Obstetrician Perth | Pain relief in labour
Pain Relief In LabourEpidural and More
Childbirth: pain relief options
The one thing most people worry about when it comes to vaginal birth is pain.
You may already know what you want to do regarding pain relief. Very commonly, women decide in advance that they want an epidural. Alternatively, many women are very reluctant to consider an epidural. They would prefer either no pain relief or other pain relief options.
I am happy for you to choose to use the pain relief that you prefer. That said, women commonly underestimate the intensity of the pain and their capacity to cope with it. When faced with reality, many are disappointed that they did not manage pain as well as they expected. They are often hard on themselves if they make a late decision to have an epidural.
Epidural for pain relief
Epidural is the most invasive form of pain relief but by far the most effective.
An anaesthetist will introduce a fine plastic catheter into the epidural space. It is taped in place so that medication can be fed into the site as required. This provides good pain control throughout the labour.
The pain nerves are very small, and the anaesthetic medicine gets into these nerves very easily. The motor and sensory nerves that control movement and sensation in the lower body are much bigger. Hence, the anesthetic medicine enters much more slowly, and therefore control of limb and bladder function is not affected. The exceptions are if the labour is long, or if stronger doses of medication are required.
Side effects of epidural
Blood pressure dropMost commonly, it drops blood pressure. Therefore, an intravenous line is routine. If the blood pressure drops it can acutely stress the baby, but this is usually easy to correct.
If the epidural needle goes a little too deep it can enter spinal fluid. This is done deliberately with a combined spinal and epidural, commonly employed for elective caesarean section.
The spinal needle is very fine, unlike the epidural needle that produces a bigger hole. This can potentially lead to long-term spinal headaches. It is the most common serious problem, occurring once in every several hundred epidurals.
Patchy blockThe tip of the catheter may sometimes lean more to one side than the other. If so, it will work more on one side than the other, producing a patchy block. Stronger doses of medicine, potentially leading to increased numbness and leg weakness, or repositioning of the catheter, will usually correct this problem.
Epidural site infection
Epidural site infection can be serious but is very uncommon. Superficial infection is more common and not important.
Epidurals will not upset the progress of the labour. Caesarean section is no more common with epidural as without. It may slow the pushing stage, and therefore vacuum-assisted deliveries are a little more common.