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The technique of painless delivery called as Epidural Analgesia or Epidural Anaesthesia is a popular technique used by women, if advised by the doctor, during labor. It gives relief from unbearable labor pain during deliveries. The anaesthesiologist and your OB-GYN will monitor the blood pressure, check that the epidural is working well and your baby’s heart rate will be checked intermittently or continuously. Like all other treatments epidural delivery also has pros and cons.

How does an epidural work?

An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. It decreases sensation but doesn't result in a total lack of feeling.

Medication is delivered through a catheter – a very thin, flexible, hollow tube – that's inserted into the epidural space just outside the membrane that surrounds your spinal cord and spinal fluid. An epidural is the most commonly used method of pain relief for labor

When is the best time to get an epidural?

In the past, many practitioners wanted a woman to be in active labor before starting an epidural due to a concern that it might slow down her contractions. These days, most caregivers will allow you to start an epidural whenever you ask for it.

Studies have shown that starting an epidural in early labor (compared with later in labor) is not more likely to prolong labor or lead to a c-section or other interventions such as a forceps delivery. (However, as we note later, having an epidural at all does increase your risk of a vacuum extraction or forceps delivery.

What are the benefits of epidural anesthesia?

  • Allows you to rest if your labor is prolonged.
  • By reducing the discomfort of childbirth, some women have a more positive birth experience.
  • Normally, an epidural will allow you to stay alerted and remain an active participant in your birth.
  • If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.
  • When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience.

The use of epidural anesthesia during childbirth is continually being refined, and much of its success depends on the skill with which it is administered

What are the risks of epidural anesthesia?

  • Epidurals may cause your blood pressure to suddenly drop. For this reason, your blood pressure will be routinely checked to help ensure an adequate blood flow to your baby. If there is a sudden drop in blood pressure, you may need to be treated with IV fluids, medications, and oxygen.
  • You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect. If symptoms persist, a procedure called a “blood patch”, which is an injection of your blood into the epidural space can be performed to relieve a headache.
  • After your epidural is placed, you will need to alternate sides while lying in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop.
  • You might experience the following side effects: shivering, a ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating.
  • You might find that your epidural makes pushing more difficult and additional medications or interventions may be needed, such as forceps or cesarean. Talk to your doctor when creating your birth plan about what interventions he or she generally uses in such cases.
  • For a few hours after the birth, the lower half of your body may feel numb. Numbness will require you to walk with assistance.
  • In rare instances, permanent nerve damage may result in the area where the catheter was inserted.

Though research is somewhat ambiguous, most studies suggest that some babies will have trouble “latching on” causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries, and episiotomies.

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