The subject of epidurals is one that should be discussed with your obstetrician long before you have your baby. No matter what you decide prenatally, make sure you leave room for your wishes to change when the time arrives. An epidural is a local anesthetic administered to the epidural region of the spine (lower back) to help alleviate pain from labor and contractions. Most doctors administer an epidural when a woman is in active labor with progression, so it can eliminate the pain of childbirth. While it blocks the pain, women are still able to feel contractions and push their baby when instructed by a birthing partner. The main goal of an epidural is to keep the mother more comfortable and relaxed during childbirth. The procedure carries both risks and benefits for both mother and baby and is by far the most common form of pain control used for labor and delivery.
Understanding the Epidural Procedure
An epidural is administered by an anesthesiologist—always. It cannot be given by an OBGYN unless they are also a licensed MD in anesthesiology. Most hospitals have one of these specialists on staff at all times. Before administering the epidural, they will usually explain the procedure to help you understand what will happen during the process. During the procedure, a small piece of flexible tubing, called a cannula, is placed for immediate access to an IV drip, as a precaution. From there, most doctors will have you lie sideways or sit up on the bed. They will clean the area and use a skin-numbing lotion to prepare you for the epidural. Once the epidural space is located, a small flexible tube is pushed through a needle to administer the temporary anesthetic. Within about 30 minutes, you should start feeling the numbing effect. The tubing for the epidural stays in place until your OBGYN determines it is safe to remove.
The epidural allows doctors to control the amount of pain medication you receive. If it becomes evident that you are still in too much pain during labor, more medication can be given. Additionally, most epidurals allow patients to push a button every hour to receive more medicine, should they need it. For most people, the epidural works effectively.
The benefits of an epidural can make the experience of having a baby much more relaxing. Many women fear the pain of childbirth, and knowing they will have pain relief can put them at ease. Because the medication is administered in limited amounts, only a small amount reaches the baby during labor and delivery. Additionally, the epidural can help lower blood pressure during labor, which is important as pain and distress often elevate it. Other advantages include the fact that the epidural is a temporary treatment, allowing you to move about shortly after your baby is born. Most women can walk within a few hours of labor and delivery, though this varies depending on the amount of medication received.
Despite the benefits, many people are frightened of the epidural, having heard various horror stories about aftereffects and possible complications for the baby. Generally, epidurals are safe. However, one disadvantage is that blood pressure can drop too much during labor, leading to nausea and dizziness. Another side effect is that some women develop headaches or backaches after the epidural (in some cases, for months) due to spinal fluid in the spine. Fortunately, this can typically be treated without much trouble. Another potential downside is that the epidural may cause labor to stall. The pain medication sometimes slows down labor progression, which could lead to the need for a C-section or forceps-assisted delivery. Many women who receive an epidural end up needing an IV drip with labor-inducing medications to help speed up labor. These medications may have side effects for both the mother and the baby, which should be considered.
In all aspects of labor and delivery, there are both benefits and disadvantages. It is essential for expectant mothers to stay informed about their options at every stage of pregnancy. While you may have strong preferences for pain relief or a natural birth, the real decision often can’t be made until you are in the moment. For many women, a natural birth is something they value, and too much medical intervention can hinder the experience, causing emotional distress. For others, the fear and stress of childbirth can cause more harm than going without relief. Ultimately, it is a personal decision that only you can make. By weighing the risks and benefits and being well-informed, you can have a birthing experience you feel positive about afterward.
