What is involved
Before siting an epidural an intravenous drip will be put in your arm. You will then be asked to curl up on your side or sit up and lean over a pillow on your lap, while the anaesthetist threads a small plastic tube through a needle into your back under local anaesthetic. It is important to keep still during this part of the procedure.
Once the tube is in place the needle s removed and the drug can be injected through the tube, which remains in place strapped to your back. You are then free to move about.
You can be given anaesthetic top-ups by your midwife whenever you need them. Your blood pressure will be checked frequently after each top-up.
Benefits
Epidural is the most effective method of pain relief
lt does not make you drowsy or sick, nor does it delay stomach emptying
Wïth a “mobile” epidural you still have some feeling in your legs and a degree of mobility
If you need a forceps, ventouse or caeasarean section for delivery or stitches afterwards, the epidural can be topped up to give complete pain relief
Disadvantages
Not everyone can have an epidural. If you have a bleeding or clotting disorder, or are receiving medication that affects clotting, or if you have had a spinal deformity/spina bifida or spinal disease affecting lower limb of bladder function, you should discuss this with the anaesthetist
The epidural may cause a drop in your blood pressure or can cause a drop in the baby’s heart rate. Fluids or drugs may need to be given through the drip to correct this
You may feel shivery for a time, this usually stops quite soon
Occasionally one area does not get anaesthetised, so you will feel the contractions intensely in this area. This can usually be corrected by adjusting or re-siting the epidural
The epidural may prolong labour, particularly the second stage. You may not feel the urge to bear down and may need help to deliver the baby by ventouse or forceps
You may be unable to pass urine and need a catheter to empty your bladder
There is a chance of you getting a severe headache after an epidural, the risk is less than 1 in 100. This can be treated if it persists
Backache is common before, during and after childbirth. There is no evidence that epidural causes long-term backache, though you may feel local tenderness for a day or two afterwards
About 1 in 2000 women suffer areas of numbness, pins and needles or weakness secondary to nerve damage in one leg after the birth. These problems may result from childbirth itself rather than from the epidural.
Other more serious epidural related problems are extremely rare
For more information: Association of Obstetric Anaesthetists:
http://www.oaa-anaes.ac.uk/content.asp?ContentID=83
