Birth Experience

Birth Management & Intervention: Epidural

5 Comments 02 March 2010

Epidural Pros and Cons

Photo Copyright ©2011 Patti Ramos Photography

Epidurals are used to relieve the pain of contractions.

Currently, epidurals are taken by 50% of women giving birth in hospitals, requested by name.

Pain medication can be helpful in some situations, specifically and especially when a mother is in so much pain that she is unable to relax her pelvic floor muscles.

This pain medication’s risks include but are not limited to the following:

  • Maternal fever
  • Chronic back pain
  • Longer labor
  • Inadequate analgesia after first dosage
  • Duration of analgesia lasting longer than 6 hours
  • Duration of analgesia lasting shorter than one hour
  • Increased rates of instrument delivery
  • Low 5 minute Apgar scores
  • Overall lower rates of mother dissatisfaction

Physical Risks of Epidural to Mom

One risk of epidurals is the result of a higher temperature or fever in the mother (24% of women get fever as compared to 6% who do not receive epidurals).

Higher body temperature increases the need for more oxygen to the baby – lack of oxygen may lead to fetal distress…and fetal distress may lead to cesarean section. What a vicious cycle!

Fever negatively affects baby because infants of mothers with fever need a diagnostic work up which may include antibiotic treatment, lumbar puncture and possibly a longer stay at the hospital.

A woman who has taken an epidural also needs completely different care than the woman who has not.

  • Lack of feeling below the hips which often results in the use of a catheter.
  • Not able to feel when the urge to spontaneously push arrives, thus having to be told when to push.
  • Limited mobility due to numbness in legs and feet which may last hours after birth.

The side effects of an Epidural

Epidurals increase the rate of other interventions to be used to help labor along such as Pitocin to strengthen contractions, intravenous drip to prevent hypotension, (low blood pressure) continuous fetal monitoring and use of forceps or vacuum to help delivery the baby (9% need assistance compared to 3% without).

Nausea, dizziness, itching, headache, feelings of weakness and drowsiness hinder the moments of maternal bonding. There is also a reduction in the amount of oxytocin (a powerful “love” hormone) released in a burst just after labor. This helps stimulate the “let down” of milk in the breast. Therefore bonding may be decreased.

Epidurals may also affect the baby by passing through the placenta.

This controversial issue was studied in Sweden and published in Birth in 2001. The study concluded that babies whose mothers took epidural medication for pain…

“Spontaneous breast-seeking behavior in newborns is part of the interaction between the mother and her newborn and is based on coordination of body movements, sensory stimuli, and communication behaviors. This study indicates that maternal analgesia during labor might disturb and delay the important aspects of the newborn’s interactive behavior and increase the newborn’s skin temperature and crying.”

A newborn’s first instinct is to move to the mother’s breast to feed. If the baby’s reflexes are compromised, it will have trouble locating the breast and nipple and struggle with latching on.

To read more about epidural safety and risks, visit this page documented by Lewis Mehl-Madrona, M.D. Ph.D., Healing Arts

This article is part 3 of a 9 part series.
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Chapters of Birth Experience Matters.

Your Comments

5 Comments so far

  1. Epidurals main side effects are to lower the mothers blood pressure, which can leave you nauseous and sick,can affect baby’s heart rate, but is corrected with an iv drip.
    The other main complication is of a dural tap and consequent severe frontal headache that ensues upon sitting up. This is corrected with a “blood patch” – essentially another epidural, but with your own blood being injected instead of an anaesthetic, to seal the hole made from the needle having been inserted slightly too far during the original procedure.
    Neither are particularly pleasant.
    However, if you need an epidural, then they are a fantastic invention that generally are very effective. Having said that, if you dont need one, then do try to avoid! Xx

  2. Leigh says:

    Thanks so much for a great post! Moms need to know this stuff! I always wondered why people make such a fuss about avoiding sushi and medication and all sorts of other things during pregnancy and then having labour as open season! I designed this pin along those lines: http://pinterest.com/pin/144326363029038874/


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