What an epidural can and can’t do during labour

Epidurals are introduced or touted as pain management analgesia they do have their own limitations

For women, who want a vaginal birth or are at least planning for one but dread the labour pains, an epidural is a boon. It is an invasive form of pain management where an epidural analgesia is given on the epidural space in the spine of the labouring mother to numb the pain sensations. Most women think that an epidural shot can make labour easy, but this is a misconception. While epidurals are introduced or touted as pain management analgesia they do have their own limitations. Read about the side-effects of epidural.

Epidural anaesthesia is most common pain management technique used in the hospital these days. In epidural painkiller medications are given in the spinal cord which numbs the nerves and stops the feeling of the pain. Basically, it changes the perception of pain. Epidural anaesthesia is becoming common these days because more and more women are opting for painless vaginal delivery, says Bandita Sinha, gynaecologist World of Women, Navi Mumbai. Here is what to expect during an epidural.

How does it work?

Epidural anaesthesia works on the areas like the abdomen, pelvic area and legs of the labouring mother. An epidural shot is given only when the mother is into active labour and her cervix is dilated up to 5 cm. A mother is asked to sit upright and arch her back when a small area of her spine known as epidural space is given an anaesthesia shot to numb it. Next, a needle is inserted into the numbed area surrounding the spinal cord in the lower back. Then a small tube or catheter is threaded through the needle into epidural space. Once the catheter is in place the needle is slowly removed. Medication is usually given either by continuous infusion or periodic injection through the catheter. The catheter is taped to the back to prevent slippage and keep it in place. The effects start to show within 10 to 20 minutes of inserting the pain management medication. The medications are given till the labour lasts. Here are things to know before you consider taking an epidural shot.

What can an epidural do?

The aim of the epidural anaesthesia is to numb the pain sensations and help a woman progress to labour without feeling labour pains. Most women who opt for epidural experiences pain-free labour. Epidural numbs the pain sensation but a woman can still feel the contractions and her baby move inside the womb. When the cervix is around 10 cm dilated she would be asked to push her baby out on doctor s advice. However, some women find it difficult to push the baby out during the third phase of labour due to the effects of epidural. Many women also complain that an epidural prolongs the labour to several hours despite numbing the pain sensations. This might be a drawback. However, it doesn t affect the baby. But if the contractions decrease with time and the baby s heart rate drops this could raise concerns and the mother might have to go under the knife to deliver her baby. Apart from this, other drawbacks of epidural are, Shortness of breath, nausea and shivering due to changes in body temperatures, Dr Mohamed Mansoor, Consultant, Anaesthesiologist, Motherhood Hospitals, Bengaluru. Read to know if epidural can harm the baby.

What can an epidural not do?

Epidural analgesia doesn t reduce the uterine contractions though it reduces the sensitivity of the patient towards the pain. It does not allow the mother to get exhausted and dehydrated. However, in case of any spinal injury or any other illness of the spine an epidural is best to be avoided. As it can make things complicated. Epidurals are not known to shorten the span of labour but at times they can prolong it, so be prepared while you go for an epidural short, says Dr Gayatri Deshpande, Gynaecologist, Nanavati Super Speciality Hospital.

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