All About Epidurals

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Gone are the days when women had no choice but to endure labor and delivery without medication to ease the pain. Now, techniques like epidurals can make an otherwise painful experience more calm and even comfortable.

Epidural anaesthesia is a popular method of pain relief during labor. More women request an epidural by name than any other method of pain relief. 

What is an Epidural?

Epidural anaesthesia is local anaesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than anaesthesia which leads to total lack of feeling.

Injecting epidural, means painkillers are passed into your back via a fine tube. It is a local anaesthetic, so the drug is injected around the nerves that carry signals from the part of the body that feels pain during labour. It will numb the tummy and provide you with very effective pain relief. With an epidural, you will feel comfortable and still fully awake.

How it is done

An epidural involves medication given by an anaesthetist through a thin, tube-like catheter that’s inserted into your lower back into the ‘epidural space’ and then into the area just outside the membrane covering the spinal cord. You will need to sit or lie on your side during the administration of epidural.

It only takes a couple of minutes to insert an epidural. You should start to feel the effects in about 10 to 20 minutes. The epidural catheter will stay in place throughout labor and delivery.

Epidural painkillers may be given as:

Injection with top-ups: Painkillers are injected into the tube to numb the lower part of the abdomen and contractions should no longer be painful. 

Continuous infusion: An epidural catheter is set up, with the other end of the tube attached to a pump. This continuously feeds the pain-relieving epidural solution into your back. 

Combined spinal epidural (CSE): This injection contains a low dose of pain-relieving medication (a mini-spinal) and works more quickly than epidural alone. 

You can have an epidural at any point during labor. Most women request it when their contractions are getting strong, often when their cervix has dilated to about 5 or 6 cm.

Benefits Of epidural anaesthesia

  • Allows you to rest if your labor is prolonged.
  • By reducing the discomfort of childbirth, you would have a more positive birth experience.
  • Normally, an epidural will allow you to remain alert and be an active participant during the birth of your baby.
  • If you deliver by caesarean section, an epidural anaesthesia will allow you to stay awake and also provide effective pain relief during recovery.

Does epidural affect the baby? 

Epidural solutions contain the fentanyl, or a similar drug, which can cross the placenta. In larger doses (more than 100 micrograms), these drugs may affect the baby’s breathing, or make him drowsy.   For this and the following reasons you will be closely monitored once an epidural has been administered.

Disadvantages of epidural

  • Epidural may cause blood pressure to suddenly drop. For this reason blood pressure will be routinely checked to help ensure an adequate blood flow to the baby. 
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect. 
  • After epidural is administered, you will need to alternate sides while lying in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop.
  • For a few hours after the birth, the lower half of your body may feel numb. Numbness may require you to walk with assistance.
  • You might experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating.

Remember Epidural isn’t the only medication that can help you to deal with the pain and stress of labor and delivery.

You should talk to you doctor about the various options and medications available and how they could affect you and your baby. If you’re interested in getting epidural, you must let your doctor know as soon as you decide. 


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