything You Need To Know”

  1. [...] types of medication available at most hospitals – namely an epidural, gas and air and pethidine. An epidural is probably the most popular option and said to be the one that currently gives most pain relief [...]

  2. Misty Carr says:

    Thank you this was very helpful but I still am not sure but this was helpful. Thank you

  3. A big thank you for your post.Really looking forward to read more. Really Great.

  4. Poppy says:

    Very informative, now I am well informed. A big thank you:)

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