Risks of an Epidural
As you begin discussing how you envision labor and delivery to go, one of the biggest decisions about labor will be if you decide to have an epidural. If you’re considering an epidural for pain management during labor, you’re not alone—over 60% of women in the U.S. choose to receive this type of pain relief, according to the CDC.
There are different types of epidurals for pain management and you should do your research before the big day. You should be prepared for the options available and the effects that it can have on your labor and delivery.
Here are some things you need to know about getting an epidural.
What is an Epidural?
An epidural is a type of anesthesia used to provide pain relief during labor and delivery. Injected near the bottom of the spine, the epidural works by blocking nerve impulses in the lower back. The result is a decreased feeling in the bottom half of the body. The goal of an epidural is to provide you with pain relief, not total numbness, while keeping your comfortable and alert during labor and delivery. You most likely will still feel your contractions, though you may not feel the pain as much. You should also still be able to push when the big moment arrives.
Types of Epidurals
Epidural. An epidural is administered via a catheter in your epidural space in the spinal area. The catheter is left in place so more medication can be given at a later time if needed.
Spinal injection. Administered directly into the spinal fluid, this single injection can be used either alone or in combination with an epidural. Because it’s a single dose, it wears off more quickly.
Combined spinal-epidural (CSE). A hybrid of the two, a CSE—often referred to as a “walking epidural”—is a combination spinal and epidural. Because it involves a lower dose of medication, it leaves you with a bit more feeling in your lower half and provides more freedom to move around and change positions, and pain relief can be a bit more customized.
According to the American Pregnancy Association, hospitals and anesthesiologists vary on the types of epidurals they offer in addition to dosages or combinations of medications. If you are interested in getting an epidural, talk to your healthcare provider to find out what the protocols are for the hospital where you will be delivering.
Does an Epidural Hurt?
There is not a straight answer on this, as it all depends on who you ask.
There are women who report varied levels of discomfort getting an epidural, while others say they felt none. One of the most common epidural fears is actually about the size of the needle. While the epidural needle is a few inches long, it’s only in place for a short time until the catheter can be put in place. Before the needle is even used, your doctor will use a local anesthetic to numb the area. Most women report feeling a “pinch” or a “sting” for about 5-10 seconds, and then pressure, but not pain, when the epidural is performed.
How Long Does an Epidural Last?
An epidural typically takes about 10-15 minutes to take effect. However, because the medication can be continuously administered via the catheter, it can last throughout labor.
Epidural Pros and Cons
There are pros and cons to any medical intervention, so if you’re considering getting an epidural during labor, it’s good to learn as much as you can so that you can feel confident in your decision.
Pain relief. It's not a surprise that there is pain associated labor. If you are looking for a way to relieve pain, the epidural is both a very common and safe way to provide relief.
Allowing you to be present for your birth. Even though you have an epidural, you will still be alert for the birth of your baby, regardless if you have one for a vaginal birth or a cesarean.
A much-needed break. Labor can last a while and leave you feeling drained after a while. An epidural can provide an opportunity for you to rest, re-focus and restore your energy before it’s time to push.
Limited movement. You will be hooked up to an IV and a fetal monitor once you receive an epidural. Between the monitoring and the epidural, you will have limited movement. If you are planning to labor upright, using a birth ball or any variety of labor positions, you will not be able to do so after having an epidural.
A longer labor. According to a recent study, labors for women delivering vaginally lasted approximately two hours longer with women who received an epidural compared to those who did not.
Postpartum numbness. Epidural effects can take a few hours to fully wear off, so if you’re looking to get up and walk immediately after giving birth, an epidural may not be right for you.
Urinary catheter. The medication used in the epidural will numb the lower part of your body, so a urinary catheter may be necessary. The catheter will be removed once the epidural wears off, but some women still report discomfort a few hours after the catheter comes out.
Epidural Risks and Long-Term Side Effects
Medical decisions are stressful overall. However, they especially feel stressful when you’re pregnant and you are thinking about the health of your baby. The good news is the risks and long-term side effects is extremely low.
“As long as the standard of care practice is followed, it is very unlikely to have any long-term side effects from an epidural,” says Dr. Mary Casciano Geneve, anesthesiologist at Monmouth Medical Center in Long Branch, NJ.
Risks and side effects can include some of the following:
Soreness/bruising around the injection site
Maternal hypotension (a sudden drop in blood pressure)
Permanent nerve damage at the injection site.
What about epidural effects on your baby? According to Dr. Casciano Geneve, one of the biggest benefits of the epidural is that it provides relief for the mother without affecting the baby. “Unlike some intravenous medications, such as narcotics, which can cause neonatal respiratory depression (respiratory distress), the epidural should not affect the baby,” she says.
Epidurals can be a generally safe method to reduce pain if want it. If you think an epidural might be right for you, talk to your health care provider about it prior to the delivery date. This will allow you more time to gather all the facts and make the decision that is best for you.
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