What to expect during an epidural

Read this if you have decided to take an epidural to help you cope with the pain during labour.

By: Debjani Arora | | Updated: October 21, 2017 6:03 pm

Epidural can help to experience painless delivery. © Shutterstock

Epidural anaesthesia is one of the most common and safest methods of pain relief given during labour. For women, who have a low pain threshold epidural helps them to endure pain and continue with vaginal delivery. Epidural is not a compulsion, however, most doctors give this option in case a mother asks for pain relief during labour. Here are five ways to deal with a backache during pregnancy.

Before the epidural is given you will be hooked to the IV fluids and this will be done before the active labour phase starts. During labour and delivery, you might get anywhere between two to five litres of IV fluids to help your body cope with the entire process.
During administrating the epidural, you will be asked to arch your back by sitting upright and remain steady for a few seconds or to lie on your left side. These two positions are the most favoured for giving an epidural shot and to make the medication work effectively. Ideally, an epidural is given when the cervix is dilated to four to 5 centimetres. It is difficult to give an epidural shot when one progresses deep into labour as it is not easy to be steady at that point. If you move the shot can end up in the wrong spot leading to complications. Know how a spinal anaesthesia is different from an epidural anaesthesia.
An antiseptic solution is used to wipe the lower back and waist to minimise chances of infection.
A small area on your lower back (the 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 effect of an epidural starts after 10 to 20 minutes of injecting the medication. If a continuous infusion is not done then medications are given every one to two hours in injection form through the catheter as the effect of the epidural anaesthesia wears off by that time. Here are three reasons why labour pain stops midway.
Epidural is given to numb the pain but in some cases, this can also prolong the time of labour. If this happens Pitocin is administered to speed up the labour process. Pitocin is a synthetic form of oxytocin, the hormone that is naturally secreted by the body to induce contractions.
During contractions even if you don’t feel the pain you can still feel the baby moving. Your doctor or the hospital staff might have to guide you to push the baby out when it is time. Usually, when your cervix is 10 cm dilated, your doctor will ask you to start pushing.
The third phase of labour where you have to push the baby out of the womb can last for hours and epidural doses will be administered as and when needed.
Some women might find it difficult to push due to the effects of epidural and not feel their contractions strongly. In such cases, there might be the need of additional support like a vacuum or forceps to bring the baby out.
Once the baby is delivered the medications are stopped and the effect of epidural wears off in some time. However, if a woman needs an episiotomy, it is done while the effect of epidural anaesthesia is still there.