The Pros and Cons of an Epidural

“Doctor, get me that epidural NOW!”

We have all heard that line in some movie or show, screamed by a panicky woman between contractions, amniotic fluid pooled at her feet.

We have all heard the jokes: “I won’t let them do anything until I know the epidural is on its way!” or “Can I get my epidural before I start labor?”

But what do women actually know about the epidural?

Epidurals usually consist of a local anesthetic combined with a narcotic, which is then injected into the epidural space, which is the outermost layer inside your spine (meaning that there are a few layers to go before you get to the spinal cord). Using these medications in combination reduces the amount of each drug that you need in order to get maximum pain relief. Because it is injected into the spine, there is minimal interaction between the medicines and your baby.

So, let’s learn about the Pros and Cons of epidural anesthesia!

Pros:

• Very effective pain relief
• Allows you to sleep during a long labor
• Doesn’t affect your level of consciousness, unlike oral narcotics and sedatives
• If a C-section becomes necessary, the epidural is effective anesthesia for the procedure, so you can be awake and alert during your baby’s birth
• Does not affect your baby as much as other pharmacological pain relief

Cons:

• Limits mobility, which can stall labor (NOTE: a “walking epidural” allows for greater freedom of movement, but still restricts you somewhat)
• May cause labor to slow, requiring a jumpstart with Pitocin
• May cause a sudden drop in your blood pressure, which can affect your baby’s heartrate
• May affect your ability to push, requiring interventions such as vacuum or forceps (which, in turn, requires an episiotomy)
• May not work 100%
• May leave your lower half numb for a few hours after delivery
• May raise your temperature over time, causing your care provider to worry that you have a fever. This may cause your baby to require some extra monitoring.
• Some studies show that an epidural may raise your risk of C-section (probably due either to stalled labor, to stress on the baby from falling heartrates related to blood pressure drops, or to distress from Pitocin-augmented contractions)
• There may be side effects, as with all medications. In rare cases, serious side effects may occur. Very rarely, there may be permanent nerve damage.

In addition, some people say that babies born to mothers who received the epidural have more difficulty latching on and beginning to breastfeed. Studies are still unclear on whether this is an effect of the epidural of not.

The good news? First of all, epidurals are widely used and considered quite safe, so get one if you want. BUT, if you decide that the risks are not for you, there are plenty of alternatives available! Doulas, hydrotherapy, meditation, and hypnotherapy are all wonderful pain management techniques with no negative side effects. And the best part? If you start with non-pharmacological pain relief and don’t like it, you can always still ask for that epidural.

For more information on epidurals, check out AmericanPregnancy.org.

Happy birthing!