The epidural, a form of local anesthesia delivered to the lower half of the body, is probably the most common form of pain relief during childbirth. Recent figures estimate that upwards of 60 percent of women who give birth in a hospital choose to use an epidural. However, given that it is invasive (delivered through a small catheter into your lower back), and sometimes controversial (plenty of enduring myths about epidurals continue to give women pause) moms-to-be like to ask plenty of questions before giving the OK for an epidural.
Frequently asked questions include:
Will the epidural hurt?You’re probably worried enough about the pain of childbirth; you don’t want to think about any additional pain from getting an epidural. The good news is, the doctor or nurse will numb the area with a local anesthetic before inserting the needle to start the epidural. Some women report a little stinging or a feeling of pressure during insertion, some report mild discomfort, and some find that they are so focused on their contractions that they don’t feel anything at all. Once the catheter is in, it should take about 20 minutes before the numbing takes effect, and you shouldn’t feel the catheter itself except for some bandages on your back that hold it in place.
When should I get the epidural done?Getting the timing “right” is something that many pregnant women worry about. If it is your first child and you are more likely to have a longer labor, you might want to wait it out until you really feel that you need pain relief. It’s good to spend the early part of your labor walking around, staying upright to help the baby get into position, and getting used to the rhythm of the contractions. At that point you and your doctor (and the anesthesiologist) can help you decide if the timing is right. It’s rare for a first-time mom to “run out of time” to get an epidural, but some women who are on their second baby or more may arrive at the hospital in the late stages of labor and not have enough time for an epidural to take effect (10 to 20 minutes) before the baby arrives.
What if it I get an epidural too early and it stalls my labor?Some expectant moms worry that the epidural will slow or stall their labor. If this is the case, your doctor may give you Pitocin to get it going again. However, it’s worth noting that a 2005 study of first-time mothers found that labor tended to be shorter and there was a lower incidence of c-sections among women who were given epidurals when they were less than four centimeters dilated, than among those who got the epidural later.
What if I can’t feel enough to push?Many doctors “dial down” the epidural dose during the pushing stage so that you are able to feel the strong contractions and get your pushing reflex in gear. Many women believe that having an epidural helps them relax during labor and gives them more energy to push when the time comes. However, with an epidural, there is a risk that you will need additional help during the pushing stage, such as with a vacuum or forceps.
Is an epidural harmful to the baby?Epidurals are widely considered to be safe for the baby. However, due to the small risk of side effects for the mother (such as a sudden drop in blood pressure) your baby will be monitored constantly while you are on the epidural. Some studies suggest that babies who were born with an epidural have trouble latching on when it is time to start breastfeeding; but thus far there is no conclusive evidence given the many different factors that can affect a baby’s condition at birth.
How you decide to manage pain during labor is a personal decision to be made between you and your doctor, taking into consideration all possible variables involving you and your baby. Many women decide that epidurals are right for them, and are happy with that decision. But before you decide if an epidural is right for you, you should ask as many questions as you need to until you feel comfortable.