How to Understand Epidural Placement in Labor

Epidural anesthesia is probably the most popular form of pain relief used during labor. Epidurals work by blocking the nerve impulses from the lower spine. This results in decreased sensations in the lower half of the body. Epidurals certainly have a number of risks and benefits associated with them, so it is important that you understand these before making a decision. Epidural placement in labor is relatively easy for the anesthesiologist to do, but the mother may feel some discomfort. The following steps will explain how an epidural is given.

Instructions

1. You will be given a specific amount of I.V. fluids to help reduce the chance of your blood pressure dropping. Most doctors want at least two bags of fluid given before administering the epidural, but may make exceptions based on the circumstances.

2. You will be instructed to either lie on your side with her body curled up, or sit up on the edge of the bed with your back curled towards the anesthesiologist.

3. The anesthesiologist will clean your lower back with a cleaning solution and then numb you with a local anesthetic. This will make the actual procedure much more comfortable.

4. The anesthesiologist then inserts the needle into the epidural space. A plastic catheter, that is usually very thin, is carefully threaded through the needle. Once the catheter is in place, the needle is removed and the catheter is taped to your back.

5. The anesthesiologist will then inject the anesthetic. The catheter is attached to a device that will automatically regulate the medicine drip.

6. After dosing, your blood pressure, pulse and oxygen levels will be checked frequently, as well as the fetal heart tones and your contraction pattern.

7. If everything is OK, the anesthesiologist will leave. If there are problems, he will stay until they are resolved or administer another epidural if necessary.

Tips & Warnings

• Epidurals can provide pain relief without impairing mental awareness.

• Epidurals can provide complete rest for you.

• Try other methods of coping with pain before getting an epidural.

• You may receive more medications if your blood pressure or oxygen level drops, or if contractions slow down.

• There may be an additional fee charged by your insurance for receiving an epidural.

• Epidurals do not guarantee complete pain relief.

• After an epidural is administered, you may be unable to move the lower half of your body for hours, even after delivery.

• You may develop a fever after receiving an epidural. The longer the epidural is in place, the higher risk of developing a fever.

• You may experience a severe drop in blood pressure, which could cause dizziness, nausea and more medication.

• Epidurals often impair labor progress by slowing things down. If this happens, you will be given more drugs to augment labor.

• Some moms experience spinal headaches and back pain after the epidural is removed.

• Epidurals can impair your ability to push effectively, which may lead to an episiotomy, a forceps delivery or possibly a cesarean.

• Anesthesia personnel aren't always available to administer the epidural when you want one.