Epidural – Your Questions Answered
Deciding whether or not to use anesthesia during delivery can be a tough decision. Epidural anesthesia is one of the most popular forms of medication that provides pain relief during labor and delivery. In fact, almost half of all women who deliver in hospitals will receive an epidural. Below you will find some important facts about epidural anesthesia, including how it is administered and the effects it will have on you and your baby so that you can make an informed decision about the best course of action for your delivery.
What is an epidural?
Epidural anesthesia is one of the most popular forms of pain relief for mothers during labor and delivery, and can be used for both vaginal and cesarean birth. Epidural anesthesia blocks the pain in a specific region of the body by blocking the nerve impulses from the low spine. This results in decreased sensations in the lower half of the body, but not a total lack of feeling. You should be aware that the amount of pain relief you experience can vary. It is important to discuss with your anesthesiologist what type of feeling you would like to have during delivery. Both the type of medication used and the location of the epidural can have an effect on your experience.
Epidural anesthesia provides pain relief and can reduce anxiety. It provides some exhausted mothers with an opportunity to relax or sleep during labor. In some prolonged labors, in which stress hormones such as epinephrine slow contractions, an epidural can help the labor progress without the help of Pitocin.
How is an epidural administered?
Your epidural will be administered by an anesthesiologist, a nurse anesthetist, or perhaps even your obstetrician. You will either be asked to sit up or remain still while lying on your side. To minimize the chance of infection, the area will be swabbed with an antiseptic solution first, just as any other injection you’ve had in the past. To minimize the amount of pain you will experience from the epidural injection, your physician will inject local anesthetic into the injection site to numb it. A needle is then injected into the epidural space between lumbar vertebrae two (L-2) and five (L-5) in your low back, and a catheter (small tube) is then threaded through the needle. The needle is removed and the catheter remains, taped in position, and administers the anesthetic agent such as lidocaine or carbocaine, which decreases the sensation in your lower body. This anesthetic agent can be combined with a narcotic agent such as Demerol, morphine, or fentanyl.
Does it hurt?
Though the sensation can vary from person to person, the placement of the epidural is usually a little uncomfortable as the needle is initially inserted. Luckily, this area will be numbed by local anesthetic.
Are there any risks?
As with all medications, there are potential risks associated with epidural anesthesia. Sometimes, epidurals can lead to fetal distress or malpositioning. Epidural anesthesia may make it difficult for you to push, which can result in the use of forceps or vacuum for extraction, episiotomy, and/or cesarean birth. Another concern will be a decrease in your blood pressure. For this reason, you will be given IV fluids and your blood pressure will be closely monitored during labor and delivery. Epidural anesthesia can also result in a headache known as a spinal headache that can be quite severe. The good news is that this headache can be successful treated by your physician. You may also experience postpartum backache at the injection site. Be sure to speak with your physician prior to delivery if you have any remaining questions about epidural anesthesia.
Are there any important questions to ask my doctor?
- What medications will be used in my epidural?
- What are the potential side-effects of these medications for me and my baby?
- Will I be able to eat or drink after the epidural is administered?
- Will I be able to get out of bed or walk around after the epidural is administered?
