Due for delivery ! Looking for painless childbirth, it is possible with epidural analgesia.

Why painless childbirth?

Normally childbirth is a process where there are intense contractions of the uterus and that causes pain. The incidence of normal delivery in women of rural areas is more compared to urban women as they are generally active throughout the 9 months of pregnancy and their pain bearing capacity tends to be more than women in the cities.

Biologically every woman is different because of that, each of them experiences childbirth differently and will feel different amounts of pressure and pain. Some women's bodies are simply better designed for fast, mostly painless childbirth. Others have a stronger level of mental control and can easily 'tune out' the pain. But even for those who aren't naturally designed for an easier birth experience, there are still plenty of ways to help reduce and alleviate the pain. One of the options for Painless Delivery with an epidural anesthesia in medical terms it is called the “Epidural Block.” A woman whose pelvic passage is adequate, and who wishes to opt for a normal delivery but is afraid of the pain can choose this option.

What Is an Epidural Analgesia procedure ?

Epidural anesthesia or analgesia refers to total or partial loss of sensation in the trunk between the fundus and the pubis or lower. It is the introduction of small doses of medicines into the lower back spine through a fine plastic tube. The back is cleaned with an antiseptic and the area where the catheter is to be introduced is numbed with a local anesthetic. The needle is then passed into the epidural space and one does not have to enter the spinal canal as feared by some. The tubing is then strapped to the back with tape and kept in place. Other than the prick of the local Anaesthesia there is generally no other discomfort. Once the tube is in place medicines are introduced into the catheter, which are enough to block your pain, but you will be able to push the baby.

Advantages of epidural block

Reduction in labor pain without affecting the mother's mental state.

The exhausted mother can sleep during the labor without being anxious.

Additional medication can be easily administered if needed once the catheter is in place.

• Epidurals often lower blood pressure, this may benefit some women with pregnancy induced hypertension.
• Epidurals reduce pain without reducing other sensations or muscle function, hence the women can change positions more easily than with anesthetics.
• The women remains aware of her contractions and often continues to participate; using breathing patterns and other comfort measures.

Disadvantages of epidural block

Epidural blocks carry some risks to the mother, fetus and newborn. Unwanted effects tend to be greater

On the mother like:

Inadequate pain relief (up to 10%)

Drop in the mother’s blood pressure

 Short or long-term backache from bruising caused by the injection or from ligament strain caused by prolonged time spent in a damaging position or inappropriate movement

Long-term backache is almost twice as likely to occur with an epidural than without.

Possible unintentional spinal block and resulting spinal headache requiring days of bed rest.

Mild to severe itching of the skin

Retention of urine, requiring a bladder catheter.

Problems caused by human error or maternal structural anomaly, such as inability to place catheter properly; inadvertent injection of anesthetic into a blood vessel; or too much anesthesia, affecting respiration and swallowing (rates vary with skill of the practitioner and anatomy of the mother).

Rare complications, such as residual numbness or weakness from needle injury to nerves

Delayed respiratory depression with epidural narcotics

Undesired effects on the fetus:

Abnormal heart rate patterns,

If the mother develops post epidural fever, it can affect the baby by passing on the infection thus leading to need of antibiotics etc for the baby.

Undesired effects on the newborn:

Some babies may show subtle neurobehavioral effects, such as irritability and inconsolability and decreased ability to track an object visually or to shut out noise, bright light.

It is reported that there are more difficulties in feeding babies whose mothers had an epidural when compared to unmedicated babies.

Decreased infant responsiveness may lead to long-term consequences for the parent-infant relationship.
Parents need to be counseled to give their babies time to recover from the birth and medication

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