EPIDURAL: How To Have A Stress Free Labor

EPIDURAL: How To Have A Stress Free Labor

How painful can labor get? I raised a brow in thought. More painful that the usual menstrual pain I know, but how much more painful? X10 or X20(menstrual pain) or even much more than that? Anyone with child birthing experience can kindly share.

Labor is painful (for most), and you have to be prepared to brace yourself.  Still, there are women who bounce in and bounce out of the labor ward. I came up with two possible reasons:

  • It was painful but with the joy of seeing the child, the experience of the past has been washed away, ‘’so it really wasn’t that painful’’.
  • Pain tolerance levels are very high. Likely their body secretes huge amounts of endorphins (natural pain killers).

Bonus point: truly it probably wasn’t that painful. What do we know?

Thanks to modern medicine, there is a procedure to help expectant mothers. It is called epidural. I have heard the term a couple of times, but never gave it much thought.  Epidurals are anaesthetics injected into the base of the spinal cord to help numb pain/ reduce feeling in the pelvic region during childbirth.  As anaesthetics kick in, birthing mum feels less pain and can be more aware of what transpires around her, right until the baby is born.

Epidural analgesia is usually recommended in cases such as:

  • Prolonged labor
  • Difficult forceps delivery
  • Maternal exhaustion during labor
  • Pre-eclampsia

And the ‘cliché’ excuse; unacceptable pain during labor. Who else will be giving this excuse sharp, sharp and won’t wait for, ‘’a woman’s body produces its very own pain killer (endorphins)’’ lecture?

If this is your first time hearing the word epidural, don’t be jubilant just yet. It comes with side effects which you have to weigh carefully, and involve in intense deliberations with your doctor before making an informed choice.  The moment you decide to go ahead with it, and then you should alert your medical counsel to:

  • drug allergies
  • Spinal deformity
  • Blood clothing problems
  • Cardiovascular diseases

And other medical conditions…yikes! Importantly, your doctor needs be kept informed of your routine drugs.

The Process

Intravenous (IV) fluids will be started before active labor begins. Anticipate 1-2 liters of IV fluids throughout labor and delivery. An antiseptic solution will be used to wipe the waistline area of your mid-back to minimize the chance of infection.  You will be injected with a local anesthetic to numb your back. A needle will be inserted into the numbed area surrounding the spinal cord in the lower back. After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.  Epidurals are administered when the cervix is dilated to 4-5 centimeters in active labor (So yeah, you have to experience pain small. Epidurals are not administered until the cervix is dilated 4-5 centimeters).

The glossy package

Epidural allows rest if labor is prolonged, and Stay alerted throughout the birthing process. In the event of a C-section, you can be awake and watch!

 Challenges of epidurals

In some cases, analgesia or anaesthesia fails; this simply means after epidural has been administered, it has little or no effect hence a higher dosage might be administered.

Why this happens

Ineffective epidurals have been traced to:

  • Obesity
  • Multiparity(production of more than one offspring in one gestation e.g. twins)
  • Cervical dilation of more than 7 cm at application.

What’s beneath the bag?

Yep, there are side effects too, and they include:

  • Sudden drop in blood pressure
  • Severe headache caused by leakage of spinal fluid. A procedure called a “blood patch”, which is an injection of your blood into the epidural space, can be performed to relieve a headache.
  • Difficulty in pushing
  • Difficulty in urination you will need urinary catheterization to pass out urine. After your baby is born, the catheter is removed and the effects of the anesthesia will fade.
  • For a few hours after the birth, the lower half of your body may feel numb and sore.
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
  • Neurological injury, due to complications.
  • Paraplegia
  • Arachnoiditis
  • Extreme cases; Death

Epidural is said to slow down labor if this occurs, you might be given medicine to help speed up labor.

What about my baby?

Some studies have found that epidurals may compromise fetal heart rate and blood supply at birth due to the reduced blood pressure in mom. Infants who are exposed to epidurals are more likely to be evaluated and treated for sepsis and may have reduced immune system function.

Reasons why some women can’t have an epidural

Epidural is out of it for some women in cases such as these:

  • You use blood thinners
  • Have low platelet counts (low PCV)
  • Are hemorrhaging or in shock
  • Have an infection on or in your back
  • Have a blood infection

Finalysis

The catheter comes off when you are able to take oral pain medications. Catheters can remain in place for several days with little risk of bacterial infection. Depending on the type of epidural and dosage administered, you can be confined to your bed and not allowed to get up and move around.

The greatest benefit of an epidural is the potential for a painless delivery. While you may still feel contractions, the pain is decreased significantly. Most risks from epidurals are either mild or rare.  If carried out by a highly trained professional, the odd of having a complication decreases.

Science deserves some accolades don’t you think?

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