Epidurals are a pain relief method during birth. If you choose to have an epidural, an anesthesiologist will insert a needle and a catheter (a tiny tube) into the epidural space, just outside the membrane covering the spinal cord. The needle doesn’t stay inside and you won’t feel the catheter.
Epidurals usually take away the pain and often also reduce the feeling in the legs. They are given via continuous infusion or are intermittently administered by the medical staff. There are also patient-controlled epidurals (PCEA). With PCEA you choose when it is time to add an additional dose and you can have a low-dose epidural so that you are more likely to still feel your legs. PCEA is available or even standard in many hospitals. There is also something called “walking epidural” which allows you to stand and move so you can still have an active birth. St.-Joseph hospital is the only hospital in Israel where walking epidurals are available.
So, you do not only have to decide if you are planning on having an epidural or not, or in which situations you would consider taking one but also which kind of epidural you are interested in having. It can be a good idea to check what epidural options are available at the hospital you consider giving birth in.
Some advantages of epidurals are
- Very efficient pain relief method
- Helps with regaining power if you experience a very long labor
- Might help to relax when it is very difficult to cope with labor
Some disadvantages and risks are
- Connection to many tubes (epidural, blood pressure monitoring, oxygen monitoring, IV, maybe catheter in bladder, continuous monitoring with ctg)
- Difficult to not move while administering the epidural and having a wave.
- More likely to need a forceps or vacuum delivery (around 3 times more likely, but depended on dose and type of epidural, recent studies have seen less assisted deliveries)
- Probably more likely to have severe tears and episiotomy (one study speaks about severe tears in 10% compared to 5%, others do not see a bit difference, in one study the episiotomy rate was reported to be 28% instead of 13 %.)
- Some women feel the epidural only on one side
- More likely to give birth on your back
- Usually restricted movement, often not being allowed to leave the bed or be in an upright, forward position in bed.
- Much more likely to experience low blood pressure(14%), feel lightheaded or nauseous (20-30%)
- Maybe less oxygen supply to the uterus and baby, more likely to that baby has low 1-minutes-APGAR-score
- Legs might become heavy and difficult to move
- Need for guided pushing as you might not feel the urge to push
- More likely to have a fever (23% compared to 7%)
- Decrease of natural hormones, so you are more likely to need Pitocin to speed up your labor
- More likely to have a longer pushing phase (an hour longer)
- Likely to feel itchy (30-50%)
- Severe headache (under 1%)
- Very rare side effects: permanent nerve damage, seizures
- Likely to feel itchy
