Lately, so many of my patients have confided in me that they are afraid of requesting pain medication during labor. They have been told by friends or family members that by getting an epidural they are "wussing out", harming their baby, or depriving themselves of the true birth experience. For thousands of years, women have had to endure pain during childbirth. Now that in 2016 we have the technology and options, it is ironic there is a childbirth culture that is determined to limit women's choices by shaming. So let's review some basics about epidurals and their safety profile.
1. What is an epidural? An epidural is a regional anesthetic which means it does not affect your entire body. The goal of an epidural is to provide pain relief,rather than anesthesia, which is a total lack of feeling. The anesthesiologist will inject medication through your mid back in order to numb the nerves that carry pain signals to your uterus and cervix during labor. After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.The catheter is taped to the back to prevent it from slipping out.
2. Are epidurals harmful to my baby? No. As this medication does not cross the placenta it does not affect your baby. Occasionally after epidurals are placed, it can affect your blood pressure, which can have effects on your baby's heart rate. However, this is usually quickly corrected with medication. A lot of women will request pain medication in their IV because they feel this is safer for their baby than an epidural, however what they don't realize is that these medications all cross the placenta and can cause the following: CNS and respiratory depression, impaired early breastfeeding, and decreased ability to regulate body temperature.
3. What are the other side effects of epidurals? Hypotension (decreased blood pressure as discussed in the previous question), ringing in the ears, shivering, uneven anesthesia, numbness that can contribute to difficulty pushing and spinal headaches (this usually does not occur until a couple days after your epidural was placed).
4. If I get an epidural am I more likely to have a cesarean section? No. Currently the evidence does not show an increased incidence of cesarean section, use of forceps, or use of vacuum delivery with epidural anesthesia.
5. If I get an epidural will it increase my time in labor? It will not increase the first stage of labor (the time required for your cervix to dilate from 0 to 10 centimeters); however, studies have shown that it may slightly increase the duration of the second stage of labor (the time that you are pushing).
Bottom line: labor hurts. Embrace the pain management technique that works for you and make sure you talk to your provider about all your options. I’m sure you’ve probably heard the story of the friend who went through 12 hours of labor and 2 hours of pushing without screaming once or even breathing hard, but for others, they may require more pain relief. And that’s OK! It is estimated that more than 60% of moms in the U.S. receive an epidural for pain control during labor, but you should not have to go through it with feelings of guilt or inadequacy. Getting an epidural does not mean you are weak or a failure, nor does it mean you love your baby less than a mom who chooses not to use anesthesia. While giving birth is the most incredible experience of your life, remember, you are pushing a watermelon through your vagina and there is no shame in asking for relief from the pain. No matter how you deliver, with or without pain control, you'll be leaving the hospital with the same prize: a brand new baby!
Dr. Pam
1. What is an epidural? An epidural is a regional anesthetic which means it does not affect your entire body. The goal of an epidural is to provide pain relief,rather than anesthesia, which is a total lack of feeling. The anesthesiologist will inject medication through your mid back in order to numb the nerves that carry pain signals to your uterus and cervix during labor. After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.The catheter is taped to the back to prevent it from slipping out.
2. Are epidurals harmful to my baby? No. As this medication does not cross the placenta it does not affect your baby. Occasionally after epidurals are placed, it can affect your blood pressure, which can have effects on your baby's heart rate. However, this is usually quickly corrected with medication. A lot of women will request pain medication in their IV because they feel this is safer for their baby than an epidural, however what they don't realize is that these medications all cross the placenta and can cause the following: CNS and respiratory depression, impaired early breastfeeding, and decreased ability to regulate body temperature.
3. What are the other side effects of epidurals? Hypotension (decreased blood pressure as discussed in the previous question), ringing in the ears, shivering, uneven anesthesia, numbness that can contribute to difficulty pushing and spinal headaches (this usually does not occur until a couple days after your epidural was placed).
4. If I get an epidural am I more likely to have a cesarean section? No. Currently the evidence does not show an increased incidence of cesarean section, use of forceps, or use of vacuum delivery with epidural anesthesia.
5. If I get an epidural will it increase my time in labor? It will not increase the first stage of labor (the time required for your cervix to dilate from 0 to 10 centimeters); however, studies have shown that it may slightly increase the duration of the second stage of labor (the time that you are pushing).
Bottom line: labor hurts. Embrace the pain management technique that works for you and make sure you talk to your provider about all your options. I’m sure you’ve probably heard the story of the friend who went through 12 hours of labor and 2 hours of pushing without screaming once or even breathing hard, but for others, they may require more pain relief. And that’s OK! It is estimated that more than 60% of moms in the U.S. receive an epidural for pain control during labor, but you should not have to go through it with feelings of guilt or inadequacy. Getting an epidural does not mean you are weak or a failure, nor does it mean you love your baby less than a mom who chooses not to use anesthesia. While giving birth is the most incredible experience of your life, remember, you are pushing a watermelon through your vagina and there is no shame in asking for relief from the pain. No matter how you deliver, with or without pain control, you'll be leaving the hospital with the same prize: a brand new baby!
Dr. Pam
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