Labor Pain : Worst imaginable pain No other situation where severe pain is acceptable 15th Century – Midwives offered pain relief burned (wrong to avoid the pain of divine punishment) Biologic process subject to study and control by new methods of science. Queen Elizabeth eighth child Last 100 years : Most Effective & safe(ACOG recommended)
Uterus contracts & relaxes to push baby down. These contractions like a vigorous exercise are responsible for pain. Pain impulses travel from the uterus to the brain via nerves in the backbone. Initially mild, slowly increases in frequency and severity. More in anxious and in primi. Each women’s labour is unique.
Pain impulses are blocked with in the back bone and they do not reach the brain.
Epidural techniques block the pain produced by uterine contractions. They do not reduce intensity & frequency of contractions. Thus, it does not have bad effect on progress of labour, actually it fasten the progress.
Minimize pain but not labour and safe to both baby and mother.
Walking or Sitting more upright Speeds up the progress of labor
Active Labor :•Avoid Solid food•Clear fluid (Water, Fruit juiceswithout pulp, cold drinks, clear tea,black coffee.) 1glass/hr
Excellent worldwide safety record. As with any procedure, however, some patients may experience some minor side effects like shivering; decreased blood pressure; mild itching in labor; headache; persistent pain in some areas, etc. Other complications are very rare like local anesthetic reaction(inform if H/O allergy)
Apart from pain relief, Increases blood supply to baby and improves its well-being . Especially where blood supply to baby is compromised e.g. High BP, Growth restricted babies etc. Shorten duration of labour. Studies have also shown that the caesarean delivery rate is reduced. If a patient requires emergency caesarean section, anaesthesia given through the same catheter without additional pricks.
Does Epidural increases the chances of Cesarean Section ? No Does Epidural affect Breast feeding ? No Does Epidural cause back pain ? No. The reason for backache after delivery : -laxity of ligaments & abdominal muscles, -change in the curvature of back, -lack of calcium in diet / supplement.
Scared of needles ? Before epidural needle, numbing medicine with tiny , thin needle, less painful than labor pain. Then you only feel pressure. Will I able to push? Yes. It make pushing more comfortable. Will I be able to urinate Every hour pass urine, without urge.
Do I have to stay in bed? Not necessarily. What will I feel? Significant pain relief will occur, may aware of pressure of contractions. May temporary numbness, heaviness in legs. How long will block last ? Till delivery with additional doses. After delivery, catheter will be removed and, within a few hours, sensations will return to normal.
What if I plan for delivery without Epidural ? By all means you can go ahead. At any time if you feel that it is too much to bear the pain and change your mind, we will be happy to help you. Changing your mind should not be considered as failure. Situations where Epidural have an advantage? High BP, Heart diseases, Lung diseases etc.