I am scheduled to have an epidural and would like to have some information on it.

The epidural is an incredible medical feat, in that a woman can be completely awake during the birth of her baby without experiencing any pain. It is an extremely safe method of pain relief when administered by a trained specialist, and can be used for both surgical and vaginal deliveries. The doctor will insert a small tube into your spine using a needle, once local anaesthetic has numbed the area. The sensations you can expect will be explained to you at the time, as some women experience tingling, sharp short pains and shivering. Once the tube is in place the medication is administered in small doses and the effect on the body can be closely controlled. This medication has the effect of numbing just the lower limbs so that the mother is fully awake.

You will be obliged to have an intravenous drip in order to control your blood pressure. Also usually a catheter is inserted to prevent any bladder problems. This is necessary because the bladder often does recognize when it is full, due to the effect of the medication.

Ideally the epidural would be inserted once a few centimeters of dilation have occurred. Usually the pushing urge is not influenced by the epidural. However should the mother be struggling to push, the situation could be remedied by reducing the medication until better control is achieved. The possibility of re-administering medication exists. This means that the woman could have an episiotomy or have a tear repaired without any pain at the end of the labour. It is this incredible versatility that makes the epidural such a flexible tool in the hands of a trained professional. There are the few situations in which the epidural is not effective and pain is not relieved. This may be due to the position of the baby relative to the spine of the mother.

Because of the risk of a drop in blood pressure, your doctor may decide that this is not a feasible solution for your labour, should you be suffering from any kind of bleeding complication or foetal distress.

The foetal heart beat will be closely monitored, since occasionally the heart rate will drop due to the epidural. The epidural may also cause the contractions to slow or stop, and this will be monitored as medication can be administered to restart the contractions. While there is a school of thought that using epidurals increases the caesarian rate due to the slowing of contractions, studies have not supported that view. In addition there are some situations in which the administration of the epidural has caused relaxation of a tight pelvis which could be extremely helpful in assisting the progress of labour. Every case is different, and here again is a case where you must put trust in your doctor to guide you to the right decision.

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