Many women find the pain of labor too intense to bear without effective pain relief, and an epidural analgesia provides the best pain relief compared to all other methods. In the US, more than 80 percent of first-time moms ultimately have an epidural analgesia, other take a wait and see attitude.

How It Works

Epidural analgesia works by delivering very small doses of an anesthetic through a hollow tube to the epidural space, which surrounds the spinal cord. The anesthetic numbs nerves from the waist down, including the uterus. Epidurals are given by an anesthetist. You will have to bend forward so that he or she can guide the hollow tube through a needle and in to the correct position. You will have a local anesthetic first, which may sting a little, but other than that you shouldn't feel any pain as the epidural is placed. Once the tube is in position, it is taped to your back to secure it so that more anesthetic can be given easily at any time.

An epidural takes about 20 minutes to administer. Most women notice pain is reduced almost immediately, but the full effect may take 15 to 20 minutes. The benefits of epidural analgesia are that pain control is excellent and that very little medication escapes in to your blood stream. This means that you are mentally alert, and your baby is not sleepy after birth from pain medication crossing your placenta. The other benefit of epidural analgesia is that medication is being given continuously, so you have pain relief for the entire duration of labor.

Types Of Epidural

More modern epidurals, such as the mobile epidural use the least amount of medication possible, allowing you to move your legs (but not usually walk) and to feel pressure as the baby's head moves down the birth canal. Women who feel pressure can push more effectively, reducing the likelihood that they will need a cesarean or forceps delivery. Some hospitals allow you to control the epidural yourself by pressing a button that slowly releases more of the analgesic. Another type is the combined spinal epidural analgesia, in which a small amount of medication is injected in to the spinal space before the epidural tube is placed. This provides faster pain relief and is often used for women who are close to delivery when the epidural takes place, or when a cesarean delivery is needed.

Timing The Epidural

Many physicians will delay offering an epidural until you are 4cm dilated. However, this is an arbitrary cut off, so if your pain is very intense an early epidural is still an option. Discuss the various scenarios with your care provider before you go into labor.

Side Effects

Like all medical interventions, epidural analgesia has side effects for you and for your baby, although the chance of a serious side effect is very small.

Longer Labor

Most studies of epidural analgesia suggest that contractions are weakened, which means there's more chance that you will need oxytocin to return your contractions to their normal strength. On average, choosing epidural analgesia will prolong the active phase of labor by about one hour. Epidural analgesia can also prolong the pushing stage of labor by up to an hour. Since the pushing stage is often exhausting, an epidural can make it more likely that your care provider will suggest a forceps delivery.

Page 1 of 2 :: First | Last :: Prev | 1 2 | Next