WHAT DO YOU NEED TO KNOW ABOUT EPIDURALS?


As a Doula our job is to help and to support women in an educated and unbiased way through their pregnancies, childbirth and postpartum. And, the best advice that we can give to each other is to continue getting educated and gaining more knowledge, because knowledge is the most powerful tool that we can use to advocate for ourselves.

Although the following points are from the video made by Rebecca Dekker, PhD nurse and the Founder of Evidence Based Birth®, I encourage you to watch the complete video:

Epidural during Labor for Pain Management

WHAT IS AN EPIDURAL?

“An epidural is also sometimes called an epidural block. This is when a catheter is placed in your lower back in an area right beneath where the spinal cord ends. An epidural can cause some loss of feeling and numbness in the lower part of your body, but the person who’s in labor remains fully awake and alert.”

WHAT IS A SPINAL BLOCK?

“A spinal block is somewhat similar to an epidural. It’s given as an injection in your lower back, but it’s given with a much smaller, thinner needle, and with a much smaller dose of the drugs. The drugs are injected into a sac of spinal fluid that’s right below the spinal cord in your back, and it causes a loss of feeling in your lower body.”

WHAT IS A CSE?

“You can also combine these two treatments into one and that is called a Combined Spinal-Epidural block or sometimes abbreviated CSE. With this method, you get both the benefits of both methods.”

WHAT ARE THE BENEFITS?

1. “[Studies show that-] epidural-type pain relief methods lowered pain on average about three and a half points when you’re looking at a zero to 10 scale, with zero being no pain and 10 being the worst pain possible. An epidural was effective by lowering that about three and a half points.”

2. “Epidural-type pain medications are also safer for the baby, compared to giving pain medications through an IV.”

3. “Another benefit of epidurals during labor that is not mentioned in some of these studies, but anecdotally you hear a lot, is that if somebody is really tired or exhausted from labor, epidurals can help them rest and relax, and get some much needed sleep if they’ve been having a long labor.”

WHAT ARE THE RISKS?

“The Cochrane review that found that epidurals are very effective with pain management during labor also found a lot of different side effects [such as]:”

1. “[A women is] much more likely to need a forceps or vacuum delivery to help the baby come out at the end of the pushing phase. This type of delivery is more likely to cause severe tears in your perineal area.”

2. “[A women is] much more likely to experience low blood pressure, which can make you feel lightheaded or nauseous, and may require additional IV fluids or medications to manage. [And,] a drop in the mother’s blood pressure can also compromise the oxygen status of the baby.”

3. “[A women has] an increased risk of needing a cesarean for signs of fetal distress if you have an epidural during labor.”

4. “[A women is] more likely to experience something what we call heavy motor-blockade. And that means that your legs might become so heavy and difficult to move that you can’t really move the lower part of your body. “

5. “[A women is] much more likely to have a fever during labor with an epidural, lose bladder control and not be able to urinate, and so often, there’s a catheter inserted into your bladder to drain your urine throughout the rest of labor.”

6. “[A women is] likely to need Pitocin to speed up your labor because the epidural during labor can slow your labor down. Then, you’re more likely to have a longer second stage of labor, the pushing phase, with an epidural.”

WHAT ARE OTHER RISKS?

1. “Other risks and side effects from epidurals, spinals, and CSEs include feeling itchy, having itchy skin. This is a very common side effect.”

2. “Feeling sick or nauseous, although this is less common with an epidural than it would be. It’s more common if you’re are given medications through your arm through an IV.”

3. “Inadequate pain relief, researchers estimate anywhere from one in eight to one in 10 people with an epidural will not have satisfactory pain management with the epidural.”

4. ”About one in a 100 mothers reports a spinal headache.”

5. “Epidurals can cause slowed breathing and drowsiness in the mother.”

6. “The site where the needle went in could cause slight infection, but usually, those are not serious and can be treated with antibiotics.”

7. “You can have a temporarily sore back from the epidural injection.”

8. “Now more severe complications, things like nerve damage, seizures, severe breathing difficulty, and death are extremely rare. In fact, death from epidurals is so rare that one study during a 10 year period in the United States, found zero recorded deaths from epidurals during labor.”

WHAT IS THE CONCLUSION?

“The bottom line is that epidurals, spinals, and combined spinal epidurals during labor are very effective ways to help manage pain. However, they do carry potential risks and side effects for the mother and the baby.”

Finally, I encourage again to what this video and talk about it with your care provider. Momma, remember that YOU ARE YOUR BEST ADVOCATOR !

Blessings,

Dayana Harrison

RESOURCES:

Deccer, Rebecca . “Epidural during Labor for Pain Management.” Evidence Based Birth®, 31 Jan. 2018, evidencebasedbirth.com/epidural-during-labor-pain-management/.

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