Epidural Anesthesia for Childbirth

What is an epidural?

Epidural is the technique of passing small amounts of drugs into your spine through a catheter to numb your lower body. This technique helps remove the pain during delivery and makes you feel more comfortable.

How is the epidural performed?

Epidural spaceThe anesthetist will give you an injection in your lower body part, and then guide a needle into the spine to find the epidural space. A fine catheter is passed through the needle into the epidural space. The needle is removed. The catheter is taped on your back, up to your shoulder.

The anesthetist will use the catheter to administer the drugs during the delivery or the operation. The catheter can be set to a pump that continuously injects the drugs with small amounts.

What are the contraindications for the epidural?

-  Scoliosis or previous spinal surgery

-  Allergy to the anesthetic

-  Skin Infection around the epidural injection space

-  If the patient is under anticoagulant medication which causes bleeding and hematoma

-  Heart valve problems

When the epidural is used?Epidural

You can use the epidural at any time during the labor. However, some doctors wait till your cervix dilates to about 4cm and where the contractions become stronger. Also, doctors prefer not to perform the epidural if your cervix is dilated above 7cm, since by the time you install the epidural you will have delivered.

The epidural medicine will be decreased at the end to help you push more effectively. The epidural is left till after the placenta is delivered.

Does epidural affect my baby?

Researches on epidural’s effect on babies are still ambiguous. Epidural drugs are given in small doses compared to the IV medications that are administered to mothers during labor or during a general anesthesia. The risks are very minimal and they are mostly related to the low blood pressure that they cause and might affect the flow of oxygen to the baby.

What are the risks of the epidural?

There are some risks associated to the epidural

-  Puncture of the layer that surrounds the spinal cord, called “dura”

-  Nerve damage

-  Severe headache after delivery

-  Difficulty in urinating which necessitate the placement of a urine catheter

-  Fever

-  Skin sore where the epidural was fixed to your back

What are the benefits of the epidural?

- It allows you to rest and enjoy labor which creates a positive experience.

- If allows you to be awake during cesarean section and enjoy the birth of your baby.

- You will feel the contractions of your belly but with no pain.

- It can lower your blood pressure if you are experiencing high blood pressure during your pregnancy.

What are the disadvantages of the epidural?

- Epidurals may cause low blood pressure. An IV medication will be put in place to treat such problem.

- Epidural may cause labor to slow down since you will be lying on your back all the time. This requires the involvement of medications as the injection of Syntocine to speed the process.

- You might experience shivering, itching, backache and pressure soreness.

- Your baby will be monitored all the time as well as your blood pressure.

- The pushing phase might take longer than usual since you will not feel the urge to push.

- There is a high chance that your baby might need a forceps or ventouse to be born.

- You might experience severe headache mainly due to the puncture of the bag that surrounds the spinal cord causing a leakage of the fluid.

- After birth your lower body will stay numb for few hours thus, which will make you need help to walk or move.

All women hope to get through labor and childbirth without any medication. However, once labor starts and contractions become strong, most of women change their mind and ask for drugs to relief from pain. It is important to ask your doctor about the epidural and be prepared for your delivery. After all, it would be great to have a positive experience and enjoy your baby’s birth.