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Epidural

Epidural

How does an epidural work?

An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. It decreases sensation but doesn't result in a total lack of feeling.

Medication is delivered through a catheter – a very thin, flexible, hollow tube – that's inserted into the epidural space just outside the membrane that surrounds your spinal cord and spinal fluid. An epidural is the most commonly used method of pain relief for labor in the United States.

When is the best time to get an epidural?

In the past, many practitioners wanted a woman to be in active labor before starting an epidural due to a concern that it might slow down her contractions. These days, most caregivers will allow you to start an epidural whenever you ask for it.

Studies have shown that starting an epidural in early labor (compared with later in labor) is not more likely to prolong labor or lead to a c-section or other interventions such as a forceps delivery. (However, as we note later, having an epidural at all does increase your risk of a vacuum extraction or forceps delivery.)

What are the advantages to having an epidural for pain relief during labor?

  • An epidural provides a route for very effective pain relief that can be used throughout your labor.
  • The anesthesiologist or nurse anesthetist can control the effects by adjusting the type, amount, and strength of the medication. This is important because as your labor progresses and your baby moves farther down into your birth canal, the dose you've been getting might no longer cover the pain, or you might suddenly have pain in a different area.
  • Since the effect of the medication is localized, you'll be awake and alert during labor and birth. And, because you're pain-free, you can rest if you want (or even sleep!) as your cervix dilates. As a result, you may have more energy when it comes time to push.
  • Unlike with systemic narcotics, only a tiny amount of medication reaches your baby.
  • Once the epidural's in place, it can be used to provide anesthesia if you need a c-section or if you're having your tubes tied after delivery.
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