What is Epidural? Benefits, Side Effects on Mother and Baby
The article is for information purpose only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
1. What is Epidural?
2. When will epidural is given during birth delivery?
3. Types of epidural
4. Benefits of epidural
5. Side effects on mother
6. Side effects on baby
It is important for you to read hospital’s policy in the use of epidural, combination of drug used, duration of pain relief, drug’s effect on you and your baby before your birth delivery. This is because anesthesiologists may give a different dosage of the drug in different hospitals.
1. What is Epidural?
Epidural anesthesia is a method of pain relief during labor. It has been estimated that more than 50% of women giving birth at hospitals use epidural anesthesia.
Epidural anesthesia is a regional anesthesia that relieves pain in a particular region of the body. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body.
2. When will epidural be given?
In a typical situation, an epidural is given when the cervix is dilated to 4-5 centimeters and you are in true active labor.
In some hospitals, an epidural can be given to the mother at any time as long as the mother is in active labor. In some hospitals, obstetrician or anesthesiologist will determine when the best time for administration is.
3. Types of Epidural
Exact method and drugs used may vary from hospital to hospital.
A. Regular Epidural
In regular epidural, anesthetic is administered either by a pump or by injections into the epidural space. Narcotic such as fentanyl or morphine is given to reduce some of the adverse effects of the anesthesia.
B. Combined Spinal-Epidural (CSE) or “Walking Epidural”
In this type of epidural, an initial dose of anesthetic is injected beneath the outermost membrane covering the spinal cord, and inward of the epidural space.
This type of epidural allows more freedom to move while in the bed and greater ability to change positions with assistance. With the catheter in place, you can request an epidural at any time if the initial intrathecal injection is inadequate.
CSE should provide pain relief for 4-8 hours.
4. Benefits of Epidural
1. Epidural provides a route for very effective pain relief for the mother, this makes the birth delivery more pleasant.
2. As the effect is localized, the mother will still be alert and awake during labor and birth. Use of epidural allows mothers to rest, relax and stay relatively focused, this will give mothers strength to participate in the birth delivery.
3. If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.
4. Epidural analgesia can reduce the incidence of postoperative pulmonary, thromboembolic and cardiac complications associated with the birth delivery.
5. Side effects on mother:
1. First, it slows down the uterus contraction and therefore lengthens labor. This is because epidural dilutes the contract-causing hormones circulating in the blood stream.
2. Epidural increases the risk of a severe perineal tear. Study has shown that the use of epidural has tripled the risk of a severe perineal tear.
3. Use of epidural may increase the risk of cesarean section by 2.5 times.
4. Use of epidural increases the occurrence of induction with synthetic oxytocin (Pitocin) by threefold.
5. Epidural quadruples the chances that a baby will be persistently posterior (POP, face up) in the final stages of labor, which in turn decreases the chances of spontaneous vaginal birth. This is because epidural makes it difficult for the baby to get into best position for birth.
6. Epidural increases the risk of pelvic floor problems (urinary, anal and sexual disorders) in mothers after birth, which rarely resolve spontaneously.
7. Studies have shown that epidural can affect breastfeeding. Study has found that an epidural during birth is correlated with women ending breastfeeding by the time their baby was 24 weeks old.
6. Side effects of epidural on babies
Drugs administered by epidural also enter the baby’s bloodstream and this is why the baby is also affected. Because of an immature immune system, it will take a longer time for baby to eliminate epidural drugs. For example, many studies have found bupivacaine metabolites in the urine of exposed newborns for 36 hours following spinal anesthesia for cesarian.
1. Many studies have found that local anesthetics used in epidurals adversely affect the newborn’s immune system.
2. There is evidence that epidurals can compromise fetal blood and oxygen supply, probably via the decrease in maternal blood pressure that epidurals are known to cause.
3. The baby’s rooting and sucking reflex may be affected due to the use of epidural. This will make it hard for him or her to latch and suck. All these mean it will be harder for the mother to breastfeed.