Ask any mother and she'll tell you all about the pain of childbirth. That's the whole point behind Epidural. Epidural is an anesthesia that, over the years, has become the most popular way to control pain during labor and childbirth. Statistically, more than 50 percent of those giving birth use Epidural to help with the pain. As you prepare for the big day, spend some time researching the pain relief choices available--and the various kinds of Epidural. To get you started, we've prepared this primer.
Epidural is known as a regional anesthesia, which just means it blocks pain in a specific area of the body. Epidural is not a complete anesthesia, which creates a complete lack of feeling. Rather it's a pain reliever, which means it helps to control the pain sensations. There are three classes of Epidural: bubivacaine, chloroprocaine and lidocaine.
Epidural is given intravenously. IV fluids will start before the onset of active labor, and just before placing the Epidural. About one to two liters of the IV fluid will be given during the labor and delivery. Someone from the medical team will ask you to arch back, and to stay still as you lie on your left side or sit up. Then someone will wipe the waistline of your mid-back with an antiseptic solution.
This decreases the possibility of infection. Someone will then inject your back with anesthetic in order to numb it. Then someone will insert another needle into this numb area surrounding the spinal cord, and then threading through the tube a catheter. Periodic injections will then be allowed to move through the catheter as needed.
The two main types of Epidurals used today are Regular and "Walking Epidural." With Regular, after the catheter has been placed, a combination of anesthesia and narcotic will be administered through a pump or periodic injections. This narcotic could be either morphine or fentanyl, and is injected in the Epidural space.
With "Walking Epidural," a first dose of either anesthetic or narcotic, or a combination of them both, will be injected under the outer membrane, and will cover the spinal cord and inward of the Epidural's space. Then the anesthesiologist pulls the needle back to the Epidural space. He will thread a catheter through this needle, then withdraw the needle and leave the catheter. This should allow you to move freely in your bed.
There are 2 basic epidurals used today.
Regardless of which type of Epidural is used, you should experience pain relief for 4 to 7 hours. The benefits are that it will allow you to rest in case labor takes a long time; it relieves much of childbirth's discomfort; it keeps you alert during the process; and in case of cesarean, it allows you to keep awake during the procedure.
Some of the disadvantages are that it sometimes causes a sudden blood-pressure drop, it might cause a bad headache due to a spinal fluid leaking, and you might experience side effects such as backache, shivering, ear-ringing, nausea, or trouble urinating. Also, for several hours following the birth, the lower half of the body might feel numb. You should also know that there have been some studies suggesting that a few babies, as a result of Epidural, have had breastfeeding problems, while some have experienced respiratory depression or fetal mal positioning.
Will placement of the catheter hurt? Some women have reported feeling some discomfort, while others have said it was fairly painless.
When will the epidural actually be placed? Normally, when the cervix has dilated to around 4 to 5 cm and you are in active labor.
When will my epidural be placed? Typically epidurals are placed when the cervix is dilated to 4-5 centimeters and you are in true active labor.
How will Epidural affect labor? It could slow your labor or even make contractions weaker. The medical staff might give you Pitocin to speed things along, if this happens.
How will the Epidural make me feel? Within just a few minutes, the nerves to the uterus will start to numb. Within 10 to 20 minutes, you'll feel the full effects of the numbing. After the first dose wears off, you'll be given more doses every hour or two. As it wears off, you might feel a burning sensation around your birth canal.
Will it keep me from pushing? Sometimes pushing is hard to control. For this reason, sometimes the baby needs help making its way down through the birth canal. Someone might have to apply some pressure on the abdomen to help pull the unborn child out.
When is an Epidural not recommended? It should not be used if the mother uses blood thinners has a low platelet count, is hemorrhaging, is in shock, has infection in her back, has a blood infection, isn't at minimum 4 cm dilated or her labor is moving along too fast to administer the Epidural.