Epidurals are one of the most effective and popular methods of pain relief during labour. Like all things pregnancy related, you probably want to know about their benefits and risks. Will it pose a harm to me or my baby?
What is an epidural?
Epidural analgesia is an injection by a qualified anaesthetic into the lower back that pierces the outer coverings of the spinal cord. This way, anaesthetic medications are injected around the spinal nerves. This anaesthetic usually blocks the pain from labour contractions very effectively. It usually just takes 5-30 minutes for you to feel significant pain relief. Don’t worry, you can still move and push your baby when you need to.
Pros of an epidural
- Available in most hospitals
- Highly effective and safe
- Reduces stress
- You can still move around and push
- Allows you to recover your strength in a long labour
- Allows you to stay awake during a caesarean or vaginal birth
- The dosage can be adjusted should you need an emergency C-section or repair of teared tissue
Cons of an epidural
- Not everyone can have one due to medical reasons
- You may lose feelings in your bladder and legs
- You will need IV fluids in the arm and a catheter to pass urine (depending on your hospital’s policy)
- It may slow down the second stage of labour
- You and your baby will need to be closely monitored during labour
- Harder time peeing after birth
Are there risks or side effects with epidural?
When the epidural kicks in, some women experience a drop in blood pressure. However, your blood pressure will be constantly monitored and the IV fluids should help it return to normal quickly.
Rarely, an epidural can cause a headache, fever or soreness. Some women also feel itchy, cold and nauseous. The procedure may also in rare cases leave a bruise or infection around the spinal cord.
In extremely rare cases, epidurals may injure the spinal cord and nerves. This may cause breathing problems and permanent nerve damage.
Women who have bleeding disorders may not be allowed epidurals, due to the risk of hematoma. Women who have scoliosis (curved spine) may also make epidurals tricky, although an experienced anesthesiologist should be able to insert the needle correctly.
What are some other options?
If you think that an epidural is not for you, or that your doctor doesn’t recommend it for your specific health condition, there are some other options:
- Relaxation techniques, eg. breathing, massage, bath
- Gas (entonox)
- TENS machine
- Pethidine (strong painkiller injection)
The best way to find out which pain relief option is the most appropriate for you is to discuss them with your obstetrician and midwife. For more information, you can contact Melbourne-based obstetrician Dr Alex Polyakov here.