An epidural block is a local anaesthesia given in the lower back in order to achieve pain relief during the dilatation period.
The epidural is given by an anaesthetist.
Prior to the epidural the birthing woman will be given a saline drip, and the bloodpressure and temperature will be measured. After numbing the skin on the lower back with local anaesthesia, a very thin catheter is inserted through a special needle. The catheter is inserted into a cavity right behind the spinal canal (the epidural space) – and hereafter the needle is removed. The epidural catheter is attached to the back with tape, and it will stay there throughout the birth.
The epidural is given while you are sitting up. It will be necessary to sit completely still for the 5-10 minutes while the epidural is given.
When the epidural catheter i inserted the midwife will monitor your blood pressure and the foetus will be monitored using an electronic foetal monitor.
You can move freely in bed, and many times you will also be able to stand up with support after a shorter observation period.
Most women will have good effect from the epidural. In a very few cases it will not be possible to place the epidural catheter in the right place. In that case the birthing woman will be offered another kind of pain management.
The epidural may not be used simultaneously with residing in a bath tub.
Sometimes waiting time may occur if the anaesthetist is occupied by an emergency.
Side effects of the epidural block
The most common side effect is a momentary drop in the blood pressure. The blood pressure is frequently measured, especially in the beginning, and you will be given medication that will immediately bring your blood pressure back up in case it shows a downward tendency.
The sensation of a full bladder may be impeded making it difficult to feel urinary urgency. It is important that the bladder doesn’t become overfilled. Thus, it may be necessary to empty the bladder with a catheter.
The epidural may prolong the duration of the birth, and it may be necessary to use a oxytocin drip stimulating the contractions.
The urge to push may be impeded which means that the risk of having to use a vacuum extractor during the birth will be slightly increased.
In a few cases temporary pain or soreness may occur from the area in which the epidural has been given. These inconveniences will disappear by themselves during a few days.
1-4% women will get a headache after having an epidural block. The headache can be very strong and may occur up to three days after the epidural has been given. There is an effective method to treat this kind of headache. Thus, it is important that the woman contacts the Maternity Ward in case the headache starts after being discharged.
Itching of the skin may occur but is rarely so troublesome that treatment will be needed.
An epidural will not increase the risk of having to perform a C-section.