BaiBoo

An epidural is an injection into the small of your back, using a curved, hollow needle. The needle goes between the vertebrae of your back, and into the space outside the coverings that surround your spinal cord. A fine tube is passed through the needle and then the needle is removed. The tube is taped up your back and over your shoulder. The anesthetist injects a local anesthetic into the tube to numb the lower part of your abdomen. Generally, your legs and feet go numb as well. You can’t feel your contractions any longer.

It works in the same way as a local anesthetic works when the dentist numbs your mouth before extracting a tooth. The anesthetic deadens the nerves which are carrying pain signals from your womb and cervix.

You could have an epidural at any point in labor, even in the second stage when you are pushing your baby out, although a spinal anesthetic would probably be offered in that phase. Most women choose to have an epidural when the cervix is about 5 to 6 centimeters dilated and the contractions are getting pretty strong. If you are 8 or 9 centimeters dilated, your doctor might say that it’s too late for an epidural and advise you to manage without because your baby should be born soon.

Pro’s

• More than 90% of all women get complete pain relief
• Your mind remains totally clear
• Can help to control high blood pressure
• Can put you back in control of your labor, and restore your confidence
• Epidurals are more sophisticated than they used to be and you might find that your legs and feet are not completely numb

Con’s

• May make you feel shivery
• You may be numb down only one side of your body
• You have to stay in bed
• You need to have a drip in your arm. This is because epidurals make some women’s blood pressure drop which seriously affects the flow of oxygen to the baby. The drip is a safety precaution so that the volume of your blood can be quickly boosted to bring your blood pressure back to normal again.
• You will probably have a catheter into your bladder. An epidural means you can’t tell when you need to empty your bladder, so this has to be done automatically for you.
• You might feel very out of control. You have three tubes going into your body and you have to be told when to push if the anesthetic hasn’t worn off by the second stage of labor. Your doctor manages your labor for you.
• Epidurals can increase the length of labor, especially the pushing stage. Your baby’s heartbeat will be monitored continuously, using a transducer strapped to your abdomen.
• If the epidural needle goes beyond the epidural space, there will be a leakage of cerebro-spinal fluid after the tube is taken out. Even a very small leak will give you a terrible headache. This is usually treated by taking a small amount of blood from your arm, perhaps the day after your baby is born, and injecting it into your back to seal the hole made by the epidural needle.
• Some women have problems passing urine after having an epidural.
• It’s not available for a home birth.

Tips

• Keep very still while the anesthetist is setting up the epidural. You will be on your side or sitting on the edge of the bed, leaning forward. Concentrate on your breathing. Breathe in deeply through your nose and sigh out slowly through your mouth. Hold your partners hand and keep eye contact with him.
• Discuss the possibility of letting the epidural wear off for the second stage of labor when you are going to deliver your baby. Being able to feel the contractions will help you push more effectively.