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Epidural: 8 things you need to know

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Epidural: 8 things you need to know
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During childbirth, the epidural can relieve contractions and pain, by injecting an anaesthetic into the base of the spine. However, before automatically going for the epidural, it is good to inquire first, and you should consult an anaesthetist in advance who will ensure that it is not contra-indicated for you. Here are a few things you need to know

Am I allowed to have an epidural?

Every woman can have an epidural, as long as you don’t present with any contra-indications, such as a high temperature, an infection in the back/spine, a problem with blood coagulation, or certain neurological illnesses. In these cases, the anaesthetist will refuse an epidural, which would be too risky. You should check in advance that there is an anaesthetist available in your chosen hospital, as an epidural can only be administered by them. It would be in your interests to make an appointment with them a few weeks before the birth.

In concrete terms, what is an epidural?

A consult with an anaesthetist in the weeks coming up to the birth is obligatory nowadays, whether you have decided to go for the epidural or not. The anaesthetist will inform you about the procedure and will examine you to check for possible contra-indications. They may require you to have a blood test. Take advantage of the situation and ask your questions!

During labour, an anaesthetist will re-examine you, as a precaution. If there are no contra-indications, they will give you an injection into the base of the spine, between two vertebrae, into which they can insert a small catheter. A dressing will keep it in place during the birth, and the doctor can use this catheter to inject an anaesthetic, while monitoring your blood pressure and heart rate. As an epidural eliminates the urge to urinate, they will probably insert a urinary catheter.

After the first injection, it will take 10 to 15 minutes before the pain starts to ease. The remaining injections of anaesthetic, which are painless, can be repeated in accordance with the duration of your labour.

Can I change my mind at the last minute?

Yes, up to a certain point. You can ask for an epidural until the cervix is dilated to 6 or 7 centimeters. After that, it will not have time to work.

Is it painful?

The first injection can be a little painful, as obviously you feel the needle penetrating the lower back. After a few minutes, the pain from the contractions is much relieved.

Will my legs be so paralysed that I won’t feel anything?

No, your legs will feel weak and heavy, but you can continue to move and feel what is happening.

Are there risks involved?

Most of the side effects are benign. For example, the epidural may have little to no effect. You could also have pain in your back, but this could be due to your birthing position. In less than 1% of cases, certain women present with very low blood pressure or get bad headaches and vertigo for a few days after. As with any anaesthetic, serious complications can arise (anaphylactic shock, heart attack, etc.) but these are very rare.

How does it affect the baby?

The baby obviously receives a small dose of anaesthetic but this does not pose a risk to their health. The epidural does not change anything for the baby, however, it means that assisted delivery such as forceps delivery or vacuum extraction are more likely, because the mother, being under anaesthetic, feels less urge to push, as she has less sensation in the muscles of the uterus.

Can I demand a caesarian under epidural?

Yes, it is the same principle as for a vaginal delivery, but the doses of anaesthetic need to be more precise. You remain conscious while the doctors get to work. You hear what happens but you don’t see everything.

In short, apart from in the cases of contra-indications, the choice regarding epidural is up to you!

Source : Doctissimo