Epidurals and Narcotics During Labor - Yes or No?

Source

Background - Epidural Anesthetic

This is a summary of my own related experiences among my group of pain-and-stress patients and myself with pain controlling pharmaceuticals. Each individuals experience is unique and should be discussed with a qualified health practitioner before application of any controlled substance(s). A list of links at the end of this work will help you learn more. Thanks for reading. - Patty Inglish.

In preventive medicine I was able to study disease prevention and control, the course of epidemics, the effects of stress in the workplace, ADD/ADHD. violence in America, emerging methods in space medicine, and a few medical procedures in some of these areas. Personally, I was able to study anesthetics a little more in depth. Procedures and products change quickly over time in America, and this material covers many of them in the 2000s. Be on the lookout for new and better techniques in future.

Today, I doubt that babies will ever be "beamed out" on their birthday. Perhaps one day I wll be incorrect about that, We know that beaming a photon in the late 1990s resulted in a slightly different subatomic arrangement at the destination and this may be a problem..

During a 40-minute surgery to repair a lower extremity, I received a single-injection epidural anesthetic (Intrathecal Epidural) that worked quite well in its main function. It produced a feeling of my lower body simply disappearing, rather than being numb. It was also relaxing. Ten minutes before the end of surgery, I felt something like a wave pass over me from foot to head and at the conclusion of the procedure, I took a nap in recovery and my lower body had returned upon awakening. It's as though that portion of my anatomy passed through to another dimension damaged and returned corrected. However, this is different from birthing epidurals, in which a common practice is to access the spine and leave a catheter in a space between the spinal cord and the vertebrae to reach the target nerves (Caudal Epidural - a] Local Only or b] Narcotic Only), for multiple administrations or continuous drip of an anesthetic during/after labor. The Narcotic Only Epidural is also called the Walking Epidural, except the patient cannot sometimes walk. She can often move around, though and the hospital will have rules about walking, moving, and eating during labor, so ask..

PROBLEMS OF SIDE ACTIONS

My particular side action or adverse reaction to anesthetics post any non-dental surgery is nausea and disorientation. I have had two such surgeries only: tonsillectomy and compound (open) fracture reduction. Each time, I experienced some nausea at first and for 30 days thereafter,disorientation and confusion. The experience was like brain damage. Could mothers receiving epidurals experience this phenomenon?

Concerns of Accessing the Spine

  1. The spine is accessed. It is always dangerous to access the spine and the patient signs consent forms for this as well as for the entire birthing experience. Some patients might concern themselves with fear of infection, but this is extremely rare. In even rarer instances, the epidural might begin numbing in the wrong direction - up instead of down - and you need to speak up quickly so that standard procedures for countering this can be given as quickly as possible. My only experience with this is with one of my pain patients that had leg surgery; the anesthetist countered the problem quickly and effectively. Another pain control method was used in his case. Spinal Cord Injury is rarely a result of accessing the spine for an epidural, but ask questions about it and make sure you understand the answers.
  2. The patient may feel odd with a catheter taped to her back attached to a thin plastic tube connected to a pump, but there should be no pain in this after the initial slight pain of the needle inserted to make way for the small plastic catheter. -- In my case, I had one injection that hurt only slightly and felt some heat as the anesthetic entered. However, some catheter-using patients feel a tingle, some stating that it is rather "electric." That makes sense, since the spinal nerves form a living electrical cord of sorts.
  3. Pain control of any sort is subject to individual differences. The numbness can start anywhere form the top of the belly to the lower part of the uterine area and cannot be precisely predicted. The epidural may even not work at all, in which case other pain control methods can be applied.
  4. If the legs are numb, then the epidural patent cannot walk and may wish to do so. This can be frustrating. Aside from this, a bladder catheter may be needed to drain off urine due to lack of control int that area and to prevent additional pressure in the region.
  5. An epidural medication may possibly slow down labor and also prevent a woman from pushing through a contraction. Help is available from IV medications that promote contractions, including Oxytocin[Pitocin], which is described in Drug Therapy in Nursing, By Diane S. Aschenbrenner, Samantha J. Venable; Page 1166 - 1180.
  6. Epidurals may contain only Local Anesthetics: bupivacaine, chloroprocaine, lidocaine or locals in combination with Opiods or Narcotics: fentanyl, sufentanil, or similar and possibly in combination with Others: epinephrine, morphine; clonidine for blood pressure control, its original use; and others [ibid, CH 59.]. Ask your treatment team what specifically you will be receiving. Your body may have a problem with any or all of them. Blood pressure may plummet, headaches or ear ringing occur, or other events may happen [ibid, CH 59].
  7. An infant delivered via epidural may have difficulty breast feeding (see American Pregnancy Association link below).

Allergies

Allergies can be a bomb waiting to explode. Some are deadly. (public domain)
Allergies can be a bomb waiting to explode. Some are deadly. (public domain)

Narcotic Pain Relief

The health and medical community needs to be aware of th drug sensitivities and allergies that patients incur. Patients must report any and all drug sensitivities and allergies that they recognize -- One's new health professionals will not automatically know about them and current professionals should be reminded. A drug sensitivity can be understood as a less severe adverse reaction to a drug than is a drug allergy, which can culminate in such serious reactions as anaphylactic shock and death. Individual differences still occur and you may even be allergic and unaware that this is true.

Narcotic Side Actions

I learned that when one reports a drug allergy in a hospital, staff sometimes do not believe it. Take care not let this happen to you.

I am allergic to codeine. I am allergic to all narcotics.Having reported this in hospital, I received morphine anyway, over protests.

I devloped restlessness and an intense rash that spread up and down the right side of my body (IV entry point: right arm) and itched like nothing I have previosly experienced. I even scratched in my sleep. The rash bled. The examining doctor did not know what the rash was, Morphine was stopped and the rash gone in 24 hours.

If you are sensitive or allergic to narcotics, make enough noise about it so that your medical team listens to you.

Next for me came Oxycodone. They insisted that I take at least one. It gave me a stabbing stomach pain and nausea. I was given a prescription and said I would not use it. I took acetaminophen for pain prevention for a week afterward and then nothing. My advise to you is: If you are allergic to any narcotic, do not take any other narcotic, but talk to your personal health practitioner about this.

Some Products and Concerns

Oxytocin as Pitocin (Hormone)

  • Can effectively increase contractions in uterus and mammary glands.
  • May produce over-contraction in the uterus and harm the infant or mother.
  • May produce fluid buildup and resulting intoxication by water, which can be fatal.
  • May produce tachycardia (fast heart beat), palpatations, nervousness in the mother.
  • May produce depressed respiration and a range of heart rate changes in the infant.
  • May result in the other adverse actions: chest pain, breathing problems, confusion, fast or irregular heartbeat, severe headache, irritation at the injection site (MedLine of the National Institutes of Health). Consult MedWatch for up-to-the minute drug news.

Morphine as DepoDur (Narcotic)

Fentanyl as Duragesic (Narcotic)

  • May cause breathing to become severely and dangerously decreased.; has been implicated more clearly as a pain patch application,
  • May impair physical and mental abilities.
  • May cause vomiting, constipation, excessive sweating.
  • Has been found in breast milk and may affect the nursing infant.

Licocaine/Xylocaine (a Local)

  • May restrict movement to the extent that it required bedrest.
  • May result in spinal anesthesia that must be reversed.
  • May produce dropping blood pressure in mother or infant.
  • May inhibit the ability to push through a contraction.
  • Constipation (this is one I experience in dental use, but is very unusual, not even listed as "rare").
  • Other side effects, usual and uncommon.

Source

Consult the Professionals.

Remember to consult your health care professional before making any decisions about the use of drugs in conception, pregnancy, childbirt, aftercare, and early infant development.

Have a wonderful family if you choose to have children!

Your Opinion of Drugs During Birthing

Which Methods and Products Do You or Your Friends, Families, and Acquaintances Prefer?

  • Epidurals - Locals Only
  • Epidurals - Narcotics or Combinations
  • Epidurals - Narcotics Only
  • Natural Childbirth, No Drugs
  • Natural Childbirth While Submerged in Water
  • Anesthetics for Complete Unconsciousness
  • NSAIDS Only - Non Steroidal Anti-Infammatories like aspirin, advil, tylenonal
  • Chocolate - (Effects of chocolate during pregnancy and labor are under investigation).
See results without voting

© 2009 Patty Inglish

More by this Author


Additions and News 25 comments

kneeyee Alex 7 years ago

You just pulled off another important write up here on hubpages. great hub.I hope otherrs are reading.i am gonna invite a couple of others to read this too. I like to be your fan, how about you joining mine too


Eldritch Elegy profile image

Eldritch Elegy 7 years ago

Whoa.

More information than I hoped for! Thank you so, so much. This will be very useful for me, and just in time; my appointment is in an hour and my baby is due in three days. :P

Thanks again, and on a site note, you make some very beautiful, professional Hubs.


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

O my! - Pease tell us all about it when you're all done ahvng a great new family member. :)


Rochelle Frank profile image

Rochelle Frank 7 years ago from California Gold Country

Both of mine came fast. The epidural only kicked in after the delivery. Might as well have skipped it all together.


Misha profile image

Misha 7 years ago from DC Area

Patty, of course it depends, yet I believe for average woman and baby natural birth is the most beneficial way to go on the great scale, and should be a norm, not an exception. And yes, all my three kids were born naturally, and I was there and helped with the last too - so I have some idea of whatI am talking about :)

And birth into water starts to seem to be even more natural way of doing things after the recent ideas of our ancestors being a beach dwellers...

Great hub as usual!


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

Rochelle - AFTER the delivery? Wow that was very fast. Hope you did not have very much pain during delivery.

Misha - I like it that you are accepting natural birth and even helped with the last baby.  What a wonderful experience! I saw a video of a water birth and was very much impressed. The baby came out and swam and looked like he was smiling.


amy jane profile image

amy jane 7 years ago from Connecticut

This is an excellent hub Patty! I wish all expectant parents would read it. So many doctors leave out the very important facts about these pain management options! I personally think that water-birthing is the way to go. I had the epidural with my 1st, water-birth with my 2nd and emergency c-section with my 3rd. The water-birth was by far the easiest on my body (and easy on the baby). I was up and walking right after. :) Again, great hub!


Mighty Mom profile image

Mighty Mom 7 years ago from Where Left is Right, CA

Very informative hub that should be required reading for all pregnant women. For example, who knew there were so many variations on the epidural theme? Who know pitocin had so many potentially negative side effects (beyond the uber-contractions, of course). The time to have the discussion with your ob/gyn is BEFORE you go into labor. I suspect this is not common practice.

I am also appalled that your reports of being allergic to certain drugs were not taken seriously. It's lucky that you ONLY got a rash.


Sandy 7 years ago

I have a very strong threshold of pain and went completely drug free. But then again I was in labor for 3 weeks prior to the birth. No joke. I was haven't small contractions. My doctor said it happens to some women but nothing to worriy about.


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

So many differences! That;s why we ladies need to be listened to and not shrugged off in healthy are.

Amy Jane - Yours is an encouraging and happy story and I hope more people learn about it from us.

Mighty Mom - I find so many people don't tell their doctor anything and leave it all up to her or him. Doctors can't do and know everything, of course. And yes, it's not good to be disbeleived and then proved right by body results.

Sandy - This is the longest labor I have heard of, but I have no doubt it occurred. Everyone is different. I hope the labor stopped AFTER the child was born.


LondonGirl profile image

LondonGirl 7 years ago from London

I think it depends on the birth, really. The longer it goes on, and the more tired the mother, the more useful an epidural is, I think.


Mighty Mom profile image

Mighty Mom 7 years ago from Where Left is Right, CA

Being one who was induced with pitocin, my experience is -- well, my experience. I do know I was thrilled to finally hit that 5cm mark so I could FINALLY get my epidural. The epidural worked so well that I could not feel my legs at all. The problem with that was when the baby got into distress they had me up on my hands and knees so they could touch/tickle his head. Problem with that was it's pretty hard to kneel when you can't feel your knees!

All ended well, thank God.


mulberry1 profile image

mulberry1 7 years ago

Very informative! I need to find out more about hydrocodone, my mother is on it and she's having some breathing trouble but I have no idea if it's related (after reading about the Oxycotin I'm wondering about it.)


MandM 7 years ago

I had never heard about chocolate during pregnancy and birth.


Jesus_saves_us_7 profile image

Jesus_saves_us_7 7 years ago from Seeking Salvation

Excelent hub Patty! Very nformative.


G-Ma Johnson profile image

G-Ma Johnson 7 years ago from NW in the land of the Free

Yes I agree with everyone...but why don't they ??? give us all the information about all this way, way before the baby is due??or maybe they do...but not for me and I think not for many other's...There are so many reason's to be up front, not to frighten new mom's but to be educated so one can make the best choice...Great Hub...G-Ma :O) Hugs & Peace


jjrubio 7 years ago

I had an epidural with my first delivery ( normal) and I had no problems whatsoever with the epidural itself or pain.

The second pregnancy was C-Section but even then they have to give you somewhat of a "saddle block" to numb you from the stomach down. All in all I am glad that is available to us, whereas in my grandmothers day they didn't have that available. Also, there is always risk in every procedure. Remember that adults and infants who doctors check for Meningitis also have to do Spinal Taps on them and that is almost the same. My son had a Spinal Tap done on him at 2 weeks old. He had no side effects or damage done. Medicine is a risk....sometimes the benefits outweigh the risks.


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

Hydrocodone is Vicodin, is derived from opium and is addictive. 

>>Allergic reaction:

hives; *difficulty breathing*; swelling of face, lips, tongue, or throat. 

>>Serious side effects:

shallow breathing, slow heartbeat;

feeling light-headed, fainting;

confusion, fear, unusual thoughts or behavior;

seizure/convulsions;

problems with urination; or

nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice.


JamaGenee profile image

JamaGenee 7 years ago from Central Oklahoma

For my 3rd child, who began her arrival in the wee hours of a Saturday morning, the doctor didn't show up until the *very last minute*. Meaning the only pain relief available during labor was a standing order for Demerol.  I could feel the contractions and push, etc, but NO pain.  Giggled during contractions and nodded off a few times in between. The baby's APGAR was 10, so obviously she wasn't affected. 

My second Demerol "trip" was two weeks after shattering an elbow in a fall.  A metal rod had been inserted (under general anesthesia) into the bone in my forearm until an inch or so of bone regenerated.  When it came time to remove it, I was given Demerol and immediately felt like I was floating.  Even though I watched the doctor pull the rod out, didn't feel a thing except a bit of "tugging".  No surprise then that Demerol is and always will be my drug of choice!

As for drug allergies, I had a reaction to sulfa drugs as a baby, but as an adult felt silly having to declare this, as I assumed they were no longer used.  Then I was informed they aren't used in same form, but *can* be part of more modern drugs.  So now I don't feel so silly. 


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

I am happy that the Demerol works so well for you, with no side effects. It's like heaven when we get something to work for us, isn't it? I had a very bad reaction to ether as a child. I still list it as well. Thanks for visiting and telling us your good story.


Research Analyst profile image

Research Analyst 7 years ago

Well thought out and informational hub, its interesting to see the adverse reactions from epidurals, this would explain why some women who are not educated about the process may not make the right decision.


Patty Inglish, MS profile image

Patty Inglish, MS 7 years ago from North America Author

A Cinese friend in Ohio was denied any pain medications by her older white phsycian, went through labor 24 hours and then had a C-Section because her pelvis size vaginal prevented delivery. The doctor told her that women need to work for their babies.

Yes, women deserve to know the facts.


christryon 6 years ago

I had an epidural with all 3 of my sons.

If I had decided against the epidural with my last son, I may not have survived the labor process. I am thankful for the staff and my doctor for their incentive to get it.

As far as other forms of pain reliever during surgery, I prefer to stay awake, if that is an option. I have a tendency to get nauseated when I am "put under." Fortunately it only lasts for a day or two.

You have shared a lot of really great information.


Felisha 5 years ago

At Tacoma General Hospital in TACOMA WASHINGTON- how many centimeters do you have to be dilated to get the epidural


hippie mommy profile image

hippie mommy 4 years ago from South Carolina

Very informative! Thanks :)

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.


    Click to Rate This Article
    working