Some swear by it; others avoid it like the plague! To make an informed choice, it is best to be well informed: here are 10 things to know about epidurals.
Who can have an epidural?
Unless contraindicated (fever, back infection [boils], blood clotting disorders, certain neurological diseases), all women can receive an epidural.
It has long been feared that tattoo ink contains toxic elements and, for fear of contaminating the woman with the puncture needle, refused epidurals to women who had a tattoo on their lower back. This hypothesis is now denied, but it is nevertheless possible that the anesthetist refuses to administer the epidural if he judges that there are risks.
Also, to have an epidural, an anesthesiologist must be present at the time of your delivery. It is therefore necessary to discuss this with the medical staff as soon as possible.
Can I have the epidural anytime?
You passed your turn when you were first offered the epidural, and now that time is running out and the pain is increasing,do you regret your choice? It is sometimes possible to change your mind and still be able to have access to the epidural – under certain conditions. On the one hand, the anesthetist must be present and free. Also, if the labor is too advanced (usually past 7 cm dilation), they will refuse to give it to you, since she will not have time to act.
What is an epidural?
If you ask to receive the epidural, an anesthetist will come and examine you and make sure you have no contraindications. Then it will prompt you to sit or lie on your side. There, he will prick you in the lower back, between two lumbar vertebrae. Yes: To administer the epidural, the anesthetist must stick an infusion needle into the epidural space, which is around the spinal cord. Once the infusion is done, the medication is injected through a catheter that is attached to the needle. The effect is felt quite quickly (15 to 20 minutes). Continuous infusion of the drug through the catheter allows this effect to last until delivery.
The painkiller liquid is composed of a local anesthetic and a narcotic.
“The latter increases the potential for the analgesic effect – which eliminates or reduces pain,” says Dr. Christian Loubert, anesthetist at Hôpital Maisonneuve-Rosemont.
Does it hurt?
At the time of the bite, you may indeed feel some pain whenthe needle enters the lower back. But this pain does not last. Also, the pain of the contractions might just distract you.
Do we have paralyzed legs?
The local anesthetic present in the painkiller liquid does not, however, only inhibit the transmission of pain: it also impairs the motor function of the nerve. In short, a higher dose can therefore lead to partial paralysis of the lower body. It is for this reason that anesthesiologists have substantially reduced the dose over the past ten years, always points out Dr. Loubert. It is therefore possible to move even if you have received an epidural.
What are the risks for the mother?
There are some side effects, but most are mild. It therefore happens that the effect of the epidural is incomplete, or non-existent. Some women also experience lower back pain. An epidural can also slow down labour.
Very rarely (less than 1% of cases), an injury to the dura mater can cause headaches. There are also rare cases of hypotension.
In addition, serious accidents are extremely rare (allergic shock, heart attack, etc.), but, as with any anesthetic procedure, they are not impossible.
Are there any risks for the child?
Epidurals are considered safe for both mother and child. But since the woman no longer feels the contractions well, the thrust may be longer and less effective. InIn addition, analgesia does not completely spare baby, and it is possible that he is more sleepy at birth. With this in mind, a link is sometimes made between epidurals and difficulty in starting breastfeeding.
Are there alternatives to an epidural?
Of course! But these natural alternatives require preparation on the part of both mother and father. We are of course thinking of the Bonapace method, self-hypnosis, massage…
Nitrous oxide (also called laughing gas) is one of the pharmacological treatments: combined with oxygen, it is aspirated in puffs after each block of two or three contractions. The method is effective, but its effect is short-lived.
A caesarean section under an epidural: is it possible?
Yes! Same as most Caesarean sections are performed under epidural or spinal anesthesia (the lower body is numbed). Thus, you are conscious and can see baby when he comes into the world. Of course, you won't see everything, since surgical drapes hide the belly.
Are you going to get an epidural?
It's best to ask the question before the big day. As we mentioned, alternative methods of pain management require preparation. Thus, the woman who arrives on the day of her delivery with no idea of what awaits her will probably be overwhelmed by events. The epidural will then allow him to breathe a little and calm down. However, several studies haverevealed that women who do not use medication during labor are the most satisfied with their experience after the baby is born.