Epidurals for childbirth

Posted on 20 September 2012

Dr Lodé Fourie is a gynaecologist at Mediclinic Welkom.

What is the benefit of opting for an epidural during delivery?
Epidural anaesthesia is regarded as the best pain relief available for labour. It enhances labour in that both pain anxiety and adrenaline secretion are reduced, and therefore labour progresses faster.

Are there any risks for me or my baby if I choose an epidural for pain relief?
The biggest risks are a sudden drop in blood pressure and possible puncture of the membrane surrounding the spinal cord (the dura mater), which could result in headaches. Other medical complications such as infections and bleeding are possible but occur very seldom.

Would I still be able to push if I opt for epidural anaesthesia?
You’ll still have the sensation of bearing down, although it might not be as effective as without an epidural. An epidural could therefore increase the chance for an assisted delivery. However, modern techniques and medication concentrations allow the patient enhanced control without any pain.

The injection needle seems daunting. Will it hurt?
The anaesthetist will first apply local anaesthetic to the area where the epidural needle will be inserted. So you won’t feel any pain when the needle goes in, although you might be aware of some pressure. Once the needle has been inserted, a small, soft plastic catheter is threaded through and the needle is removed.

How long does the pain relief last?
Because the anaesthetic is administered continuously, pain relief will last for as long as you’re in labour. Once the infusion has been stopped, continued pain relief may be experienced for up to six hours. It is therefore recommended that you stay in bed for at least six hours after the epidural, since your legs might be weak during this time.

Are there other options for pain relief during childbirth?
An epidural is the most effective way of pain relief during labour, but there are other options. For example, you may choose to have a doula (or support from a family member) or acupuncture. Pethidine and Aterax are drugs that reduce pain by about 50%. Laughing gas, as regulated by the patient herself, may be inhaled, although this is mostly effective at sea level. Spinal anaesthesia, which provides pain relief for a shorter period, is usually opted for during a Caesarean section.

Are there circumstances or conditions that could rule out an epidural during childbirth?
Yes, you may be advised against an epidural if:
• there is any local infection in the injection area
• your bleeding tends not to stop easily
• you are allergic to local anaesthetic
• you are very far dilated or not in established labour

 

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.