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You Should Know

5 Things You Should Know Before Getting An Epidural

According to The New York Times, epidurals are the most common form of pain relief in the United States, with 73% of laboring women deciding to get one. They’re also the most effective. And still, there’s a lot of confusion out there. We asked Anesthesiologist Dr. Kyle Roberts with US Anesthesia Partners of North Texas to speak to some of the most popular questions women (still) have when it comes to epidurals.

Will it prolong my labor?

Having an epidural will not prolong your labor. This used to be a possibility when epidurals were dosed using only local anesthetic or numbing medicine and doctors recommended waiting until 4cm of dilation. However, now that we’re using a combination of numbing and pain medicine, it’s no longer true. There’s also no real reason to wait if you’re uncomfortable and know you want an epidural.

Will it cause back pain?

Backaches throughout pregnancy and after delivery are quite common. This is usually due to changes in your body’s position during pregnancy and has not been more highly associated with having an epidural.

Will it affect my baby?

Epidural medication has not been associated with decreased apgar scores and has minimal effect on baby versus alternative pain medication. Intravenous pain medicine is administered at higher doses and can make baby sleepy so these meds are usually held as you get closer to delivery. But with an epidural far less medicine enters the bloodstream and is therefore less likely to affect baby.

Can it cause nerve injury?

Epidural can cause nerve injury in rare cases, as can the baby’s journey through the birth canal. Temporary nerve damage following an epidural is rare and permanent nerve damage following an epidural is extremely rare. Epidurals are placed where the spinal cord ends, so most cases are minor and self-resolved.

Will I be more likely to have a C-section?

There have been some concerns about this in the past when labor was more likely to be prolonged, but this has been outdated by 15 to 20 years as dosing rules have changed. Epidurals are no longer believed to increase the risk of C-section or even forceps or vacuum deliveries. Some advantages, however, of having an epidural, is that if a woman does end up needing a C-section she is more prepared for urgent surgery and can avoid the higher risks of general anesthesia and remain conscious for the birth.

So, all that said, what are some reasons people choose not to have an epidural?

There is a risk of a one sided epidural or an epidural that doesn't work at all, but this can be resolved by changing the dosage, moving the epidural or replacing it. There's also a risk of getting a headache that’s particular to epidural placement. Shaking, light-headedness and nausea can all be normal reactions because it causes your blood pressure to decrease. So there can be side effects, and some women want to avoid that all together. But there is also a high percentage of women who think they don't want an epidural and end up changing their mind. So my advice would be to at least speak to the anesthesiologist as early in the process as possible to gather information and ask any questions that you have. Communication before, during and after the epidural is key.