What is an epidural?
It is an anaesthetic that is injected around the nerves, which transmit pain during labour.
- It is helpful during the first stage of labour when the cervix is dilating.
- It allows you to be aware of your contractions, but do not feel any pain.
- It is useful particularly for women experiencing a long labour or finding it difficult cope with the pain and getting tired.
- It is given for vaginal births and can be used for caesarean sections.
- It is effective at reducing high blood pressure during labour
There are many;
- You will not be able to move about during labour and may find it difficult find a comfortable position due to your legs feeling heavy. It also means you are likely to need a catheter to help you pass urine.
- It may not work only numbing parts of your tummy.
- More monitoring is required of you and your baby.
- There is an increased chance that you may need some sort of intervention during the birth for example a forceps or ventouse delivery.
- Backache can be a side effect for some time after the birth.
- Temporary or permanent nerve damage can occur causing weakness and numbness in your leg or foot.
Requesting an Epidural
If you think that you might like an epidural then discuss this with your midwife towards the end of you pregnancy so any appropriate checks can be made at your local hospital for the availability of anaesthetists. The on call anaesthetist will be called when the midwife confirms you are in established labour.
In certain circumstances for example elective caesarean section you will have an appointment to see an anaesthetist to discuss the following:
- Your past medical history.
- To ensure there are no reasons not to have one
- To explain how the technique works.
How it works
An epidural is performed when your contractions become more frequent and painful and when the cervix is sufficiently dilated - approximately 4cm or more..
- You will be asked to lie on the side or sit on the edge of the bed.
- The anaesthetist injects a local anaesthetic in the lumbar region.
- He then places a needle between the 3rd and 4th lumbar vertebrae.
- A catheter is inserted to facilitate the passage of the analgesic product during labour.
- The effect of the epidural takes approximately 20 - 30 minutes for the pain to disappear.
- In some maternity units your epidural will be attached to a continuous pump and you will have control of when you feel the need to top it up.
- Top ups are more commonly given by an experienced midwife, which is usually every couple of hours.
- The epidural will remain in place until after you have delivered the placenta.
- Episiotomies, caesareans and suturing can be performed under an epidural.
Does it affect my baby?
- Epidurals can cause your blood pressure to drop therefore affect the flow of oxygen to the baby. Having fluids through a drip to increase your blood volume helps maintain your blood pressure.
- Some of the drugs used in a epidural can cross the placenta and cause your baby to be drowsy.
- You can breastfeed your baby as soon as he/she is born.
Risks and side effects of an epidural
An epidural may have some very rare complications, which are worth knowing about.
- A tingling and warm feeling in the legs, generally very limited in time and harmless.
- A risk of a hospital-acquired infection, a rare situation.
- A pain at the bottom of the spine, at the level of the injection.
- A headache which can occur 12 to 24 hours after the injection - this can be corrected by a small procedure.
- The injected drugs can cause an allergic reaction.
Péridurale - Anesthésie péridurale