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An epidural is a method of pain relief that a doctor can administer during labor and other medical procedures. However, there are benefits and risks.
This article will look at the pros and cons of an epidural, as well as other options that may be available.
An epidural is a nerve blocker. A doctor can give an epidural for a variety of reasons, including for pain relief during labor, back pain, such as sciatica, and chronic leg and arm pain associated with an irritated spinal nerve root.
According to the American Society of Anesthesiologists, an epidural, which lessens the pain between a woman’s belly button and upper legs, will begin to take effect after roughly 15 minutes.
An epidural does not take away all sensation, and a woman will still feel some pressure.
Other benefits of an epidural during labor include:
- it is typically safe
- is it typically effective
- it allows a woman to remain awake during a cesarean delivery
- women still have control of their upper body
An epidural injection for back pain may have some of the following benefits, including:
- Effective pain reduction: According to a 2016 systematic review, people who had an epidural for sciatica noted a 50–83% improvement in pain.
- Decrease surgical intervention: According to the same review, about 80% of people did not need surgery after receiving an epidural injection.
- Decrease functional disability: An epidural may aid those with a functional disability, which is a long-term disability due to an injury, illness, or condition.
Some side effects of an epidural may include:
- sore back
- numbness in the lower body following labor
- a decrease in blood pressure
- urination problems
According to the American College of Obstetricians and Gynecologists (ACOG), serious side effects are rare, but they can include spinal injury, breathing problems, a racing heart, and numbness or tingling.
An epidural during labor may have separate side effects. The data regarding the effect of an epidural on the length of labor varies. According to the Office on Women’s Health (OWH), an epidural may prolong the first and second stages of labor if the doctor administers it too late. However, other providers have different takes on the best time to give an epidural.
Other side effects may include:
- weakness in the legs
- increased risk of needing the help of forceps or a vacuum
- skin infection
- some people may get permanent nerve damage, but this is rare
According to ACOG, the opioids in an epidural can lead to some short-term side effects in the fetus. These include:
- reduced muscle tone
- a change in heart rate
- breathing problems
These side effects generally resolve quickly. If a person is worried about how an epidural might affect the fetus, they should talk to a doctor.
Roughly 60% of women in labor choose to have an epidural as a form of pain relief. However, a woman does not have to have an epidural to give birth.
Whether a woman chooses to use an epidural during labor is her choice, but women should keep as open a mind as possible. Sometimes, a doctor may need to administer an epidural or another type of pain relief. This might happen if, for example, a woman requires a cesarean delivery.
If an individual chooses not to have an epidural, other pain management techniques may be available. However, not all hospitals offer all the options, so women should talk to their healthcare providers about pain relief options when they present.
Medicinal pain relief
Medicinal pain relief alternatives may include:
Some women choose nitrous oxide to help them relax during labor and while giving birth. This involves inhaling the nitrous oxide 30 seconds before a contraction starts. Although it is safe, some people may feel dizzy and nauseous temporarily.
A doctor can administer opioids through an IV, or inject it into the muscle. They do not affect a person’s ability to push, and an epidural is still an option later on. However, they do not get rid of the pain entirely and are short-acting.
Side effects include feeling drowsy, nauseous, and may induce vomiting. The OWH note that here is a time limit on the use of opioids during labor. Typically, a doctor will avoid the use of opioids if a woman is due to deliver very soon, as opioids can slow down the baby’s breathing and heart rate.
A person may want to talk to a doctor regarding the use of a pudendal block.
A pudendal block is a numbing medication injected into the pudendal nerve and vagina right before the fetus’ head crowns. The numbing medication can help alleviate pain associated with pushing the baby out.
However, not all doctors know how to do a pudendal block as the technique has generally fallen out of favor.
A person looking for an entirely natural delivery may consider home remedies for labor pain.
Some potential home remedies include:
- hot compresses
- cold compresses
- labor ball
- adjusting the position to find one that is comfortable
- massaging the lower back or other areas
- breathing exercises
- TENS unit
- essential oils
- tub bath
Some potential alternatives to an epidural for other procedures include:
- cold or hot therapies
- spinal anesthetic, which is a single injection of medication into the spine
- general anesthetic
An epidural is a safe form of pain relief during labor and for reducing chronic pain. Although it has some risks, these are either temporary or very rare.
A person does not have to have an epidural, and alternatives are available.
Pregnant women should talk to their doctor or midwife about what kind of delivery and pain relief they require during labor. They should also take the opportunity to discuss any plans and concerns they may have.