Epidural for childbirth
We look at what an epidural is and how it can help you cope with the pains of labour.
Every woman is different and each birth experience is unique, so the need for pain relief varies. Your doctor may recommend an epidural to help reduce the pain. An epidural is one of the most effective ways of making childbirth pain free, and it can be a safe approach for both you and your baby.
How does an epidural work?
Your spinal cord runs through a channel formed by your vertebrae (bones in your spine) and carries signals between your brain and your nervous system. At each level of your spine, nerves leave your spinal cord to reach different parts of the body. For example, nerves from the lower part of your body join your spinal cord in your lower back. The spinal cord is surrounded by three protective layers of tissue called the meninges. The area just outside all these layers is called the epidural space.
An epidural involves injecting local anaesthetic and other pain-relieving medicines into the epidural space in your lower back. This injection numbs the nerves that carry the pain signals from the birth canal to the brain. As it is a local anaesthetic, you don’t go to sleep like you would with a general anaesthetic.
Preparing for an epidural
An anaesthetist is the only person who can give an epidural, which means it is not available at home. Also, an epidural isn’t suitable for everyone – women who have problems with blood-clotting or infection may need another pain relief method. Your doctor will be able to discuss all pain relief options with you.
For women having an epidural, the procedure will start with a consultation. An anaesthetist will discuss with you what will happen before, during and after your epidural. This is a good time to make sure you understand what will happen. Feel free to ask any questions you may have. Especially about the risks, benefits and any alternatives. This will help you to be informed, so you can give your consent for the epidural to go ahead.
What to expect during an epidural
Before your anaesthetist gives you an epidural, you will have a small tube (cannula) inserted into a vein in your hand or arm. This is used to give you fluids and medicines that you may need during labour. Your blood pressure and your contractions will be monitored continuously. Your baby’s heart rate and pulse will also be monitored closely.
Your anaesthetist will inject the local anaesthetic through a catheter (flexible plastic tube) that’s been inserted into the epidural space in your lower back. The injection blocks the nerves lead to the lower part of your body, numbing the pain from childbirth.
It takes around 20 minutes for the epidural to work. Your anaesthetist can control how much feeling is lost, depending on the amount and type of medicines used. Different people require different doses of anaesthetic. And because it works for a short period, your anaesthetist will top up the epidural to provide lasting pain relief.
Recovering from an epidural
The numbness may take several hours to wear off. During this time, do not attempt to walk without someone to help you. You may also feel sore for a day of two after the injection. If you experience persistent numbness, weakness, headaches or severe back pain in the first weeks after your epidural, contact your anaesthetist.
What are the alternatives to having an epidural?
There are several other methods of labour pain relief you can try if you don't wish to have an epidural.
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