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Epidurals: Need It or Leave It?

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According to the Centers for Disease Control, more than 60 percent of women who had vaginal deliveries received an epidural during labor. With the number of women receiving epidurals nearly equaling the number of women who don’t, it’s truly a personal preference. There are many questions surrounding epidurals and we’re providing you with all the answers from our nurse practitioner, Katie Neely, to help you with your decision.

What is an epidural?

Epidurals help ease the pain of contractions and delivery. They can also give relief to women experiencing long, grueling hours of labor. Numbing medication or epidural anesthesia is injected into your spine, blocking the nerve impulses from lower spine segments. This helps decrease sensation to the lower half of your body.

“Ideally, the epidural will be strong enough to block the pain receptors resulting in pressure as the only sensation,” Neely says.

Epidurals are given by an anesthesiologist. You will first receive a local anesthetic beforehand to numb the area where you’ll be receiving the epidural injection. Once in place, the epidural needle is replaced with a small catheter tube that can administer more medication as needed.

Many women fear epidurals will make them drowsy or foggy during delivery, but mothers-to-be are fully awake and aware during the labor. However, there are some side effects that mothers may experience:

  • Low blood pressure
  • Cold chills or shivering
  • A headache
  • Nausea

When can you get an epidural?

Typically, you can receive an epidural as early as when you are 4 to 5 centimeters dilated and in active labor. Normally, it takes about 15 minutes to place the epidural catheter and for the pain to start subsiding and another 20 minutes to go into full effect.

There are a lot of stories about women being too far along to get an epidural, but this is a myth. You can get an epidural any time you want. However, you shouldn’t wait too close to delivery because you need to make sure the anesthesiologist is available and have at least 30 minutes for it to be administered and take effect.

Common questions about epidurals:

Now that you know the basics about epidurals, here’s a look at our most frequently asked questions.

Do epidurals hurt?

The local numbing agent alleviates most of the pain you may feel during the epidural. Most women feel pressure and a stinging sensation as the epidural medication is injected through the needle.

“The epidural placement discomfort is about the same as having the IV inserted,” Neely says. “Most patients say they are more focused on the pain of the contractions, that they hardly notice the epidural placement.”

Can epidurals slow down labor?

“They do not,” says Neely. “Older studies suggest that epidurals cause women to push less effectively and cause labor to last longer. It was thought that if an epidural was placed before 4 centimeters dilated, it would cause a woman to need a C-section for delivery.”

“In my previous experience as Labor and Delivery nurse, I found the epidural to help the woman progress in labor,” Neely says. “The epidural takes away the pain and suddenly the mother relaxes, and the baby finally progresses – this happened consistently.”

Recent randomized studies over the past few years have not found the epidural to be correlated with the mother needing a C-section. These studies were so profound that it encouraged The American College of Obstetricians and Gynecologists (ACOG) to change their guidelines in 2014 to reflect these findings.

If labor does slow down after your epidural, you may be given Pitocin, a synthetic version of oxytocin which is a natural hormone that helps your uterus contract during labor. Speak with your doctor about your different options for epidural medication and your dosage.

Can you feel contractions with an epidural?

With an epidural, you are still aware of contractions, but you won’t feel any pain.  However, an epidural does change the game when it comes to pushing. This is where the nursing staff can help. “Any well-trained labor and delivery nurse knows how to get the mother pushing effectively without having to sacrifice her pain management,” Neely says.

Can epidurals cause permanent back pain or paralysis?

Epidurals can last for several hours after delivery. Depending on the dosage and type of epidural, the lower half of your body may still be numb after birth. You will most likely need assistance to walk and to use the bathroom while the medication is wearing off.

However, serious complications from an epidural, including paralysis, are extremely rare. “Some women have discomfort in the lower back where the catheter was inserted for a few hours or days after the epidural, but it doesn’t last,” Neely says.

Can an epidural hurt the baby?

“No,” says Neely. “Any risk to the baby is minimal.”

What do moms who have received epidurals have to say?

“I have yet to ever hear of a woman who had a normal labor and delivery ever regret it,” Neely says. “Even those who had natural labor with their previous deliveries have always responded with, ‘Oh my gosh, this epidural thing is amazing. Why have I not done this before?’”

A lot of moms-to-be aren’t getting a lot of sleep toward the end of their pregnancy, and during a long labor, epidurals allow them to get much needed rest and relaxation.

Is an epidural right for you?

It’s important to us that our patients understand that the choice to have an epidural or natural labor is up to them. No matter the decision, our goal is to give the mother and family the best delivery experience they can have.

“It’s not just the baby that is important, but the mother’s physical, emotional, and mental wellbeing,” says Neely.

Our patients are provided with many options for a safe birthing experience and we are happy to answer any questions you may have. Your doctor can also direct you to appropriate birthing classes and additional information.