Understanding the Epidural

Epidural anesthesia is very common in labor. It is usually a combination of different “caine” drugs including Lidocaine, Carbocaine, Nesacaine, and more. The drugs are injected into a catheter which the has been placed outside the spinal canal and may be given as a continuous drip.

The benefits of an epidural are:

• Loss of pain sensation usually from the abdomen down
• Relaxation
• Sleep, for a mom exhausted from prolonged labor

The risks and procedures associated with the epidural are:

• Inability to move lower half of body
• Insertion of a bladder catheter, which could lead to bladder or kidney infection
• Restriction to bed with frequent checking of blood pressure and blood oxygenation
• Continuous electronic fetal monitoring
• Toxic reaction to anesthesia (rare)
• Withholding of food and drink
• Fluids administered intravenously
• Oxygen Mask
• Slowing of labor, leading to administration of oxytocin to increase contractions
• Inability to push effectively
• Increased use of vacuum or forceps extraction
• Increased risk of episiotomy
• Increased chance of cesarean if epidural is given too early in labor (before 5cm)
• Maternal fever after prolonged use of epidural, causing heart rate changes and lack of oxygen for baby
• Subtle changes in reflex for baby
• Increased difficulties with breastfeeding

The decision to receive an epidural is a personal one between the mother and birth partner. Weigh the risks and benefits before labor so that whatever decision you make will be an informed one.