The Low-Down on Epidurals

Don't Stress

Today, the most popular medication for relief during labor is epidural anesthesia. It is estimated that more than half of women giving birth in hospitals use epidural anesthesia. As in all procedures relating to labor and birth, you'll want to educate yourself about the epidural, so you can make informed decisions without stress or worry.

Pain Relief

The epidural is regional anesthesia that blocks pain in a specific location in the body. The goal is to give pain relief, rather than provide total anesthesia which is defined as a complete lack of feeling. Epidurals serve to block nerve impulses in the lower spine, resulting in decreased sensation for the lower half of the body.

The medication used in epidural anesthesia is often a combination of local anesthetics like lidocaine in conjunction with narcotics or opioids, such as fentanyl. The use of the opioids allows the anesthesiologist to use less of the local anesthetics so that the patient suffers fewer side effects. Sometimes, still another drug is added to help prolong the effects of the anesthesia or to stabilize the mother's blood pressure.

Before the epidural line can be placed, the laboring mother will be given intravenous fluids, and will continue to receive fluids throughout her labor and delivery, about 1-2 liters. The epidural will be administered by an anesthesiologist, obstetrician, or nurse-anesthetist. You will be asked to lie on your side and hug your knees to your chest while arching your back. You will need to remain still during this time. Your back will be cleansed with an antiseptic solution and this may feel a bit cold. A local anesthetic will be injected into your back to numb the area prior to inserting the epidural.

At this point you are ready for the epidural placement in which a needle will be inserted into the numbed area surrounding the spinal cord in the lower back. A small tube or catheter is threaded through the needle and into the epidural space. Then the needle is removed with care, leaving the catheter in place. Medication is given by way of the catheter through periodic injections or by continuous infusion. The catheter is taped to your back to prevent slippage.

There are many benefits to epidural anesthesia:

Helps you rest when labor is prolonged

Makes the birth experience more positive by removing the pain

Allows you to remain an alert and active participant in your birth

May speed the process since the relaxation provided by pain relief can help your labor progress