Epidural For Pain Free Delivery
I remember very clearly that as my delivery date neared in the last few weeks of pregnancy, more than anything else, the biggest fear in my mind was the labor – the pain, the pressure. I had never had so much as a hairline fracture in my life – the only real pain I had ever known is that of waxing. So, you get the point – I was petrified that I would not be able to bear the physical pain of labor and delivery. It doesn’t matter what people tell you – Women have been going through this for ages; Everybody gets by, etc. etc. These reassurances failed to soothe me, and so I finally decided to talk to my Ob/GyN about this. And I am glad I took that decision. My doctor took me through the details of Epidural and we mutually decided that would be my pain management method during delivery. I entered my labor room with a lot of confidence and knowledge, which really helped me to ease my fears and focus on the most important aspect: the baby!
Sharing the knowledge that I gained through my personal experience and study with you all here.
What is an Epidural?
An epidural is an anesthetic that is administered in the lower (small) portion of your back via a fine tube to provide effective pain relief during delivery.
How is an Epidural administered?
You must sit at the edge of the bed leaning forward such that your lower back is stretched. An anesthetist gives an injection on the lower area in your back – a hollow needle is inserted into the spinal column. A fine tube (catheter) is passed through this needle and then the needle is removed while the tube is tapes to your back. The other end of the tube is attached to a pump, which continuously feeds the medication into your back.
Does it pain during the Epidural administration?
Yes. But just as much as an injection. While the needle is being guided through the bones of your back, you need to sit still and breathe well so that the needle doesn’t move from its intended course. If your anesthetist is good and experienced, this should not pain. However, there is a possibility that the needle touches your funny bone – and it hurts like hell. It happened in my case and though the pain lasts for only about a minute or two, it was extremely severe.
There is no pain while the needle is removed and the tube placed. The only other pain you will feel is when after the delivery the tape from your back is snapped, that’s all. And after all what you have been through, you won’t even wince a wee bit.
How does it feel after you are on Epidural?
It takes about 15 -30 minutes for the affect to kick in. You cannot feel any sensation from your tummy and down till the legs. Since you cannot get up because of the tube, a catheter is inserted into your urinary tract to empty your bladder. Once the contractions kick in, you will not feel any pain but just a dull pressure (like dull menstrual cramps). You can sleep through the cramps too :).
When should you ask for an Epidural?
I strongly believe in being adequately prepared before your delivery date. If you are concerned about your capability to bear pain (and even if you are not), it is a very good idea to talk to your trusted doctor about the options that you can ask for during delivery for pain management. Discuss and think you’re your options, weigh all the pros and cons and know what you are going to choose when the time comes. You need to choose the right hospital and the best anesthetist for an epidural – as how it is administered is of prime importance.
During labor, technically you can ask for an epidural at any time. However, keep in mind that it takes about 20-30 minutes for the actual procedure and another 20-30 minutes for it to take effect. Add to that the time the anesthetist will take to show up – so do your math, and request an epidural as soon as you feel the contractions are becoming too difficult to bear. There is no point in going through the pain for more than half the time and then going into panic. Also, if it is too late in the labor – that is, you are already fully dilates and the baby’s head can be seen – at that point it is not advisable to go for the epidural procedure.
I asked for epidural when I was about 4 cm dilated an my contractions were getting quite painful At a scale of 1 to 10, I felt 6.
Can the Epidural affect the baby?
The epidural can affect your blood pressure, and thus affect the flow of oxygen to your baby. This is why, once you are on epidural, the nurse on duty is supposed to monitor your blood pressure every 5 minutes for the first 30 minutes and then at regular intervals. Mine was monitored every 45-60 minutes. You will already be on an IV for fluids, so you don’t have to worry about nutrition for yourself or the baby. The blood pressure can also be managed by pumping in more fluids.
Like any drug, if Epidural is administered in a very large quantity, it can pass to the baby through the placenta and make it drowsy or affect breathing. However, the quantity of drug needed for pain relief is much less than the quantity that can harm the baby even slightly.
Disadvantages of Epidural
There’s a lot of literature available on the side effects of Epidural and sometimes many women forego the use of the drug keeping these in mind. However, what my doctor explained was that the probability of these side effects is very low. Every drug has a probable side effect. Even the common Tylenol/acetaminophen is said to cause liver damage if taken more than the prescribed quantity. So you need to read those side effects in that perspective. However, some common disadvantages are as follows:
- You become immobile, which means you may be prone to soreness/cramps because of pressure and your inability to get up and walk. You should try to change the side you are lying down on every 30 minutes or so to help relieve some discomfort.
- The most crucial disadvantage of the epidural is that since you cannot feel any pain but just a dull pressure, the urge to push is not very strong. My doctor had to stop epidural for a few minutes so that I could “feel” the pain and the need to push. (By the way, that little pain was enough to make me shriek out and congratulate myself on the choice of epidural.)
- After the delivery, you will need some support and time to get your legs back in action. Also, your peeing will be constantly monitored to make sure the epidural affect has worn off. (This means, you will have to pee in a bowl so that your urine quantity can be measured by the nurse – they have a cut off mark – about 750 ml – that you should mandatorily pee in order for you to be deemed okay – yuck but important!)
- Some people complain of headaches and backaches – but I did not have any. A few hours after delivery, I couldn’t even pin point the location of the tube on my back. Doctors say that these aches may be more a side effect of the labor and delivery process than the actual epidural.
Advantages of Epidural:-
- No pain, need I say more
- Based on the effectiveness of the dosage administered you can ask for top up (increase), which can be added effortlessly.
- It keeps your blood pressure low.
- Even if your labor does not progress as planned and you need to undergo an emergency C-section, the epidural will continue to act as the anesthetic for C-section too. Only the dosage is increased.
- And the biggest advantage ever: Since your entire being is not focused on the pain, you can actually enjoy the process. You are in a clear state of mind when the baby comes – tummy up, there is no anesthesia so you can cuddle and nurse your newborn immediately.
So, the verdict? Epidural is a drug, which needs to be “prescribed” by your doctor who knows your body and your medical history well. It relived not only a lot of pain but a lot of other trauma associated with labor and delivery. Therefore, it is an excellent option to discuss with your healthcare provider and family. I personally feel it was one of the best decisions I made for my delivery you could experience the same too.
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