Should I Get an Epidural?

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These days, it seems everyone has an opinion on how a woman should give birth. Despite all the well-meaning advice from friends, relatives, and even strangers, the best thing any soon-to-be mom can do is gather all the facts and make informed decisions about what will be best for her and baby.

As you go through your information gathering process, there’s one thing you will definitely need to take into account—how to manage the pain associated with childbirth. There’s no denying that childbirth is painful. How you choose to manage it is up to you and your doctor or midwife.

Epidural anesthesia is the choice for over 60% of women in labor. An epidural can help provide you with pain relief as you go through the experience of bringing a child into the world.

What is an epidural?

An epidural is an injection in the lower back that provides pain relief from the waist down. A small tube called a catheter is inserted into the epidural space surrounding the spinal cord. The tube allows medicine to block the pain signal from the nerves in your lower body as they enter the spinal canal, before the pain signal gets a chance to travel up to your brain. Depending on the strength of the medicine you should still be able to feel the pressure of contractions during labor, just not the pain.

When the anesthesiologist (a physician who specializes in managing pain during medical procedures) administers the epidural, you will most likely be asked to sit on the edge of the bed and bend forward over your belly. An alternate position is laying on your side with your knees tucked. This allows the doctor access to your lower back and spreads the vertebrae (the bones of your spine) enough to open the space into which the medicine will be delivered.

The doctor will sterilize the area on your back where the catheter will be inserted, then he or she will numb the area. You may feel a slight prick and a burn with the numbing medication. After the site is numb, the doctor will insert a needle and then slide the catheter over the needle. The catheter is left in place and is connected to a tube that will be taped up to the back of your shoulder. This tube will deliver the medicine to you.

Pros

First and foremost, you will get pain relief. With that comes a reduction in the amount of stress involved in labor. Stress is not always a bad thing in labor as it helps release hormones that get you and your baby ready for delivery. But if you’ve been pushing for a while, it’s nice to have a break. Another good thing about having an epidural is that the dosage of medication that’s delivered to you can be managed to provide more or less numbing as needed. Additionally, if you were to have a c-section, the medication in the epidural will allow you to remain conscious so you can witness the birth of your baby.

Cons

Epidurals may have adverse effects you should be aware of. One possible adverse effect of epidurals is a quick drop in maternal blood pressure. For that reason, your blood pressure will be closely monitored. If a blood pressure drop does occur, medicine will be given to correct it.

Another adverse effect is that epidural anesthesia could slow labor (although there is some evidence that it may actually speed the first phase of labor) by limiting your ability to push. In that case, a forceps- or vacuum-assisted delivery may be necessary.

Additionally, a very small percentage of women (about 1%) experience post-epidural headache. Finally, aside from some pain and swelling around the injection site that should subside in a few days, there is very little evidence to support that having an epidural can result in long-lasting back pain.

How will having an epidural effect my baby?

While all medicine administered during pregnancy has the potential to reach your baby, only a small amount of epidural medication reaches the mother’s bloodstream. Further, although some evidence suggests babies of mothers who have received epidurals have trouble latching to breastfeed, there is no strong evidence that medications administered during an epidural have any adverse effect on baby.

What if it isn’t in my birth plan?

Having a birth plan is wonderful. That means you’ve thought about this very important day… a lot. You’ve gathered the information and made decisions about how you want to proceed. Unfortunately, things don’t always go as planned, especially when babies are involved. Know this: no matter what is in your plan, you can always change your mind. Epidural anesthesia is one option that is available through all the stages of labor to help you manage your pain.

Janette DeFelice
Dr. Janette DeFelice is a writer currently focusing on how the changing environment affects our health. She holds a Doctor of Medicine degree from Chicago Medical School where she taught clinical and diagnostic skills to beginning medical students, and a Master’s degree in Humanities from the University of Chicago. She also has a Bachelor’s degree in Political Science. Her writing can be seen online at BeTheChangeMom, ChicagoNow, and Medium, and she’s very excited to have published her first novel, Delia Rising: A Ballet in Three Acts. She lives in Chicago’s west suburbs with her school-age twins, her husband, and a family cat named Clara Barton.

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