The Epidural
Its Advantages and Disadvantages

Advantages of the Epidural

A pain free labor! Rapid pain relief Medications can be increased or decreased based on your comfort level-without additional injections No groggy feeling or cloudy-headed side effects

Disadvantages of the Epidural

A common side effect is a drop in mom's blood pressure (repositioning or medications are used to correct this) Fewer than 10 percent of women report itching all over their body Labor time may increase by approximately an hour You will need to be connected to an IV and monitor- and if you are mobile, need to move with your equipment A small percentage of women, usually first time moms, will spike a fever during labor.

Most women will choose to use an epidural for pain relief at some point during labor. In some hospitals, over 80 to 90 percent of women who give birth use an epidural for pain control, and nationally, around 70 percent of women have an epidural during birth. Although most women use this form of pain relief, many women report that they know very little about the advantages and disadvantages of the epidural. Here are some basic facts that may help you feel more prepared in the labor and delivery room, if you like many other women decide to use this safe and highly effective form of medical pain relief.

What Is An Epidural and How Is It Given?
The epidural is an injection of medications into your lower spine. Typically the medications used are a narcotic and a local anesthetic. Today's epidural involves far less medication than in the past, so women often have no pain, but enough sensation to stay mobile-often by repositioning in bed, or moving from bed to chair during labor.

An anesthesiologist will place the epidural, the entire process takes about 10 to 15 minutes, and most women find the procedure pain-free. A quick shot of local anesthetic (like the kind you may receive at the dentist's office) is injected to numb your lower back- then, on that site, a needle which threads a fine, narrow tube called a catheter, is placed in your lower back. The needle is removed quickly and the catheter stays in place. The medications then flow from a pump into the catheter and can provide pain relief within minutes, that will last throughout the rest of your labor and birth.

The Odds Are on Your Side
Only 1 percent of women who receive an epidural have a complication that leads to severe headache. This is a common worry, but an uncommon occurrence.

Women who use an epidural report very high levels of satisfaction with this form of pain relief. Most women, however, do not rely only on the epidural for pain management. Women who prefer to manage their labor pain by using this method, also use other forms of non-medical pain relief and comfort measures. Techniques such as repositioning on the birth ball, receiving a massage, or soaking in a tub are often used during the beginning of labor to stay comfortable, until they feel ready for the epidural.

This article is based on an excerpt from the new book on labor pain relief, titled Easy Labor, Every Woman's Guide to Less Pain and More Joy During Childbirth, by William Camann, M.D., and Kathryn J. Alexander, M.A., published by Ballantine Books, January 2006.