There are many women who turn to use of epidural anesthesia when giving birth. And although this anesthesia has undoubtedly been a before and after in the management of pain during childbirth, it is a personal decision that must be taken in a thoughtful way.
If you are pregnant and you are thinking of giving birth with epidural anesthesia, we explain what it is, how it acts during labor and what its implications are.
What is epidural anesthesia?
Anesthesia is the use of medications that are used to prevent the sensation of pain during surgery or a painful procedure. There are different types of anesthesia, but all have as their purpose block nerve impulses and therefore pain.
During childbirth, the anesthesia that is most frequently used is epidural, which consists of reversible blockage of nerve roots avoiding pain in an entire region of the body.
In Babies and more Anesthesia in childbirth: how many types exist and what advantages and disadvantages each of them present According to the statistics produced by the hospitals themselves, eight out of ten pregnant women resort to it at the time of delivery.When is it administered?
It will be the doctor or midwife who indicates the most appropriate time to administer epidural anesthesia according to your type of delivery. Usually, it gets when the contractions are regular and intense (at least three contractions every ten minutes), three to four centimeters of dilation have been reached, and the cervix has been cleared at least half.
In case of a very advanced state of dilation it may not be advisable to put it, because it takes some time for it to take effect (between 15 and 20 minutes), and in those cases the risks could outweigh the benefits.
How is it administered?
The anesthetist will tell you how should you register to administer anesthesia. You should be sitting or lying on your side, and always with the back bend out. Before administering the epidural, the skin is disinfected and a local anesthetic is applied, to avoid pain when puncturing the lower back.
Then a needle is inserted between the second and third vertebra, or between the third and fourth. This needle penetrates the epidural space between the bony walls of the medullary canal and the medulla envelope. Through her a very thin and hollow tube called "catheter" is inserted which is inserted after removing the needle. Y
The necessary anesthesia dose is applied through the catheter using an automatic infusion pump. In this way, every time more anesthesia is needed, it will not be necessary to puncture again.
What do you feel after the administration of anesthesia?
The most common is that after the application of anesthesia contractions feel more bearable, and the legs are feeling tingly and somewhat heavy to the movement. During the expulsive phase it is normal (and advisable) to notice the pressure exerted by the baby's head; This will allow you to direct the bids and help the baby to be born.
In Babies and more When giving birth, better mother's bids or targeted bids?But, Not all women react the same to the epidural. There are times when the legs remain completely immobile, the contractions are not felt and there is no desire to push. While in other cases it is not as effective as expected.
Advantages of epidural anesthesia
Some pregnant women recognize that they are afraid of childbirth, especially because of the pain that it may cause and the uncertainty of knowing if they will be able to cope with it. In these cases, epidural anesthesia can be a great help for women to face their calmer and more confident delivery.
This would be one of the main advantages of epidural anesthesia, but there is more that we detail:
Pain relief occurs without blocking any of the mother's mental faculties, so that she can consciously live the birth of your child.
Epidural anesthesia can be used throughout labor, and regulate the intensity of the medication whenever the mother wants.
Avoid the need to apply another anesthetic in case the delivery is instrumental or an episiotomy is performed.
In case the delivery must finally end in a caesarean section, it is not necessary to apply any additional anesthesia so the mother can be aware at all times.
Risks of epidural anesthesia
But epidural anesthesia also carries a series of side effects and risks that the pregnant woman must know, in order to make the decision with which you feel most comfortable at the time of delivery:
A review of studies published in 2009 by Cochrane concluded that the epidural increases the risk of instrumental delivery (use of other drugs, forceps, suction cup, episiotomy, etc.), since in many cases the woman loses the reflex of the bout and need help to get the baby out.
Some women have a decrease in contractions, which lengthens the dilation phase and increases the chances of using oxytocin.
Fall in maternal blood pressure.
Severe headaches as a result of accidental puncture of the dura.
Post-puncture low back pain is one of the most frequent problems, affecting between 22% and 45% of patients
Uncontrollable tremors after delivery.
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Some women experience fever after anesthesia administration, and without any infection causing it.
Urinary and / or fecal incontinence.
Nausea and vomiting after childbirth.
Increases the risk of caesarean section when placed before recommendations for minimal dilation.
It can affect the baby, lowering his heart rate during childbirth and / or affecting his state of consciousness, which in turn would affect the early onset of breastfeeding.
There are more rare cases in which the epidural can have serious or very serious effectssuch as seizures, paralysis, meningitis due to an infection in the area of the puncture, lung infection or strokes.
Contraindications of epidural anesthesia
As we can read in this fact sheet prepared by the University Hospital of Fuenlabrada (Madrid), epidural anesthesia is absolutely contraindicated in those patients who present with puncture point infection, significant hypotension, endocranial hypertenction, severe infrecient syndrome, coagulation disorders and anticoagulant treatments.
In Babies and more Tattoos in pregnancy: the answer to all your doubtsSpinal disorders and obesity are not contraindications, but they can make the technique difficult and even prevent it
Its use is widespread by all hospitals, so the consultation with the anesthetist in the last phase of pregnancy is usually highly recommended to clarify doubts and analyze the risks and benefits of using epidurals.
A very personal decision
The first thing to consider when deciding whether or not to use epidural anesthesia, is that the experience can be very different from one woman to another, and even from one birth to another. Therefore, it is advisable not to get carried away by subjective opinions and in case of doubt always consult a professional.
And it is essential to make the decision correctly informed, analyzing the pros and cons of your specific case.What if you have made the decision not to resort to epidural anesthesiaWe recommend that you put it in writing in your birth plan, because although the use of this anesthesia is widespread and most women choose it, no hospital should take anything for granted.
Undoubtedly, this is a totally personal decision that you should evaluate, and choose if you prefer to prioritize not feeling pain to the possible risks (which although they are minimal, there are), or on the contrary you prefer to look for other alternative methods to cope with the pain of Birth.
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