The Epidural: Information, Risks and Benefits By: Amanda Holmes
The Epidural:
The epidural block “has been used for pain relief in labor and caesarean sections over the past 50 years” (Simkin 1). The epidural is the most popular form of pain relief sought by women today. This article explores a few of the risks and benefits of the epidural and answers basic questions about the procedure.
What is an Epidural?
The epidural block is a local anesthetic administered through a catheter that is inserted into the spine. It is a mixture of lidocaine or bivucaine that is sometimes “mixed with a narcotic” and “is injected into the cerebrospinal fluid in the lumbar region of the spine.”Only the abdomen, legs and feet are numbed by the epidural block, allowing “the woman to be awake” during the childbirth process. Typically the epidural block is administered when the cervix is dilated between 4-5 centimeters and delivery is expected within two hours (Encyclopedia Britannica). An “anesthesiologist – a physician who specializes in anesthesia – an obstetrician, or nurse-anesthetist administers” the epidural (“Epidural”).
How is an Epidural administered?
The American Pregnancy Association explains the epidural insertion process precisely:
“You will be asked to arch your back and remain still while lying on your left side or sitting up. This position is vital for preventing problems and increasing the epidural effectiveness. An antiseptic solution will be used to wipe the waistline area of your mid back to minimize the chance of infection. A small area on your back will be injected with a local anesthetic to numb it. Then a needle will be inserted into the numbed area that surrounds the spinal cord in the lower back. A small tube or catheter is threaded through the needle into the epidural space. The needle is carefully removed leaving the catheter in place so medication can be given through periodic injections or by continuous infusion. The catheter will be taped to your back to prevent it from slipping out” (“Epidural”).
Benefits of an Epidural:
·Provides relief of labor pain without affecting the mother’s mental state, making childbirth a more positive experience (Reynolds 751).
·A fearful, anxious mother can relax, allowing labor to speed up (americanpregnancy.org)
·Reduces pain without reducing other sensations or muscle functions (Simkin 2).
·Beneficial to high risk mothers with pre-eclampsia because it prevents the rise of blood pressure associated with pain (Reynolds 751).
·If emergency cesarean becomes necessary, the epidural block will already be in place and the mother can be made ready for surgery quickly, allowing her to be alert and part of the birthing process (Reynolds 751).
Risks of an Epidural:
·Mother’s blood pressure may drop too low, requiring constant monitoring (Simkin 2).
·Retention of urine, requiring a bladder catheter (Simkin 2).
·Post epidural headache, which can require days of bed rest (Simkin 2).
·Post partum backache and bruising (MacArthur 883).
·Rise of mother’s vaginal temperature, which may lead to treatment of mother and baby for non-existent infection (Simkin 3)
·Shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating (americanpregnancy.org).
·May slow labor (Simkin 3).
·Possible side effects due to the amount of medication in the baby’s circulatory system include less efficient suckling behavior, irritability, inconsolability, decreased ability to track an object visually, and newborn fever (Simkin 3).
This list of benefits and risks is not all-inclusive.There is a great deal more useful information available to you on the internet and at your local library.Make sure you educate yourself well and seek the advice of your doctor so that you can make an informed decision during or prior to labor.
Great websites for further information:
americanpregnacy.org
childbirthsolutions.com
Works Cited:
“Epidural Anesthesia.” American Pregnancy Association. 25 June 2010. Web. 25 June 2010.
--- Encyclopedia Britannica. 2010. Encyclopedia Britannica Online. 25 June 2010. Web. 25 June 2010.
MacArthur, C., Lewis, M., and E. G. Knox. “Accidental Dural Puncture in Obstetric Patients and Long Term Symtoms.” British Medical Journal. 302.6882 (1993): 883-885.
Reynolds, Felicity. “Epidural Analgesia in Obstetrics.” British Medical Journal. 229.6702 (1989): 751-751.
Simkin, Penny. “Weighing the Pros and Cons of the Epidural.” Child Birth Solutions. 25 June 2010. Web. 25 June 2010.