Epidural During Labour
As you count down to the big day when you get to meet your baby, you may be thinking about your pain relief options for labour. One common method you might have heard about is the epidural injection. Read on to find out more about what an epidural is, how it works, and what the risks and side effects can be.
What Is an Epidural?
An epidural block is one of the most common types of pain management used during labour.
The chief benefit of an epidural is that it allows you to remain alert and awake throughout labour and delivery while eliminating most of the pain by numbing your lower abdomen and birth canal. Once you’re on the epidural, you can still move and push, but you may not be able to walk. You will still be aware of your contractions.
If you think you might like to have an epidural, you should ask your healthcare provider at one of your prenatal sessions whether it is available at the hospital or birthing center where you will be giving birth. If you’re working on a birth plan, you might like to include your pain relief preferences. Of course, when the time comes, it’s perfectly normal to change your mind; just let your medical team know.
When Is an Epidural Given?
The epidural is often administered during active labour but can be given earlier in the process, such as when your contractions begin, or later on, such as during the second stage of labour when you push your baby out. Discuss the timing with your provider to figure out what’s best for you.
Your provider may recommend you have an epidural if your vaginal birth is induced, because contractions can sometimes be more painful in this case.
Epidurals are sometimes used during cesarean sections, too. For example, you may be given an epidural during a planned vaginal delivery only to find out that you’ll need to undergo a cesarean section due to unforeseen complications. In this case, with the epidural catheter already in place, your anaesthesiologist can administer more medication to prepare you for surgery. A quick-acting spinal block can also be given if you have an unscheduled cesarean section and you haven’t been given an epidural.
Labour isn’t the only time when you may be given an epidural. If you have a pelvic exam any time after week 37, and your provider determines your baby is in a breech position (not in a head-down position), she may attempt to turn your baby using a procedure called ECV, or external cephalic version. In this case, an epidural can help relax your uterus to make turning the baby easier and less uncomfortable.
How Is an Epidural Given?
A small area on your lower back called the epidural space will be cleaned and numbed using a local anesthetic. Then, you’ll need to sit or lie on your side while an anaesthesiologist inserts a needle into this epidural space. The anaesthesiologist will then insert a catheter and remove the needle. The pain relief medication is delivered through this catheter, which remains in place during your labour and delivery. You won’t need another injection once the epidural catheter is in place.
When Does an Epidural Start to Work?
It typically takes about 10 to 20 minutes for the epidural shot to start to work. Your anaesthesiologist can adjust the amount of medication as you need it, meaning the pain relief can last as long as you need it to. In some hospitals, you may be able to control your own dosage by pressing a button programmed to release safe amounts of medication at your command throughout your labour.
Epidural Risks and Side Effects
Epidural blocks have a low level of risk, but it’s worth being aware of some of the potential complications and side effects:
Reduced blood pressure (If you have an epidural, you’ll also be placed on an IV fluid drip to help prevent a drop in your blood pressure.)
Soreness at injection site
Back pain after the epidural
Labour lasting longer than it might without an epidural.
Does Getting an Epidural Hurt?
Having a needle and a catheter inserted into your lower back may sound like a painful procedure, but before you get an epidural inserted into the space outside your spinal cord, your doctor will give you a local anesthetic to block this pain.
Other Types of Pain Relief During Labour
An epidural is one of several types of regional anaesthesia you may have access to during your labour. Other types include spinal blocks and combined spinal-epidural blocks. Your provider can help you decide which type might be right for you.
Spinal block. In this case, the epidural medication is injected as a shot directly into the spinal fluid in the spinal cord. It generally takes effect more quickly than an epidural block, but the pain relief wears off more quickly, too (usually after one to two hours), because there is no catheter in place to continuously administer the medication.
Combined spinal-epidural (CSE) block. As its name suggests, this method of pain relief can give you the benefits of both the spinal and epidural block. The spinal block is given first to provide fast pain relief, and the epidural catheter is inserted later to provide more long-lasting comfort throughout your labour.
There are other, non-medical types of pain relief you can try, too, and you may have learned about some of these in a childbirth class. These labour comfort measures can be used whether you’ve had an epidural or not. Some of these options include:
Hypnobirthing. This is a relaxation technique that can help reduce fear, anxiety, and pain during labour.
Massage therapy. Your birthing partner can gently massage your lower back or shoulders, which may help relieve some of the pain of contractions.
Breathing exercises. Controlled breathing, such as the techniques taught in Lamaze classes, can also help you relax and decrease painful sensations during labour.
FREQUENTLY ASKED QUESTIONS
Before your baby’s arrival, explore all the pain relief options available to you to find the one you feel most comfortable with. Remember that you can also change your mind once you’re in labour. For some moms-to-be, an epidural is the best option, while others may also consider alternative ways to be more comfortable during labour.
Although giving birth can seem daunting and there’s a lot to think about, before you know it your baby will be home and you’ll be focused on what comes next. Make sure you’re nice and prepared for what’s ahead by having all the diapers and wipes you’ll need for those first few weeks with your little one. Plus, download the Pampers Rewards app to start earning gifts and discounts now.
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