Getting an epidural is a subject that nearly every soon-to-be parent considers. The idea of being present for the birth of your first child is a powerful and exciting one. The birth process can be challenging, and you want to try and alleviate pain in any way you can, but do you really know what having an epidural entails? Read along to learn more about it.
What Is An Epidural?
Epidural is a type of anaesthesia used for pain relief during childbirth. It's given through a catheter placed in the lower back, and the medication is injected into the epidural space around the spinal cord. This blocks pain pathways from the uterus, pelvic area, and lower body.
It's a great option if you're having a c-section, and it can also be used to treat back pain.
What Is Epidural Injection?
An epidural injection is a procedure used to relieve pain in the lower back and legs. It involves injecting a steroid medication into the spine's epidural space at the base of the spinal cord. The steroid medication blocks nerve impulses in the lower body, which reduces inflammation and swelling.
The epidural space is located between two layers of tissue or membranes that cover your spinal cord: an outer membrane called the dura and an inner membrane called the arachnoid. The area where these two membranes meet is called "epidural space."
How Does An Epidural Work?
An epidural injection is usually done by a physician or nurse practitioner with special training in anaesthesia and pain management techniques. This person will inject medicine into your back through an epidural needle attached to a syringe.
You may need several injections during one visit depending on how much pain you're having and how many days in advance you've scheduled your appointment for treatment.
Epidural vs Natural Birth
In order to relieve labour discomfort, most patients have an epidural or spinal anaesthetic, according to the Centers for Disease Control and Prevention (CDC).
Others decide on a drug-free, minimally invasive "natural delivery." (Note: A preferable word would be "drug-free delivery" or "unmedicated birth" because all births are natural processes regardless of whether the mother got pain medication or not.)
You can choose the option that is best for you by being aware of the advantages and disadvantages of both epidurals and "natural births" (which simply refers to deliveries without the use of painkillers).
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Pros of "natural birth"
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Cons of "natural birth"
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• After birth, they might recover more quickly. • Possible reduction in vaginal tears • Some folks might push more quickly than others. • Capability of switching labour positions, including moving around • Lower likelihood of requiring dangerous interventions • Some individuals experience a sense of achievement and fulfilment. • Steer clear of epidural-related adverse effects |
• Must be able to manage discomfort without medical help • Physical discomfort could make childbirth less enjoyable. • Women who are carrying high-risk pregnancies may not be able to have a "natural birth." • The pregnant woman may still require procedures or medications for medical reasons. • The possibility of protracted labour if the person giving birth is exhausted, worried, or stressed • In "natural home births," the mother and/or child could not have access to medical supplies in an emergency. |
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Pros of epidurals
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Cons of epidurals
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• During labour, which starts after roughly 10–20 minutes, pain relief • Epidural dosage can be changed to suit the parent's preferences and adjusted as necessary. • Enables the soon-to-be parent to maintain calm, focus, and stress-free • You can typically still have an epidural if you decide against your "natural birth" plan while you are in labour. • It's often secure and efficient. • For some people, letting the muscles to relax during an epidural can actually speed up the birth process. |
• According to certain research, epidurals increase the likelihood that dangerous delivery-related interventions will be required (forceps and vacuum extraction, emergency C-section, etc.)
• A potential extension of the delivery period • Pushing could be more challenging, which raises the possibility of perineal tears. • Lower body numbness during childbirth restricts movement • Possibility of requiring a urinary catheter • Epidural needle infection or spinal damage (although this is extremely rare) |
How Big Is The Epidural Needle?
The terms "epidural needle sizes" and "epidural needle gauge" both refer to the thickness of the needle.
A thinner epidural needle is equivalent to a greater gauge needle. Adults typically utilise an 18G (thinner) or 16G (thicker) epidural needle.
The epidural needle needs to be long enough to extend from the patient's lower back to the epidural space.
In pregnant women, there is typically 4.9 cm between the skin and the gap. 8 cm is a typical needle length.
A longer epidural needle might be needed to reach the space if the patient is obese.
Epidural Side Effects
A headache is one of the most frequent side effects. This happens because the drug used in an epidural can result in weakness or numbness in your arms or legs. You may have this for up to 24 hours following your epidural. Additional negative effects include:
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Low blood pressure
When you receive an epidural, it's common for your blood pressure to slightly decrease. This might occasionally give you the flu.
You'll have your blood pressure constantly watched. You can get fluids and medication via drip if necessary to maintain normal blood pressure.
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Loss of bladder control
Because an epidural affects the nearby nerves, it's possible that after getting one you won't be able to feel when your bladder is full.
Your bladder may be inserted with a catheter to allow urine to drain out. After the epidural wears off, you will be able to control your bladder normally.
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Itchy skin
This might be a side effect of the painkillers that were put in your epidural, if one was utilised.
The medication in the epidural might be altered or administered to aid with the itching.
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Feeling sick
When compared to conventional painkillers like morphine and other opiates, nausea is less frequent with epidural medications.
Anti-sickness medications or, if necessary, boosting your blood pressure can be used to treat it.
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Inadequate pain relief
The epidural might not completely relieve your discomfort. An additional or alternative pain management technique can be suggested to you.
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Headache
If the sac of fluid around your spine is accidentally pierced, a severe headache may result. For the headache, you could require specialised care.
The puncture could be closed with a technique called a blood patch. It entails injecting a tiny amount of your blood into the puncture.
The hole will be sealed and your headache will stop when the blood thickens (clots).
A blood patch is not necessary for all epidural-induced headaches. Your anesthesiologist will talk to you about your alternatives.
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Slow breathing
Sometimes, the drugs used in an epidural can slow down breathing or make you feel sleepy.
This is something that will be closely watched for and is easily treatable.
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Temporary nerve damage
Although it is uncommon, nerve injury from the needle or epidural tube is possible. In portions of your lower body, nerve injury can result in loss of feeling or movement.
A tiny, numb patch with normal movement and strength is the most typical sign. Though it normally improves within a few days or weeks, this might occasionally take months.
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Infection
Sometimes an infection might develop in the area of skin close to the epidural tube.
The spread of the infection is uncommon. The need for antibiotics or, very rarely, emergency surgery may arise.
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Permanent nerve damage
An epidural can, in rare circumstances, result in a lifelong loss of feeling or movement in, say, one or both legs.
Causes include:
- direct injury from an epidural needle or catheter to the spinal cord
- infection in or close to the spinal cord's deep epidural space.
- epidural haemorrhage that puts pressure on the spinal cord;
- Inadvertently administering the incorrect medication through the epidural catheter
These are uncommon occurrences, and anaesthetists are well-trained to lessen the likelihood of these consequences. In addition to the epidural, there are other surgical procedures that can cause nerve injury.
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Other complications
Other, extremely rare, epidural problems include:
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- fits (convulsions)
- extremely difficult breathing
- death
You should talk to your anesthesiologist about the procedure before electing to get an epidural.
They can offer further details and guidance on the likelihood of issues arising.
What Is Epidural Hematoma?
A blood clump known as an epidural hematoma (EDH) develops between your skull and the dura mater, your brain's outermost layer of defence. The cause is typically a skull fracture that tears an artery. Severe headache and unconsciousness are symptoms. Emergency surgery is necessary because this disorder has the potential to be fatal.
A head injury is the most common reason for an epidural hematoma (EDH). In 75% of cases, a skull fracture results. The main cause of bleeding is a skull fracture that tears the middle meningeal artery. An EDH can occasionally develop as a result of vein haemorrhage.
An EDH can also arise from factors other than trauma. Among these reasons are:
- Infection/abscess.
- Coagulopathy, in which your blood does not clot as it should.
- Blood-filled tumours (tumours that cause bleeding).
- Vascular abnormalities (examples include arteriovenous malformations and cavernous malformations).
The majority of spinal epidural hematomas are spontaneous bleeds from veins brought on by coagulopathies or excessive blood thinning from anticoagulant medicines. Additional factors include:
- Bone fractures in your vertebrae.
- Anaesthesia for an epidural lumbar puncture.
- Vascular anomalies, such as spinal arteriovenous malformations.
- Tumours of the spine
- Pregnancy.
Is Getting an Epidural Painful
When you get an epidural, you'll feel a small pinch where the needle goes into your lower back. It doesn't hurt much when this happens—you might feel slight pressure or slightly stinging.
The needles are very thin and are inserted through layers of tissue, so they don't cause any damage to your skin or muscles.
The only downside is that sometimes the epidural needle can miss its target, which means it doesn't deliver the medication where it is supposed to go. If this happens, you might need another injection into another spot on your spine or another area entirely.
This isn't uncommon; about 3 per cent of women who get an epidural will have to have more than one injection before it takes effect.
How Long Does an Epidural Last During Labour?
It's important to remember that an epidural is a medical procedure, and as such, it requires medical attention. The duration of the epidural depends on how much medication you get during the procedure, so there's no way to know how long it will last until it's given.
An epidural usually wears off after about 12 hours, but some people have reported that it can last for 24 hours or more. It's also possible for your doctor to suggest another dose of medication if you need more pain relief than the first dose provided.
If you're concerned about how long an epidural will last during labour, talk with your doctor about what options are available and whether or not they'd be helpful for you.
How Long After Getting an Epidural Does Baby Come
The average time between getting the epidural and giving birth varies from person to person. Still, your body can take anywhere from one hour to six hours to fully absorb the medication.
So if you're nervous about getting it because you're worried it might delay childbirth, just know there's no need to worry. Most women don't have to wait hours longer than expected before their baby arrives.
What Does an Epidural Do to the Baby?
Doctors recommend an epidural during childbirth because it gives you more control over your contractions. This includes the pain associated with them. It numbs the nerves in your lower back, reducing the pain you feel during contractions.
This makes them much easier to manage and allows you to focus on other things—like getting ready for your new baby!
Some women worry that having an epidural will affect their baby's health or well-being. But research has shown that babies born to mothers with epidurals have no difference in birth weight compared to those born naturally.
How to Avoid Epidural During Labour
When it comes time to give birth, many women worry about the kind of pain they'll be in. That and whether they'll need an epidural.
But did you know that there are other options? Breathing exercises, walking around, changing positions, and even massage can help remove labour pain.
We've put together a few tips on how to avoid getting an epidural during labour.
- Get plenty of rest
- Eat healthy foods
- Drink plenty of fluids
- Understand your options
- Develop a plan with your providers
- Make sure everyone on your team is on the same page
- Have a variety of positions to try
- Use a birthing ball for pain relief
What Are the Disadvantages of Getting an Epidural?
The main disadvantage of an epidural is that it can slow down labour. This is because epidurals block the pain signals from reaching the brain. So, fewer hormones are released to start contractions.
Another downside is that you may have difficulty moving around during labour. Your legs may feel heavy, and you may have difficulty walking or getting in and out of bed. You might even need help getting up to use the bathroom.
Finally, it can cause side effects such as nausea, vomiting, and dizziness after birth.
Can You Feel Baby Coming Out With an Epidural?
With an epidural, you’ll be able to feel the contractions and your baby coming out of your body, but there are some things you should know about how it works.
You’ll still be able to feel everything because it will only numb your body's lower half. These include your hips, thighs and lower abdomen. This means that you’ll feel pressure and pain in these areas and any movements from your baby or doctor.
This can make it difficult to tell whether or not you're dilating. So if you're worried about this happening to you during labour, talk with your doctor. Do it before it happens so they can help guide you through what's happening.
How To Get Rid Of Epidural Back Pain
The most frequent side effect of an epidural is localised pain where the injection was made. But after a few days, that discomfort normally goes away.
You deserve to feel better even if your back discomfort is the result of your joints changing after giving birth! Numerous techniques exist for reducing back discomfort at home, including the following:
- Rest
- Massages
- Exercise
- OTC drugs such as ibuprofen (Advil or Motrin). If you're breastfeeding, consult your doctor before taking any drugs.
- Hot and cold therapy. Hot and cold compresses are alternated in hot and cold therapy to lessen pain and suffering.
Start with cold therapy as soon as you have back pain. For 20 minutes, apply a cold compress to your lower back, such as a bag of ice or even a container of frozen vegetables.Change from cold therapy to heat after a few days. You can try using an electric blanket, a hot compress, or a hot bath. However, if you're still recovering from a C-section, you should hold off on taking warm baths until your incision is completely healed.
- Physical therapy. Consult your doctor if at-home remedies don't relieve your back discomfort. They might advise you to seek out expert physical therapy. Physical therapists will facilitate greater mobility, instruct you on certain moves that can alleviate discomfort, and even demonstrate how to have a good posture.
- Medical remedies. Chronic back pain that affects your quality of life should be treated with medical assistance in addition to physical therapy.. Depending on how bad your back pain is, you may need to consider prescription drugs, cortisone injections, or even surgery.
Make an appointment to see your doctor if your back pain doesn't get better during your postpartum period or worsens over time.
How Long After Epidural Can You Walk?
If you've just had an epidural, you may wonder how long it will take to walk again. The good news is that you can walk right after receiving an epidural if you feel up to it.
When figuring out how long after the procedure you should wait before walking again, it's essential to consider all factors involved. These are your health condition, your level of pain relief, and the type of medication used in the procedure.
If you are in good health and have low pain tolerance, your doctor may allow you to walk immediately after getting it. On the other hand, if your doctor gave you a high dose of pain medication or if there were complications during the procedure, it may take longer for you to feel comfortable walking around after having it.
If you have more questions or concerns about getting an epidural when giving birth, do not hesitate to bring it up at your next doctor's appointment.
Updates from Matt Doctor
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