Painless Delivery/Epidural Analgesia

What is Epidural Analgesia?

Epidural analgesia is an extremely effective method of pain reduction to manage labor pain. In many countries, it is a part of standard obstetric care. The epidural rate varies from 30% to 69% in Canada. In the US, 60% of women now opt for this technique. However, contrary to these statistics from developed countries, this method is still not widely popular in India.

Need for Epidural Analgesia

There is no doubt that giving birth to a child is one of the most painful experiences known to mankind. To make this process less painful and more fulfilling for the mother, multiple methods have been tried out by using science to allay the pain. The strategies are both pharmacologic and nonpharmacologic in nature.

Potential Benefits of Epidural Analgesia

  1. Effective pain relief

The commonly used parenteral opioids may provide sedation and relaxation, but it has been observed that an epidural analgesic provides far more pain relief than these opioids.

  1. Safety

Any drug or procedure can affect both mother and baby, but with the use of this, the chances of permanent material injury and neonatal depression are low.

  1. Better labor outcome

Neuraxial analgesia leads to an increase in operative vaginal deliveries compared to caesarean deliveries. The length of labor usually stayed the same in the presence or absence of epidural analgesia.

  1. Minimal effects on the fetus and newborn and the mother

This has been associated with better Apgar scores for babies and also doesn’t cause neonatal depression even if the medication does cross the placenta and can be measured in the newborn.

Common anesthetics

Bupivacaine and ropivacaine are commonly used as labor anaesthetics in North America. Bupivacaine has shown to be a superior drug because of its increased duration of action, low incidence of tachyphylaxis and lower intensity of lower limb motor block.

What is the technique to administer the epidural to a patient?

  1. Preparing the patient

Initially, as a patient, you should let the doctors know about prior medicines that you’re taking and the allergies you suffer from. Usually, you aren’t allowed to eat or drink after administration, so you should eat and prepare yourself well in advance. Also, after epidural administration, you won’t be able to drive for 24 hours so you must have someone to help you out with recovery and the drive home.

  1. Procedure of epidural
  • A drip would be connected to your arm so that fluids are provided to you
  • The optimum position for epidural administration is to either sit and lean forward or lie on your side with knees brought closer to the chest
  • A local anesthetic will be given at the site of the epidural to numb your skin
  • An epidural catheter is inserted into your back near the nerves that carry pain sensors to your brain via a needle
  • The needle is then removed, leaving behind the catheter in your spine
  • Pain relief medicines will be given through this catheter and you can regulate the amount of medicine you need based on your pain level either manually or using an automatic pump
  • Expect it to take around 20-30 minutes to start working

       3. Recovery after epidural

Once the dosage of the epidural is stopped, the numbness stays for a few hours before it starts wearing off. You should stay in a lying or a sitting position until you get feeling back in your legs. Do remember not to drive or drink alcohol until after 24 hours of the epidural.

What are the side effects of this process?

  1. Mild itching, difficulty passing urine
  2. Nausea and mild to severe back pain after delivery
  3. Diabetes patients might get high blood sugar

Request an appointment at Apollo Cradle, DELHI-NCR - Moti Nagar. Call 1860-500-1066 to book an appointment.

1. Can I become paralyzed from an epidural?

To answer this, you need to understand where the labor epidurals are placed in your spine. It is always placed below the termination of the spinal cord, hence there is no risk of spinal cord puncture. Paralysis from labor epidural is exceptionally rare.

2. Can an epidural lower my labor progression?

No conclusive evidence has been found to show that epidurals slow down the progression of labor or increase the frequency of cesarean delivery.

3. What are the alternatives to epidural for pain control during my labor?

Intravenous pain medication and relaxation techniques are alternatives to managing pain but both are less effective as compared to an epidural.

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