Exploring epidurals

Lucy Meyer investigates how epidurals work and what they do for you during labour and birth.

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Every pregnant mom needs to consider pain-relief options at some point during her pregnancy. While many women still choose to labour and give birth without medication, epidurals are a very common and effective pain relief option.

How does an epidural work?

Epidural anaesthesia blocks pain in a particular region of the body. An epidural is administered to provide pain relief to a certain area, as opposed to anaesthesia, which leads to a total loss of feeling or numbness.
Epidurals block the nerve impulses in the lower half of the body, allowing you to be awake, present, and mobile.

Different types of epidurals

There are two options to choose from, but, depending on the hospital and practitioner, the dosages of medication can vary. Ask about this if you have concerns.

Regular epidural

A regular epidural numbs the lower region of the body, including the legs, which means you are unable to walk or get out of bed once the effects of the procedure have taken.

Combined spinal epidural (CSE) or ‘walking epidural’

The combined spinal epidural allows more mobility in bed and the ability to change positions with assistance. Your muscle strength, balance and reaction are reduced with this epidural. CSE should provide pain relief for 4 – 8 hours.
Find out what your hospital’s policy is on moving around and eating and drinking after the epidural has been placed.

The pros of epidurals

  • It provides effective pain relief during childbirth.
  • It allows moms undergoing a C-Section to stay awake during the procedure.
  • Moms get more rest during a long labour.
  • It’s effective for pregnancy-induced hypertension as it lowers blood pressure.
  • It offers an emotionally positive birth experience if you can’t cope with the pain of labour.

The cons of epidurals

  • It can cause mild to severe headaches.
  • It may increase the length of labour.
  • It can cause uncontrollable shivering and nausea.
  • It inhibits an active birth.
  • It can cause a temporary drop in blood pressure.
  • The use of forceps and vacuum suction may be necessary as the epidural inhibits the urge to push and makes pushing difficult owing to numbness.
  • It increases the possibility of a C-Section.
  • Sometimes several attempts are needed owing to insertion difficulties.
  • It can cause foetal heart-rate changes.
  • Although rare, it has been known to cause respiratory distress and paralysis.

Making the decision

“It’s easy to get caught up in all the negative connotations associated with having an epidural to decrease labour pains. The truth is that many women find this the best option to manage pain during labour and it often leads to a positive and less stressful birth for both mom and baby,” says obstetrician and gynaecologist Dr Veronique Eeckhout.
“I also find that many women are much happier when they’ve settled on the fact that they will have an epidural before labour day. Unfortunately some who don’t want artificial pain relief, but request it later, are too late.”

Click here for a real life account of what it’s like to have an epidural.

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