Epidural Pros and Cons

Congratulations on your upcoming baby! As exciting as this new phase of life can be, it’s extremely vital to be prepared as best as possible for the new addition. Whether a boy or girl, twins or triplets, life as you know it will turn upside down. Free time? Consider it gone. Bedtime snuggles will be better than ever, but you will also be far more tired than before. Coffee? More, please! Before this next phase of life begins, the daunting task of delivering a baby must be completed. By reading this article, you have taken the wise step to learn more about the epidural. This article is designed to give you a medical overview of pros and cons of the epidural.

Before we discuss the pros and cons we first need to know: what is an epidural? This long, intimidating word may seem unknown or complex, however, rest assured, by the end of this article you are going to feel like an epidural pro. An epidural is a type of pain relief that is used during labor. Simple enough, right? More specifically, it is a tiny plastic tube (called a catheter) that is inserted into a small space in your back to allow pain medication to numb or desensitize pain neuroreceptors. Neuroreceptors are messengers; they tell the brain whats going on. They tell the brain that pain is right “here”, or “here”. The epidural puts these messengers to sleep during labor without stopping labor.

A CRNA (Certified Registered Nurse Anesthetist) or Anesthesiologist (Dr. who specializes in Anesthesia) will come in to perform the short procedure. Word to the wise, don’t let students practice on your back.

During the procedure:

1. A healthcare provider will come into your labor suite and have you sit on the side of the bed. Standing behind you, they will temporarily place a needle into your back.

2. They will find a small place next to your spinal cord called the "epidural space". As soon as this small place where the messengers live is found, the catheter is advanced next to your spinal cord and the needle is removed.

This is important so I will repeat, NO NEEDLE stays in your back after the epidural is placed. Only the small plastic catheter is left.

3. The act of the needle insertion should only be felt by a “pressure sensation” and not “pain” as the site is numbed prior, typically with a medication called Lidocaine.

4. Placing the Lidocaine should be the only part of the procedure that is painful; this part will feel like a pinch.

5. After the procedure is completed, the provider will hand you a button to give you breakthrough medication if you are still feeling pain from contractions. Otherwise the epidural continually administers pain medication through that catheter until you deliver the baby.

Simple enough, right? Now that you understand the process of the epidural, you can have a better understanding of what will happen on your day of delivery. Knowing the process is so important because it allows you to have a basic understanding before it happens which erases the “fear of the unknown”. This fear is normal when you’ve never had a baby before because you don’t know what to expect. Anxiety is also common. You’ve probably not delivered a baby before and now you are doing your due diligence to decrease that anxiety caused by the “fear of the unknown”.

1.​Pain Relief

The epidural has the reputation to be the most effective means for pain relief. The epidural numbs from below the chest down to your toes and desensitizes the nerve impulses sent to the brain. Some may feel tingling in the legs, however, that is a reassuring sign that the epidural will work effectively. Most of the time, it completely takes away the majority of the pain felt during labor.

2.​Relaxation

Labor can be downright exhausting. When one is progressing through labor and the pain becomes intolerable, relaxation may be the most desirable goal imaginable. Once you are able to finally have pain relief your body is able to relax. Relaxation can help your muscles relax allowing more room for the baby's head to come down thus helping the labor process.

3.​Sleep

Once the pain is removed, many mothers can get the recharge they need. For those mothers laboring through the early hours in the morning, sleep will also be cherished. You can have that relief with the epidural. With plenty of position changes, you will still progress through active labor even if you are sound asleep.

4.​Comfort

The epidural is the most effective means for pain management. Do I need to say more? Pain relief from exhaustive contractions is the number one reason why mothers get the epidural.

Laboring mothers often say: “I just can’t take it anymore”, or, “That was the worst pain I’ve ever felt before”.

Many new mothers have said that the pain from contractions was the worst pain they’ve ever been in. EVER.

If you’ve ever been into a car accident and have broken a bone, or have been skateboarding and took a fall from a landing, chances are you’ve experienced tremendous pain. Now, imagine a pain, but more intense.

This is a major positive aspect from an epidural. Luckily, once the baby is delivered, the pain is mostly gone. So if you’re preparing to go natural, know the end is in sight once the baby is born. The mom’s body receives a flood of new wonderful hormones and “feel good” emotions at that time.

For some mothers, labor may last for a few days. Labor can also last just a few hours. Either way, labor is a workout. For those of you who engage in physical activity, you understand the need for rest and relaxation after a long workout. Imagine laboring for hours without rest. Luckily, the epidural can allow you to rest and recoup prior to pushing.

Next, ask your nurse for a “peanut ball” to place between your legs while you are sleeping. Imagine yourself standing at a squatting position, this position allows more room for the baby’s head to come down into the pelvis. That peanut ball increases your pelvic diameter in much the same way squatting does.

Once your cervix is completely dilated, the epidural can also allow your body to do something called, “laboring down”. If your baby’s head is still not far down enough in the pelvic canal, laboring down can allow your body to naturally contract and push your baby down in the pelvic canal, all while you are resting. “Laboring Down” has been proven by evidenced based research to shorten the time it takes for pushing especially in first time mothers. That way you can rest while your body is progressing your labor. Pretty sweet, huh?

1.​Can cause drops in the baby’s heart beat

2.​May lead to a cesarean section

3.​Lowers blood pressure

4.​Depress breathing

5.​Nausea/ Vomiting

6.​Itching

7.​Site infection

8.​Urinary retention

9.​Sensory motor deficits

The biggest downfall to the epidural is the chance that the medication may actually cause distress for the baby. The epidural can cause hypotension (low blood pressure). With that drop in pressure the body will shunt blood away from the baby to compensate and stabilize the mother as best as possible. This process takes oxygen away from the baby.

If the baby’s heart beat doesn’t come up after interventions from the healthcare team, delivery may become imminent and the baby may have to be delivered by C-Section.

Maternal implications may be fainting or simply feeling light headed.

The epidural may cause the mother’s respirations to slow down.

You may have heard of the overwhelming array of options to choose from in labor such as:

• Nitrous
• IV pain medications
• The epidural

Thinking about pain management is important. Many choices lay at your feet for the journey ahead.

Not only will knowing your pain management options help decrease the stress and anticipation of the “big day”, but you can be empowered to have a foundation of options your healthcare facility will provide when you go to deliver.

Another option is to go natural in delivery. “Going Natural” has different definitions for different people. Patients in the past have thought having a vaginal delivery (not a cesarean section) is going natural. You may be thinking, who do I want with me when I deliver? Who will be my best support? Is crazy Aunt Dorothy going to push her own ideas my way?

Preparation for (arguably) the toughest day of your physical life is brilliant. You, taking the time out of your busy life to educate yourself with these options can help you find the best avenue for you to take; for yourself and your new baby.