Epidural is the most commonly used form of pain relief during labour in the US. A catheter is inserted into the epidural space in the membrane surrounding your spine. This tube is then used to deliver continuous medications for pain relief throughout labour. An epidural usually delivers a mix of an anaesthetic and a narcotic. An epidural decreases sensation in your lower body, but doesn’t cause numbness. An epidural enables you to stay conscious throughout labour.

How is an epidural administered?
You will be asked to sit at the edge of the bed, or lie in a curled position, for the epidural to be inserted. A numbing injection will be used to prepare the insertion site. Once the area is numb, a needle will be inserted into your lower back.

The catheter will then be fed through the needle and into your back. The needle will then be withdrawn, and the catheter will be taped into place to prevent it from coming out. Once it has been taped down, you will be able to lie back down on the bed.

You will be given a test dosage of the medicine to ensure that there are no problems, and once this has been confirmed you will be given a full dose. Your baby will need continuous monitoring if you opt for an epidural, and your blood pressure will need to be checked regularly.

Can I have an epidural?
Not all women are able to have epidurals. You will be advised against having one if you:

• have very low blood pressure
• have a bleeding disorder
• have a blood infection
• have a skin infection on your lower back
• have had previous allergic reactions to local anaesthetic
• are on certain blood thinning medication

When can I have an epidural?
You should be in active labour before you have an epidural. This means you must be at least 4cm dilated and having regular contractions. You can have an epidural fitted at any point during active labour, until your baby’s head is crowning. Then it is considered too late to start an epidural, but if necessary you will be offered other forms of pain relief.

Advantages of an epidural
The advantages of this form of pain relief are:

• it is considered to be a very effective form of pain relief
• the dosage and strength can be increased or decreased easily as required
• you will be awake and alert during the birth

Disadvantages of an epidural
There are some disadvantages to this form of pain medication, including:

• most epidurals restrict your movement and mean you are unable to stand or walk during labour, and this may restrict the birthing positions you can try
• you will require an IV and regular blood pressure checks
• your baby will require continuous fetal monitoring
• women with epidurals tend to have to push for longer during labour
• an increased risk of assisted delivery by forceps or vacuum extraction
• in a very small number of women, epidurals may affect breathing, or cause nerve damage or infection

It is impossible to predict how you will experience labour. You may be crying out for an epidural after five minutes of active labour, or you may find relaxation breathing alone gets you through the birth. Keep your mind open to an epidural, but you may like to delay it until you feel it is truly necessary.

What pain relief are you planning to use during labour?

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2017. All rights reserved.

Before the birth of your child, it’s important to sit down and think about the type of birth you would like. Would you like to have your baby in hospital or at home? Do you want to use a birthing pool? What type of pain relief would you like to have available? You will need to consider all of these things when you write your birthing plan.

You should discuss your birthing plan with your healthcare provider and birth partner, so that they know how to best support you on the day. Of course, it is not a definitive plan, and you should be open to change on the day. While you may love the idea of a natural birth, on the day you may find yourself asking for drugs. Alternatively, if you plan to have an epidural immediately after the first contraction, you may surprise yourself by coping fine without.

Since you can’t predict in advance how you will feel during labour (even if you have given birth before, remember, all births are different), it makes sense to be read up on all the pain relief options available to you. That way you can make an informed decision on the day, even if labour isn’t quite what you were expecting.

Epidural

This is the most commonly used form of pain relief used during childbirth in the US, as many as 66 percent of women opt for an epidural. An epidural provides continuous pain relief during labour. A thin hollow tube is inserted into the epidural space near the base of your spine. Once in place, a combination of narcotics and a local anaesthetic will be administered. An epidural should provide good pain relief, but may restrict your movements during labour.

Systemic medications

Systematic painkillers are used to dull pain, but will not eliminate it. Systemic drugs are delivered by IV or injected into muscle, and will affect your entire body. You will remain conscious while on systemic medications, but may feel sleepy. This form of pain relief is often described as ‘taking the edge off’, and may help you relax during labour. Systemic medications cross the placenta and may affect your baby, because of this, the amount you can take is limited.

Spinal block

A spinal block is a one-off injection into the spinal fluid. This provides fast pain relief that lasts just a few hours. Spinal blocks are often used for women who decide they want an epidural too late, or for when labour is progressing at speed. The major disadvantage to a spinal block is that it can inhibit the pushing stage and lead to a longer labour.

Combined spinal/epidural

This new technique offers fast and continuous relief. For the first hour or two, you may still be able to move around during labour, so this is a good option if you are hoping to stay mobile to help your labour progress. A combined spinal/epidural will reduce sensation which could cause problems during the pushing stage and lead to a longer labour.

Water birth

As well as helping you to stay mobile and upright during labour, birthing pools are said to provide pain relief. The warmth of the water can help to ease discomfort, and the support from the water may help you to move position easily during labour. Your healthcare provider will need to assess whether you are a suitable candidate for a water birth, and then you will need to choose a birthing centre that has pools available.

Natural birth

If you’re hoping to give birth without drugs, you may find relaxation techniques useful. Breathing exercises, meditation and hypnobirthing are all great tools to help you keep calm and focused through contractions.

What pain medication are you planning to use during childbirth?

Written by Fiona (@Fiona_Peacock), mother, writer and lover of all things baby related.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2017. All rights reserved.