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SMC Dept of Anesthesia Obstetrical Anesthesia Information |
Labor Epidurals: Relief of Discomfort and Pain During Childbirth
The goal of Swedish Medical Center/First Hill's Obstetric Anesthesia Department is to make your childbirth experience more comfortable. Anesthesia services are available seven days a week, 24 hours a day to meet all your obstetric anesthesia needs.After reading this brochure, you may want to talk with your doctor or one of our anesthesiologists to discuss the use of labor epidurals, or to ask other questions you may have about this pain-control method. Your doctor can get you in touch with one of our anesthesiologists.
What is a Labor Epidural?
An epidural is a nerve block. It involves placing a very thin, soft plastic tube (a catheter) through the skin in your lower back into a space in front of the spinal canal. Various medications can then be administered through the catheter to block nerves carrying pain impulses from the uterus and birth canal. The block is mild enough to greatly reduce the discomfort of labor contractions, while still allowing you to move your legs and push the baby through the birth canal. The block can also be made stronger, if necessary, to allow for a patient to undergo surgery, such as a Cesarean section, without experiencing pain.
Receiving a Labor Epidural
The skin is first numbed by a small injection of local anesthetic. The catheter is placed into the epidural space through a needle, which is then removed. The catheter is taped securely to your back. Medications can then be easily injected into the epidural space through the catheter. There is no discomfort from the catheter while it is in place and it is removed just after the baby is delivered.
Labor Epidurals and Your Baby
Epidural anesthesia is safe for your baby. Because medications are not injected into your veins, the possibility of them reaching your baby is very small. An expectant mother will feel more comfortable soon after the epidural is placed and the drugs are injected. When a mother feels less discomfort, her stress level is reduced, and her baby, in turn, experiences less stress.
Possible Side Effects of Labor Epidurals
When problems result from epidural anesthesia, they are usually minor and temporary. For example, epidural anesthesia may cause contractions to occur further apart for about 10 to 15 minutes. Your blood pressure may also lower, requiring an increased flow of intravenous fluids or medications. Women sometimes experience a mild sore spot where the epidural was inserted, though severe back pain is rare, as are headaches, leg weakness or numbness, infections or allergic reactions. Occasionally, mild itching may result from certain medications. There is always a chance that the epidural anesthetics may not give complete protection from the discomfort of childbirth. Both mother and baby are monitored closely and emergency drugs and equipment are always available to treat the rare complication.
Labor Epidurals and First-time Moms
First-time mothers can have an epidural placed as soon as labor is well under way with a good pattern of contractions, provided their obstetrician has given permission. In certain cases, the epidural can be placed before the onset of advanced labor, but medication will not be injected until needed.
"Walking" Epidurals
Another option involves injecting a narcotic into the intrathecal (fluid space around the spinal cord) space. This provides good pain relief and usually does not slow labor or inhibit early walking. This can be effective for early labor and, in some cases, lasts fairly close to delivery time. At the same time the intrathecal injection is given, an epidural catheter can be placed so it can be used to inject medications after the intrathecal dose wears off.
Labor Epidurals and Women Who Have Given Birth Before
Because mothers who have already had one or more children usually progress more rapidly through labor than first-time mothers, an epidural is often not requested. Or, it can sometimes be placed earlier. Nonetheless, effective relief from discomfort can still be achieved if time permits, and if the mother asks for the epidural and the obstetrician consents to its placement.
Childbirth Without a Labor Epidural
Labor is unpredictable. It ranges from a relatively quick and easy experience to one that is lengthy, painful and exhausting. An important point to remember is that everyone experiences the discomfort of labor differently. A woman should never feel guilty about asking for relief since only she knows the level of discomfort she is experiencing. Many patients are able to experience childbirth without an epidural or medicines. Other pain-relief options include intramuscular or intravenous medications as well as various relaxation techniques.
Labor Epidural Costs
The cost of an epidural varies depending on how long your labor lasts. In many cases, the entire cost is covered by medical insurance.
Obstetric Anesthesia Department
747 Broadway
Seattle, WA 98122-4307
www.swedish.org
©1999 SWEDISH MEDICAL CENTER OBFH-99-201 7/99