EPIDURAL ANALGESIA FOR CHILDBIRTH

The pain of labor has been with us since the Garden of Eden. It seems to be more intense for some than others,  possibly explaining why some need more analgesia than others. Some women seem to be able to control their pain with breathing, focusing, or relaxing techniques. Others want to be 'knocked out'. The challenge for the anesthetist is to stop or minimize the pain but not the labor, and do so in a manner 'SAFE' to both the baby and mother. For the last 25 years or so, epidural analgesia has become the popular method of pain control with 70-80% of patients requesting it. Let's look at it a little in these links and discussion-- Also look at the feedback section--

    The Pros of Epidural:

  • Labor Pain Relief
  • Allows time for rest
  • Reduces hyperventilation and serum catecholamines
  • Great for PIH (pregnancy induced hypertension)
  • Great for C-sections
  • Appreciated by husbands and families
  • May enhance 'push-ability'

    The Cons: (possible spin-off problems)

  • Possible headache (with dura puncture)
  • Possible back ache
  • Possible hypotension (requires IV fluids)
  • Confines mother to bed so minimizes gravitational effect
  • May increase need for Pitocin (especially first pregnancy)
  • May cause shivering
  • May increase need for vacuum/forceps extraction
  • Increased incidence of C Section (if given too soon and with first baby)
  • Block may be 'one-sided' or blotchy
  • May cause postpartum urinary retention
  • May cause an elevation in mother's temperature
  • May hamper 'push-ability'
  • May cause mild itching of face, neck and thorax
  • May delay babies early 'latch-on' ability to breast feed.
  • May cause septic meningitis.

 

    Contraindications for having an Epidural

  • Bleeding disorder or on anticoagulants
  • Infection in area of Epidural Injection
  • Thrombocytopenia
  • Patient refusal
  • Factors Influencing Labor Pain:

    More Pain
    • Big baby
    • First baby
    • Long labor
    • Oxytocin
    • Immaturity
    • Little education
    Less Pain
    • Small baby
    • Multiparity
    • Short labor
    • Mature mom
    • Birthing classes

Feedback from readers

Epidural Links of Interest
  1. Patti Ramos, epidural site Epidural pictoral display
  2. 270 Days   Daily News for Expecting Moms
  3. Analgesia and anesthesia in labor and delivery, Guidelines and free full text articles
  4. Anesthesia Options for Labor & Delivery, AANA
  5. Epidural for Childbirth A woman doctor answers--
  6. Pain in Labor Great Links
  7. Bupivacaine, as listed in the PDR
  8. Epidurals increase cesarean section rate
  9. Epidural/C-section connection
  10. Epidural Analgesia Manbit.Com
  11. Epidural FactSheet Index a great source of information
  12. Medical Risks of Epidural Anesthesia During Childbirth  Lewis E. Mehl-Madrona, MD, PhD
  13. Pros and Cons of Epidural Anesthesia
  14. Cesarean Awareness
  15. VBAC Vaginal Birth after Cesarean
  16. Reported Side Effects of Epidural Anesthesia
  17. Pain Relief in Labor Many good articles
  18. Is Epidural Bad for the Newborn? Midwife archives
  19. Epidural Analgesia for LaborWomen's Health
  20. Epidural/Caudal Analgesia
  21. A Guide to Spinal Anaesthesia for Caesarean Section
  22. Walking Epidural Pregnancy/Birth Page
  23. Alliance for the Improvement of Maternity Services epidural graphic
  24. Iowa Women's Health Center
  25. Epidural Misadventure H.Muir,MD
  26. Women's Health-- Epidural
  27. All About Epidurals
  28. Pain Management During Labor & Delivery
  29. Prospective Studies   Epidurals Cause C-Sections
  30. Epidural Anesthesia
  31. Epidural Concerns   Maria Davis,RN
  32. Epidural anaesthesia
  33. Epidural Fact Sheet (Manbit)   Genevieve Goulding
  34. Epidurals and Connections with Cesareans
  35. Epidural Analgesia During Labor  University of Alabama School of Medicine
  36. The Epidural as a Pain Control Option during Childbirth
  37. Medical risks of Epidural Anesthesia during Childbirth
  38. Anesthesia for childbirth The Pregnancy HelpDesk
  39. Labor and Birth Resources   Childbirth.org
  40. Walking Epidurals
  41. Epidurals in childbirth for women with scoliosis
  42. Pain Relief For Childbirth,   Alexian Brothers
  43. The Labor Process and Epidural Analgesia
  44. Do epidural medications cross the placenta? 
  45. In Praise of painless childbirth
  46. Low hemoglobin: Will it preclude an epidural?
  47. Will an anesthetic affect my baby
  48. Links to Learning Disabilities, ADD and Behavior Disorders
  49. Combining Epidural Analgesia with Opioids Decreases Cesarean Risk
  50. Epidural Analgesia During Labor , American Family Physician
  51. Yahoo directory of epidural
  52. Pain Relief in Labor (childbirth.org)
  53. Backache and regional analgesia in labour. Robin Russell
  54. Epidural analgesia in labour pain
  55. Epidural Analgesia During Labor,  U of Alabama
  56. Epidural anesthesia at Brigham and Women's Hospital
  57. Better Health Childbirth pain options
  58. Pain relief options, Brigham and Women's Hospital
  59. Epidural Anesthesia for Labor, Celeste Telfeyan, D.O

Other Links

Midwife & Doula Sites

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Please let me know how your epidural was. Would you have another? Feel free to email me or sign the guestbook. Sam Blomberg     samblomberg@hotmail.com

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Will you have an Epidural for your next baby??
No! I'll have my babies naturally !
Yes! I want an epidural--
I only want IV meds like Demerol or Nubain
I'm gonna use a Midwife
I think I'll try Hypnosis next time

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