Many women in the U.S. choose to use medical pain management in labor and birth, and the most common option is an epidural. Sometimes it is referred to as epidural anesthesia or epidural analgesia. It is a regional medicine (versus local) – this means it only blocks pain in a specific part of your body.
This type of medicine is only available in hospitals. You can request it any time in labor, after you have been admitted to labor and delivery, although if you are very close to having your baby, there may not be enough time. Typically before it can be administered, you will also need a certain amount of I.V. fluids.
An anesthesiologist or a certified registered nurse anesthetist (CRNA) may perform the procedure. You’ll be asked to arch your back and remain very still while he/she first injects a local numbing medicine. Then the doctor or nurse will insert a very small tube – called the epidural catheter – into your back. This will connect via tubing to a pump for the actual medicine.
Should you find that your pain level is still too high, or if you have no sensation at all, you may request for the medicine to be increased or decreased.
Once you have received the epidural, you will stay in the hospital bed.
A nurse will most likely place a catheter to empty your bladder, since you can’t get up to use the restroom. Your contractions and your baby’s heart rate will be continuously monitored. You may still be able to move your own legs, although the sensation may be very strange.
Your doula and your nurse will help you move into different positions while in the bed. You do not have to labor on your back the entire time. A great tool for laboring with an epidural is the use of a peanut ball. Putting the ball in between your legs while lying on your side helps to open your pelvis and speed up labor.
Once your baby is ready to be born (and we recommend laboring down!), you may wish to have your partner, doula, OB, midwife or nurse help direct you in how and when to push, especially if you cannot feel your contractions. You may also ask for the medicine to be turned down if you find the lack of sensation to be a barrier to effective pushing.
What are the benefits of epidurals?
Simply put, decreased pain! For some women, labor can escalate from “painful” to “suffering.” Other women associate pain with fear and epidurals allow them to labor without stress. If you have reached a point of exhaustion and have been laboring for a very long time the epidural may also give you the break you need to rest and recuperate so you can make it to the finish line.
Are there many side effects?
You may have a headache, shivering, ringing in the ears, backache, soreness or nausea. Your labor may slow down or even stop. For a few hours after birth, your lower half will still feel numb. Rare cases have led to permanent nerve damage.
Finally, from American Pregnancy Association, “Though research is somewhat ambiguous, most studies suggest that some babies will have trouble “latching on” causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries, and episiotomies.”
Wait, it can slow down or stop labor?
Possibly. If your contractions slow or weaken, your care provider may recommend the use of Pitocin, the synthetic form of Oxytocin, to help regulate your contractions.
What other medical pain relief options do I have in Tampa Bay?
Other options include narcotics given to you through your IV. These drugs do not numb the pain. They “take the edge off” and potentially reduce anxiety making it easier to cope with the contractions. Some women have said that these drugs made them feel a bit “loopy” or “out of it” and did not like these feelings during labor. Others felt that it helped them relax and get through the experience easier.
Talk to your care provider to learn more and determine what the best options are for you.
For one doula’s personal experience read: Should I Get an Epidural?