Mothering is the most beautiful phase of a woman's life. It's a roller-coaster ride filled with many new experiences and moments of happiness and pain. We all know that women experience intense pain during labour while trying for normal vaginal delivery. Because of the fear of this pain, many expectant mothers start requesting their Obstetrician for an elective caesarean section without a trial for a normal delivery. But with the advancement in medical science nowadays, women can deliver vaginally safely without experiencing this pain, and we call it painless labour. A large number of women prefer this procedure after understanding its benefits.
It's a type of anaesthesia that is used to relieve labour pains. In this, a needle is inserted in the lower back with a tiny tube- a catheter. The needle is removed, and the catheter is left in the epidural space of the spinal cord, through which medication is given to block the sensation of labour pain. Epidural anaesthesia is given by an anaesthetist. It is usually given once the latent phase of labour is over and you are in active labour.
How does an epidural work for you?
Epidural energy is given when you are in active labour, which means when you have good contractions, and your cervix is 3-4 cm dilated. It blocks the pain sensation, not the contractions, by blocking the nerves carrying pain fibres from the uterus to the brain. But it doesn't block motor sensation, which means that you can move and walk during labour even after epidural anaesthesia.
Procedure of giving epidural anaesthesia
Before the procedure, IV fluids are given through drips. Then, you are asked to sit with a forward bend. Your back is cleaned with some antiseptic spray or liquid. Then, local anaesthetic is injected into the skin of the lower back. Then, a needle is inserted between the bones of the spine in the space surrounding your spinal cord. Then, the needle is removed, and an overlying plastic tube—like a catheter—is left in situ, through which medicine is given for epidural anaesthesia. Usually, pain is relieved within 5 to 30 minutes.
Who should have epidural anaesthesia?
All women who are in labour and trying for normal vaginal delivery can have epidural anaesthesia. It's not mandatory, but it makes your journey through labour comfortable, and you can enjoy your beautiful moments.
Who should avoid epidural anaesthesia?
Women with bleeding disorders
Women having some lower back diseases or lower back surgery
Every woman has a different tolerance to pain. Depending upon your tolerance, you can choose to have painless labour. Epidural is one of the best methods for painless labour. Other options include -
Non-pharmacologic methods such as hydrotherapy, hypnosis and acupuncture.
Pharmacologic methods such as inhalation of Entonox gas, opioid injection, etc.
Painless Delivery Advantages
Safe
Effective
If labour is prolonged, the mother is not exhausted due to pain and can rest during labour.
There is no interference with movements; you can move around and push whenever required.
It does not guarantee a normal delivery, but if a C-section is required, we don't need to give you any anaesthesia separately.
Side Effects of Epidural Anaesthesia
Side effects of epidural anaesthesia are temporary and minor.
Sometimes, it may cause low blood pressure, which can stress out the baby. However, to prevent this, you would be given I/V fluids before the procedure and fetal heartbeat is monitored continuously.
Very rarely, it can cause fever, shivering, nausea and backache. Backache after delivery is common, but epidural anaesthesia is not always responsible for it, and it is usually due to fatigue of the back muscle.
In very few cases, it causes numbness in the lower limbs. Sometimes, mothers don't get complete sensation at the time of delivery and cannot push with their full control. In such cases, sometimes a vacuum pull is required to deliver the baby.
