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The technique of painless delivery called as Epidural Analgesia or Epidural Anaesthesia is a popular technique used by women, if advised by the doctor, during labor. It gives relief from unbearable labor pain during deliveries. Such deliveries have registered 6-7% rise in the past two-three years. The anaesthesiologist and your OB-GYN will monitor the blood pressure, check that the epidural is working well and your baby’s heart rate will be checked intermittently or continuously. Like all other treatments epidural delivery also has pros and cons.

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 All mothers who are on the verge of motherhood have one common fear. The fear is of acute labor pain during the time of childbirth. The quantum of pain varies from one mother to another mother. Some has very less labor pain and the pregnancy is easy and many have long delayed labor pain.

Labor pain is severe for most women who do not receive pain relief. With advent of modern medicine and availability of techniques with skilled practitioners, it is now possible to relieve the pain of labor. Management of pain is the most crucial thing in the delivery of baby and painless delivery techniques are providing respite from excessive pain, be it in normal deliveries or caesarean (that need operations). The technique of painless delivery called as Epidural Analgesia or Epidural Anesthesia is a popular technique used by women, if advised by the doctor, during labor. The technique is not only cost-effective, but also gives relief from unbearable labor pain during deliveries. Such deliveries have registered 6-7% rise in the past two-three years.

It is estimated that out of every 25 deliveries, there are around 8-10 painless deliveries. In fact most of those going for it are educated and come from well-off families. As threshold to bear labor pain among women has reduced, they prefer to go for epidural anesthesia. Most of patients come to us after knowing about it from friends and relatives. With women postponing motherhood till late thirties and conditions like obesity and hypertension, chances for normal delivery become less. As one grows old, threshold to bear pain also reduces but epidural anesthesia increases chances of having normal deliveries, doctors say. With women postponing motherhood till late thirties, with conditions like obesity, diabetics and hypertension becoming common, chances for normal delivery were becoming less.

In an Epidural procedure a small injection is placed in your lower back, through which a fine tube (epidural catheter), the size of a thread, is passed into your back. Drugs can be injected through this tube to relieve the pain of labor. These drugs are local anesthetics which cause numbing of the nerves and pain sensation without affecting the ability to move. These drugs are also very safe for the baby. With an epidural in place, you may feel the contractions, but they will not be painful. It provides respite to expectant mother from unbearable pain during delivery. The anesthesiologist and your nurse will check that the epidural is working well.

Pain is the reason to have epidural and whenever your pain is significant you can request for an epidural. All women in labor who need pain relief can have an epidural, except those on blood thinning drugs or abnormal blood tests. Epidural is not necessary for you to have delivery, but it can be beneficial in reducing the pain of labor. You only need to be in established labor, but there is no need to wait for a particular dilatation of the cervix. Also in those very anxious or keen to have an epidural, it can be placed at a convenient time before the labor pain is too bad, so that your cooperation is better.

Advantages: There are quite a few advantages of administering Epidural Analgesia. A few are listed below:

1) Because of pain, mother secret hormones which give distress to baby. Epidural analgesia makes mother and baby comfortable.

2) It brings down high B.P which some mother has.

3) Good for patient who have heart disease.

4) Delivery is faster.

5) If required, Caesarean can be done with same tube.

6) Caesarian can be avoided for patient who wants Caesarian for fear of pain.

Disadvantages: Disadvantages of epidural anesthesia include its potential for contributing to uncommon minor complications such as persistent positional headache afterwards, shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating. Epidural makes pushing more difficult and additional medications or interventions may be needed such as forceps or cesarean.

Who should have an epidural?

In some patients epidural is recommended to optimize outcome.

1) If you have complicated or prolonged labor, in such circumstances it will benefit you and your baby.

2) If you are trying for a VBAC (vaginal birth after cesarean section)

3) If you have certain medical conditions such as certain heart conditions, hypertension & preeclampsia.

WHO should not have an epidural?

Those with certain bleeding disorders

Those taking medications that can affect blood clotting (clopidogrel, heparin, warfarin, etc)

If you have had a Lower back surgery (in certain cases)

If you have certain neurological disorders

Your obstetrician and anesthetist will discuss these with you.

You will be under the supervision of anesthetist and gynecologist. Monitoring will be done to note any changes in your blood pressure. This will be done every few minutes for about 15 minutes and then at longer intervals. Your baby’s heart rate will be checked intermittently or continuously as per the Obstetrician’s advice. Painless delivery has to be constantly monitored by experienced and trained anesthetist, along with the gynecologists, obstetricians.

Can an Epidural Fail?

Occasionally, epidural may not work as well as we would like it to. If this happens, the anesthesiologist will help by giving extra doses or changing your position or the catheter position. If it still does not work, the procedure has to be repeated (by placing the epidural catheter again).

Do epidurals increase the chance of a cesarean section?

A large amount of research has been done on this topic and it is clear that epidural per se does not influence the rate of cesarean section. A proportion of women planning normal delivery will end up having a cesarean section. This proportion remains the same with or without an epidural.

Seeking pain relief methods for child birth is mother’s choice. This is discussed beforehand only with the doctor in charge of delivery at the clinic. Moreover, a well informed patient is usually more cooperative and adaptive during labor and delivery. Hence, prenatal pain-relief education should work and mutually benefit parties, the patients as well as the care providers. Not every woman needs an epidural and not every woman wants an epidural. But women who are interested shouldn’t wait. Chhabra Hospital for Women in Bathinda is a one stop place for all Gynaec and Obstetrics problems and our expertise lies in providing affordable Laparoscopic surgeries and difficult cases of infertility. Chhabra hospital is renowned for its comprehensive services under one roof for all your Obstetric need like Painless Normal Deliveries and Caesarean Deliveries and Post natal care and advice. We have one of the best facilities of painless delivery using epidural analgesia in Bathinda. For the backup, we have the most sophisticated sonography machines at our disposal.

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