The birth of a child is one of the most exciting events in a person's life. The DMC Anesthesia, Obstetrical and Nursing staff would like to make this special experience as safe and pleasant as possible for both you and your baby.
Since women experience labor in a variety of different ways, some women may ask for help to make their labor more comfortable. Our staff, with cooperation of your doctor, is available to assist you with your labor. This introductory brochure will try to answer some of the questions asked most often about epidural anesthesia and its benefits. You may have other questions. You are encouraged to discuss further details with the Anesthesia/Obstetrical team.
What is an Epidural?
What you feel in labor is related to the stimulation of the nerve fibers, which surround the uterus. To relieve the pain, these nerves can be soaked in numbing medicine which is similar to that used by the dentist. A small plastic tube can be placed into the epidural space, which is a part of your spinal column, where the nerves pass through. Numbing medicine can be given into the space to decrease the pain. You may still feel the pressure of the contraction, but you should be much more comfortable.
How is an Epidural Performed?
An epidural is usually done while you are sitting up but can be done while you are lying on your side. Someone will help support you throughout the procedure. Your blood pressure will be taken as well as your heart rate and your baby's heart rate too. Your lower back is washed and then a tiny needle is used to numb the area under the skin. After the area is numb, another needle id put into the epidural space. Through this needle a small flexible plastic tube is threaded and the needle is withdrawn. The tube is taped to your back and pain medicine can be given through it during labor and also during delivery id needed.
Local anesthetics are used to numb the nerves. Sometimes narcotics are added to provide better pain control.
Pain relief/Removal After Delivery
The epidural makes most women much more comfortable. The beginning of pain relief is slow. You should feel more comfortable in about 10 to 20 minutes after the, medicine has been injected. You may still feel pressure as your baby moves lower in the birth canal. Sometimes, a cesarean section or assisted vaginal delivery is necessary to safely deliver your baby. Your doctor and the anesthesia team may choose to use the epidural for delivery or change to another form of anesthesia such as a spinal or generic anesthetic. The choice is based on what is safest for you and your baby. The epidural tube is usually removed after delivery but may be left in for pain relief, if necessary.
Epidural anesthesia has been proven to be a very safe and effective technique. With any procedure there may be side effects. Possible complications of epidural anesthesia for the mother may include: drop in blood pressure, headache, drug allergy, back soreness, infection or bleeding, spinal block, respiratory difficulty, slowing of labor, and increased use of forceps for delivery. If the needle hits a nerve there is a possibllity of short term numbing or tingling. These complications can be recognized and treated or possible prevented.
Other Anesthesia Options:
Several different types of anesthesia are used during Labor and Delivery. They may be used alone or with one another. Some of the anesthetics used are:
- Local Anethesia
Local infiltration: Thyese are a series of local injections that will numb the vaginal area if an episiotomy or sutures are needed.
Pudendal Block: The pudendal block is an injection of local anesthetic that numbs the vaginal area for delivery
Narcotics or Tranquilizers: These are given as a "shot" or IV. They are used to help dull the anxiety and pain of labor but will not take away all the pain.
- Spinal Block
A spinal block is a local anesthetic delivered through a needle into the spinal canal. The effects are faster than the epidural and will cause you to feel numb from your breasts down. You may not be able to move your legs. Your feeling will return gradually as the medicine wears off. Spinal block is used for Cesarean section or foreceps delivery and is rarely used during labor.
- General Anesthesia
For emergency delivery general anesthesia drugs may be given by IV and by breathing anesthesia gases. General anesthesia means you are asleep.
What You Need to Know
Information that is important for choosing the best type of anesthesia for you includes:
- History of medical problems such as heart disease, high blood pressure, breathing problems, recent cold or flu, diabetes (blood sugar) or bleeding problems.
- Medication you are taking.
- History of lower back problems.
- Family history of high fevers with anesthesia.
- Anything you have taken by mouth during the last several hours.