Epidurals

Epidurals are one of the most common pain relievers during birth. Many women today use this option to relieve pain. I want to tell you what it all entails before you get one so that way you have fully informed. Most women think they give you a shot and you are good to go. However that isn’t the case. 

There is a process to go through before the epidural. You will begin by letting your nurse know you want one. They will bring you a consent form to fill out just letting you know the risks and benefits. The anesthesiologist will also go over with you one more time as well. While you wait for them to come. 

You will be given an IV fluid first since an epidural can cause a drop in blood pressure. I typically like to advise my clients to do it in the arm rather than the hand. The nurse will continue to hang fluids throughout your labor. The nurse will then put a blood pressure cuff on you to monitor your blood pressure. Have them put it on the opposite arm of your iv. They will also need to monitor your contractions. This will be wrapped around you on the top of the abdomen.  Another monitor will go on bottom of the abdomen to monitor the baby’s heart rate. They will then put a pulse oxygen sensor on your finger to monitor your heart rate. After all these steps are completed now it’s time for the epidural.

The anesthesiologist arrives and goes over the patient's risks and benefits with you. He or she will ask you to sit up and sit with your legs off the side of the bed.  You will curl over like a shrimp position.

This will help open up the spaces between the vertebrae’s. I usually have a pillow under the arms to help with the position. Drop your chin to your chest and keep the shoulders down. At this point the anesthesiologist will located where the epidural will be placed and mark the area. Once it is located you will get it cleaned and draped with a sterilized drape. They will then numb the area. When this happens many women describe it as a small sting and prick, Almost like a bee-sting. 

After the area is numb you will then get a longer needle into the numbed epidural space into the spine. The needle is hollow and will allow for the epidural catheter to be put into place. This is where the medication will be delivered. After the catheter is in place you will then be asked to lie on your back for 15-30 mins for the drugs to do its purpose. You may wonder I just got this done why do I need to lay on my back?  When you lie on your back you allow the pain medicine to distribute equally between both of the legs. 

Epidurals can cause a change in contractions. You may be advised to have a placement of an intrauterine pressure catheter to measure the strength of your contractions. This will happen by inserting a wand into your uterus between your uterine wall and your baby. Most likely since you can’t walk you will need a catheter into your bladder until it’s time to push. This will help the contracts. 

When should I get my epidural?

There is no wrong answer for this. You are able to get anytime you are in labor. Every women’s pain tolerance is different. Only you will know when you need it. It is recommend that you wait till a little bit later in the labor to get one to prevent your chance of other interventions. 

Can I move around?

Typically you aren’t allowed to be walking around since you don’t have the sensation of feeling from the waist down. However with your partner or support of a doula you are able to still move into different positions to help open up your pelvic and cervix.  You can use a pillow or what is called a peanut ball to use on your side in between your legs. This will help make contractions more effective. 

What are the benefit and cons?

Epidurals can help reduce the level of discomfort. It can allow the mom to rest or sleep especially if it’s a long labor. It can help you stay alert during the labor. 

 There are some risks that come with it. As stated above it can lower your blood pressure, increased use of instrumental assisted delivery, may increase the need for pitocin. 

Like any medication it is advised to have a conversation with your birth team and support to make sure an epidural is right for you.

Just remember that it’s your body and your choice and there is nothing wrong with needing an epidural or not. You are doing amazing and about to meet your baby.