Epidural Side Effects - Childbirth Preparation

How many ways are there to have a baby? Well, actually not very many - but there are definitely a variety of ways to experience labor and delivery. Natural childbirth is one of the ways and is considered to be a drug free, vaginal birth.  The mother uses breathing techniques, may have a waterbirth or hypnbirth, and may also have a midwife present to coach her through her labor and birth.  Unless a woman is having a cesarean delivery, the need for medication varies with the mother and the situation at hand. If everything is going along well, the mother may decide she doesn't want or need pain medication. On the other hand, if a complication arises, the mother has high blood pressure, the pain is beyond what she can handle, or the labor is very long, then pain medication may be administered.

Controlling Pain Through Epidural

One of the more common methods of using medication during labor and delivery is through epidural. A woman may decide on an epidural while in her pregnancy, often because the idea of the pain of delivery is overwhelming. An epidural anesthesia is used for all kinds of birthing situations, including regular childbirth, cesarean, induced labor, and forceps or vacuum deliveries. An epidural during labor provides a block to the pain through freezing the body from the waist down. However, an epidural childbirth also carries side effects. Epidural side effects include itching and restrictions in movement of the woman. If the epidural catheter goes into the spinal fluid when it is inserted, the anesthesia can become a spinal anesthesia. Many women experience a headache after the birth or surgery (if the birth was a cesarean).

How an Epidural is Administered

An anesthesiologist administers the epidural which is usually done with the mother either sitting up or laying on her side, curling as tight as possible to give the best possible view of the spine. This is quite a feat with a huge belly and contractions happening at the same time. The back is washed with a very cold solution to clean the area where the catheter will be inserted and then an injection with a local anesthesia numbs the area prior to insertion. A test dose of anesthesia is given in the epidural space to ensure the medication is going where it is supposed to go, then the needle is withdrawn and the catheter remains in place. Occasionally there is an epidural hematoma (localized swelling filled with blood resulting from a break in a blood vessel) which can cause discomfort after the catheter is removed.

Effect of Epidurals on Labor

An epidural also has an effect upon the actual labor as well as the fact that there are epidural risks. It slows labor down due to the reduction in contraction strength and a reduced urge to push which increases the chance of needing a forceps or vacuum extraction of the baby by three-fold. This increases the risk of bruising the baby and causing trauma for both mother and child. There is also a three-fold risk of needing a cesarean delivery if labor slows too much or it may require pitocin, a drug used to speed labor that intensifies contractions. Blood pressure must be monitored consistently through the labor and birth because it can drop significantly during the first 30 minutes after the epidural is started. There is a potential for fetal distress as a result of this drop in blood pressure.

The Aftermath

After the delivery, the mother can experience back pain which can go on for a long time. An epidural hematoma can compound this back pain. She may have difficulty urinating and the drug injected can have the potential to interfere with breastfeeding through an effect on oxytocin release and milk let down reflexes.

One may wonder why a woman would choose to have an epidural, but women vary in their coping abilities and strategies. It is best for a woman to learn all she can about the various pain medications, including epidural, while in her pregnancy so she can make an informed decision. It is important to be well advised and also to be flexible, because things can change radically during labor and delivery.

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