Everything You Need to Know About Epidurals

More than 50% of Australian women are given epidurals during labour to minimise or block the pain.

Even though epidurals are approved safe for use in Australia, most women fear using them. There are two reasons for this: First, most women fear not only for their own safety but also for their baby’s. Secondly, it’s a big needle in the spine! To clear the air, this article will address everything you need to know about epidurals.

What exactly is Epidural Anaesthesia?

It is an injection administered to your lower back with the aim of numbing the nerves, blocking any pain during labour. If the baby is going to be your first born, you should know that giving birth is immensely painful but with the help of epidurals, this pain is easily evaded. In addition, this treatment can also be used during and after a surgical procedure, like a c-section.

An epidural will have an effect on the pelvic region, abdomen, legs and chest. The degree of numbness will depend on the type of drug used and the dosage. The good news is that one can use epidurals at any point during labour especially when contractions are getting stronger.

How do Epidurals work?

As stated above, the treatment prevents you from feeling pain on the lower part of your body. In addition, it allows you to remain fully conscious. This implies that sensation is decreased but you will be fully aware of what’s going on.

During the procedure, medication will be administered via a catheter (very thin, flexible, hollow tube). The catheter is then inserted into the epidural space adjacent to the membrane surrounding your spinal fluid and spinal cord.

How many types are there?

Generally, there are three categories of epidurals:

• Injection with Top-ups Here, painkillers are injected into a tube which numbs the lower part of your abdomen. This relieves any pain arising from contractions. As the medicine starts to wear off, re-fills or top-ups are added for another 1 or 2 hours.
• Combined Spinal Epidural (walking epidural) The injection comprises of powerful painkillers that are more effective than regular epidurals. A catheter is also set up for the purpose of delivering a painkilling solution once the injection starts to wear off.
• Continuous Infusions Here, the catheter is set up and attached to a pump which delivers painkilling solution to your back. There are top-ups for women who need stronger pain relief. Some hospitals in Australia allow patients to control the pumps.

What is the procedure like?

It can appear very scary and painful having a needle going into your back, but you’d be surprised at how smooth the whole procedure is. Before the treatment starts, your doctor will numb your skin with a local anaesthetic injection.

For the catheter to be inserted, you should sit on the edge of the bed or on lie curled on your side. Your anaesthetist will guide you as to the best position. Your lower back will be cleaned thoroughly with antibacterial solution and a needle is then guided carefully to your lower back.

Now, a catheter will be passed through the needle and then the needle is withdrawn. Your doctor will then tape the catheter in place for medication delivery.

A small dose is then delivered to ensure that the epidural was placed perfectly. If there are no problems, you are given a full dose. The doctor will take your blood pressure every 5 minutes and your baby’s heart rate is monitored continuously. This ensures that there are no negative side effects.

After about 20 to 30 minutes, you will start feeling the numbing effect. Doses will be administered continuously for the rest of your labour. After the baby is delivered, the catheter is removed.

What are the benefits of using Epidurals?

• The medication is localised, hence, you will be fully awake during labour and birth. Furthermore, since you are pain-free you can rest as the cervix dilates, hence, building more energy for the push.
• Painkillers can be used throughout your labour.
• The effects are controlled by the doctor or nurse by adjusting the dosage, strength and type of medication.
• In comparison to systematic narcotics, epidurals allow only a tiny amount of medicine to reach your baby.

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