The pain experience of a mother during labor and delivery depends on many factors including the size and position of the baby, how strong the contractions are, the stage of labor, etc. Anesthesiologists are responsible for giving laboring patients better pain control in order to allow them to relax and enjoy the miracle of birth. An anesthesiologist is a medical doctor who has completed additional residency training in anesthesiology, the practice of managing a patient’s comfort and safety during surgery or other medical procedures while administering pain medications.
One of the methods most commonly used for pain relief during labor is epidural analgesia also called epidural block. An area of the lower back is numbed then a thin flexible catheter is inserted to allow injection of pain medications whereby the nerves responsible for pain are blocked. A pump is then hooked up to this catheter to continue delivering pain medication. A patient-controlled demand dose may also be programmed to ease contraction pain. The epidural causes some loss of feeling and numbness in the lower area of the body. This technique also allows the mother to maintain the muscle activity that is needed for her to push during a vaginal delivery. Your anesthesiologist will adjust the degree and intensity of numbness for your comfort and at different stages of labor and delivery.
A walking epidural is one of the modalities of labor epidural analgesia where a lower concentration of the numbing medicine is used to allow the patient to walk while having good pain relief.
A stronger medication can be injected through the epidural catheter to be used in cases of Cesarean section, forceps or vacuum extraction of the baby, or repair of the episiotomy incision.
Most epidurals do not result in complications but some laboring patients may experience a transient decrease in blood pressure which is immediately treated by giving an intravenous fluid bolus. A few patients might also complain of mild back pain for one or two days after placement of the epidural.
Two very rare side effects include piercing of the covering of the spinal cord leading to a headache that lasts a few days but may be treated. The other is the inadvertent injection of the medication in a vein or in the spinal fluid. A trained and experienced anesthesiologist should always be available to immediately manage these and other side effects.
Will the epidural hurt? No. The administration is no more painful than the administration of an IV.
Does getting an epidural early in labor result in having a Cesarean-section? No. Several studies have shown that early initiation of epidural analgesia does not cause an increase in the incidence of C-section or any type of instrumental delivery.
Does having epidural analgesia mean the birth is not natural? No. A woman should enjoy labor and delivery. To have labor pains does not make a woman’s experience any better or any more “natural.” Better pain control allows the mother to enjoy the birthing experience more fully.
Is an epidural the same as spinal anesthesia? No. Spinal anesthesia provides profound sensory and motor block to the lower half of the body. This technique is most commonly used in obstetrics for elective C-sections.
Relax and enjoy your experience.
Check out several labor and delivery hospitals in your area. Take tours of birthing centers and meet healthcare and support staff.
Ask about the hospital‘s reputation and experience in Obstetrics and Anesthesia.
Look for a hospital that has an in-house obstetrician, pediatrician, and 24-hour dedicated in-house obstetric anesthesiologist.
Choose a hospital with excellent neonatal support care in case of unexpected problems arising with the baby. A level III Neonatal Intensive Care Unit is an added benefit in case the baby were to need immediate specialized help.
Ask to meet with your anesthesiologist as early as possible to discuss labor and delivery pain relief options.
Tell your anesthesiologist about your past medical and surgical history or any problems with previous anesthetics.
Attend pre-natal anesthesia tours to familiarize yourself with techniques for anesthesia and analgesia for labor and delivery.