Every mom says it: No matter how many books you read or friends' stories you hear, you won't quite know how you'll feel during labor and delivery until you're actually in the midst of it. That said, you'll most definitely want to get a feel for your pain relief options ahead of time. The epidural is one of the most common forms of anesthesia. Here, the must-knows about the pain-blocking drug.
"Epidural anesthesia for labor pain relief is a type of anesthesia where pain medication is injected near the lower spine or backbone," explains Sangeeta Kumaraswami, M.D., an anesthesiologist specializing in obstetric anesthesia at Westchester Medical Center, the flagship of the Westchester Medical Center Health Network in Valhalla, New York. "It numbs the body below the injection, allowing a woman to remain awake and alert but more comfortable throughout labor, and feel pressure to push when it is time to deliver her baby. It can also be referred to as an epidural block or epidural injection."
When you're in labor, your uterus contracts, leading to pain that travels from the uterus via nerves in the spine or backbone to the brain, explains Dr. Kumaraswami. "The pain is usually mild early on in labor, but gets worse closer to delivery."
By opting to have an epidural, you can block those intensifying sensations. Iffath Hoskins, M.D., clinical associate professor in the Department of Obstetrics and Gynecology at NYU Langone Health in New York City, explains that the anesthetic agent is injected into the epidural space, which is a compartment surrounding the nerves in the spinal cord. "The anesthetic agent then bathes the nerves, which become numb and thus prevent the transmission of pain sensations," she notes.
If you happen to need a cesarean section or tubal ligation following the delivery of the baby, the epidural treatment can continue through these procedures.
You may experience side effects such as decreased blood pressure, mild itching, back pain, and headache, notes Dr. Kumaraswami. "A major complication such as nerve damage, bleeding, and infection in the spine and paralysis are extremely rare events," she says.
To minimize risk, speak to your doctor beforehand about any medical issues, such as allergies to local anesthetics, breathing problems, bleeding problems, spinal surgery, etc., says Dr. Hoskins. You'll also do well to go slow when you start to move. "After delivery, wait to move until you've regained full feeling in the lower extremities because there is a high chance of falling and injury if there is residual numbness," she says.
Ultimately, the pain of labor and delivery is different for every woman and for every pregnancy. Dr. Kumaraswami recommends women weigh their pain-relieving options by having discussions with the birthing educators, physicians, or midwives responsible for their care and then decide what method is best for them.