Epidural Anaesthesia: A shot at relieving pain during labour

If you are pregnant and delivering soon, you have probably heard of “painless labour/ painless baby delivery” and epidural anaesthesia.

What is the meaning of an “epidural?”

An epidural is an injection administered in the epidural region of the spinal cord. In the context of childbirth, this route is used to numb the pain signals going from the uterus to the brain.

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How is epidural anaesthesia different?

An epidural is not akin to general anesthesia. You can be fully conscious and aware after receiving an epidural injection to relieve normal delivery pain.

In what position is an epidural injection administered? Is it painful?

An epidural injection usually requires that you sit or lie down on your side. A tiny prick of the needle may be felt for a few seconds, but epidural injections are otherwise painless.

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The anesthetic is then sent in through a thin catheter inserted at the prick site. You will most probably receive a test dose first, followed by the full treatment according to your body weight. In most cases, an epidural injection is a painless, complication-free process.

Is An Epidural For Me?

Many women do not discuss epidurals with their gynecologist. Especially in an Indian context, they are often told to grin and bear it; that not putting up with labor pain is a sign of weakness.

However, an epidural is a chance to experience a normal baby delivery minus the pain, and your choice. Whether you are the right candidate for a painless delivery is determined by your medical condition.

You should know these risks before going in for an Epidural:

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  • If you have had a low blood pressure throughout pregnancy, you may not be a candidate for epidural anaesthesia. Even in other women, blood pressure monitoring is continuous as epidurals can cause a sudden drop.
  • Epidural births require the use of assistance (such as forceps, vacuum or an episiotomy) more often than births without epidural anesthesia.[1]
  • There is some reason to believe that babies born with an epidural have trouble breastfeeding in the first week.[2]

Long-Term Side Effects Of An Epidural Injection:

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Some women experience urinary incontinence after receiving an epidural injection. This makes logical sense as you cannot feel your full bladder while the anaesthesia works. Sometimes, an epidural can injure the surrounding nerves, thus causing temporary damage for a few weeks. In women whose spinal canal is accidentally punctured, a severe headache is common and treatable. Like all medical procedures, an epidural too can cause complications, making it difficult to ease back to normal life after delivery. Fits, breathing difficulties and permanent nerve damage are infrequent side effects. However, you should discuss your options with your gynecologist early on, so that the labour team is informed of your choice well in advance.

References:

  1. Zhang, Jun, Michael K. Yancey, Mark A. Klebanoff, Jenifer Schwarz, and Dina Schweitzer. “Does epidural analgesia prolong labor and increase risk of cesarean delivery? A natural experiment.” American journal of obstetrics and gynecology185, no. 1 (2001): 128-134.
  1. Torvaldsen, Siranda, Christine L. Roberts, Judy M. Simpson, Jane F. Thompson, and David A. Ellwood. “Intrapartum epidural analgesia and breastfeeding: a prospective cohort study.” International Breastfeeding Journal1, no. 1 (2006): 24.

 

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