Pain relief in labour: Epidural

Continuing our discussion on pain relief options during labour, we’ll focus on one of the most widely used but debated methods: the epidural. If you’re uncertain about whether to opt for an epidural during labour and childbirth, we’ve compiled an article outlining its pros and cons to help you make an informed choice. 

A gentle reminder of the importance for your birth partner to review this information and be aware of these options, learning how they can assist you when the time comes. It’s also advisable to discuss with your midwife to ensure you can choose your preferred pain relief option.

The epidural is administered by an anaesthetist and is a local anaesthetic. It’s the only pain relief method that can effectively eliminate all pain (if it’s successful) by numbing the nerves carrying pain signals. This is particularly beneficial for prolonged and painful labour. Here’s how it’s done:

• A drip will be set up to deliver fluids through a needle into a vein in your arm.
• An anaesthetist will cleanse your back with antiseptic, numb the area, and insert a needle.
• Through the needle, a tiny tube called an epidural catheter will be placed, through which pain-relieving drugs will be delivered.
• You can control your epidural dosage by pressing a button connected to a pump, delivering 8ml of the epidural solution.

Setting up the epidural takes around 10 minutes, and it takes about 30 more minutes to take effect. Since it might not work perfectly on the first try, some adjustments might be necessary. If you plan to give birth in a birth centre, it might take over an hour to be transferred to the labour ward, where epidurals are available, and an anaesthetist needs to be present.

Discuss your intentions with your midwife and include them in your birth plan so they can accommodate your preferences whenever possible.

While an epidural provides pain relief, it’s important to consider its downsides. Here are some:

• It could potentially slow down labour and increase the need for oxytocin drip to stimulate contractions.
• Epidurals can make instrumental delivery more likely, involving forceps or vacuum extraction, due to reduced pushing ability from numbness.
• An increased likelihood of requiring a urine catheter.
• Continuous monitoring for your baby.
• An intravenous fluid drip of crystalloid will be necessary.

When contemplating an epidural, it’s crucial to weigh potential side effects. Many new mothers worry that epidurals could cause permanent nerve damage. This isn’t typically accurate. Epidurals are generally considered safe pain relief options.

Here are some recognized side effects:

• Low blood pressure, which might cause lightheadedness or nausea.
• Temporary loss of bladder control due to numbness, necessitating a catheter.
• Itchy skin or shivering.
• Headaches may arise, potentially prolonging hospital stays (1 in 100 cases).
• Extremely rare instances of temporary or permanent nerve damage.

When I gave birth to my son, I had mixed feelings about an epidural. However, as contractions began, I knew there was only one way forward. I have no regrets about my decision, and I’d make the same choice if given another opportunity.

You know what’s best for your body, so listen to it. With or without an epidural, you’re strong, and welcoming a baby into this world is an incredible feat. Feeling accomplished doesn’t require feeling pain; it’s 2024, so let’s embrace progress.