Contents
What is an epidural?
Epidural analgesia consists of relieve a woman’s pain during childbirth.
Note that only the lower part is numb.
The anesthetic product is injected between two lumbar vertebrae via a catheter, a thin tube, in order to reinject it more easily if necessary. The epidural is used for natural deliveries, but also for cesarean sections. Whether or not you opt for an epidural, a pre-anesthetic consultation is scheduled at the end of pregnancy. The goal ? See if there is any contraindication in case of possible epidural or general anesthesia. The anesthesiologist will also order a blood test shortly before delivery.
Is an epidural dangerous?
The epidural is not not risky for the child because it is a local anesthesia, little of the product passes through the placenta. However, a slightly strong epidural can lower the mother’s blood pressure which can affect the baby’s heart rate. The expectant mother can also suffer from other temporary incidents: dizziness, headache, lower back pain, difficulty urinating. The other possible accidents (neurological injury, allergic shock), but rare, are those linked to any anesthetic act.
The course of the epidural
The epidural is performed at your request, during labor. It should not be practiced too late because it would no longer have time to act and would then be ineffective on the contractions. This is why it is most often placed when the dilation of the cervix is between 3 and 8 cm. But it also depends on the speed of the work. In practice, the anesthetist begins by examining you and checking that you have no contraindications. Lying on your side, standing or sitting, you must present your back to him. It disinfects then anesthetizes the part concerned. He then pricks between two lumbar vertebrae and introduces the catheter into the needle, itself held in place by a bandage. The epidural is theoretically not painful, insofar as the area is previously put to sleep with local anesthesia. This does not prevent that one can be anxious in front of the 8 cm needle, and it is this which can make the moment unpleasant. You may experience small electrical sensations, paresthesias (disturbances in feeling) in your legs or back very briefly when you are given it.
The effects of an epidural
The epidural consists of numb the pain while preserving the sensations. It is better and better dosed, precisely to allow the mother to feel the birth of her child. Its action usually occurs within 10 to 15 minutes after the bite and lasts about 1 to 3 hours. Depending on the length of the birth, you may need to give more injections through the catheter. It is rare, but sometimes the epidural does not have the desired effect. It can also lead to partial anesthesia: one part of the body is numb and the other. This can be linked to a badly placed catheter, or to a badly adapted dose of products. The anesthesiologist can correct this.
Contraindications to epidurals
Are recognized as being contraindications before childbirth: skin infections in the lumbar region, blood clotting disorders, some neurological problems.
At the time of labor, other contraindications may cause the anesthetist to refuse it, such as an outbreak of fever, bleeding or a change in blood pressure.
New forms of epidurals
Self-dosed epidural, also called PCEA (Patient Controlled Epidural Analgesia), is developing more and more. Almost half of women were able to benefit from it in 2012, according to a survey by (Ciane). With this process, you have a pump to dose yourself the amount of anesthetic product depending on the pain. The PCEA mode ultimately reduces the doses of anesthetic product, and is very popular with mothers.
Another innovation unfortunately still too little widespread: ambulatory epidural. It has a different dosage, which allows you to maintain the mobility of your legs. You can therefore continue to move and walk during labor. You are equipped with portable monitoring to monitor the baby’s heart rate, and you can call the midwife at any time.