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Fairly one of the safest methods of pain relief management, epidural barely reaches a woman’s blood and rarely affects the baby- a primary reason why 70% of pregnant women advocate the usage of epidural for labor pain. Not only does epidural minimize the infamous labor cramps but it also helps mothers stay active for the delivery.
Even though doctors generally mark epidurals safe for labor and delivery, there’s still a lot of debate around taking an epidural for labor pain relief and management. Let us find out everything there is to know about using an epidural for pain relief during labor in this blog today!
But First, What is an Epidural?
An epidural is a safe local steroid or anesthetic that is injected directly into the spine which numbs the receiver waist down. Epidural is recommended for laboring women to reduce labor pain and to help them remain active, awake, and alert for the childbirth process.
Where and How is Epidural Administered?
Epidural injection for labor pain is administered into the space between the membrane that covers the spinal cord and the ligament sheathing the vertebrae.
The epidural administration varies from one hospital to another and depends on a hospital’s policies. As per the independent policy of your delivery hospital:
- A urinary catheter or thin tube is first inserted into your bladder to help you get rid of the urine while the epidural is in effect, as you may not want to use the loo.
- In another scenario, your bladder may be first drained with a catheter.
- You will also be administered IV fluids before the administration of the epidural to prevent a drop in blood pressure.
- Before you get the main epidural shot, you will first be given a shot of local anesthesia in your low- to mid-back area.
- Once the anesthesia shows its magic and numbs the area, you’ll be asked to lie on your side or lean over a raised bedside table.
- When a comfortable and administrable position is ensured, a larger needle will be inserted into the epidural space of the spine as the main epidural shot.
- When the needle is removed a fine, flexible catheter is left behind through which the drug is administered.
- The medicine delivering tube will be taped on your back to allow side-to-side movement.
Can You Feel an Epidural Shot?
While some women do not feel anything when given an epidural injection for labor pain, some report having felt a slight pressure, a tingling sensation, or a brief shooting pain. But ultimately, all women agree that the briefly felt sensation is incomparable to the mighty labor pain.
When Can You Get an Epidural?
Epidural can be administered to you whenever you ask your doctor for it. There is no minimum dilation requirement for using an epidural shot. However, it is usually recommended to take an epidural as soon as possible because the shot requires the receiver to sit perfectly still. As you may have guessed, the sitting still requirement gets harder to achieve as the labor advances.
Does Epidural Increase the Chances of a C-section?
No, epidural does not increase the chances of cesarean delivery or reduce the possibility of a normal delivery. There have been no studies to confirm the statement and so, this is a baseless myth. However, it should be noted that if you do happen to end up having your baby via C-section, the dosage of the epidural for labor pain will be increased to ensure you don’t feel anything in your lower half of the body at all.
How Long Does an Epidural Take to Work?
The effect of an epidural for labor pain and subsequent relief can be experienced in less than 15 minutes. Here’s what happens after an epidural is administered:
- Within 3-5 minutes of the dost, your uterus nerves begin to numb.
- The full effect is then seen in another 10-15 minutes.
- Typically, 15 minutes past administration of an epidural, women cannot feel anything ribcage-down, making the contracts bearable.
What Does Pushing With an Epidural Feel Like?
If you take an epidural for labor pain, it becomes hard for you to feel any pain in the lower body at all, or in other words, it can numb the lower half of the body. However, most women are typically known to be able to push desirably even with an epidural in. In some other cases, however, if the pushing does not progress owing to the lack of sensation, the epidural could be adjusted to help you feel the contraction and sensations. Pitocin may also be administered in case the labor tends to slow down.
Walking Epidural (Combined Spinal-epidural Anesthesia)
Some women may prefer to be administered a smaller amount of pain management medication in comparison to the traditional epidural shot. Such an epidural injection for labor pain is generally known as a “walking epidural.”
A walking epidural uses a small amount of medication to offer pain relief while allowing some sensations to remain in the lower part of the body. It should be noted that:
- Unlike an epidural, a walking epidural is administered as a shot of analgesic directly into the spinal fluid.
- While a traditional epidural shot makes a laboring mother numb to contractions, a walking epidural allows the sensation and use of muscles in the legs (since it is a spinal fluid).
If at a later point, you happen to feel the need for a heavier dose, medication may then be placed into the epidural space. Besides, though the name suggests ‘walking’ a walking epidural for labor pain will make you feel weak in the legs and will restrict your movement. In other words, you cannot get up and walk after the administration of a walking epidural, you can just expect not to be numb to lower body sensations.
Epidural Injection for Labor Pain and its Effect on the Baby
Does an epidural injection affect the baby? There is no one-word answer to this question. Here’s why: Since a typical epidural for labor pain will be a combination of anesthetics and opioid analgesics, it may increase the heart rate of the baby (owing to the nature of opioid analgesics). Post childbirth, your baby may also have temporary trouble breathing, drowsiness, and reduced muscle tone. In the initial days, it may also be difficult to latch on and breastfeed the baby.
However, these effects usually fade away and are not long-term, and are momentary concerns. It is also for these reasons that doctors advise constant fetal monitoring with an epidural. Hence, though there are some effects on the baby, the effects are only temporary.
Is an Epidural for Labor Pain Safe?
Epidural may cause a drop in blood pressure after kicking in and hence, your doctor will ideally hook you up with an IV before epidural administration. Lying on the side is also recommended to allow the body to counteract the BP dips.
In some rare cases, epidural may also cause headache, fever, or a sore feeling. The infamous opioids may also cause some itchiness, nausea, or vomiting. In some unfortunate (and very rare) cases, epidural may injure the receiver’s spinal cord and nerves and result in breathing problems. Permanent nerve damage may also take place in rarest, unfortunate scenarios.
But again, though there are these rare risks, an epidural is generally considered fairly safe. If you are in doubt, talk to your healthcare provider and receive some professional consultation on epidural in advance.
Risks and Side Effects of Taking Epidural for Labor Pain
Though rare, some side effects of epidural may be experienced by women including:
- Headaches: About 1% of women who received epidural shots experienced intense headaches due to a rare leakage of spinal fluid. Persistent headaches of this sort are treated by injecting some of your blood into the epidural space.
- Back pain: Women experiencing back labor will experience prolonged back pain after epidural for labor pain relief.
- Limited birthing options: An epidural for labor pain negates the possibility of water birth and does not support delivery at a birthing center. You will have to mandatorily give birth in a hospital if you choose to have an epidural administered.
- Perineal tear: Studies have shown that perineal tears are common in women who took epidural injections. Here are some other causes of perineal tear:
- Labor induction
- The heavy weight of the baby
- Longer labor: As per research, “Epidurals may extend the length of the second stage of labor by an hour or more.” It also makes pushing a bit difficult which means longer labor. This can increase the chances of a C-section, medication, or forceps to help you deliver.
- Difficulty in peeing post-delivery: Epidural numbs the sensitivity of the bladder and makes urinating in the first 24 post-delivery hours very difficult in terms of urination.
Advantages of Epidural Shots
Here are some pros of getting an epidural injection for labor pain relief:
- Pain relief: Epidural effectively reduces labor pain with minimal side effects on both the baby and the mom. It works its magic quickly and within 10 to 20 minutes, the recipient feels little or no pain due to labor.
- Relaxing: When you don’t feel pain during labor, you are more relaxed and calm. This is beneficial if you have a long labor. Being able to avoid pain and relax can give you a positive birth experience.
- Alert: It makes you alert which means you play an active part in your birthing journey and spare the discomfort of vacuum or forceps to get the baby out. An epidural while having a C-section delivery ensures that you stay awake during the procedure and helps in pain relief while recovering post-surgery.
- Postpartum depression: A study published in 2014 found some evidence of a decrease in postpartum depression (PPD) in women who took epidural shots. However, recent research showed that there is no evidence of reduced postpartum depression.
Another study found a possible connection between women who intended to use epidural and did use it during their labor and had a reduced risk of postpartum depression. It meant that having a pain management plan and being able to work the plan out can help reduce postpartum depression.
The Bottom Line: Epidural for Labor Pain
Still doubtful about taking an epidural for labor pain relief? There is nothing to worry about as this decision is completely yours to make. Take some time, speak transparently with your doctor, and make the decision you deem fit for yourself and your baby.
Epidural For Labor Pain FAQs:
1) Can epidurals be taken for multiple pregnancies ?
2) Can an epidural be taken with lower back tattoos ?
3) Does scoliosis interfere with epidurals ?