Pros and Cons of Epidural

Tolerance and perception of pain during childbirth vary enormously. The prospect of pain frightens some women, who request pain medication early in labor. Others want a completely “natural” birth, with all the intensity of sensation and the fewest interventions possible. The topic of epidural anesthesia and pain relief is controversial, even though epidurals are widely used in this country. First-time expectant mothers may feel confused by the debate. Are epidurals a completely safe method that will make childbirth easier and more enjoyable, or a risky business which may create unwanted complications?

What Is an Epidural?

In an epidural, a local anesthetic (sometimes along with painkillers) is administered through a catheter placed in the epidural space in the lower back, just next to the spine. It’s different from a spinal block, which is injected directly into the spine.

Advantages of Epidural

An epidural allows a woman to remain awake and aware, but mostly pain-free during childbirth. Some say women can appreciate the whole experience more when they are not distracted by racking pain.

Studies show that epidurals are more effective painkillers than intravenous narcotics, another common pain-relief method. Another benefit is that if complications arise and emergency interventions are needed, it is helpful to have it in place, ready to dispense additional medications.

A more recent form called the combined spinal or “walking” epidural numbs only the abdominal muscles, not the whole lower body. It still controls pain, but allows women more mobility than a traditional, which prohibits walking.

Disadvantages 

Dangerous side effects are rare. But there are several less-serious effects to consider. Epidurals seem to prolong labor. Doctors often counter that effect with pitocin, a hormone that accelerates labor. They have also been linked to an increase in births involving C-sections, vacuum aspiration and forceps.

A fairly common side effect of an epidural is low blood pressure, often accompanied by nausea, vomiting and dizziness. This is usually averted by giving the woman intravenous fluids before. Occasionally, epidurals cause backaches and headaches. They may also cause urinary problems after birth.

Previously, it was thought epidural medications did not affect the baby. Now it is known that some of the drugs do cross the placenta. They haven’t been shown to cause any lasting harm, but more research is needed.

Learn About Your Options 

Epidurals are just one of many options for pain relief, many of which do not involve medication. The more you learn about all the options — and about the process of childbirth — the better equipped you will be to make the best possible decisions during your own labor and delivery.