The majority of women have several pain relief options when they go into labour, including Entonox, a TENS machine, and even hypnotherapy. However, an epidural is considered by many to be the preferred method of pain relief during pregnancy.
The Royal College of Midwives in the UK state that epidural use during labour has doubled from 17% in 1989 to 33% of births in 2017/2018 (“Pain and Epidural Use in Normal Childbirth). They attribute this to a number of factors, including the influence of celebrities and the loss of a sense of the pain during childbirth being a “rites of passage,” resulting in stress and pain being viewed negatively.
This article will discuss how an epidural is administered, and the advantages and disadvantages of this method of pain relief.
What is an Epidural?
An epidural is a local anaesthetic that blocks pain in a specific area of the body, namely (during labour) the lower back, groin and legs, by blocking the nerve impulses which travel down the spinal cord. An epidural can be administered in conjunction with other drugs to assist the mother in various ways, such as stabilising the mother’s blood pressure.
How an Epidural is Administered
Firstly, the mother is given various fluids via an intravenous drip during the early stages of labour. A trained anaesthatist will then administer the epidural whilst the mother lies on her left side or is sat up, with her back arched.
An antiseptic solution is then wiped over the area to reduce the risk of infection, and a small area on the mother’s back injected with a local anaesthetic. A needle is then inserted through into the lower back, in the area that surrounds the spinal cord. A small tube or catheter is then threaded through this needle into the space surrounding the cord, and the needle removed. The tube is then carefully taped into place, and drugs administered as and when required, either through periodic injections or continuous infusion.
Some epidurals allow the mother a greater degree of movement and activity. The mother should study her hospital’s policy on the administering and use of epidurals to ascertain what to expect.
The Advantages of an Epidural
An epidural is the most popular form of pain relief for a number of reasons, namely the advantages that it provides to the mother, including the follow
- discomfort relief: This can help some women have a more positive birth experience, as pain is minimised.
- alertness: Whilst other pain relief drugs during labour can cause a loss of alertness in the mother, an epidural allows her to be awake during her labour.
- blood pressure: An epidural helps to stabilise high blood pressure, which can cause complications during labour.
- medication regulation: The amount of anaesthetic administered can be increased or decreased, dependant upon the mother’s comfort and requirements.
The Disadvantages of an Epidural
As with all methods of pain relief, there are a number of disadvantages to having an epidural, including the following:
- blood pressure: As well as stabilising blood pressure, an epidural can cause it to drop suddenly. This will be regulated during other medication.
- headaches: Although the risk is minimal (less than 1% of cases), some women may experience severe headaches as a result of a loss of spinal fluid. Again, this can be relieved using what is known as a “blood patch.”
- slowing labour: As the mother may be mostly immobile, the labour process can be slowed.
- baby welfare: Although the effects of an epidural on the newborn are still being investigated, some experts believe that it can affect the baby’s ability to “latch on” to the mother during breastfeeding.
- side effects: Although advances in medicine mean that the risk of side effects has been reduced, some mothers may feel shivers, backache, and nausea.
- increase in assisted delivery: Due to the childbirth process being slowed, there is a higher risk of assisted delivery, such as the use of forceps, ventouse or Caesarean section.
Pain relief during labour should be deeply investigated by both parents when creating their birth plan. Whilst an epidural is often considered and requested, both expectant mother and father should be aware of both the advantages and risks involved when this has been administered.