Epidurals & Delivery Drugs

Why Epidurals Are Not for Everyone

You're screaming for an epidural -- but the doctor says no. What's the deal?

  • You have a bleeding problem. If you have a condition that keeps your blood from clotting, like preeclampsia, or if you're on blood thinners, you might not get a regional block. There are a lot of veins in the epidural space. If your anesthesiologist nicked one, you'd be in trouble.
  • You have a skin infection. If you have cellulitis or another infection in the area where the doctor needs to insert the needle, she probably won't go ahead with the epidural for fear of spreading the infection deeper into your body.
  • Your doc can't find the spot. If you've had scoliosis, it might be more difficult for the anesthesiologist to find the right location on your spine. It can also be difficult for doctors to place regional blocks in obese women because it's harder to see or feel the spinal bones.
  • An anesthesiologist isn't available. Birthing centers and some smaller hospitals don't offer epidurals. Also, labor and delivery is always unpredictable, and you never know how many women will be delivering when you are.

The Lowdown on IV Drugs

When you get to the hospital, a nurse may start you off with an IV narcotic to take the edge off the pain until the anesthesiologist shows up for your regional block. Which meds you get depends on the hospital, but Stadol, Sublimaze, Demerol, and Nubain are the most common. Here's what you need to know about these drugs.

  • Expect some side effects. Narcotics do sedate you a bit and can make you feel woozy, so anesthesiologists use low doses that last for a short amount of time.
  • The drugs cross the placenta and enter the baby's bloodstream -- but it's not something to worry about. In low doses, narcotics won't have any permanent effects. After all, children are safely anesthetized all the time.
  • If there are complications, your doctor may not give you these meds. Sometimes the obstetrician won't want the mother to have narcotics in her bloodstream.

Copyright ? 2006. Reprinted with permission from the August 2006 issue of Parents magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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