How to make the most of your epidural

You know the exchange heard more often than not when you’re dishing post-delivery: Did you get the drugs? Oh, yes. But although the epidural is the labor pain–control method of choice for American women, like any medication, it has side effects:pesky ones like itching and shivering, and uneven spreading, when the drug pools on one side of the body. Yet a few tricks can minimize these side effects—and maximize the epidural’s benefits.

The latest advance in epidural anesthesia is the patient-controlled epidural (PCEA). “It used to be that everyone got the same dose of medication,” says William Camann, M.D., director of obstetric anesthesia at Harvard Medical School and co-author of Easy Labor. “With the PCEA, you can control how much you get.” As opposed to a one-size-fits-all traditional epidural, a doctor can start a PCEA at a lower dose, and then you push a button to get more as you need it. But while the PCEA is increasingly common, it’s not available everywhere, so check—before you go into labor.

Itching’s probably the most common side effect of an epidural, but it doesn’t mean you’re experiencing an allergic reaction. Still, it’s annoying. Cool compresses to the itchy parts and distractions like TV or conversation can take the edge off. If you get the shivers, you probably won’t actually be cold, but warm blankets will still feel good.

You might also feel light-headed or dizzy, because an epidural can temporarily drop your blood pressure. Some hospitals administer extra IV fluids or medication to bring it back up. Help yourself by sipping clear liquids (if your hospital lets you) and staying off your back. Sit up, if you can handle it, or shift from one side to the other.

Five to ten percent of women experience uneven pain relief (numbing on one side). If this happens to you, let your health care providers know immediately. The epidural catheter may need to be adjusted so it more evenly bathes your nerves. Because epidural medication is a liquid, it works with gravity, so changing positions frequently can help prevent uneven pooling.

– Jennifer L.W. Fink wasn’t prepared for the blood pressure cuff, IV, and fetal monitor that came with her epidural. She blogs about her sons at bloggingboutboys.blogspot.com.