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Epidural anaesthesia: 8 things you need to know before opting for it

Written by Debjani Arora |Updated : November 2, 2015 6:55 PM IST

epiduralTalking about labour in today's day and age doesn't seem to send jitters down the spine anymore. Thanks to the advances in medical sciences, epidural anaesthesia has come as a boon for expecting mothers. Many women think that if the pain during labour becomes unbearable opting for an epidural anaesthesia can provide with much needed respite. While this is true, most women only have a far-fetched idea about the pros and cons of epidural. Here we tell you all that you need to know about epidural before opting for one.

Epidural anaesthesia is the most commonly used pain relief option during labour.

There are various other methods to help an expecting mother manage labour pain gentle massage, corrective breathing, narcotic drugs but these are not as effective as the epidural. The epidural anaesthesia is a mild but highly active analgesic. It is introduced in the cavity of the spinal cord called the dura. The nerves carrying pain signals travel through the dura on their way to the brain. The analgesic blocks the pain but the motor neurons remain unaffected, hence there is still control over the muscles needed for delivery.

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The doctor and the hospital staff would help you get in the position for the epidural shot. A local anesthesia is then inserted on your back just under the skin before inserting the epidural. A fine bore tube is then passed into the epidural space and the medications are deposited either continuously or intermittently. While administering an epidural, finding the epidural space is most important. The trick here is not to puncture the dura or to stay outside the dura.

Epidural anaesthesia is not for everyone.

Even if you are enthusiastic about opting for an epidural know that it isn't for everybody. If you are suffering from an infection in and around the spine, or septicaemia (infection in the blood stream), have blood clotting problems or suffer from severe maternal haemorrhage, an epidural is not an option you can choose.

Epidural administration can either slow down or speed up the process of labour.

An epidural might not interfere with the first stage of labour. But however in the second stage of labour an epidural can prolong it by few minutes -- sometimes for even as long as 20 minutes. Since it relaxes the pelvic muscles it can also make the pushing phase a little longer. Epidural can also slow the process of labour if it is given too early. On the other hand if a woman is already in labour an epidural can relax your pelvic muscles and help you dilate quickly.

An epidural cannot be taken right at the start of your labour.

You might be eager to opt for an epidural to shrug off labour pains, but you cannot give them a miss altogether. The reason being, you need to be well into your labour to get an epidural shot. Usually a woman is offered an epidural only when she is in the second stage of labour. In general unless the cervix is sufficiently dilated an epidural is not administered. Early administrations of epidural will only slow the process of labour. Know more about how epidural anesthesia works.

Epidural takes time to work.

Like all medications, epidurals take time to work, so don't expect a no-pain sensation state right after the administration. It will take around 10 to 15 minutes for the epidural to take full effect. For women in the advanced stages of labour it can also take up to 20 minutes to start showing effect. Also if you have not planned for an epidural before, it might take time for the anesthesiologist to arrive and this will only add to your distress. If you know that you have a low pain threshold, plan accordingly. Also read how to counter back pain during labour.

An epidural may come with some side effects and has its own share of complications.

The common side effects of epidural are mostly reversible and also rare. They include a transient hypotension or low blood pressure, bradycardia or heart rate slowing, backache or headaches. Sometimes, though very rare, it can also cause a spinal infection. At times it may also increase one's body temperature giving rise to a fever. This can confuse your gynecologist about the cause of the fever i.e. if it's due to the epidural or an underlying infection.

Another epidural complication is that if the anesthesiologist fails to find the epidural space and punctures the dura. In such instances a patient can have severe headache, vomiting with blurred vision for 2-3 weeks on assuming erect position or on coughing.

If this puncture is not noticed and the whole dose of the medicine is injected in a patient then a patient can suffer from fall in blood pressure, difficulty in talking as well as breathing leading, very rarely, to even a cardiac arrest.

Epidurals do not affect the baby.

Medications used for labor and delivery are safe and normally do not affect the baby. But it can cause the mother's blood pressure to decrease in the first few minutes. Once you get an epidural shot your anesthesiologist and doctor will closely monitor you and your baby throughout your labor and delivery.

An epidural will restrict your movements.

Because the epidural makes you go numb from back and below you may feel light and not be able to stand upright. So be prepared to be bed-bound after the epidural shot.

Epidurals do not increase the chance of a C-section

Epidurals do not necessarily increase the chance of a C-section. There aren't any studies or facts that can support this dictum. But if there is a complication like failed epidural then a C-section might become necessary. Mostly a C-section happens due to a medical emergency during the labour and not due to epidural complication. It is seen that mothers who have opted for epidurals could progress to painless and problem-free labour under normal circumstances. Know when do you need a C-section.

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