Epidural

Many women want an epidural.  They know that when it is time to push a watermelon out of a space the size of a grapefruit, the pain associated with that is not something they want to endure.  But, how many actually know anything about the epidural? 

Let's investigate....

There are three layers to the membranes that cover your spinal column.  The three are collectively called the meninges.   The epidural space, or where the epidural is administered, is outside the outer layer of the spinal column, or outside the outermost layer of the meninges. 

The anesthesiologist will insert a catheter into that space in order for the anesthetic to enter your body.  The anesthetic is mixed with saline.  I learned all of this while I was laboring at Milford Regional Medical Center!
While the catheter is being inserted, you will be required to sit over the edge of the bed with your legs dangling over the side.  You will be hunched over with your back rounded out.  Some hospitals will let you lean against your partner for this, while others will ask for your partner to wait outside.  The skin will be cleaned and then a local anesthetic will be injected in order to numb the area.  The needle/catheter will be put in place and the needle will be removed.  The anesthetic will flow and you will most likely become some what numb. 

I say "most likely" because there are varying degrees of numbness or pain relief.  I had an epidural where I couldn't move my toes.  My legs kept falling off the bed.  I have also had epidurals where I could tell that I was pooping on the table.  I don't know if it was the dosage or the way my body metabolized it.  There have also been instances of the catheter being slightly askew, causing the epidural to only give pain relief on one side of the body. 

Keep in mind that the epidural is a funny little thing.  If you lie on one side of your body, the epidural will pool on the side you are lying on...causing the other side to feel pain.  There can also be gaps in your epidural...I'm not sure of the term for it, but there are spaces where your epidural may not relieve pain and you'll only feel pain in that small, concentrated spot.  Again, these are all things that I have learned along the way. 

In choosing pain relief, I believe it is important to find out all the information you can on your choices and then make your decision.

Here are some pros and cons from Americanpregnancy.org:

What are the benefits of epidural anesthesia?

•  Allows you to rest if your labor is prolonged
• Relieving the discomfort of childbirth can help some woman have a more positive birth experience
• Most of the time an epidural will allow you to remain alert and be an active participant in your birth
• If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery
• When other types of coping mechanisms are not helping any longer, an epidural may be what you need to move through exhaustion, irritability, and fatigue. An epidural may allow you to rest, relax, get focused and give you the strength to move forward as an active participant in your birth experience.
• The use of epidural anesthesia during childbirth is continually being perfected and much of its success depends on the care in which it is administered.

 What are the Disadvantages of epidural anesthesia?

 

• Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen
• You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache
• After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop
• You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating
• You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary
• For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance
• In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
• Though research is somewhat ambiguous, most studies suggest some babies will have trouble "latching on" which can lead to breastfeeding difficulties. Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.