Opting for an epidural during labor
You’ve probably heard of epidurals or read about them. This is the most common type of anesthetic given to relieve pain during labour. When administered, an epidural numbs the area from the navel to the upper legs, allowing women to stay awake and alert during labor. Although the contractions are still felt by the mother, the pain is significantly less and helps her push when it’s time to deliver.
Dr Madhavi Reddy, Consultant Obstetrician and Gynaecologist, Motherhood Hospitals, Bengaluru, says: “The prospect of childbirth can be daunting, and an epidural is much needed relief for pregnant women anxious about pain. But it is important to know some things about epidurals before opting for them. Awareness will help pregnant women make an informed decision. She explains further.
How and when are epidurals given?
An epidural can be taken while sitting or leaning forward on a pillow. A local anesthetic will be injected into the lower back in small amounts. Then a needle and a small tube (a catheter) are inserted into your lower back. The anesthetist will then remove the needle and leave the catheter in place to administer the medication. “The process is quite painless as there is numbness from the local anesthesia. Women may feel some pressure when the needle is inserted. It can be given at any stage of labour, early, in the middle or at the end. Once administered, the epidural can take about 15 to 20 minutes to start working,” adds Dr. Reddy.
Benefits of epidural
Epidural analgesia is a benchmark for analgesia during labor because:
- It effectively relieves pain
- It’s certain
- It has minimal side effects on labor progress or results
- It has minimal side effects on the fetus or newborn
- It has minimal maternal side effects (nausea, chills)
Risks associated with taking an epidural
Women may experience the following after taking epidurals:
- Back ache
- Lowering of blood pressure
- Pain due to needle insertion
- Cold or itchy
- Not everyone can take an epidural, people with certain medical conditions should avoid them
- Increased risk of needing forceps or a vacuum to facilitate delivery
Busting Epidural Myths
There are many myths surrounding the use of epidurals which unfortunately are believed by too many women. Dr. Reddy erases some of them.
Myth 1: Epidural analgesia has many side effects
Reality: Epidural use has minor side effects that are transient and self-limiting, eg, loss of sensation, muscle weakness, nausea, chills.
Myth 2: Epidural analgesia causes long-term back pain
Fact: Studies have failed to establish a link between long-term back pain and epidural analgesia.
Myth 3: Epidural analgesia harms the baby
Reality: This is not the case. In fact, there is some evidence that it can improve blood flow through the placenta.
Myth 4: Epidurals prolong labor and increase the risk of needing a caesarean section
Fact: There is no credible evidence that an epidural slows labor or increases the risk of having a caesarean section. If a woman has a C-section, other factors usually come into play, including having a large baby or slow progress in labor due to other issues.
When it comes to natural birth versus epidural, there is no right answer for all pregnant women. “Many factors come into play when making such decisions. Some women may have a higher pain tolerance and may not need it. Other factors like the size of the baby, the size of the woman’s pelvis, the intensity of the contractions, etc. will also play a role in deciding if an epidural is needed. Deciding which type of childbirth you want to adopt depends entirely on the situation and your individual needs,” says Dr. Reddy. The important thing is to keep an open mind, think about both options and weigh the pros and cons. If the birth experience is positive, it doesn’t matter which way you choose.