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Epidural 101: How It Works

epidural

 

One of the most painful experiences known is childbirth. It is a multidimensional experience where we need to keep a balance between pain relief physical, emotional, and psychological considerations.

 

The idea of epidural anaesthesia understandably worries many women. This is partly because, the thought of a needle so close to your spinal cord isn’t really the most comforting thought, and and partly because they may have heard or read stories that are alarming.

 

Dr Nupur Gupta  (Gynecologist & Obstetrician, Well Women Clinic, Gurgaon) reassures mums-to-be about what an epidural actually involves.

 

What is an epidural analgesia?

 

It is an extremely effective and popular treatment for labor pain. The anaesthetist administers an injection into the space around the spinal nerves in the lower back, which numbs the area above and below the point of injection. It can be used for either a natural vaginal delivery or a Caesarean Section.

 

How is epidural given?

 

A sterile guide needle along with an epidural catheter is inserted into the epidural space. Prior to the injection, local anaesthesia is given at that point. Then the guide needle is inserted and removed, while the catheter remains in place, to provide pain relief as and when needed.

 

How does an epidural work?

 

After injecting the medication, the pain nerves get numbed. The extent of the numbness depends on the type of drug used, and the amount injected. Pain reappears once the effect of medicine goes away.

 

When should I have an epidural?

 

It is best given when contractions are getting stronger, often when cervix dilates to about 4 to 5cm, and chances of natural childbirth are highest.

 

Does an epidural affect my baby?

 

Most of the medications that cross the placenta will reach the baby, However, with an epidural, the amount that enters your bloodstream is quite small, and with a spinal, it’s even smaller and does not cause neonatal depression or any harm.

 

What are the advantages of having an epidural?
  • You can relax and rest if your labour gets prolonged
  • You can have a more positive birth experience
  • If you need Caesarean, epidural can be used as anaesthesia as well
  • It prevents exhaustion, irritability, and fatigue and gives the strength to keep moving

 

What are the disadvantages of having an epidural?

 

The most common side effect from epidural anaesthesia is lowering of the mother’s blood pressure. Less common side effects include severe headache after delivery, walking difficulty after delivery, fever, and prolonged labour.

 

Because a standard epidural can decrease your ability to push, a forceps delivery may sometimes be needed.

 

Some risks include puncture of the outer layer surrounding the spinal cord and brain and rarely nerve damage.

What else should I know about epidural?

Usually the epidural catheter is removed after delivery and its effect wears off within 2 hours after the medicine is stopped. There might be some back or hip pain during the recovery period.

 

 

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By Dr Nupur Gupta
Gynecologist & Obstetrician, Well Women Clinic, Gurgaon

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