What is an epidural?

Epidural anesthesia is a very popular method of pain relief during labor. More than 50% of women giving birth at hospitals will use epidural anesthesia.
By doing your research you will gain an understanding  of the different types of epidurals, how they are administered, and their benefits and risks. So what exactly is epidural anesthesia? 

Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. The main goal of an epidural is to provide pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body. There are two main types of epidurals.  Regular epidural and combined spinal epidural (CSE). 
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REGULAR EPIDURAL

After the catheter is in place, a combination of narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. Most hospitals have policies that do not allow persons on labor to get out of bed or eat at this time.  You will want to ask about your hospital’s policies about staying in bed and eating.


COMBINED SPINAL EPIDURAL (CSE) 

A spinal block is sometimes used in combination with an epidural during labor to provide immediate pain relief. A spinal block, like an epidural, involves an injection in the lower back. While you sit or lie on your side in bed, a small amount of medication is injected into the spinal fluid to numb the lower half of the body. It brings good relief from pain and starts working quickly, but it lasts only an hour or two and is usually given only once during labor. 

EPIDURAL BENIFITS

• Allows you to rest if your labor long.
• When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability.  An epidural can allow you to rest and get focused. Sometimes that little rest is all you need to move forward as an active participant in your birth experience.

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​EPIDURAL RISKS

• Epidurals may cause your blood pressure to suddenly drop. If his does become a problem, you may need to be treated with IV fluids, medications, and oxygen.
• You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect. 
• After your epidural is placed, you will need to alternate sides while lying in bed and have continuous monitoring for changes in fetal heart rate. 
• You might experience the following side effects: shivering, a ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating.
• You might find that your epidural makes pushing more difficult and additional medications or interventions may be needed, such as forceps or cesarean.
• For a few hours after the birth, the lower half of your body may feel numb. 

Compiled using information from the following sources:

Americanpregnancy.org
American Academy of Family Physicians https://www.aafp.org
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 19.
Mayo Clinic Guide To A Healthy Pregnancy Harms Roger W., M.D., et al, Part 2.