For many women, labour is an extremely painful experience. The American College of Obstetricians and Gynaecologists says, “There is no other circumstance where it is considered acceptable for a person to experience untreated severe pain, amenable to safe intervention, while under a physician's care.” Hence, although it not a prerequisite, one can choose to undergo labour with the help of an epidural.
An epidural is a small injection placed in your lower back with a help of a fine tube known as an epidural catheter. Drugs can be injected through this tube to relieve the pain of labour. These drugs are local anaesthetics which reduce pain without affecting the ability to move and are also very safe for the baby. With an epidural in place, you may feel the contractions but they will not be painful. It is useful during labour as:
It is the best method of pain relief in labour, among all the options available.
It can help you deal with exhaustion, irritability and fatigue. By reducing the discomfort of childbirth, most women have a more positive birthing experience.
Epidurals are given to all women in labour who need pain relief. While it is not necessary to take it, it is recommended for some women to optimise the outcome. Epidurals are also administered if you have a complicated or prolonged labour or if you have medical conditions such as certain heart conditions, hypertension and pre-eclampsia.
However, epidurals should not be taken by women who have had lower back surgery, certain bleeding disorders or neurological disorders. Your obstetrician and anaesthetist will discuss these with you. An epidural can be given to you whenever your labour pain is unbearable. It can be placed at a convenient time before it gets too bad.
Occasionally, an epidural can fail. If this happens, the anaesthetist will give you an extra dose or change your position or that of the catheter. If it still does not work, the procedure has to be repeated.
Side effects for this can include headache and numbness or heaviness in the legs, which wears off once epidural is discontinued. If you are worried about getting a backache when the epidural is put in, don’t fret. Research now indicates that it does not cause any long-term backache.
A dedicated team of anaesthesiologists is needed to provide round-the-clock epidural service for painless labour and to deal with any problems that may arise. With such precautions in place, having a pain-free labour will not be that difficult.
(The author is lead consultant, department of anaesthesiology and pain medicine,
Rainbow Children’s Hospital, Bengaluru)