Everything you need to know about epidurals

February 11, 2014 12:00 AM by

It's no secret that childbirth is a pretty painful experience. Talk to almost anyone who's gone through it, and she'll tell you it definitely didn't feel good. However, these days, childbirth doesn't have to be as painful as it usually is. Women today have the option of epidural anesthesia, and about 50 percent of women who give birth in hospitals opt to get it. But what exactly is an epidural, what are the positives and negatives, and how does it work? Here's a breakdown of the most important facts you need to know about this procedure.

What is epidural anesthesia?
Epidural anesthesia is an injection that's given to your lower back. Its goal is to numb the nerves and stop you from feeling pain. It's often used in childbirth, but it can also be helpful during and after surgery. The chest, abdomen, pelvic region and legs are the areas that can be numbed by an epidural. How numb the areas get depends on the type of drug that's used and the amount that's given. You can get an epidural at any time during your labor, and most women ask for one when their contractions are getting strong. The tube can stay in until after your baby is born.

What are the different types?
There are three main types of epidurals. One involves an injection with top-ups. In this method, painkillers are injected into a tube to numb the lower part of your abdomen, which helps relieve contractions. As the effects begin to wear off, you'll have top-ups (which are basically refills) that last for one to two hours.

Another method involves continuous infusions. If you get this, an epidural catheter is set up and attached to a pump that feeds the painkiller solution into your back. If you need stronger pain relief, you can also receive top-ups during this method. Some hospitals allow patients to have control of the pumps.

Finally, there's combined spinal epidural, also called a "walking epidural." You'll get an injection of painkillers that works more quickly than a regular epidural, and the anesthetist will also set up a catheter. When the first injection starts to wear off, you'll get a painkilling solution delivered through the tube.

What does it feel like?
It might seem scary to have a needle going into your back, but most women report that it's not too bad. Doctors will numb the skin first, so you'll just feel a slight prick and possibly some pressure. Once it's in, you might be conscious of it, but it won't be painful or uncomfortable. It takes about 10 or 20 minutes to take effect. When you have contractions, you'll probably be able to tell that they're happening, but they won't be painful. As the dosage is adjusted, your legs might feel a little weak, heavy, warm or tingly. You won't feel foggy or lethargic.

What are the positives?
There are several benefits of epidurals. Aside from the obvious pain relief, there's also the benefit that you'll be able to rest – especially if you have a long labor. This can make the overall experience a better end to your pregnancy. It also can allow you to be more engaged and positive during the birthing process. It can even help lower your blood pressure if it's high. If you need a C-section, you'll be able to stay awake during the procedure and see your baby right away.

What are the negatives?
Epidurals do come with their fair share of disadvantages. For one, not all women feel total pain relief with epidurals. If you don't feel pain relief within 30 minutes of having the procedure, ask your anesthetist to adjust the dose or try again. Another disadvantage is that you won't be able to get up and walk around, since your legs will likely feel weak and heavy. You may also need a catheter after giving birth, since it might affect your ability to pee.

Because your blood pressure can fall with an epidural, you'll have to be monitored closely, with someone monitoring your baby's heartbeat and taking your blood pressure regularly. Some women experience longer pushing stages when they have an epidural, since it reduces the urge to push. This can also make it more likely that your baby won't get into the best birth position, which could lead to the use of forceps or a ventouse, which is a vacuum device.

Finally, you may have side effects like shivering, fever, headache, backache, ringing of the ears, soreness, nausea, difficulty urinating or itching.

All in all, epidurals are great if you're having a difficult birth and could really use the pain relief as you're getting ready for baby to enter the world. Talk to your health care provider to find out more and whether you're a good candidate for the procedure.

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