Epidural anesthesia: option for painless child birth

Epidural anesthesia is the most common method applied for combating
pain during delivery. The pregnant lady remain conscious and aware of
the activities going on, but there is a numbness at the pelvic region.

Epidural is a combination of pain killing medications. It is injected at
the small of the back to numb the lower part of the spine when labor is
well established and the cervix is at least 3 to 4 cm wide. The
medication prevents transmission of pain signals from the womb and
cervix to the brain. Although, epidural could be administered any time
during labor, it is preferably injected when the contraction becomes
strong. Despite the numbness, a woman could sense the contraction during
delivery.

How does epidural anesthesia work?
An epidural anesthetic blocks the nerve roots that lead to the uterus and lower part of the body.

These roots are located in a space near the spinal cord called the
epidural space. This lies within the spine just outside the outer
covering of the spinal cord.

According to the American Pregnancy Association Epidural is usually
administered by: "Intravenous (IV) fluids will be started before active
labor begins and prior to the procedure of placing the epidural. You can
expect to receive 1-2 liters of IV fluids throughout labor and
delivery. An anesthesiologist, a physician who specializes in
anesthesia, an obstetrician, or nurse-anesthetist will administer your
epidural".

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Advantages of Epidural Anesthesia
• Almost complete relief from pain with the patient being mobile.

• No postpartum headache as in spinal anaesthesia.

• Mother is conscious and alert throughout the labor.

• It reduces anxiety and irritability caused due to labor pains.


An Australian study, reported in the journal BJOG, that
epidurals could prevent pelvic muscle damage during delivery. Pelvic
muscle damage leads to organ prolapse in later life, when the weak
elevator muscles could no longer hold the bladder and uterus in their
respective places. Nearly 10 per cent women suffer from organ prolapse
due to vaginal delivery.

Another advantage of epidural anaesthesia is that it makes easy for
instrumental delivery if any forceps are required and even is sufficient
anaesthesia if an urgent caesarean section is required.

Disadvantages of Epidural Anesthesia
• The biggest disadvantage is that in some case there is sudden drop in blood pressure.

• Epidurals can cause nausea, dizziness, headache, backache, shivering and tinnitus.

• Because of pelvic floor relaxation, baby's head may not rotate and forceps application may be required.

• Complications such as meningitis can occur, but are extremely rare if adequate sterile precautions are used.

Some health experts claim that babies born to mothers on epidurals are
sluggish. They might require resuscitation. The babies might appear
disoriented. They might have problems latching to their mothers’
nipples, which prevent them from receiving their first milk.

However, the best option is still the natural way of giving birth.