SHOULD I GO FOR EPIDURAL ANALGESIA?

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SHOULD I GO FOR EPIDURAL ANALGESIA
Lets address a very commonly asked question for
labor pain relief i.e. Should I go for Epidural
Analgesia?
No two labor are exactly alike and no two women
have the same degree of labor pain. The best
approach to labor pain relief depends upon your
pain tolerance, your preferences, and how your
labor progresses.
Sometimes you wont know what kind of pain relief
you want until you are in your labor. But still,
its a good idea to think of the options for
managing labor pain ahead of time. Understanding
these pain relief options can give you more
control over the labor and delivery process.
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Lets consider the options. There are many ways
to address labor pain without medications. These
techniques wont stop the pain of contractions
but they might help you feel more relaxed and
better able to cope with these labor pains. These
options include relaxation techniques like
breathing techniques, walking, moving, changing
positions, labor support, music, touch, or
massage.
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Further on as the labor progresses, the
contractions become stronger and more frequent.
Then, you might find a need for better analgesia.
And yes, the most common popular method for labor
analgesia is epidural. Women request for an
epidural by name more than any other method of
pain relief. In fact, more than 50 of women
giving birth at hospitals use this analgesia.
What is epidural analgesia?
Lets understand some more about this method of
pain relief. Epidural Analgesia is a regional
pain-blocking procedure that blocks pain in a
particular region of your body. The goal is
basically to provide analgesia or pain relief
rather than anesthesia which is a total lack of
feeling. Epidurals block the nerve impulses from
the lower spinal segments. This results in
decreased sensation in the lower half of the body.
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How is it given?
An anesthetist will administer your epidural. You
will be positioned for that. You will be asked to
arch your back and remain still while lying on
either your left side or sitting up. The position
is basically vital for preventing problems and
increasing epidural effectiveness. Once you are
positioned, an antiseptic solution will be used
to clean your back to minimize the chances of
infection. Then the small area on your back will
be injected with the local anesthetic to numb it.
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Further via a small catheter into a small space
outside the spinal cord into your lower back i.e.
epidural space. One or more pain medications
called anesthetic medications will be injected.
The catheter will be taped to the back to prevent
it from slipping out. And via this catheter, we
can give you repeated or continuous
administration of medications. The onset of
effect usually takes around 5 to 10 minutes for
the placement of epidural and an additional 15 to
20 minutes for medications to take full effect.
Coming to the benefits, the epidural analgesia
alleviates most pain in the lower body without
significantly slowing your labor. Normally an
epidural will allow you to stay alert and remain
an active participant in your birth. When other
types of coping mechanisms are no longer helping
then this method can help you deal with
exhaustion, irritability, and fatigue. This will
allow you to rest, relax, get focused, and give
you the strength to move forward as an active
participant in your birth experience. By reducing
the discomfort of your childbirth, you are more
likely to have a more positive birth experience.
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If we discuss the disadvantages, there can be
inadequate or failed epidural. You might find
that your epidural makes pushing more difficult
thus prolonging the second stage of labor and
possible increased risk of instrumentation.
Then what are the associated risks? No analgesia
and anesthesia are risk-free. The good thing is
that most people dont suffer any serious
complications. Common side effects are difficulty
in passing urine, temporary leg weakness.
Uncommon side effects include epidurals that may
cause your blood pressure to suddenly drop,
rarely you might develop a bad headache.
Common questions about epidural
When to take it?
Usually, an epidural is placed when the cervix is
about 3 to 4 cm dilated.
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Does the placement of epidural anesthesia hurt?
Some women describe the placement of epidural as
creating just a bit of discomfort in the area
where the back was numbed and then feeling of
slight pressure as the small tube or catheter is
placed.
Does epidural increase the chances of normal or
caesarean section?
Basically this epidural analgesia doesnt affect
whether the patient will be delivered normally or
by caesarean section. There are a number of
factors, maternal and fetal factors on which the
normal vaginal delivery or the caesarean section
depends.
Will I be able to push?
We dont give epidural in the second stage of
labor or the working stage of labor in which you
have to push. But in case if you do not feel your
contractions then pushing might be difficult in
this stage. And in such a situation, your baby
might need additional help for coming down the
birth canal. And this is usually done by the
instrumentation like forceps delivery.
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Can the epidural analgesia lead to back pain
post-delivery? Pregnancy has many physiological
changes in the spinal area, back pain can be a
result of multiple factors including incorrect
posture while breastfeeding, inadequate rest and
neglect of mothers health, pre-existing spine
problems, etc. Epidural injection doesnt cause
back pain nor does it aggravate pre-existing back
pain.
We hope that you will find this information
useful in your decision making regarding this
method of pain relief.
Wishes for a happy, healthy and safer pregnancy!
Contributed By Dr Shikha Sardana Obs Gynae
Consultant
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Screening in pregnancy in Chandigarh for safe and
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