Epidural Pain Relief

In this article:

‍

An epidural is a pain relief medication that is injected into the spine to provide relief from labor pain. Epidurals are most commonly used during labor but can also relieve pain during delivery.

An epidural is a pain relief medication that is injected into the spine to provide relief from labor pain. The word 'epidural' literally means in between the vertebrae, where the spinal cord is located. The epidural medication is injected into the spinal cord area to relieve pain.

Epidurals are most commonly used during labor but can also be used for pain relief during delivery. Epidurals are most effective when given in the early stages of labor. Labor typically lasts about ten or twelve hours, depending on your particular situation; therefore, timing will help determine whether you may want to consider an epidural.

The epidural medication is injected into the spinal cord area to relieve pain. The medication works by blocking the nerve impulses sent to the brain, which blocks the pain signals from reaching the brain, resulting in pain relief.

An anesthesiologist most commonly administers epidurals. Still, they can also be given by a nurse or a midwife who has received additional training and certification. Anesthesia, however, should not be confused with the method sometimes referred to as an "injection" through anesthesia called perineal blockage. This procedure requires only local numbing cream (lidocaine) to be placed on the perineum and is done.

‍

There are several different types of epidurals. Most women receive either what's known as continuous monitoring or intermittent monitoring; these two procedures both involve using tiny needles to insert the epidural catheter. During continuous measurement, monitor pressure sensors keep track of blood vessels dilating. It must release some anesthetic solution until everything returns to a stable status. During intermittent monitorations, only allow anesthetic access at certain times for 5-20 minutes at a time based upon your doctor's orders. Other types of epidurals include using a spinal block or a combined spinal-epidural. Combined injections require no separate needle sticks, whereas all other forms usually do more.

‍

• Standard Epidural Medication Delivery. Delivery of the medication through a small, flexible tube inserted into the epidural space. This is the most common method. It involves injecting medicine directly into one of more than 200 spaces that lie outside (but near) our largest bones - the vertebrae.
• Continuous Epidurals. A continuous epidural is a delivery method that uses a small, flexible tube to deliver the medication directly into the epidural space. The epidural catheter is left in place, and a steady stream of medication flows into the space. This method is usually used when patients need long-term pain relief.
• Intermittent Epidurals. Intermittent epidurals are a delivery method that uses a small, flexible tube to deliver the medication directly into...'. They can also refer generically to techniques often used without anesthesia in which medications are sometimes instilled using a Tuohy needle.

The epidural is not painful. A small needle is used to insert a catheter (a thin, flexible tube) into the epidural space. The catheter is then taped in place. A small amount of medication is then injected into the epidural space. This medication numbs the area around the spinal cord. Because they reduce pain by interrupting nerves from getting messages about how you feel, your perception of pain depends on what type of epidural you have.

The epidural usually lasts for several hours, and the length of time it lasts depends on your epidural type. Some epidurals last for hours, while others last for days.

After the epidural procedure, you will need to remain lying down for a period of time. You will also need someone to stay with you for a while. This is because you may feel lightheaded or sleepy, and you may also have a headache. These side effects will go away within a few hours.

The epidural is a safe procedure. However, there are some risks associated with it. These risks include infection, blood clots, and fat embolism. The benefits of the epidural include: pain relief, reduced labor and delivery time, and decreased opioid use.

Your healthcare provider can help explain how any significant medical problems might affect your specific anesthesia plan.

There are options other than an epidural available for pain management during labor. We recommend you work with your doctor or midwife to determine the best options for you.

Opioids

Opioids (also called narcotics) are pain medications given by injection or through an IV. These pain medications don't provide as much pain relief as an epidural. Still, they can make the pain bearable without causing numbness. Side effects may include drowsiness, nausea and vomiting, and itching. Opioids cannot be given immediately before delivery because they may slow the baby's breathing and heart rate.

Pudendal block

A pudendal block is a numbing medicine injected into the vagina and the pudendal nerve late in labor, just before the baby's head comes out, providing some pain relief while allowing you to remain awake and push. 

Nitrous oxide

Commonly known as "laughing gas," this odorless gas is an inhaled analgesic administered through a handheld face mask. Nitrous oxide takes effect within one minute and can be used continuously or as needed during labor. Pain relief requires inhaling the gas for approximately 30 seconds before a contraction. Side effects of nitrous gas may include dizziness, drowsiness, nausea, and vomiting.

‍

Natural remedies

You can also use natural remedies on their own or in combination with medicine to alleviate labor pain, like:

• Heat or cold to the lower back
• Massage
• Warm baths or showers
• Finding comfortable positions
• Hypnobirthing
• Using a labor ball

Epidurals are generally safe, but the decision to have one is personal. You should work with your doctor and birth team to determine what's best for you and your family.

Developing a birth plan can help you feel more prepared for labor. Though it's a good idea also to have an alternative birth plan that you are comfortable with should things not go as expected during birth.

A note from Anja Health

An epidural does not affect cord blood collection, which occurs shortly after birth. Cord blood banking is a process of collecting stem cells from the umbilical cord and placenta and storing them for future stem cell treatments for cancer, blood diseases like anemia, and some immune system disorders. The Anja Health Stem Cell Safe makes it easy for your healthcare team to collect your cord blood.