What Is Labor Epidural Analgesia and What Should I Expect Going Into Labor?

Women experience a lot of pain during pregnancy, labor, and childbirth. Most soon-to-be-moms suffer from nausea, back pain, indigestion, and constipation during the different stages of pregnancy.

Medications, therapies, and other alternative methods are administered to manage these pregnancy symptoms. Visit Motherhood Community for pregnancy and great parenting tips. However, these treatments must be validated and approved by a doctor to prevent adverse repercussions.

Pregnant women may experience more painful contractions during the later stages of pregnancy.

Pregnancy labor is managed through various medical pain relievers offered by healthcare providers. These pain relief methods include anesthesia, Entonox, and epidural analgesia.

What Is an Epidural Analgesia?

Epidural analgesia is a type of regional anesthesia generally used in pain management during childbirth.

Epidural analgesia is a combination of pain relief with a loss of sensation (anesthetics) and pain relief without the loss of movement (analgesics).

This type of analgesia uses a catheter or a thin plastic tube placed in your back to administer medicine during labor. An epidural paralyzes you from the waist down but lets you participate in childbirth.

Unlike typical anesthesia, epidural analgesia aims to provide pain relief rather than total numbness. It blocks nerve impulses from the lower spinal segments.

What to Expect During an Epidural

Epidural analgesia is given only when you ask for it. It can be done even when you are minimally dilated in the early part of labor.

Before the epidural is inserted, you will be given IV fluids to prevent your blood pressure from dropping. Depending on the hospital protocols, they can provide a urinary catheter before or after the epidural.

The epidural is injected directly using a catheter into your spine, specifically in the epidural space. This space is found between the membrane of your spinal cord and the ligament that covers the vertebrae.

Pain relief can be experienced within 10 to 15 minutes after the epidural is inserted.

Although epidural can give you pain relief, it is essential to note that it will not be a hundred percent pain-free. You may still feel some pressure when contractions occur.

Moreover, some women may still have some sensations when pushing during childbirth. The effect of epidural analgesia may last up to eight hours(1).

Benefits of an Epidural Analgesia

  • Epidural reduces the discomfort during childbirth and allows you to rest when your labor is reduced.
  • Epidural enables you to stay active and alert during delivery.
  • It can help you deal with fatigue, irritability, and exhaustion.
  • A minimal amount of medicine goes into the infant.

Risks of an Epidural Analgesia

  • The numbness caused by epidural anesthesia may make pushing difficult. If you experience this difficulty, you may need additional interventions.
  • Even though it is rare, there might be a leakage of the spinal fluid that may cause severe headaches.
  • There are some cases where epidurals may cause a sudden drop in your blood pressure.
  • You may experience side effects, such as backache, soreness, shivering, soreness where the needle was, nausea, ringing of the ears, and difficulty urinating.
  • There might be complications experienced after the administration of epidural. These complications include(4):
    • Nausea and vomiting
    • Epidural hematoma
    • Meningitis
    • Hypotension
    • Nerve injury

Preparations for Epidural Analgesia

  1. Before the epidural, emergency equipment and medications are prepared for the procedure. 
  2. If necessary, an IV will be administered for other medicines and fluids needed.
  3. ASA (American Society of Anesthesiologists) monitors will also be ready before proceeding with the epidural process.

ASA monitors include an ECG (electrocardiography), a noninvasive blood pressure device, a pulse oximeter, and a temperature monitor.

  • You will be seated with your back arched for better exposure of your intervertebral interspaces.

Other Pain Relief Options During Childbirth

Before choosing the best pain relief options for you during labor, make sure that you understand your options and their repercussions.

You can talk with your doctor about the various choices before your delivery day. Keep in mind that the pain relief method you choose should be governed by specific circumstances and considerations of your pregnancy plan, delivery, and labor.

During the pain relief method of your choice, your doctor will assess your comfort and progress. Here are some options for your pain relief methods:

1. General Anesthesia

This type of pain relief during labor is administered during emergency birthing. It puts you to sleep and should only be given by a licensed anesthesiologist.

One advantage of general anesthesia is that it is generally safe. However, it prevents you from seeing your baby immediately(6).

2. Analgesic Medicine

Analgesic medicines are injected into your muscle or vein to decrease your labor discomfort. It is generally used during early labor to conserve your energy and help you rest.

Even though it lessens the pain of labor, it does not entirely stop it. It makes you and your baby feel sleepy and affects your entire body(7).

3. Local Anesthesia

This type of anesthesia is used by your doctor during birth or delivery and after delivery to numb you of the pain, especially when stitches are needed after childbirth(8).

Local anesthesia cannot reduce labor discomfort.

4. Non-Medical Pain Relief Option

If you are critical about medical anesthesia and medicine during labor, you may opt to do these natural and non-medical procedures(9). However, these methods start even before delivery.

These non-medical pain relief options aim to reduce anxiety and modify the perception of pain during childbirth. You can try the following methods for your natural pain relief options(10):

  • Attending antenatal classes or birth and parenting classes will give you sufficient information on what to expect during labor. These classes may help reduce your anxiety and prepare you.
  • You may learn some breathing techniques to use for every contraction.
  • Keep a healthy routine. Engage in light exercise and eat a healthy diet throughout your pregnancy.
  • Massage, hot or cold compress, and warm bath immersion may be helpful during labor.

5. Entonox (Gas and Air)

Although this method won’t also completely eliminate the pain, it makes it bearable. Entonox is a combination of nitrous oxide gas and oxygen(11).

You can control your intake of Entonox during labor, and it is easy to use. You just have to breathe in the gas through a mouthpiece or mask.

This gas may take 15 to 20 seconds to work, so you can use it for every contraction that you may have(12).

It is recommended to take deep and slow breaths when you use this method. While this procedure cannot harm you and your baby, it can make you feel lightheaded and sleepy, and make concentrating difficult.

If this procedure is not effective as a pain reliever, you may request your doctor for other methods.