What is an Epidural and how does it work should I get it ?

Question

I am a first time mother and I am not sure if I should have an Epidural . I have heard many things about that were not so promising. I'm also very scared of having this done and the afects that it will have on me and my son . PLEASE help me get the facts correct .

Answer 1

I recommend looking into the book "The Thinking Woman's Guide to a Better Birth" - by Henci Goer. She takes all of the medical studies findings and puts them in layman's terms - making an easier read and informative piece of literature.

The epidural is administered by placing a needle between the L3 and L4 vertebrae. Then, a small plastic tube (catheter) is threaded through the needle and into your back. The needle is removed and the catheter is taped in place. Then, medication is fed through the catheter into your back. The space that the epidural is placed is before the dura that encloses the spinal cord and spinal fluid. Thus, epi (before) dura.

Unlike many will tell you, the medication, which is a cocktail of analgesic, anesthetic and cocaine derivatives, DOES in fact cross the placenta and enter the babies blood stream. Epidural medications affect babies in different ways from the laboring mothers because, primarily, the babies blood brain barrier is not fully developed at the time of pregnancy/birth.

Epidural medication affects baby by: it can cause fetal bradycardia (abnormal or sluggish heart tones), oxygen deprivation, drowsy baby at birth, fetal distress,depressed rooting (breastfeeding) and sucking reflexes, and carry a higher incidence of neonatal jaundice.

It can affect mom by causing: depressed blood pressure, inability to push, ineffective or stalled contractions, headache, fever, etc..

It IS the most reliable and effective MEDICATED pain relief option, but it is not 100% guaranteed that it will work. There are roughly 10-20% of women who report windows of ineffective pain relief or no pain relief at all.

Personally, the risks outweigh the benefits for me, I have unmedicated births. I would recommend looking in to alternative pain management options.

Answer 2

An epidural is medication that is put in through a catheter in your spine. There will be plenty of people who will tell you to have one, that it's great, that it's the only way to go through labor, etc. I personally have chosen not to have one with any of my 3 births. I know too many people who have had major problems, including permanent nerve damage. Do a lot of research before deciding what is best for you. And if you choose to go without one, be sure to take a good childbirth class.

Answer 3

An epidural is medication put into your back through a catheter. It completely numbs you from the waist down and you don't even feel your contractions. I had one when I had my son. I wish I wouldn't have had it now because it was a little too much. I couldn't tell when to push, the nurse and doctor had to tell me when to push. I couldn't move after I got it. I got sick after they gave it to me. Although, everyone's experience with epidurals are different.

Search Google for them and you will find loads of information.

Answer 4

basically what this does is numbs the lower half of your body. legs and all. and provides comfert when going through labor and delivery.what they do is either make you sit up and hunch over or lay on your side and curl up like a fetus and then insert a long ,thick,needle into your spinal cavity and usally you will be hooked up like an i.v. so basically they will insert a small tube into your spine so you will be hooked up to a drip. or i could just be a shot.but the risks are there but limited. for example, if dont probably put in. i could case back pains,i could not fully work. i would suggest looking up more info online. tons of women chose natural birth tons chose epidural.. so the choice is totaly up to you.

Answer 5

Its a personal choice that depends on your personal level of pain tolerance.
I was able to get through 12 hours of my 27 hour labor without it. But when the pain got very intense I opted for it. Glad I did...another 15 hours of pain like that wouldn't of left me with enough energy to push when the time came.
I didn't have any affects other than the swelling in my feet and ankles and the tingling. Which weren't bothersome to the point that I couldn't function like walking and it subsided after a few days.

Answer 6

HOPE THIS HELPS ~~ BEST OF LUCK


Right now, you are probably wondering to yourself, what is an epidural? Epidural anesthesia or analgesia refers to total or partial loss of sensation in the trunk between the fundus and the pubis or lower. An anesthetic agent, a narcotic, or a combination of the two is injected into the lower space between lumbar vertebrae two and five. Epidurals should not be used during labor by women in labor because of the negative effects such as increased length of labor, increase in cesarean delivery, and interference with mother-infant bonding.

One negative effect of epidurals during labor is an increased length of labor. Researchers at the Southwest Medical Center in Texas have completed a study that says that epidural anesthesia used in labor does cause delays in the length of labor, and therefore increases the use of Pitocin (to speed labor), cesarean sections because of the prolongation of labor can lead to fetal distress, and to instrumental deliveries (forceps/vacuum). Researchers led by Dr. James M. Alexander of the University of Texas Southwestern Medical Center in Dallas, studied 19 women of normal pregnancies who were admitted to the hospital with labor contractions. The women were given the choice between and epidural injection for pain or intravenous Demerol. Women in both groups entered labor spontaneously, had similar degrees of cervical dilation when pain medication was given and received equal dosages of oxytocin-a drug given during labor to stimulate uterine contractions. However, researchers reported that the active first stage of labor and the time from admission to delivery were all significantly longer among women who received an epidural. A prolonged second stage of labor can weaken the muscles in the uterus necessary to push the infant out during delivery. Of the 126 woman who received an epidural, length of labor averaged nearly eight hours, compared to approximately six and a half hours among the 73 women who chose Demerol.

Another negative effect of epidurals is an increase in Cesarean Sections. In a Cesarean Section, the baby is delivered through the uterine and abdominal walls. Cesareans may be elective, meaning planned ahead of time, and they can be done either before or after labor begins. This is, obviously not a natural method of birth. Many studies associate epidural anesthesia with a greater incidence of cesarean delivery (which is associated with 2-9 times greater maternal mortality than a vaginal delivery), and it has been proven that an increase in Cesarean Sections has been linked to the usage of epidurals during labor.

According to studies revealed at the November 1997 meeting of SELCA- Southeastern Lactation Consultants Association a regional division of ILCA- International Lactation Association, there is an increase of inversion of otherwise non-inverted nipples of women possibly due to epidurals causing lack of muscle tone, therefore interfering with the ability of mom to easily breastfeed. This keeps the mom from having the mother-child bond during the time that the mother is breastfeeding, if she chooses to do so. The importance of the relationship of mother and child has recently been reported in USA Today, April 6, 1998. The major indicator of a child's success in social adjustment is the bond between mother and child. A baby born whose mother has epidural anesthesia is almost 4 times more likely to be admitted for septic work-up than a baby born without epidural anesthesia. The mothers can sometimes spend two days in ICU with IV antibiotics away from their babies Adverse effects of the physiological disruption of the birth process by the epidural anesthesia is shown in animal studies.

One myth about epidurals is that they ease away the pain and create an easier, more comfortable birth. According to a Robbie Davis Floyd study, some women reported effective pain relief from the drugs they were given. Others reported that the drugs had no effect on the pain, but only made them drowsy and less able to deal with their contractions. The women who felt that pain medication was forced upon them resented the interference in their experiences of labor and the lack of support for their desire to avoid medication. So, all in all, the negative effects of epidurals thoroughly outweigh the positive effects. Some of the negative effects include an increased length of labor, an increase in Cesarean Sections linked to the usage of epidurals during labor and an increase of inversion of otherwise non-inverted nipples of women. These are just a few of the numerous reasons negative consequences of choosing to use an epidural during labor. Hopefully, in some way, knowledge had been gained by the reader that will encourage him or her in a positive way.

Do epidurals increase your chance of a c-section delivery? Commonly held beliefs say yes, but a recent study may dispel that.
By Francesca Kritz




The Myth
Mothers having babies these days could find themselves backing right up into their epidural. A recent study by researchers at Northwestern University in Chicago, Illinois, and published February 2005 in the New England Journal of Medicine, could dispel a long-held belief among obstetricians that getting an epidural early in labor increases your chance of a cesarean section delivery.

Doctors have long thought that epidurals given before a woman's cervix was dilated 4-5 centimeters increase the risk of a cesarean. For that reason, says Cynthia A. Wong, MD, lead author of the study, many doctors have delayed letting their laboring patients have an epidural until labor is well established -- often hours after arrival at the hospital.


The Study
In the Northwestern study, 750 women in labor with a cervix dilation of less than 4 centimeters were selected for one of two pain relief options: 1) an epidural as soon as they requested pain relief, regardless of how much their cervix was dilated; or 2) an injection of a morphine-like drug when they first requested -- but no epidural until they were 4 centimeters or more dilated or had asked for pain relief for a third time. Dr. Wong says her data on all the women shows that the early epidural did not increase the rate of cesarean delivery, and also provided much better pain relief for the mothers than the morphine-like drug.

The epidural given in Dr. Wong's study is called a combined spinal epidural (CSE). The CSE technique involves the injection of a narcotic medication, Fentanyl, into the spinal fluid at the time that the epidural catheter is placed into the epidural space outside the membrane that contains the spinal fluid and spinal nerves. The narcotic medication in the spinal fluid gives pain relief for one and a half hours without causing relaxation of the abdominal and pelvic muscles. When the narcotic effects wore off, and the mothers requested more pain relief, a traditional epidural was established by injecting a local anesthetic into the epidural catheters and infusing that local anesthetic throughout labor and delivery.

More and more hospitals are offering the combination epidural these days, says Dr. Dana Hershey, a physician with Southeast Anesthesiology Consultants in Charlotte, North Carolina. Dr. Wong says that other published studies confirm the fact that epidural space epidurals also do not increase the risk of cesarean sections so "women can feel comfortable opting for an earlier epidural regardless of which option their hospital provides."


Bottom Line for Expectant Parents
For now, the American College of Obstetricians and Gynecologists recommends the following course of action when it comes to epidurals: "ACOG supports waiting, when feasible, to give laboring women epidurals until they have dilated four to five centimeters. However, since labor produces severe pain for many women, ACOG believes that a woman's request for an epidural should be the deciding factor, even if she hasn't yet reached a four- to five-centimeter dilation." Dr. Hershey and other physicians think Dr. Wong's research could push ACOG to rethink that policy recommendation.

Most important, says Dr. Hershey, is not to wait until labor to discuss epidural options with your obstetrician. The green light to have an epidural when you are in labor is actually given by your obstetrician, not by the nurse or anesthesiologist. So take the time during a pregnancy visit to discuss epidural options with your physician.