Deciding On Whether Or Not To Take An Epidural? Here’s What You Should Know

by Stephlina D'cunha

So you’ve beautifully journeyed through those nine months of pregnancy and now it’s time to bring your little bundle of joy in the world. But while you are excited to have a baby, are you also a little apprehensive about the birth?

You may have read every book on labor and the birthing process, under the sun, but when the time arrives, even the bravest of the hearts can become feeble, whether or not it’s your first time. Beginning with spotting the signs right, picking up your hospital essentials, keeping calm and not freaking out, every little thing matters until you reach the maternity ward. However, in times of labor one really cannot expect the would-be mom to be calm because she’s going through a lot.

Lisa, a new mom who delivered Ethan a month back describes labor pain saying, “Every contraction feels like someone is probably stabbing you repetitively in your chest with a sharp pointed knife. Only this time imagine that happening in your nuts.”

However, now-a-days women have an effective tool which helps them escape this agonizing pain conveniently. Epidurals are pain medications which are injected in the epidural space in your spine and help block the transmission of pain impulses to experience a supine labor.

Dr Jane Frederick, MD, a specialist in fertility and obstetrics from Orange County, CA says, “An epidural is the most popular choice for women to alleviate pain during childbirth. The choice to have an epidural can be planned ahead of time or in some cases last minute.”

How Does An Epidural Work
Wonder how the drug came to be called an epidural? Dr Edna Ma, a practicing anesthesiologist from CA, makes it easy for you to understand.

“An ‘epidural’ is simply a space within the body which is located outside the spinal cord, within the bony confines of the spinal canal. The “dura” is the membrane that contains spinal nerves in the spinal cord. Thus an “epidural”, is the space above the dura”, she explains.

“A labor epidural is a local anesthetic pumped into a catheter inserted into the epidural space. One is not completely paralyzed since the medication doesn’t go into the spinal fluid, although there is enough anesthesia to make one’s legs useless until it wears off. Many hospitals now have patient-controlled epidurals, which allows the mother to control the flow of the pain-relieving drug through the push of a button,” adds Dr David Rivera, a board-certified obstetrician/gynecologist in Rockford, Illinois.

How Is An Epidural Injected?
The injection should be placed by a practicing anesthesiologist. Below is a video of Dr Edna giving a demo of how epidurals are injected in the spine.  The demonstration uses a dummy for representational purposes only.

Can Epidural Harm The Baby? Do They Have Any Risks?
Dr Rivera, quickly notes, “Anesthesiologists don’t like doing epidurals in women with clotting problems. Putting an epidural through an infected site is a bad idea. Abnormal anatomy may make inserting an epidural needle/catheter difficult or impossible. An epidural causes the blood pressure to drop and, consequently, the heart tries to compensate by pumping more blood. That is bad when one has restricted heart valves (aortic or mitral stenosis) and can’t accommodate the increased blood flow needed.”

In some cases, an epidural can make it hard for the woman to push, and the use of a vacuum-assisted delivery may be needed to help in pulling the baby through the birth canal. It’s rare, but some women experience headaches due to a leakage in spinal fluid. Other side effects include but are not limited to, nausea, back-aches, soreness near the injection site, and shivering.

“An epidural is safe for most women, but not all. Some women with existing medical conditions could be put at risk, should they choose to have an epidural. This is the same case for the baby.  It’s best to consult with your doctor and discuss the risks before deciding if an epidural is the right choice for you and your baby”, concludes Dr Frederick.

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