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One of the most hotly debated subjects during pregnancy is whether or not to use an epidural. Getting an epidural can be a great way of reducing pain and trauma for the mother during childbirth. However, there may be some potential downsides to epidurals as well. This guide will answer all your questions about epidurals, so you can see if it’s a good choice for your labor process.
How Does an Epidural Work?
An epidural is a type of anesthesia that helps block pain signals before they can travel to the brain. It gets its name due to the site of injection. When you get an epidural, a needle delivers the anesthetic medicine right to the epidural space inside the spine. The epidural space is a narrow spot right below the bones and above the membrane that coats the spinal cord. This numbs all the nerves in the lower part of the body while still leaving you clear-headed.
People divide epidurals into two categories based on the amount of anesthetic one receives. If you just get a low dose, you have a “walking epidural.” The anesthesia enters your body in gradual dosages, and you can still change positions or move around as needed. A higher dose of epidural may entirely numb the body. This type of epidural is so strong that you can have a C-section without feeling discomfort.
What’s the Process of Having an Epidural?
If you decide to get an epidural, an OB nurse will administer it. First, they will shift you on your side or ask you to sit up. Then, they will sanitize the area and inject a small amount of numbing medication.
Once they finish preparing the injection site, the nurse will thread an epidural needle into your back. This needle threads a catheter into the epidural space inside the spine. Then, anesthetic medications move through the catheter to fully block pain signals. The whole process usually takes around 10 minutes. After the catheter is in place, you or your health care professionals can add anesthesia at various doses for as long as you need it.
How Do You Know When to Get Epidural?
It’s pretty common to not know whether you want an epidural until contractions start. Just let your birthing team know in advance that you might want one. The only reason your doctor may recommend skipping an epidural is if you have low platelet counts, take blood thinners, have spinal problems, or have an infection.
Timing for an epidural can be tricky. You do not want to do it too soon because that can slow down early labor. However, if you wait too long, it can be hard for you to be still enough to get the epidural. The ideal time for an epidural is when you are around 4 centimeters dilated and still have a couple of minutes between contractions.
What Does an Epidural Feel Like?
Many women worry about epidurals being painful, but the reality is that the procedure isn’t too awful. When you get the first numbing shot, you might feel a slight sting. However, by the time the nurse is threading the catheter into the epidural space, you will not feel anything but pressure. Once the epidural is in, you do not feel anything but the tape holding it in place on your back.
Within 10 to 15 minutes of getting your epidural, you will start to feel the effects. Typically, the epidural affects your body from below your breasts to your knees. It can make your body feel completely numb. Many women report being able to sleep through contractions until it is time to push. Others may feel a sensation of pressure or motion, especially if they are getting a C-section.
Is Childbirth With Epidural Any Different?
The main thing that’s different about having childbirth with epidural is simply that you are less likely to feel discomfort. This reduced pain can improve your mental health and change the way your body reacts to certain things. Without your body’s reaction to pain, you are less likely to have a high heart rate or low oxygen levels in the placenta.
Epidurals do little to interfere with the main physical processes of labor. Your cervix still dilates at the same rate, and your contractions still come at about the same speed. Some research indicates that an epidural may cause you to spend up to 20 minutes longer in the pushing phase. However, overall labor length remains roughly the same.
What Are the Side Effects of an Epidural?
The most common side effects of epidurals are low blood pressure, fever, or difficulty urinating. These side effects occur in about 15 to 20% of patients, and they go away when you take out your epidural. Since an epidural may make it slightly harder to push, your risk of needing a vacuum or forceps during labor is also a bit higher.
In rare cases where the person administering the epidural puts it too close to the spinal column, you may experience some spinal fluid leakage. This causes unpleasant headaches for a few days but no permanent problems. Another rare but potentially serious side effect is nerve damage. This happens in about one in 100,000 women, and it can take a few months to heal.
How Will an Epidural Affect Your Baby?
Epidurals are typically even safer for the baby than they are for the mother. Epidurals do not cause fetal distress or make it more likely that you’ll need a C-section. There is no difference in APGAR scores between babies born with or without epidurals. In the long run, an epidural does not affect your baby’s health. They breastfeed normally and don’t have any differences in growth rates over time.
How Long Does an Epidural Last?
Your birthing team can add more anesthesia through the epidural catheter as needed, so they can last a very long time. You can keep getting more medication as long as your labor lasts. Once you quit getting the medication, it will usually take around a couple of hours to wear off. This gives you plenty of time to bond with your baby and take a nap before any discomfort sets in.
Ultimately, there’s no “one size fits all” approach to using epidurals. Some women may find that an epidural improves their childbirth experience while others prefer to go without it. Are you thinking about having an epidural during your birthing? To pick the best option for your needs, it’s a good idea to discuss your options with an experienced OB/GYN. Call now to schedule a consultation.
Dr. Ellman is a Board Certified OBGYN who established his medical practice in South Florida over 25 years ago. His office, Women’s Healthcare of Boca Raton, is located in Boca Raton, Florida at West Boca Medical Center. Dr. Ellman attended Albert Einstein College of Medicine of Yeshiva University, where he received his medical degree. He went on to intern at Beth Israel Hospital in Boston- an affiliate of Harvard Medical School- and continued his residency at North Shore University Hospital in Manhasset, New York- an affiliate of Cornell Medical School.
Dr. Ellman has practiced Obstetrics and Gynecology in the Boca Raton area since 1995. In addition to treating patients at West Boca Hospital, Dr. Ellman also treats patients through his own private practice, Women’s Healthcare of Boca Raton, located on the West Boca Medical Campus.