Epidural Pain Relief
One of the most effective forms of pain relief during labour is an Epidural. An Epidural is a procedure which can provide complete freedom from pain, throughout your labour. Currently about 1 in 4 women opt to have an Epidural in labour.
You may have already decided on whether or not you want to have an Epidural, but once in labour it is not unusual for women to change their mind. Below you will find information to help you decide if an epidural is the right pain relief for you:
What is an Epidural?
Epidural is the name given to the Epidural space in the spine, this lies between the vertebrate (backbones), which forms the walls of the spinal canal, the spinal cord, and the nerves, which lie within it.
Local anaesthetic is injected into the space around the spinal cord, using a fine hollow tube (catheter) inserted into your lower back. This numbs the nerves and the pain of contractions, although you should still be able to feel a touch on your skin. The Epidural will last for about two to four hours but can be 'topped up' through the catheter, usually via a small pump that delivers the anaesthetic at regular intervals.
When can it be given?
Theoretically you can have an Epidural almost at any point in labour, even in the second stage when you are pushing your baby out. Most people however, choose to have an Epidural when they are 5-6cms dilated and the contractions are getting pretty strong. If you are 8-9cms dilated your midwife may tell you it is too late for an Epidural, as your baby will be born soon.
How is it given?
Anaesthetists start Epidurals, although once they are in place and working, your midwife will take over. You will be asked to lie on your side or sit up and bend over a pillow. This opens the spaces in your spine to make the procedure simpler. Your skin will be made numb with a little local anaesthetic and then a small hollow needle is inserted into your back. A very fine plastic tube called a catheter is then threaded through the needle and secured into place with tape once the needle has been removed. The anaesthetic and pain relieving drugs are then administered through the catheter. It takes about 10-20 minutes for the epidural to become effective
Advantages and Disadvantages
Advantages
- Most women get complete pain relief and remain alert and in control throughout labour. It can help you to relax and enjoy the birth of your baby
- It can reverse or reduce your bodies stress-related responses to labour pain, making the experience of birth better for both you and baby
- Epidural is more sophisticated nowadays and you may not lose all feeling in your legs
Disadvantages
- You have to stay in bed and will have a drip in your arm
- Epidural is associated with higher rates of intervention during labour, such as the use of Forceps, Ventouse or Episiotomies where the woman has to be cut to ease delivery of the baby.
- Some women complain that they cannot feel when to push with an epidural, and contractions can slow down after an epidural, prolonging labour.
- Your baby's heartbeat will have to be closely monitored.
- Other problems some women can suffer after an epidural are severe headaches, itchy skin, problems passing urine and infection in the site where the Epidural was..
- You may in some cases, still get pain in one side of your body or have a ‘window’ of pain, where the epidural has not taken effect.
Are they safe?
As with any medical procedure, there are potential side effects but serious complications are very rare.
What are the alternatives?
In a straightforward labour, most midwives will tell you to try and manage your pain using other methods before opting for an Epidural. Natural methods include using breathing techniques, Hypnotherapy, labouring in a birthing pool and even some Acupuncture.
If you need something stronger then Gas and Air (Entonox) and Pethadine are available for both home and hospital births.
Gas and Air is a mild painkiller that takes the edge of the contractions, and is given through a mask or a mouthpiece, which you hold, so you are in total control of. It can be used throughout labour, but it can make you feel sick and light-headed.
Pethadine is a synthetic version of morphine that is both a painkiller and an anti-spasmodic so it helps you to relax. Your midwife can give you an injection of Pethadine every three or four hours to ease pain. It takes about 20 minutes to kick in and provide pain relief. However, it can make you feel sick and drowsy. It is to be avoided close to delivery as it can affect the baby's breathing after birth, make the baby sleepy and affect feeding for the first few days.
This is a members article written by RIN1983
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